A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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Dec. 4, 2001 - Probably one of the most significant days for NIH and me regarding the budget of the institution. Word was that the "pass back" for NIH would be $0.5 billion, which would be devastating for NIH (no new initiatives and $275 shortfall on Type 5s). I entered into intensive negiations with Tommy Thompson over a 2-3 hour period in his office during which time he frequently called the White House discussing our negotiations. The bottom line is that Tommy and the President wanted to give the NIH a pass back that I would be able to publicly defend to the constituents, the Press, and the Congress. I laid down some strict conditions of this support. It was $2.0 billion for NIH excluding bioterrorism. I calculated that it would take $1.3 billion to reach current services, $200 million for maintenance of campus (including security). This would leave about $500 for new initiatives. On top of that I needed 1.0 billion for bioterrorism. They wanted to know my opinion of whether the constituents would accept this "almost" meeting the doubling trajectory. I told Tommy to tell the President that I would definitely defend this pass back since it actually was a great deal given the constraints on budget due to the demands of the war and the bioterrorism (BT) defense. I gave him my word that I would support him and the President. Tommy also informed me that a few people in OMB were very pissed off at me because I testified at the 2 Senate Hearings (especially the Specter Appropriations Hearing) that we needed $200 million more in FY2002 for BT. He also re-affirmed that Sen. Brownback was not in favor of my nomination for NIH Director because he felt that I was too liberal and he wanted his candidate who is Bob Redfield, a born-again Christian. Tommy said that the President wanted me , but was getting pressure from the far right. I am perfectly comfortable with this situation. I am what I am. Take me or leave me. I am happy with what I am doing now.
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Dec. 7, 2001 - Negotiated with Ed Sontag (Asst Secr. For Management at DHHS) regarding restructuring and consolidation of the NIH from an administrative standpoint, i.e. Budget, HR, Legislation, Procurement, Public Affairs, Grants Management, IT, etc. I had an agreement with Tommy Thompson that Budget should be sacrosanct and should stay in the ICDs as opposed to consolidating at the level of NIH. Ruth Kirschstein (Acting Director, NIH) almost gave away the farm in the negotiations. I stepped in and took over the meeting for NIH. Ruth was about to agree to give up 850 FTEs. I insisted that we could not cut down by any more than 200. Sontag came down to 275; we agreed upon 250. Also, Sontag was concerned that the new Clinical Research Center was projected to be $142 million over. Ed asked how we were going to handle it and Ruth said that this did not happen on her watch and that it was someone else's fault at NIH and she would see that this person (Steve Ficca) would be held responsible (?fired). She gave no indication how she would handle the real problem except to say that she would take it out of the IRP. I insisted that we would need major flexibility from the Department regarding how we could make up this money and that we could not hurt the IRP so abruptly and severely. Sontag agreed to help. Poor Ruth is in way over her head. I will have to make some difficult decisions if I become NIH Director about keeping her on as Deputy. I may need to appoint another Deputy and have her keep her title, but not her responsibilities.
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Dec. 8, 2001 - Thompson tried to call me at home last night (Friday), but I was out. He called me on Saturday in my office and told me that President Bush has agreed to appoint me NIH Director. Thompson wants me to speak with Sen. Brownback to try and alleviate his concerns about my position on stem cells, embryos, etc. I will set up to meet him next week. Thompson wants to make announcement before Christmas.
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Dec. 12, 2001 - Met with Sen. Brownback and his aide Rob Wassinger. Brownback was concerned about statements that I made 13 years ago! Concerning the then new SCID mouse that could be reconstituted with fetal tissue to regenerate a human immune system in a mouse. I stated at an ACT-UP meeting in NYC that this was a promising area of research and that it would require the use of fetal tissue. At the time there was the beginning of a moratorium by President Reagan and later Bush on the use of fetal tissue for transplantation into humans. I apparently (reported in the press) urged the ACT-UP people to make their concerns known so that this could be taken into consideration by the administration and lawmakers. Brownback and Wassinger said that several "right-tolifers" had called them very concerned that I was being considered for NIH Director when I had been a vocal advocate for the use of fetal tissue. I had a lengthy (1 1⁄2 hour) discussion with Sen. Brownback about embryonic stem cells, fetal tissue, etc. I believe that the conversation went as well as could be expected. He was very cordial, but concerned about "how I would advise the President if I were NIH Director". I told him that I do not advise the President on Ethical or Moral issues since I trust that the President has his own strong moral compass. I mentioned that I am a scientists and that I merely give him accurate scientific facts and he can make up his own mind within the framework of his own values. I think that Brownback respected that answer. We left with his still being concerned about me, but I do not think that he will try to block me.
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2001-12-14 00:00
Anthony S. Fauci
Dec. 14, 2001 - Spoke with Rick Klausner about his perception about NIH Director. Rick feels that the WH is not leveling with Thompson since he has heard that they think that doing both jobs (NIH and NIAID) is a "non-starter" and they are against it. There is a disconnect here since Thompson feels that they (WH) will accept this, and he merely needs to get the Brownback issue out of the way. Something is strange here since Thompson is talking about getting the President to announce me before Christmas and Rick says the "rest of the WH" is against this. Stay tuned. Dec.15, 2001 - Sat. meeting at NAS regarding recommendations of giving anthrax vaccine to people who were exposed to anthrax and who are just finishing their 60 course of antibiotics. I, Jeff Koplan, D.A. Henderson, and Kathy Zoon (FDA) playing major role of setting policy and advising the Secretary.
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Dec. 16-19, 2001 - Much controversy and last minute scrambling in getting the consent form and the protocol out for the discretionary use of anthrax vaccine in exposed people who had been receiving antibiotics, but who are coming off their 60 day course. The CDC is really relinquishing their responsibility of doing a good job with the informed consent. They handed us a piece of junk as a draft. Stewart Simonson (Counsel to Secr. Thompson) has asked me to help get it right. I had been working all day and into the night on Dec.16-19 revising the consent forms and helping people get straight why DHHS is offering the vaccine to people. The Press are very suspicious and as usual critical of the Administration. I have exhaustively reviewed the data (with Cliff Lane as a great help) and come to the conclusion that vaccine + antibiotics is no better than antibiotics alone for post-exposure. Yet, Dr. John Eisold (the Navy physician who takes care of Capitol Hill people) is insisting that the Senate staffers also get the vaccine. We are in a dilemma. It is true that there is a "theoretical" reason to make the vaccine available in that animal studies show persistence of spores weeks after antibiotics and there is a fear that after antibiotics are discontinued the disease will occur. I would not take antibiotics. However, Eisold and the Senate Staffers are demanding that they get the anthrax vaccine. In fact, I received a phone call from Ms. Laura Petrou from Senator Daschle's staff on Dec. 19, 2001 enraged that we were taking so long in getting the vaccine to the staffers. Apparently, D.A. Henderson and Tommy Thompson had told Daschle that the vaccine would be available 2 days ago. They were insistent. The blacks in the postal service are quite skeptical. I have insisted that if I am going to help we must not "recommend" the vaccine since the data in animals show that it is not better than antibiotics alone. The difficult situation is that politically we essentially have to give it to the Senate staffers since they are demanding it. If we give it to them and do not offer it to the postal workers, we will be accused of racism and not treating the postal workers equally. Remember that they were outraged that the Senate staffers got antibiotics right away and the postal workers only got antibiotics after 2 people at Brentwood died. Therefore, we are offering, but not recommending the vaccine for any of the 9000 people who were put on 60 antibiotic course. We are not explicitly telling the public that this is really the rationale for what is going on. There is some confusion as to why we are not recommending it and if we are not recommending it, why are we even offering it. I have tried to articulate this to the public as I did on a Dec. 19 appearance on Jim Lehr's News Hour.
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Dec. 19-24, 2001 - As expected, publicity went bad for HHS on the anthrax vaccine story. Washington Post writer Ceci Connelly keeps blasting HHS and particularly Tommy Thompson and the CDC for lack of clear guidelines. The mostly black postal workers for the most part refuse the vaccine, saying that they do not trust the government and do not want to be "guinea pigs". They completely miss the point that no one really is telling them that they should take the vaccine. In contrast, the staffers from Daschle's office have a high % of people who are taking the vaccine.
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Dec. 27, 2001 - Receive a letter from Sen Brownback dated Dec. 19, 2001 in which he states that he is "deeply concerned by your inability to define the entity created after the successful procedure referred to by some as human somatic cell nuclear transfer (SCNT)..." He wants me to respond. I do not want to put anything in writing and so I call his office and ask to speak with the Senator. His unbelievably right wing staffer, Rob Wassinger, answers and says that they will not put the call through to the Senator and that I should answer the questions in writing. Clearly, they are trying to trap me and clearly Wassinger is an asshole.
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Feb. 4, 2002 - An editorial in the Washington Post calls for President Bush to appointment me as the NIH Director.