A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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July 14, 2002 - C-SPAN's Washington Journal - I appeared for 45 minutes on the show the morning after returning from the AIDS conference. I had spent July 7-10 at the conference and July 11-12 in Genoa as Chair of the International Scientific Committee that is reviewing the Gaslini Institute for Lorenzo Moretta (its Scientific Director)
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July 16, 2002 - Diane Rehm Show - Spent a terrific 1 hour alone on the show with Diane. I went over the AIDS Conference highlights. I explained about and defended Secretary Thomspon vis-a-vis the demonstration against him. Also, I defended the Administration in that I related that they actually are willing to greatly support international AIDS efforts, but that they require developing nations and others involved to put forth a strategic plan with accountability, endpoints, projected deliverables, etc. I received excellent reviews for the show. I have it on tape as a reference.
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July 17, 2002 - Meeting at the White House with Gary Edson and Jay Lefkowitz. We discussed the details and implementation of the MTCT project. Obviously, there will be difficulties with USAID. They are resentful that DHHS is getting involved in international AIDS issues. Anne Peterson was at today's meeting. I have no confidence that she or her staff are capable of successfully pulling off this program. Mark Dybul alone can do better than their whole group. Sorry for being so direct, but it is true. Of note is that I brought up to Gary Edson and Jay Lefkowitz the issue that I had discussed with Josh Bolten regarding the more Global plan of therapy, prevention for HIV and other diseases in a "low-tech" manner. I discussed my meeting with Peter Mugyenyi and Cissy (?last name) from Uganda (see above). I told Jay and Gary that I believe that we could pull off a program based on the "Mugyenyi model". He told me to put together a proposal in a very short time frame (before the WH leaves for August break ( i.e. <2 weeks). They want to determine if the POTUS could bring this initiative with him on his upcoming trip to Africa in January, 2003. I will work with Mark Dybul to do this.
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July 21, 2002 - Over the past few weeks important issues have evolved regarding Biodefense. There is a major struggle going on in the Congress about the formation of the new Department of Homeland Security (DHS). At issue (among other important issues) is whether the $1.748 billion that is in the President's budget for FY2003 will be transferred over to the new DHS and who will actually be responsible for the strategic plan and prioritization for biodefense. DHS people (Gov. Ridge and Richard Falkenrath) clearly state that they want the money and the responsibility, but that they will work very closely with me. The Congress and all of the scientific Societies (FASEB. ASM. Etc.) say that they want the money and prioritization with me. As usual, I must publicly defend the President's position, but I work behind the scenes with people like Sens. Lieberman, Kennedy, and Frist to get language in the new authorizing Bill that will not transfer the money or responsibility (let us see what actually happens). Meanwhile, VP Dick Cheney is pushing for a Manhattan Project approach to Biodefense. He mentioned this at his visit to CDC and told Julie Gerberding that he would mention this to me also. Of note, I was quite influential in supporting Julie for the CDC job. We have CIA intelligence that Iraq has smallpox and everyone in DHHS and the WH are scrambling to get together an immunization plan that will go well beyond what the ACIP is recommending (i.e. pre-emptively vaccinate only about 10,000 - 20,000 health workers and rely on ring vaccination in the event of an attack). Cheney is pushing for a much wider vaccine plan. TGT will present our plan to Cheney within a few days, which recommends a staged (1,2,3) process that vaccinates about 500,000 health workers from Oct. 02, to December 02 and then from Jan. 03 through the end of 03 vaccinate up to 10 million responders (phsyicians, nurses, police, firefighters, EM people, primary care personnel). After that and depending on the adverse event rate and the perception of threat, we will make vaccine available for the entire USA population on a voluntary basis. One of the reasons for the push by Cheney is that he knows that Iraq has smallpox and he is planning to push out Sadam Hussein either by direct invasion of Iraq or by funding the opposition. He is afraid that Sadam will strike Israel or even us if his back is against the wall. There will be very intense discussions over the next couple of weeks with the WH and DHHS that involve me regarding smallpox vaccine policy. Things are obviously very busy with my being involved simultaneously with Biodefense and International response to HIV/AIDS. Both of these involve my direct interaction with the White House.
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2002-07-22 00:00
Anthony S. Fauci
July 22-24, 2002 - Went to the beach (Beach Haven) to link up with family. In the car on the way up and while I was there, I spent considerable time on the phone trying to work out with Sen. Spector's staff (Bettylou Taylor et al) language in the Lieberman Bill on authorization of DHS that Spector could support. They want to make sure that I am comfortable with the language. I am trying to get language that give DHS ultimate lead in the overall prioritization of the research on biodefense, but the money stays in DHHS and the research is executed by NIH, but the development of the research agenda in done by DHHS in consultation with DHS. Finally we had a conference call (I took it in the kitchen of the beach house) among me, the White House (Richard Falkenrath) and the Senate staff that are marking up the bill. Richard and I agreed upon what I listed above. Hopefully, the bill will get through with that language. It was important to have the WH on the phone since I was getting concerned that they might think that I was undermining their efforts to get the DHS going. By hashing it out with them, we are doing it up front and honestly.
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July 25, 2002 - Had top secret conference call with Jerry Hauer (HHS), Phil Russell (HHS), Stewart Simonson (HHS), and Lester Crawford (FDA). Subject - VP Cheney has indicated that we will hit Iraq soon and we expect retaliation with a smallpox attack on us or on Israel. Cheney wants us to greatly accelerate the process of getting vaccine available to vaccinate everyone if necessary. I offered to accelerate studies to determine if we can dilute the Dryvax even more than 1:5 and whether we can also dilute the 77 million doses of Aventis Pasteur WetVax. Stay tuned. The House and the Senate Committees have adapted the language that I had suggested to Richard Falkenrath. Therefore, at this time it appears that the money will go to DHHS, the overall prioritization will rest with DHS, the strategic plan and specific priorities will be the responsibility of DHHS in consultation with DHS and the research will be executed by and through the NIH. If this holds, I will have won a big victory.
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July 26, 2002 - Got an e-mail from Gary Edson at the WH asking if I had completed the Global AIDS Treatment plan to present to him in order to determine if it is worth presenting to the President for him to announce in his upcoming (January) visit to Africa. Mark and I are finished and we set up a meeting at the WH for Wednesday, July 31. Let us see what happens. Had an unusual meeting at the Rayburn Building with Chairman Kolbe (R-AZ) of the House Foreign Relations Committee and his chief staffer Charlie Flichner. I accompanied Claude Allen (Deputy Secretary, DHHS). They are very upset at the White House, particularly Gary Edson, for having the President announce the MTCT initiative without first consulting with them. They made disparaging remarks about Gary ("Emperor Edson", "President Edson"). They were cautious about being disrespectful about the President; however, they were pissed. They also disparaged Tommy Thompson about getting involved in International issues when this is not the purvue of DHHS. Actually, it is becoming the purvue of DHHS with the CDC's GAP (Global AIDS Program). This clearly was a turf issue. They are a powerful Committee and they are pissed that the President made an announcement without consulting them. Wait until they hear about the Global AIDS Treatment package that we are presenting to Gary Edson and Jay Lefkowitz on Wednesday, July 31. I am going to have to relate to Gary the essence of my meeting with Kolbe and Flichner.
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August 1, 2002 - Met at the White House with Gary Edson, Jay Lefkowitz, and Margaret La Montagne Spellings to present the Dybul/Fauci plan for comprehensive treatment and prevention of HIV in African countries. This was in response to the original request by Josh Bolten and then the specific request by Gary Edson to put together a plan based on the "Mugyenyi Model " of Uganda (see July 17 above). Also present at the meeting was Terrell Halaska, Joe O'Neill, Mark Dybul, and Allen Gilbert. Gary, Jay and Margaret was extremely pleased and excited about the plan. They mentioned that we had done a "fabulous" job. They asked us to respond to about 5-6 questions in writing. Clearly they are going to run it by the President when he returns from his August vacation in Crawford, Texas. He may well want to make this a Presidential initiative similar to the MTCT proposal that we had put together for him.
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August 16, 2002 - Went back to White House to present the revised Global AIDS Plan to Gary Edson. Also present were Terrell Halaska, Mark Dybul and Joe O'Neill, Director of Office of National AIDS Policy (ONAP). Gary again liked the revised plan and liked how we answered the questions that he and Margaret Spellings posed to us at the last meeting concerning: a) impact on Domestic AIDS issues; b) development of a sharp sound bite for the State of the Union Address in case it comes to that; c) relationship to Global AIDS Trust Fund; d) Inclusion of Russia, India, and China; e) reason why the Gates/Merck/Harvard/Univ of Penn initiative in Botswana has failed; f) administrative structure of the program. He asked me to revise the document by tightening it up to an Exec Summary, 5 pages of text and a group of tables. He wants us present it to Josh Bolten when Josh gets back from vacation next week. Mark and I can quickly make this revision.