A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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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.
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2002-08-26 00:00
Anthony S. Fauci
August 26, 2002 - Meeting at the White House with Gary Edson, Jay Lefkowitz, Margaret Spellings, Ken Thomas (ONAP), Jim Capretta, Robin Cleveland (OMB) and Mark Dybul. We presented the condensed version (see above) to Gary , Margaret, and Jay. Several minutes into the meeting Robin and Jim showed up and in a somewhat offhand manner without evening knowing the details of what we were presenting, Robin became very critical of the idea and the project. She actually parroted words that we had heard weeks ago from the Kolbe Committee (Charlie Flichner) about how they were very skeptical that we could actually get "twin pairs" of hospitals. Also, she questioned whether the Uganda model would work even though she knew virtually nothing about it. I kept my cool, was subliminally sharp in response to her, but was very pissed inside. Gary intervened and defended what we had done and indicated that we would come back to Robin with more details about the Uganda model etc. (which we had already done among us previously). Afterwards, Gary, Ken, Mark and I met for about 45 minutes in The Situation Room and discussed further revising of the documents. I would not be surprised if Robin leaked all of this to USAID and the House Foreign Ops Committee. I did not like the way she acted at the meeting and I do not trust her. She acted a bit disrespectful to us in my mind; however, I believe that this was not her intent and she was reflecting the questions that the House Foreign Ops Committee was asking her. te House today: August 26 - Sept. 5 - Much discussion about pre-emptively attacking Iraq to neutralize them before they use or get capacity for "weapons" of mass desctruction. This is pushing our HHS team to be ready to vaccinate the USA population. Our plan for "staged" smallpox vaccination of immediate first responders to broad first responders to voluntary vaccination of general public is ready to go. We are waiting for word from the White House to roll out the plan.
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Sept. 6, 2002 - Two meetings at the White House today: 1) Meeting in Executive Office Building (EOB_ in OMB's Robin Cleveland's office with Robin, Gary Edson, Joe O'Neill, and Mark Dybul. We presented our reenforced implementation with a beautiful computer model of accessibility to central medical centers (CMCs), primary, secondary and tertiary clinics in Uganda as a prototype. Robin was still not entirely satisfied with the presentation since she was hung up on quarantees that this plan would work given failures in previous endeavors in these countries. She and Gary also wanted to flesh out the computer model on India, Mozambique and Guyana. We will go back and try again. Next meeting likely will be with Josh Bolten. 2) Meeting in EOB with General Bruce Lawlor (deputy to Gov. Ridge of OHS), Col Kadlac (OHS), and Col Gerald Parker of Ft. Detrick for me to present to Lawlor the NIAID plan for research including collaborations with DoD and facilities at Ft. Detrick. I presented the NIAID Strategic Plan and Research Agenda. It was a great meeting. Lawlor was extremely impressed and highly supportive. We promised to work together and he offered to help in any way possible. He is a tough, nice , straight shooter. His background is that he commanded a tank battalion in the Gulf War.
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Sept. 17, 2002 - Another meeting at the White House on the President's AIDS initiative. This time I presented the program to Josh Bolten in his office in the West Wing. Also present were Gary Edson, Jay Lefkowitz, Terrell Halaska, Mark Dybul, Joe O'Neill, Robin Cleveland, Kristen Silverberg, Carol Thompson. We are definitely moving along. Clearly Josh wants to do it. He thoroughly liked my presentation. The problem will be OMB and the question of where we are going to get the money. Issue also is if the President accepts it, when can we announce since the budget for 2002 has not even been settled and 2003 has virtually decided. We want to announce soon since WHO and other organizations are dancing around the question of an implementation strategy and we do not want to President to lose the leadership edge. Josh asked OMB (Robin) to work out a budget scenario and get back to him. They also will elevate it up one more notch to Andy Card, Condolezza Rice and Mitch Daniels. We will meet again soon.
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Sept. 18, 2002 - Briefed Secretary Thompson about the upcoming smallpox vaccination policy and role-out. Also present were Julie Gerberding, Stewart Simonson, Michael Osterholm, Jerry Hauer, Les Crawford, Ann Agnew, Terrell Halaska, etc. We are advancing towards the 3 stage policy that ultimately would allow voluntary vaccination for anyone who wants it. Had briefing at the White House on the fact that West Nile Virus can now be spread via blood transfusions (and transplants). We are in the midst of a major epidemic with about 1641 cases and 80 deaths. It has been clearly documentd now that blood transfusions can transmit WNV. We discussed how we would handle the press, etc. I strongly suggested that we avoid the mistakes of the early 1980s regarding HIV and the blood supply. I suggested that we obviously try to avoid panic, but that we make it clear that transfusions are NOT entirely risk free with regard to WNV as well as several other pathogens. It is a question of relative risk of the transfusion versus not getting the transfusion. INCREDIBLE evening - Bono the lead singer of U-2 and the best selling musician in history had called my office yesterday (his chief-of-staff) to say that he wanted to talk to me by phone or preferably in person to discuss how we could partner and how he could help me in my work on trying to get AIDS treament and care and prevention to subSaharan Africa. He had, this past year, gone to Africa in a much-publicized trip with Treasury Secretary Paul O'Neill. At mid-day we got a call that Bono wanted to fly from Chicago to speak with me in person that evening. He did and we met at my house. We had wine, Chris cooked pasta and we had an amazing evening, talking for hours. He is alsolutely fantastic, passionate and very intelligent. He will try to help by supporting me and President Bush in the evolution of our implementation plan for Africa. Also visiting was his staff Jamie Drummond, Lucy Matthew, and Katrina...... We promised to stay in close touch and work together. I did not tell Jenny, Megan and Alison that Bono was coming to the house for dinner. When he walked in the door, they were speechless; however, he was wonderful with them. They (and I) will never forget this extraordinary night.
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Sept. 24, 2002 - Had CIA briefing and overall review of smallpox plan in Secr. Thompson's office with Gov. Ridge, Col. Bob Kadlac, Julie Gerberding, Jerry Hauer, and a Ridge person . Clearly Russia had modified smallpox and very likely Iraq has smallpox. We reviewed the pre-emptive plan for vaccination that will be presented to Pres. Bush tomorrow by TGT in anticipation that he will make the policy decision soon. We will recommend the 3 stage proceedure of 500,000 to 10 million to the general population. Word in the meeting is that we will definitely attack Iraq by January.