A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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Nov. 1, 2002 - Had a great meeting with Carol Kuntz, Noreen Hynes, and Seth Carus regarding the request of the Vice President for me to list what added powers that I would need to make the BioD program work at NIAID. Stewart Simonson and Phil Russell also present I listed a group of these and Carol et al liked and agreed with them. They were mostly sole source contracting authority, rapid grants, DARPA-like powers, etc. Next step is arranging a meeting with me, TGT, and Cheney.
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Nov. 12, 2002 - See note of Oct. 30 - Nov. 1 above. Gary Edson called me last week and said that they were on the verge of making the decision regarding whether we will go for the major implementation plan. However, there is skepticism on the part of OMB (and likely others that he did not mention) concerning whether this can be done. They need to do due diligence and get some outside opinions and so they Gary has asked me to gather for a meeting at the WH a group of people who have actually done developing country implementation. They want to speak with these people without my being there, i.e. to check up on me. I suggested and they agreed to bring in the following: Peter Mugyenyi (Uganda), Jean (Bill) Pape (Haiti), Paul Farmer (Harvard-Haiti), Eric Goosby (Pangea Foundation and Rwanda). Gary asked me on a Friday and I needed to contact these people who were scattered all over the world to come to DC to see me and then have a visit to the WH. Gary insisted that I not reveal the plan to them and so I had to convince them to travel within a 72 hours period merely on faith as a favor to me. They all agreed and came: Mugyenyi from Uganda, Goosby from Rwanda, Farmer from Germany, and Pape from Haiti. Still Gary insists (despite my asking him again and again) that I cannot tell Terrell Halaska about any of this. I pushed Gary and he checked with Josh Bolten who said that this week we indeed will be able to tell Secretary Thompson. On another issue, things are heating up regarding possible war with Iraq. This makes compelling the imminent decision of policy regarding smallpox vaccination of civilians. The Pentagon will imminently announce that 250,000 to 500,000 troops will be vaccination with vaccinia (Dryvax). The question of the availability and recommendations for civilians remains. I am pushing for "recommending" that the 500,000 and then the up to 10,000,000 health workers and first responders get vaccinating. However, I feel that although we should make available the vaccine for the general public, given that the threat assessment is very soft, we should recommend that they not take the vaccine unless they feel very strongly that they do not want to take any chances. This is different from the situation with the anthrax vaccine where the DHHS said that had no recommendation either way; they just made the vaccine available if people wanted it. Went down to the White House to pre-brief Gary Edson and Jay Lefkowitz on Mugyenyi, Goosby, Pape, and Farmer. They both inquired as to what pretense I used to get these people to come to the USA. I said that I asked them to come and advise me about clinical trials in developing nations. Had dinner at the Trattoria Sorrento in Bethesda (Cordell Street) with the 4 visitors and told them exactly why I called them in and explained what type of questions would be asked of them at the WH. They look upon me as a hero for what I am doing.
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Nov. 13, 2002 - Multiple meetings in the DHHS to plan roll out of smallpox vaccination plan. It is imminent. The President is planning on having to start bombing Iraq in the 2nd week of January and wants to start vaccinating the 500,000 people smallpox response teams by December 1 and the 10,000,000 first responders by January in order to prepare for a release of smallpox by Iraq. Much discussion about timing the announcement of vaccinating the military with the announcement about the general population. Concern is that if we do not link the 2, the people will react to vaccinating the military by saying "what about us?" It looked like we were going to make the announcement on Friday, Nov. 16. However, at the WH, the President told the cabinet (including TGT) that he now wants to wait until he comes back from a foreign trip (Nov. 27) since Osama bin Laden just released a tape yesterday indicating that he is still alive and threatened the USA, UK, and Russia. Bush does not want it to appear that we are panicking in response to the tape. I am relieved that we decided to wait since I would have had to cancel my going to Los Angeles to receive the RAND Prize ($10,000.00) in order to remain in DC for the Press. Heard that the WH meeting with the 4 visitors on the global AIDS plan went extremely well. I believe that we are convincing the skeptics that we can effectively treat HIV in developing nations. Of note, Robin Cleveland asked to have Nils Daulaire there for his opinion. It is my impressions that she is resentful of the NIH and me. This is likely due to the fact that her OMB account for which she is responsible includes USAID and there is obviously some competition in her mind given that NIH always does so well with the budget.
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November 19, 2002 - Another meeting at the White House with Jay Lefkowitz, Gary Edson, Joe O'Neill, Mark Dybul and me to further discuss the potential for getting the President to accept our proposal for a comprehensive $50 billion over 5 year plan. Gary and Jay want me to further refine the presentation and actually start finalizing it for presentation first to Mitch Daniels and then ultimately to President. Jay had shown me a memo that Nils Daulaire had sent to Robin after the meeting with Mugyemnyi et al and it was clear that Robin and Nils are working together. Nils is a fine former public servant and is now in the private sector. However, judging from his memo, he is dead wrong on certain issues, i.e. he does not believe that Russia, China and India will surpass Africa within the next 5 years in AIDS impact. Also, I am not happy that Robin previously told Nils about the plan at the same time that Gary and Jay will not allow me to tell Terrell Halaska or Secretary Thompson about it. Strange situation in this WH regarding secrecy - they are almost pathologic about it. At the meeting, Jay and Gary asked me and Mark to prepare again even more material for an upcoming meeting with Mitch Daniels (see above). We got it to them within 1 day.
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2002-11-21 00:00
Anthony S. Fauci
November 21, 2002 - Another pre-roll out meeting at the Department to prepare for the upcoming announcement by the President on the Smallpox vaccination policy. Meeting was with Kevin Keane, Bill Hall, Jerry Hauer, and on teleconference - Michael Osterholm, Julie Gerberding and an assortment of CDC public affairs people. I have convinced them that we should not recommend to the general public that they take the vaccine give the non-quantifiable risk. I am also convincing them that for the Stage 2 (10,000,000 first repsonders), we also should not make a blanket recommendation that they get vaccinated. Rather, we should say that as a group the vaccine should be offered to them, but since this is a heterogenous group, the actual recommendation to take it or not should rely on discussions between the CDC and the State and local public health officials in light of the particular needs and situation within a given jurisdiction. Clearly, the Stage 1 group (500,000 smallpox response teams) should have a recommendation to take the vaccine voluntarily. -ourt
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Nov. 22, 2002 - Gave keynote address at the Holy Cross function at The Supreme Court for "Lift the Cross High". Justice Clarence Thomas was our host and was the other speaker. My remarks were very well received by all. It was a very elegant evening aimed ultimately at fund-raising for Holy Cross. Thomas is also an alumnus.
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Nov. 26, 2002 - Briefing of Vice President Cheney at the White House regarding Project Bioshield (I made up the name) which is requesting his help in getting me special authorities for Countermeasure Advanced Development. Meeting included VP Cheney, "Scooter" Libby (both on teleconference from secret location), Secretary Thompson, Stewart Simonson, Bill Raub, Carol Kuntz, Noreen Hynes, Seth Carus. Bill Raub presented the need for a $1-2$ billion Vaccine Trust Fund. Meeting went extremely well. VP was very supportive of my proposals and told Carol to set up a meeting between me, TGT, Stewart and Josh Bolten. Also met later in the day with Richard Danzig (former Secretary of the Navy under Clinton). He is a private consultant under contract to the DoD for Biodefense and wanted to get to know me since he has "heard so much about me". He wants to start an informal group of people linked by common interest in biodefense.
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Dec. 3, 2002 - Still waiting for the President to decide on the announcement of the smallpox vaccine policy. Should be tomorrow or next day. Also, a lot of back and forth between me, Jay Lefkowitz and Gary Edson. I believe that we are moving towards a Global AIDS Initiative. Jay will present our plan and budget to Mitch Daniels today. Phone call with Jay Lefkowitz and Keith Hennessey and Doug Badger called wanting to know why we needed a vaccine trust fund as opposed to other mechanisms to guarantee purchase of vaccines. This is what Bill Raub presented to the VP (see above); however, they are asking me about it because of "my credibility" (according to Carol Kuntz. Carol was on the phone with Kristen Silverberg. There is some concern as this passes through the WH that there is not enough justification for a "Trust Fund". Carol Kuntz wants to set up a meeting at the WH for me to help explain this sometime later this week or next week.
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Dec. 4, 2002 - Amazing day. I was at one time on 3 different lines with 3 different people at the White House - Gary Edson, Jay Lefkowitz, Carol Kuntz. There was an intense and critical issue with Gary and Jay. Gary was getting ready to meet with Mitch Daniels regarding our AIDS plan and he heard through his WH grapevine that Mitch was going to try to "Steamroller" him by bringing up the Washington Post article from a couple of days ago about the program in Botswana being a failure. In other words, if Botswana failed, why did we believe that our program would succeed. I explained to Gary that the Botswana Program was "Top Down" government as opposed to local network. They were using high tech., approach instead of grass roots. Gary asked me to contact our African friends and get their opinion (in one half hour!!!!). I contacted Peter Mugyenyi, Sam Kibende, and Eric Goosby and they all agreed with me. Peter mentioned that the big mistake that the Gates Foundation and Merck went directly to the Botswana Government and asked them to put together a plan. Botswana then employed the Harvard AIDS Institute who developed a high-tech USA Harvard like plan with CDReleased by Chairman Rand Paul ROMs for developing voluntary Counseling and Testing. Peter said that it was doomed to failure. I relayed this to Gary and he was satisfied. Also, more delays in the announcement of the smallpox vaccine policy. It will not be this week and so I will be able to go to Albany to give a talk associated with my Albany Prize from last Spring.