A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
-
June 8-10, 2004 - Went to Savannah, GA (Sea Island) for the G8 Summit hosted by the USA. I was part of a White House Team that served as Presidential Surrogates to brief the Press before, during and after the President's proposals of initiatives to the G8 leaders gathered in Sea Island (UK - Tony Blair, France - Jacques Chirac, Germany - Gerhard Schroder, Italy - Berlusconi, Japan, Canada - , Russia - Putin, and USA). The other surrogates on the Team were: Elliott Abrams (Special Assist. To the president and Senior Director for Near-East and North African Affairs at NSC); Andrew Card (WH Chief of Staff); John R. Bolton (Under Secretary of State, Arms Control and International Security); James L. Connaughton (Chairman, Council on Environmental Quality); Glyn T. Davies (G8 Political Director); Kristen Forbes (Member, Council of Economic Advisors); Jendayi E. Fraser (Special Assistant to the president and Senior Director for African Affairs at NSC); Robert Joseph (Special Assistant to the president and Senior Director for Proliferation Strategy, Counterproliferation and Homeland Defense); Alan P. Larson (Under Secretary of State, Economic, Business, and Agricultural Affairs); Constance Berry Newman (Assistant Administrator for Africa of USAID); Randall Quarles (Assistant Secretary of Treasury for International Affairs); Condoleezza Rice (National Security Advisor to the President); Frances Fragos Townsend (Assistant to the President and Homeland Security Advisor); Dan Bartlett (White House Communications Director); Scott McClellan (Assistant to the president and White House Press Secretary); Gordon Johndroe (Laura Bush's Press Secretary); and Jim Wilkinson (Deputy National Security Advisor for Communications at NSC). My job was to brief the press at formal and informal briefings on the Health Issues which were mainly the Global HIV Vaccine Enterprise (see above), the Polio Eradication Initiative, and to a much lesser extent, the Famine Initiative. I also briefed on the progress of PEPFAR the Global Fund for AIDS, Malaria and TB and the issues on Fixed Dose Combination (FDC) and co-packaged antiHIV drugs. The weather was beautiful and we stayed at the Westin Resort Hotel on Hutchinson Island in Savannah. All I did was work and did not get off the compound. The security to get on and off the compound was as tight as I have seen anywhere except for Iraq. The Press center was adjacent to the Hotel. I spent most of the time in the White House press unit with White House staff led by Pamela Stevens, Paul Morrell, Jim Wilkinson, Barry Bennett (Deputy of Communications, G8 Summit Planning Organization, Colby Cooper, Dana Perino, M.C. Koch, Jana..?, Corey..? and others. It was exciting to be there and I ran into virtually all of my reporter friends on the White House Press Corps including among others, David Gregory, Terry Moran, Norah O'Donnell, Ann Compton, Bill Plant, John Roberts. I had a great interview with an AP reporter Scott Lindlaw, whom I had not met before. The initiatives were very well received. However, as I have seen before, unpredictable events shape everything. Former President Ronald Reagan and died a few days before and the press was totally saturated with Reagan history and funeral news to the point that the G8 issues were literally pushed from the front page. I appeared on TV only one time on CNN and that was for an interview with Anderson Cooper on my impressions of Reagan's legacy on AIDS, particularly during the early years when he did not even mention AIDS publicly. I stated on camera that the criticism of this silence on the part of the activists was certainly justified; however, the activists are being too harsh (Larry Kramer wrote a piece calling him worse than Hitler) since many things occurred behind the scenes that were good. For Example he allowed me to go out and be proactive and speak on behalf of the gay constituents. Also, Surgeon General Koop was allowed to mail his report to every household in the USA. I also got some press with interview in foreign TV such as VOA, Al Jazeera, Canada National TV, BBC, etc. Also, a few mentions of my briefings in WSJ, and many papers that picked up the major AP story by Scott Lindlaw. Otherwise, there was much less press for the G8 in general and for me than would have occurred had not Reagan died.
-
June 18, 2004 - Attended a farewell party at the White House for Gary Edson. He is leaving NSC to work in the campaign. His main job will be to prepare the POTUS for the debates with Kerry. I was the only non-WH person at the reception that was hosted by Condi Rice and Steve Hadley of NSC. In her praising of Gary for his work, she mentioned 2 accomplishments among many: 1) the millennium account, and 2) the PEPFAR. When she spoke of the PEPFAR, she caught my eye and said, "Oh Tony Fauci is here; they were the team that did this. Tony was the brains and Gary was the brawn".
-
July 9, 2004 - 2 meetings in West Wing. First was a top secret briefing of Fran Townsend, the new Director of the Homeland Sceurity Council. She replaced Gen. John Gordon who retired in June (see above). Present at the briefing were Ken Bernard, Bob Kadlec, Larry Kerr, Kate Spitler (CIA) and some others. Purpose was to brief Fran on the experiments that were being proposed regarding genetically engineered monkeypox virus to duplicate what was shown in the mousepox model where inserting the IL-4 gene into mousepox made it lethal and elusive for both vaccine and therapy. Debate was whether to do experiments and whether to classify them. Purpose of doing experiments was to determine whether the mousepox work also applied to the monkeypox. In addition, if it did, then we needed to develop countermeasurs such as anti-IL-4 drugs. Fran was extremely complimentary to me saying that above all people, she wanted to know what my opinion was and she wanted me to explain the details and implications of the experiments. Next meeting was in the office of Faryar Shirzad (replaced Gary Edson on NSC; see above). Present was Martina Strong. Purpose was to plan the Fall meeting of the G-8 Vaccine Enterprise as promised by the POTUS. We discussed what the format of the meeting should be and what level of representation from G-8 countries should be there. I suggested at least a top scientist from each country and then for formality, we should have the Ministers of Health there after the strategic plan had been finalized.
-
July 11 - 16, 2004 - Went to the XV th International AIDS Conference in Bangkok. The depth of misunderstanding about the PEPFAR and the reason why the PEPFAR wants expedited approval by FDA of the "copy" generics that are being used before USA money is used to buy them is huge. The activists were out in full force disrupting Randy Tobias's speech with signs of "He's Lying". Ultimately they let him speak, unlike the situation in Barcelona in 2002. There was an extraordinary amount of USA bashing by activists, the liberal press and even by international figures such as Kofi Annan who stated that the USA was not showing leadership because we were not giving more to the Global Fund. He seems to have selective amnesia regarding the PEPFAR's $15 billion program. Chirac made a similar statement. Issues that were particularly misunderstood were: 1) why the USA was not giving billions to the Global Fund; 2) why we wanted to have an expedited approval of copy generics before the PEPFAR paid for these drugs; 3) Why the DHHS only allowed 50 people from HHS to attend the meeting. Most people claimed that it was because the activists booed TGT at Barcelona and because we were upset that we were not controlling the agenda. Before the meeting a group of far-right Congressmen wrote to the organizers of the meeting saying that they condemned the meeting since more faith-based organizations were not given prominent roles in the meeting and because not enough emphasis was placed on abstinence. This made the USA look real bad. Stupidly, the DHHS restricted the numbers of meeting participants generally without doing it by category and as it turned out, some scientists who were already on the program had to cancel out. Thus, the topic was this stupidity rather than all of the good things that were happening. The activists were more misinformed than I have ever seen. They had no idea what they were talking about. All they wanted to do was condemn the Bush Administration. Bush asked the FDA (through Tobias, me, Kristen Silverberg and others) to provide expedited review of these FDC products so that we could have some guarantee of the safety and quality of the product before USA taxpayer money paid for it.(see above). This was the correct thing to do. Can one imagine if we tried to give drug to Africans by a process that was "not good enough for Americans"" We would all get killed by Congressional Committees and activists, some of which are the very ones who are crying for generic drugs right now. By the way, the approved drugs are now available for hundreds, not thousands of dollars in Africa. The claim of the generics companies that the drugs are available for $140 does not take into account that it cost much more for shipping, storage, etc. and so the real price is not that far away from the brand price. Furthermore, no one is going without drug since it is not the generics versus nothing. The PEPFAR is buying the brand name drugs and distributing them. The response was that the administration is in bed with PHARMA since we do not want to allow generics for fear of PHARMA losing money. The generics are "pre-qualified" by the WHO. However, the WHO is not a regulatory agency. The FDA and Tobias and I pleaded that the generics companies submit the applications and give the FDA a chance to show that they could give an expedited review. We were asking for clinical data that Medicines Sans Frontiers already has and has published, plus biochemical equivalency and pharmacokinetic data and plant inspection, all of which are real easy to get. However, no generic company has thus submitted applications. They say that they do not have to since WHO has prequalified them. The real reason is that they are afraid that the FDA will actually find that the product may not be good. I think the product likely is fine, but the mistrust on the part of the rest of the world for FDA and the USA is palpable. This likely relates to the situation in Iraq. The other source of contention is the situation of Global Fund versus PEPFAR. I took great issue with the incredibly inappropriate public statement by Kofi Annan about the lack of USA Leadership in Global AIDS (Kofi, did you forget your leadership on the Rwanda genocide??). I tactfully blasted him and this concept on BBC radio and TV and CNN. I was quite discouraged by this Conference. The science was irrelevant although my Special Lecture on HIV Pathogenesis went very well and was extremely well-received. A major issue is that the USA is doing some stupid things like allowing the restriction of numbers of scientists at the meeting and by having the far-right people act like they are representing the USA. However, this time, the activists and the international community are even worse. They are totally misinformed about what is really going on, but they are louder than ever. This in turn feeds the far-right and it becomes a vicious cycle. The following is a Washington Post article that summarizes the situation very well:
-
2004-07-19 00:00
Anthony S. Fauci
July 19, 2004 - Appeared on the Jim Lehr Newshour defending the USA position on PEPFAR. Steve Lewis from the UN was my "opponent" and we duked it out over the bilateral approach of PEPFAR versus the multilateral approach of the Global Fund. I said both are good and working. He feels that the USA should put all of its money into the Global Fund. He also did not understand the need to have some sort of approval for generic copy drugs (see above). Everyone told me that I appeared cool and collected while Steve was shrill.
-
July 21, 2004 - Two visits to WH today. The POTUS invited me to be at the signing ceremony for the BioShield Legislation in the Rose garden. I was asked to go up on the stage for the photo with the POTUS and the VP as well as Tom Ridge, Congressmen Chris Cox and Waxman, House Speaker Dennis Hastert, Senators Ted Kennedy, Bill Frist among others. Michael Allen of WH Legislative Affairs was my advocate to get me on the platform. The White House protocol women (?name) wanted Julie Gerberding on the platform (even though she had nothing at all to do with BioShield) since there were no women there and she bumped me. Michael insisted and they compromised by putting us both up there. The POTUS, VP and Senators were very nice with me. I now know all of these people very well. In the afternoon, I briefed Carol Kuntz. Ernie Takafuji accompanied me. Carol is great, but she is going through one of her periodic periods of sadness and anxiety about her CML even though she is in a crisp remission on Gleevec. I intermittently give her private psychotherapy and I did so that night.
-
July 22, 2004 - Testified with Secretary Thompson and Julie Gerberding to the Senate Committee on Health, Education, Labor and Pensions (HELP) on Public Health preparedness, surge capacity and medical countermeasures. Present were Chairman Judd Gregg, Ted Kennedy and Lamar Alexander. It was a very friendly hearing and very complimentary to me and the others.
-
July 23, 2004 - West Wing - Had individual photo op with VP Cheney together with the entire "team" that worked on BioShield. Many people there: Stewart Simonson, carol Kuntz, Scooter Libby, Sally Canfield (DHS) (she just announced that she is leaving Tom Ridge and going to work for Speaker Hastert), Mark McClellan, Ken Bernard, Michael Allen, Brenda Becker, Sharon...(Sen. Gregg's staff), Noreen Hynes, Seth... (Noreen's husband), Vince Ventimiglia (Sen Gregg's Committee Staff). I will provide full list later. Very happy occasion. Again, VP was very gracious towards me.
-
August 11, 2004 - Met at EEOB Room 283 with Carol Kuntz and Bruce Miller and Dorothy.... to discuss tentative plans to determine whether IL-4 gene inserted into monkeypox would have the same effect as IL-4 inserted into mousepox virus, i.e. it would suppress the immune response enough to allow lethal disease in the animal. This relates to concerns that terrorists will genetically engineer variola with IL-4 and so override vaccination and cidofovir. Carol wanted to know which of several options for experiments I would favor. A White Paper was drawn up by the Office of Homeland Secrurity (Ken Bernard) with the various options. Of note, I had previously briefed Frances Townsend in the White House Situation Room a couple of weeks ago (not recorded above) on the same topic. I favor Option #3 which is to conduct the research on IL-4-altered monkeypox in monkeys and do it as classified research. However, we should announce that we will be conducting such experiments so that people do not get suspicious that we are totally hiding things. We would keep the design, details and results classified since if we found out that it did work in monkeys , but did not yet have a countermeasure for it, then we would expose our vulnerabilities.