A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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Jan. 30, 2009 - Comment on the firing of Mark Dybul as head of OGAC (Office of Global AIDS Coordinator) . It is a shame the way Mark was handled. I am attaching a NY Times article covering this. Mark is back in my office until his retirement. NY Times article:: The abrupt departure of the State Department's global AIDS coordinator has led to debate over who should run what may be President Bush's greatest legacy: his commitment of billions of dollars to fighting AIDS overseas. The position -- U.S. Global AIDS Coordinator and director of the President's Emergency Plan for AIDS Relief, which is known as Pepfar -- is a State Department post with ambassador's rank that had been held by Dr. Mark R. Dybul, a Bush administration appointee. On Jan. 9, Dr. Dybul circulated a memo saying he had been asked by President Obama's transition team to stay on the job temporarily. But on Jan. 22, one day after Hillary Clinton was confirmed as secretary of state, her staff announced that Dr. Dybul had resigned. No reason was given, but he was reported to have packed up his office and said an emotional goodbye to his staff that afternoon. Dr. Dybul did not return phone messages, but he has told friends that he does not even know on whose orders he was dismissed. "He deserved better," said a friend who asked not to be identified for fear of jeopardizing his government job. "He didn't want to stay, but he was asked to." The ambassador disburses Pepfar's funds; Congress authorized $15 billion over five years in 2003, and the fund has since paid for AIDS drugs for about two million people, mostly in Africa. Last year, after a bitter fight between liberal and conservative lawmakers over what the money could be spent on, the fund was renewed as part of a law authorizing $48 billion over five years for combating AIDS, tuberculosis and malaria. The question of who should run the program seems to be a legacy of that fight. Several names have been discussed as possible candidates, but AIDS activists say they know of no one who has been seriously vetted for the job by the Obama transition team since November. A day after Dr. Dybul's resignation, word began to circulate among AIDS activists that the job had been offered to Dr. Eric Goosby, the director of AIDS policy in Bill Clinton's administration, who now runs a San Francisco foundation devoted to fighting AIDS. According to a member of an anti-AIDS group speaking on the condition of anonymity, Senator John Kerry approached Mrs. Clinton, seeking the job for Dr. Jim Yong Kim, a Harvard medical school professor and former World Health Organization AIDS chief, and was told that she had offered it to Dr. Goosby. Through a spokesman, Dr. Goosby declined to confirm or deny that he had been offered the job, and Dr. Kim did not return phone calls seeking comment. Senator Kerry's spokesman said he would not discuss the senator's personal conversations with Mrs. Clinton. Both men had been discussed as possible candidates, along with Dr. Nils Daulaire, president of the Global Health Council; Dr. Wafaa El-Sadr, an epidemiologist at the Columbia School of Public Health; and Warren W. Buckingham III, Pepfar's director in Kenya, who is openly gay and taking AIDS drugs himself. Dr. Daulaire declined to be interviewed, Dr. El-Sadr said she had not heard that her name was among those being discussed, and Mr. Buckingham said he knew his name had been suggested by others but had not lobbied for the job and had not been contacted by either the Obama or Clinton teams. The abruptness of Dr. Dybul's departure and the secrecy of the process to replace him has upset some AIDS policy specialists. On Monday, a coalition of 68 anti-AIDS groups sent a letter to Mrs. Clinton asking her not to fill Mr. Dybul's post immediately but to convene a committee to identify top candidates and get many viewpoints, including theirs. One of its authors, Brian Hennessey of the Vineeta Foundation, expressed his irritation at how the request was ignored. i "Goosby is not bad," he said. "There are plenty of people who want Goosby -- but they'll be damned if the job is filled this way. This isn't the truth-in-advertising of the Obama campaign." Dr. Dybul's departure was both celebrated and condemned. Jodi Jacobson, a former head of the Center for Health and Gender Equity, which wants financing for all aspects of women's reproductive health, including abortion, wrote a blog post titled "Dybul Out: Thank You Hillary!!!" It argued that he had worked too closely with the far right, and she accused him of lobbying to please the Roman Catholic Church by letting its relief groups opt out of distributing condoms. Michael Gerson, a former Bush speechwriter and Washington Post columnist, shot back that "blogging extremists" like Ms. Jacobson had lied about Dr. Dybul's record and that his firing had left an important program without a leader. At the heart of the debate was the difficult bipartisan compromise behind Mr. Bush's AIDS plan. It is the darling of two groups that normally oppose each other: foreign policy liberals who want to help Africa and evangelical Christians who support mission hospitals there. Dr. Dybul was straddling some personal fences too: he was one of the Bush administration's few openly gay officials, a doctor who had treated AIDS patients in San Francisco and Africa, and he had donated to Democratic causes. His only predecessor, Randall L. Tobias, a former pharmaceutical executive, was promoted within the State Department, then ousted in the D.C. Madam scandal after acknowledging he had received escort-service massages -- a development that led to derision over the fund's abstinence policies. Mr. Tobias and Dr. Dybul surprised many with two early decisions that activists had expected fights over: Pepfar has paid for millions of condoms, and it buys cheap generic drugs from India, despite the pharmaceutical lobby's opposition. But conservatives in Congress imposed other restrictions: one-third of the money spent on prevention had to be used for teaching abstinence until marriage. Groups getting funds, including those helping prostitutes, had to sign a pledge condemning prostitution. And no money could be spent on clean needles for drug addicts. These issues were divisive not just for liberals and conservatives, but also between liberals. For example, some feminists think women needing money have a right to engage in prostitution, while others oppose it, saying it contributes to human trafficking and child rape. In separate studies, the Government Accountability Office and the Institute of Medicine both found that the abstinence earmark unnecessarily tied the hands of fund recipients, especially in countries where AIDS was concentrated among drug users and prostitutes. e 7500 range. Thus Dr. Dybul defended the teaching of abstinence, especially to young children, because it can be effective among deeply religious rural Africans. And he argued that countries could get funds for prohibited uses, like clean needles, from other donors like the Global Fund for AIDS, Tuberculosis and Malaria or European countries. Although the restrictions have been criticized, no one has presented scientific evidence that they cost any lives. And although there was grumbling in 2003 when the Bush administration created its own AIDS program rather than simply contributing to the Global Fund, Rajat Gupta, chairman of the Global Fund's board, said Thursday in Davos that Pepfar was "one of the truly great contributions of the last administration." Jan. 30 - Feb. 20 - Stock market continues to crash with DOW in the 7500 range. Thus far I have lost on paper more than $1 million of my wealth. Tom Daschle had to drop out of running for the Secretary of HHS because of concern over unpaid taxes for private car and driver that was loaned to him for 3 years without charge by a friend. He did not claim it as taxable income, which it is. Also, he made $5 million on influence peddling (access to people in government) since he stepped down as Senator. Too bad since he is a very good person and would have made a great Secretary. I still think that I would fit for that job, but I really do not want to leave what I am doing and besides, no one in the administration has asked me. They apparently only would want me for NIH Director and I do not want that at all.
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Feb. 21, 2009- Had great time receiving the Science and Medicine Award at the 15th Annual Steve Chase Humanitarian Awards Gala at Palm Springs, CA sponsored by the Desert AIDS Project It was an amazing and enjoyable glitzy affair at the Palm Springs Convention Center with Red Carpet arrival similar to the Academy Awards (which actually took place the next day (Sunday) in LA. Star-studded Affair with Linda Gray ("Dallas TV Series), Donna Mills (Knots Landing) and Morgan Fairchild (old friend from AmFar days) MC'd the event. Other Awardees were Bebe Neuwirth (Broadway star) and Kristin Chenoweth (Broadway Star) for Arts and Activism; Harriet Goldberg won the 100 Women Award; Bill Jones won the Partner for Life Award; Barry Manilow won the Silver Anniversary Community Service Award. He came with Suzanne Somers who was wonderful with me and had been following my career for years. She said that she knew all about me because she was a "doctor junky". She has written several book on Health for Women. Best was Morgan Fairchild who made sure that I was introduced to everyone and also partook in my introduction on stage to receive the award. She really was wonderful and friendly. The main introducer of me was Regan Hofmann (Editor of POZ Magazine). She was beautiful and very nice. Donna Mills seemed a bit artificial and had a forced smile, but everyone else was great. Lv
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March 4, 2009 - Over the past few weeks the stock market continues to plunge with no end in sight. The Dow is now at 6500 down from 14,000 in Oct., 2007. I have lost a SUBSTANTIAL portion of my savings including the money form HPIM, Prizes, etc. - well over $1 million. The retrospectoscope is always right, but the fact is, I always had serious concerns about the vicissitudes of the market and always said that I would rather not lose money that try to make it since my salary + book + prizes get me a lot of money. John Katkish, who is a good man and conservative convinced me otherwise and here we are - trapped since we cannot sell now since the losses would be phenomenal. On the evening of March 4, I attended the annual Friends of Cancer Awards night reception at the Hotel Monaco on 4th and F Street, N.W. Ellen Sigal and Marlene Malek run this group and always invite me. The awardees were Steny Hoyer, Sen, Judd Gregg, Lisa Paulsen of the Motion Picture Industry Foundation and Janet Woodcock of the FDA. Usual DC glitterati of politics there. Steny was most gracious to me in accepting the award and went on about what a great man and scientist I am and how we go back so many years. He brought up (again) the story of how George H. W. Bush called me his hero in the 1988 Presidential Debates. Also, had good conversation with Sen. Gregg and told him that I respected his action of dropping out of contention for Secretary of Commerce since he felt he could not go along with the Obama fiscal policy for the "Bailout". During the evening, go to have good conversations with Obama White House people such as Dr. Kavita Patel who is assistant to Valerie Jarrett (closest person and friend to the POTUS) and Neerha Tandem who formerly was with Hillary Clinton and is now Special Assistant to the POTUS. Both said that they would get me to do some WH briefings and briefings of the HHS Secretary designee - Gov. Kathleen Sibelius of Kansas, whom I have never met. Zeke Emanuel was there and is establishing himself at OMB as the Health policy person since there are few other people who know about health.
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March 5, 2009 - Zuckerman Fellows reception at the home of Beth and Ron Dozoretz - 3005 - 45th Street, N.W. (around the corner from my house). Clear, nice night. Usual impressive event with Dave Gergon and Mort Zuckerman hosting the Fellows who are in town for the week to get a glimpse of how USG is run. I will lecture to them tomorrow. Met the usual crew from DC and had nice conversations: Tom Daschle - I expressed my sorrow at his misfortune of having to drop out of contention for HHS secretary. Wolf Blitzer (CNN), Nora O'Donnell (MSNBC), Gloria Borger (CNN), former Sec. Dan Glickman, Gen. George Casey, Ambassador from Israel, etc. The young people there was amazing: wounded vets of the Iraq war now going to Harvard Business School; Physicians studying economics, health people in government schools. You feel good about USA when you see these people.
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2009-03-07 00:00
Anthony S. Fauci
March 7, 2009 - Very interesting dinner at Café Milano thrown by Catherine and Wayne Reynolds for about 10 - 12 couples in the private room. Unseasonably warm (70 F) and clear (stars and moon) night. Guests include Gen. George and Sheila Casey (Army Chief-of-Staff). I sat between him and Marlene Malek (who was there with husband Fred). Also in attendance: Don Graham and Dana Priest (Washington Post); Beth and Ron Dozoretz; Francis Collins; Rick Atkinson (War Historian and best-selling author); Sen. Ted and Kathy Stevens; Jim Wolfensohn stopped in; Margaret Spellings (Former Sec. of Education); Joe Aldrich(?); and others whom I forget. Had Calamari, focaccio, Salad, Spaghetti and truffles, Chilean Sea Bass, chocolate soufflé, Jordan Chardonnay wine. Very lively discussion orchestrated by Catherine Reynolds. Francis Collins and I were asked to comment on Stem Cells - Pres. Obama has just announced that he is removing the ban on stem cell research on Monday by executive order. Chris also spoke on the ethics of the situation. I also spoke about the responsibility for Global Health. I also commented about the dire HIV/AIDS situation and the health care problems in the country and particularly with AIDS in Washington. They asked Gen. Casey to comment on Iraq and Afghanistan. Casey felt that we should have gone into Iraq and that we can be successful. He did not get much sympathy from the others, including me. When asked what "success" was, he commented on an Iraq or Afghanistan type democracy with order in a central government. Others, particularly Rick Atkinson, pointed out that a few thousand years of history would argue against this since there cannot be a "central government" democracy in Iraq or Afghanistan. Sen. Stevens' comments were to the right of Attila the Hun and frankly quite naive -- he stated that Arabs are trying to take over the world by immigration in Europe and the USA (Oy!). Margaret Spellings spoke about the issue of education in this country and Jim Wolfensohn commented on the terrible situation of the economy. Jim said that the bailout to the banks was a failure since the banks did not use the money to lend; they used it to consolidate and pay dividends, which he feels is a waste of billions.
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Mar. 8, 2009 - Had my first entry into interactions with the new Administration. Background is that there have been recent reports of the terrible situation in Washington, D.C. regarding prevalence of HIV/AIDS with 3% of the population infected and 6.5% of black men. This is worse than 22 countries in sub-Saharan Africa. We at NIAID and NIH (Fauci, Dieffenbach, and Henry Masur) have been putting together a collaborative program with DC Department of Health (Shannon Hader) to address this issue with a combined research-care program that also involves the recently promoted "test and treat" concept. This model (appeared in Lancet on Nov. 27, 2008) suggests that if you test everyone 1X per year and treat people immediately regardless of their CD4+ T cell count or viral load, you could decrease the level of virus in the community so that you could conceivably get the Ro to <1, which would in essence shut off the AIDS epidemic. Such a concept would require the answering of questions of safety, efficacy, adherence, access to people for testing, benefit to individual versus community, cost effectiveness, etc. We could help to district by making this "test and treat" research agenda a part of our collaborative effort with the District. While this is going on, Zeke Emanuel is now detailed to OMB as an assistant to OMB Director Peter Orzag to handle health related issues. Zeke heard about the initiative and feels that it would be a good idea to get the WH and the POTUS involved in an announcement of such a program for the District. Thus, I was called down to the OMB in Room 263 in EEOB to present the program. Zeke was present as was Jeff Crowley, the new WH AIDS Coordinator and Director of the Office of National AIDS Policy. Connected by phone was Jenny Backus (HHS Public 'ed in California and 1 the Affairs Director), Dora Hughes (General Counsel to the Secretary, HHS), Nick ?. I presented the proposal and they asked good questions and were very excited about it. We will proceed with rolling it out after nailing down a few details. While at the EEOB, I ran into Peter Orzag who greeted me as if we were friends. He clearly knew who I was from seeing me down the hall. Good news that this WH at least is up on what is going on in AIDS and health in general. Let us see how things evolve.
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March 13, 2009 -- Had fun day. Flew to NYC to participate in a "Science Rock Stars" photo shoot at the MILK Studios in the Meatpacking District of NYC -- 450 -- West 15% her connections at GQ Magazine and Geoffrey Beene Clothing, she arranged for an issue of GQ that matches real rock stars with "scientific stars" to draw attention of young people to science. I was involved as was Harold Varmus, Francis Collins and others. They matched us up with a rock star and took 1000s of pictures for a spread in the June issue of GQ. Harold Varmus and I were matched up with Sheryl Crow. She was terrific. The Geoffrey Beene people outfitted me in a great suit and then the fashion editor for GQ (Mike Nash) decided that he wanted a "hip" look for me so he opened my tie and shirt button, got rid of my jacket and replaced my dress shoes with sneakers. It was very cool. I met and spoke with WilI Am. Steve Tyler and Joe Perry from Aerosmith Band were supposed to shoot with me also, but the timing was off. All in all it was a lot of fun.
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March 14, 2009 -- Flew to San Francisco to attend and speak at the Memorial Service for Martin Delaney, my dear activist friend and Founding Director of Project Inform, one of the best and most prominent AIDS Activist Organizations devoted to hastening FDA approvals for HIV drugs where appropriate and educating people about HIV, particularly the at risk population. Met Marty in 1985 and we have a long and deep history. I will attach 2 document for this history: 1) my eulogy for Marty and 2) an e-mail exchange between me and Brenda Lein, Marty's co-worker and dear friend. Marty was not HIVinfected. He was a gay man who contracted Hepatitis B and then went on to cirrhosis and died in Jan., 2009 of hep. B/Cirrhosis-related hepatoma. I was very involved with Brenda in his terminal care and attempts to get him a liver transplant - it was too late for the latter. It was an cloudy, cool and damp day in SF. The ceremony was held in the Eureka Community Center at 100 Collingwood, around the corner from the hub of the Castro District - 18th Street and Castro. Big time déjà vu as I walked the streets of the Castro since I got there a bit early (ceremony at 4:30 PM). I had flown in from DC in the AM and took the red-eye back to DC that night. The streets of the Castro were crowded with people bustling around. The usual crowd plus the fact that it was St. Patrick's Day and the parade had just ended. I recall back in the mid-80s when I visited the Castro several times. It looked like the "walking dead" were in the street. So many cachectic people. Today, everyone looks healthy, but the typical protease inhibitor and other drug "facies" were evident with lose of facial fat pads.. You could tell that such a substantial proportion of the people were infected, but now, in contrast to the 80s, they were doing very well on drugs. Gave me a bittersweet feeling of how much we had accomplished over these 27.5 years. The ceremony went well - packed with people from the Castro who were so happy that I was there. I was the only government or health official there - a shame since he was such a great man and contributed so much. Fauci Eulogy for Martin Delaney Eulogy for Martin Delaney by Anthony S. Fauci, M.D. Director National Institute of Allergy and Infectious Diseases National Institutes of Health
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March 14, 2009 San Francisco, CA Ladies and Gentlemen, friends of Marty Delaney, I feel extremely honored and privileged to be here to celebrate the life of Marty Delaney and to have been asked to express a few brief reflections about Marty and his extraordinary work on behalf of people with and at risk for HIV/AIDS. I knew Marty Delaney for 24 years. I first heard about him in early 1985 through some of my staff and HIV researchers who were actually quite intimidated by him, mostly because he was, as they said, "making trouble for them" regarding the design of clinical trials. He certainly was a big-time headache for the FDA. Actually, the problem for them was that Marty was so smart, articulate and well-informed to the point that he knew more about HIV/AIDS and the complexities of treatment access, patient education, and a sound research agenda than some of them did. As they soon found out, he was correct most of the time. Now, confrontational and theatrical activism certainly has its place and has been very effective in calling attention to important problems, notably HIV/AIDS. But Marty's brand of AIDS activism was somewhat different. As I recently described him, he was analytical, well-informed, passionate, articulate, persistent, tough-minded, gracious, transparent, fair, and above all a thoroughly decent human being. He did not confront just for the sake of confrontation. I became very interested in learning more about this person whom I had not yet met. And so I began to read what he had written and I examined press reports about him and what he was doing in San Francisco and throughout the country. Furthermore, when I found out that he was formerly a Jesuit Seminarian, I decided I absolutely had to meet him personally since for better or worse I had experienced 8 years of Jesuit education in high school and college. And so I imagnied that we might have a lot in common He beat me to the punch me by calling me up and saying that we needed to get together to talk about patient access to experimental drugs within the context of highly restrictive clinical trials. Although he was well-aware that I was not with the FDA, he wanted my support in confronting the FDA about accelerated approval of drugs for HIV and its opportunistic complications. We soon met and began one of the most extraordinary relationships that I have ever had with a colleague and a peer. When we both realized that we were fighting for the same thing, but we were just wearing different uniforms, we developed a respect for one another that gradually morphed into a genuine friendship that got stronger as the years went by. He never hesitated when he felt it necessary and appropriate to nudge me, critique me, advise me, scold me, and point out things that were not yet on my radar screen. He was an extraordinary source of information regarding the community needs: Where was the pain? Where was the anxiety? When was the time right to get out into the trenches and talk to specific people? It was in this context that our collaboration was born, specifically in my speaking publicly for the Parallel Track program despite the resistance on the part of the FDA and many AIDS clinical researchers. Other activists, including Jim Eigo and his colleagues at ACT-UP in New York, also were pushing for a parallel track of accessibility for drugs in clinical trial. However, it was Marty who pleaded with me -- successfully -- to come to San Francisco and see firsthand patients from the Castro who were suffering physically and psychologically more than they should have been because the doors of access to drugs were shut to them. He then arranged the Town Hall meeting where I was to speak and as I was getting ready to go out on stage, he looked me in the eye and said, "Tony, do it; please do it". He already had convinced me earlier in the day and so I did it, the New York Times reported it; Washington and the FDA relented and we had parallel track. I received credit for that, but it was pure Marty Delaney. That is just one of many stories and accomplishments in Marty's legacy. As things got a bit calmer over the years, Marty accomplishments did not diminish. He made extraordinary contributions in helping to frame the HIV research agenda. He was a member of the NIAID AIDS Research Advisory Committee from 1991 to 1995 and served on NIAID's Advisory Council from 1995 to 1998, and well as on many other official advisory committees. But, it was not just the official advice that I treasured, it was the phone calls at home at 8:30 PM San Francisco time and 11:30 PM DC time opening with the comment" "I knew that you would be awake and so can you talk?" In a 20 minute call I would learn more about what was going on in the trenches -- and what he thought I should be doing -- than if I had 5 official briefings. As I was preparing my remarks for this Memorial, I reflected that it is difficult to conceive of the struggle against HIV/AIDS without the presence of Marty Delaney. But then again, I quickly realized that this struggle against HIV/AIDS will always have Marty Delaney. For Marty left for us by his leadership and example a unique spirit, a fierce integrity, and a commitment to activism that does not die with physical death. He has left something of himself with all of us. When I presented Marty with the NIAID Director's Special recognition Award a few weeks before he passed, I called him a Public Health Hero. Indeed, he always will be a hero to me and I will miss him dearly. E-mail exchange with Brenda Lein Immediately below is e-mail that Jenny sent to me after my e-mail to my family on Mar. 17 at 8:18 AM: Wow. That is really wonderful dad. What a special friend you are and he was. T'm sorry about what happened. On Tue, Mar 17, 2009 at 8:18 AM, Fauci, Anthony (NIH/NIAID) [E] <AFAUCI@niaid.nih.gov> wrote: Guys: In sent to me right after I returned from San Francisco where I attended memorial service. For those of you who do not know, passionate, extremely articulate, persistent, tough, gracious, fair, and above all a thoroughly decent human being. He was based in the Castro District of San Francisco and he influenced me more than any other activist. He trained for 6 years in a Jesuit seminary before he realized that he was gay and needed to do something else. He became a business man and then when AIDS came along, he started Project Inform in 1985, the first and best organization advocating for treatment access and educating the public about HIV/AIDS. At first he confronted me about government policy, but he did so with respect and outreach. He was almost always right and always ahead of the curve. Over the years, he and I became very close friends. ie joined Project Inform when she was a teenager and became disciple. I remember her as a "punk rock" person with a Mohawk haircut, black jeans, combat boots, many pierces, etc. I could not tell if she was gay, bisexual or straight. It obviously did not matter; she was (as is) beautiful and amazingly competent. Over the years, she grew into one of the main players in Project Inform, a mature woman, and the mother of a beautiful little girl. Love, Dad Anthony S. Fauci, MD Director National Institute of Allergy and Infectious Diseases Building 31, Room 7A-03 31 Center Drive, MSC 2520 National Institutes of Health Bethesda, MD 20892-2520 Phone: (301) 496-2263 FAX: (301) 496-4409 E-mail: afauci@niai The information in this e-mail and any of its attachments is confidential and may contain sensitive information. It should not be used by anyone who is not the original intended recipient. If you have received this e-mail in error please inform the sender and delete it from your mailbox or any other storage devices. The National Institute of Allergy and Infectious Diseases (NIAID) shall not accept liability for any statements made that are the sender's own and not expressly made on behalf of the NIAID by one of its representatives.