March 14, 2009

Extracted statements

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In context

A single line often inverts meaning once you see what it answers, so neighbouring messages are always shown.

1. 2009-03-07 00:00 Anthony S. Fauci open
   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.
2. 2009-03-08 00:00 Anthony S. Fauci open
   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.
3. 2009-03-13 00:00 Anthony S. Fauci open
   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.
4. 2009-03-14 00:00 Anthony S. Fauci open
   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
5. 2009-03-14 00:00 Anthony S. Fauci
   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.
6. 2009-04-16 00:00 Anthony S. Fauci open
   April 16, 2009 - My Op-Ed on "Policy Cocktail for HIV" appeared in Washington Post. Got many nice comments. I am starting to get on the radar screen of the Obama people.
7. 2009-04-17 00:00 Anthony S. Fauci open
   April 17-18, 2009 - First cases of an "untypeable"influenza noticed in California and identified by CDC as a swine influenza of H1N1 type.
8. 2009-04-21 00:00 Anthony S. Fauci open
   April 21, 2009 - Had lunch at the Oval Room across from Lafayette Park with Michael Gerson (Washington Post, Council of Foreign relations) to catch up on some of the projects that I am involved in re; Global Health issues. Mike was very influential in helping me during the Bush 43 years with PEPFAR and the President's Malaria Initiative. I told him about my pushing for PrEP, Test and Treat, and Eradication of HIV (my new "Big Three" for control of HIV). Nice time at lunch. He is a very, very sharp guy and we have become good friends over the years - recall he invited me to private dinner with George and Laura Bush at his home last year. I had turkey Club; Mike had asparagus soup. Whether was sunny with threatening rain.
9. 2009-04-23 00:00 Anthony S. Fauci open
   April 23-24, 2009 - First days of public awareness of the "swine flu" pandemic with the "quadruple reassortant H1N1 influenza A. Around the clock conference calls and meetings. In "battle mode" at HHS. I am handling everything for NIH, but there is something strange regarding relationship with HHS (see below re: Jenny Backus.)

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