A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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Feb. 1, 2010 - Another meeting in the Situation Room of the WH with Heidi Avery with the usual cast of characters. For the past 2 meetings, Andy .... From DoD has joined as has John Holdren from PCAST. There is tension building where the HHS people (particularly Nicki Lurie and to some extent Jesse Goodman, Peggy Hamburg and Tom Frieden are getting nervous about the boldness of the proposal and whether we can "deliver" on the promises. Heidi is trying here best to explain that we need a bold initiative and if we are not bold and transforming, we will get nowhere. They are concerned that this is moving quickly particularly since Heidi is talking about possible face-time with the POTUS to have him accept and sanction this bold "new initiative'. I am leaning much more towards Heidi and have served as somewhat of an intermediary to try to alleviate their concerns. They are somewhat in the weeds. Heidi has been calling me up at night to get my confidential feedback about how we can get the HHS group from being so conservative.
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Feb. 2, 2010 - Had AIDS Vaccine Research Subcommittee (AVRS) meeting at the Bethesda North Marriott Hotel to discuss the way forward following the Thai trial (RV144). We discussed the same issues that I discussed at the smaller meeting of my "Kitchen Cabinet" on Jan. 25. As usual, people had insecurities about pursuing a path that was not their path. In addition to the Jan. 25 group, also present were Dennis Burton, Bruce Walker, Nelson Michael, Jerome Kim, Debbie Birx (now at CDC). I made it clear to them in no uncertain terms that they needed to speak up openly and not stay silent and then after the meeting say they disagreed with the conclusions. It turned out to be a good meeting since they obviously heard what I said.
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Feb. 4, 2010 - Opened the Genomics Blue Ribbon Panel at the Bethesda North Marriott to plan the direction of genomics research for NIAID. All the stars were there - Ian Lipkin, Eric Lander, etc. Eric gave a great speech. About the use of genomics in infectious diseases. That evening presented my usual "State of NIAID" talk to the ASM Executive Committee. Feb. 5 and 6 and Feb and Feb 9 and 10 - 2 worse snow storms in the history of Washington, DC. Shut down schools and government for a week - it was a 0ne (32 inches at IAD) - two (20 inches in DC) punch. During this time we intensified the development of the PHEMCE (Public Health Emergency Medical Countermeasure Enterprise) Initiative via Heidi Avery. Getting hot and heavy in that the HHS folks are getting cold feet. Although good friends of mine - Nicki Lurie appears afraid and over her head. Jesse Goodman is forever in the weeds. Peggy Hamburg is cautious but just now is starting to realize that this train is moving.
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Feb. 8, 2010 - Whole city is socked in with snow, but we still had meeting in Sit Room with the usual cast of characters. Heidi has obtained 1 hour face time for us with the POTUS, but the HHS crew is afraid. Issue is that they think that the concept is too bold and Nicki Lurie is afraid that it will supersede the IOM-led review of the enterprise that Sec. Sebelius has ordered for Feb. 22-23 and that must report to her by March 31. Heidi wants to leap over all of the nonsense and get the POTUS buy in. The pillars of her transforming plan are : 1) Multi-use principle - NIAID has already been pushing for this in the sense of partnering with industry to develop multi-use products and advance new platform technologies; 2) Collaborations, Partnerships and Cooperatives; 3) regulatory innovation and Advancement of regulatory Science; 4)Product Development and manufacturing services; 5) End-to-end Multidisciplinary Project Management (see entire document in records of My Documents).
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2010-02-10 00:00
Anthony S. Fauci
Feb. 10, 2010 - We (the HHS team) brief Bill Corr (Deputy Secretary). Again conservative concern. I am all for Heidi's initiative. These people just do not understand how important it is to get personal support of the POTUS (remember PEPFAR). Again, multiple conference calls with Heidi fine-tuning the document. Richard Hatchett (who actually works for me in DAIT, but is detailed to Heidi) and Heidi often call me late at night for help in getting this group off their asses. They are afraid that she will promise too much. She keeps saying (and I totally believe her) that we are not going to promise the POTUS anything, we just need to get his buy-in and then we will implement what we can.
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Feb. 11, 2010 - HHS team briefs Secretary Sebelius over the phone. She is smart, but clueless about what all this means. Nicki Lurie is inarticulate in explaining it to her. Nonetheless Heidi is going to give it a go with the POTUS even though she is terribly frustrated with the HHS people except for me. My time has been totally consumed with this despite the shutdown of everything with the snow.
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Feb. 12, 2010 - Meet with the POTUS from 2:00 to 3:00 in the Situation Room. Richard and Heidi present and the HHS team answered questions. I was not shy in telling the PTUS what I thought. He said "Are we making this more complicated than it should we? Why not contract out for the relatively limited number of countermeasures that we have Intel. On that could be threats". I reminded him that in his SOTU address he said that we would develop an initiative to counter all threats to public health even naturally emerging infections. I then told him that the dual use and new platform technologies were essential to get industry involved since they would not take the investment risk unless we helped them with the technology, etc. He agreed. He recognized who I was without even an introduction and called me "Tony". All in all, the meeting went well and he said that he endorsed the plan. Parenthetically, The traffic was horrible getting to the WH via the GW parkway by Taxi. I took a taxi because the METRO Red Line shut down due to a derailment. Stressful getting there, but great to have 1 hour face time with the POTUS. This is now the 5th POTUS that I have personally advised via serious face-time.
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Feb. 15-17, 2010 - Went to annual CROI meeting in San Francisco. Gave Opening Session Plenary on "The HIV/AIDS Research Agenda: A View from NIAID". Gave a bold and provocative talk about the high risk, high impact, potential "game-changer" research that we plan to do over the next few years. The 3 "pillars" of this research are 1) Aggressively seek, test and treat infected individuals. However, the math tells us that the treatment paradigm in a vacuum will never end the AIDS pandemic since more people get infected than get put on treatment. Hence we need to do something different such as getting people who are on therapy off therapy by developing a 2) CURE for HIV - tough challenge. Also we need to 3) Prevent new infections by a) ARVs as prevention - ARV containing microbicides; PrEP; test and treat; and b) vaccine. Beautiful days in SF. Stayed at the Westin St. Francis. Many people said that it was the best and most inspiring talk that I have ever given - "bold and challenging". On Feb. 17, I briefed by teleconference the PCAST working group about the POTUS initiative and gave them background info. On the call were co-chairs Harold Varmus and Eric Lander. Also, David Baltimore, Ed Penhoelt, Emilio Emini, Harvey Fineberg, among others.
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Feb. 18, 2010 - Another meeting at the Sit Room of the WH from 4:00 to 5:30 PM with Heidi Avery and the "team". Getting ready for the various meetings next week of IOM (Secretary's review), PCAST, and National Biodefense Science Board (NBSB). I brought up that reports from these other meetings may confuse people regarding the POTUS's initiative to transform PHEMCE. Heidi will likely let the other meeting happen, incorporate some ideas from them and still have the POTUS initiative be the driving force of policy. During the day prior to the WH had a visit from Rick Klausner. I had been talking to Rock about these issue for awhile and he is very much in agreement with my stand on how we need to transform the way the USG interacts with industry in the development of products.