A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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June 29, 2014 - Interesting spin-off of my "Big Idea" at the Aspen Ideas Festival. My idea was that we can end the AIDS pandemic in 10 years (by 2024 - theme of festival - global health by 2024 and we were asked what single thing (big idea) do we think would greatly influence global health by 2024). Gov. Andrew Cuomo has stated that he wants to end the AIDS pandemic in NY State in 6 to 10 years. The NY Times wrote this up in the Sunday Times and quoted me since the reporter had heard about my Big Idea from the Aspen Festival. The article had me praising Gov. Cuomo and my saying that NY could be a model for the rest of the country.
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July 3, 2014 - The Ebola outbreak in Guinea, Sierra-Leone and Liberia is getting out of control. Latest number are 759 cases and 476 deaths (63% fatality) making this the largest outbreak of Ebola on record. Net highest was in 2000 in Uganda with ~400 cases. Major concern since it is now spreading in the cities of these countries and the population is not cooperating in containing it by ignoring the recommendations about how to handle patients and dead bodies. Also, major ignorance causing population to attack and stone doctors and nurses from Doctors without Borders and WHO, saying that there is a conspiracy on the part of the government to deplete the population. I appeared on CNN today to discuss the situation.
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July 4-8, 2014 - Interesting 4th of July weekend. Found out from Deb Persaud and Hannah Gay that the "Mississippi baby" rebounded at 27 months following D/Cing of ART. Baby is 46 months old. Unfortunately, so much for the "cure" baby. We are sequencing the virus now to determine if this is not a "new" infection, i.e. abuse from an HIV-infected person. More on this later. Also, heard (and spent many hours on conference calls) that an FDA employee who was cleaning out a cold room in Building 29A (FDA building on NIH campus) found a cardboard box that contained 6 glass undisturbed vials labelled "variola". Likely there unnoticed since the 1950s. CDC and FBI notified. Good news is that leaks did not occur and within a couple of days, the CDC came up to NIH, area secured by FBI, and material flown down to CDC on FBI plane. Examined there by Select Agent people and PCR'd to confirm smallpox. Will determine if viable within 1 week and will be destroyed as witnessed by WHO. Technically, the presence of this material in Building 29A was a violation of an international agreement to destroy all smallpox samples except for 2 aliquots kept at CDC and at VICTOR in Russia.
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July 9, 2014 - PCR confirms that the Mississippi Baby has indeed rebounded with virus at 16,000 and 10,000 copies RNA per ml. Baby has been off cART for 27 months and is 46 months of age. Disappointing, but raises many questions. The baby had no detectable immune response for these many months. Since the virus was obviously there in a reservoir somewhere, what then was the mechanisms that was preventing it from rebounding. Will hold press conference with Deb Persaud, Hannah Gay, and Katherine Luzuriaga on Thursday (tomorrow). Had interesting rounds today to see our first patient (Phil Diers) that received an allogeneic PBMC transfer from a HLA-B27 HIV-infected Elite Controller donor. Recipient has CD4+ T cell count of 0-4 and >150,000 copies of HIV on cART (resistant virus). Hope is that the immune response of donor cells will impact in some way the infected cells of the recipient. More to come. Way out chance of a graft versus infected cell effect that might eliminate reservoir (too much to ask for). See picture below of me on Rounds the day after the allogeneic transfer.
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2014-07-10 00:00
Anthony S. Fauci
July 10, 2014 - Press briefing with Deb, Hannah and Katherine today (Thursday - thunderstorms). Followed by major press that appeared tonight and tomorrow (July 11) with my quoted or appearing on TV or radio tonight or tomorrow: AP TV that subcontracted to BBC TV seen in Italy by Bruce Gellin (sent me e-mail); CBS Evening News
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July 11, 2014 - Front page NY Times and Washington Post. My picture and front page LA Times; Wall Street Journal, USA Today and all major print papers and many, many blogs including CNN BBC Radio; BBC TV; NewsHour with Jeff Borwn; VOA, Reuter's TV, NPR. I make the point that this is disappointing and not a "setback" since we are still in the early discovery phase of cure research and this is what happens when you are in this stage.
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July 13, 2014 - Had conference call today on Sunday with Francis Collins and Tom Frieden of the CDC. Tom has a significant problem in that they have been multiple lapses at the CDC with people not adhering to protocol in the experiment with a transfer of select agents such as anthrax, Brucella and influenza. He wanted to run this by Francis and me so that the NIH and CDC could be on the same page. We had the problem described above with the smallpox discovery in a cold room in building 29a and so his issue and ours are somewhat aligned. He is under pressure to decrease the number of investigators throughout the country who are working with select agents. The rationale for this is the fact that if the CDC could make mistakes like this, then virtually anyone can. This is aligning with the issue of many people wanting to put a clamp on gain of function research, particularly with influenza. More to come.
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July 14, 2014 - More press on Mississippi Baby (Al Jazeera TV) as well as fluff over the WHO coming out with recommendation that MSM who practice unsafe sex should take PrPE (Truvada). Press misinterpreted this (partly fault of WHO) to mean that all gay men should be on Truvada as PrEP. I had to clarify this on Al Jazeera and in the NY Times (article soon to appear). Preparing to go to Melbourne for the IAS International AIDS meeting.
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July 16, 2014 - The situation is heating up considerably with regard to the three infractions that have occurred in HHS concerning potentially lethal microbes. The first was the finding of the smallpox vials in the FDA building (29A) on the NIH campus. The next was the egregious dysfunction of the teams involved in dealing with selective select agent research down at the CDC and third was the contamination at the CDC of a highly pathogenic influenza virus (H5N1) with a nonpathogenic influence virus (H7N9). This has been all over the media in a very intense way. The White House as well as the Department of Health and Human Services is involved. Francis Collins and I received a letter from Nobel laureates Paul Berg and Richard Roberts to discuss how we might address this escalating issue. They have been consistently against gain-of-function research, especially on influenza. In addition Francis and I together with Peggy Hamburg and Tom Frieden were called to a meeting this evening at HHS with Secretary Sylvia Burwell to discuss the HHS plan as well as the fact that Sylvia will be meeting with the POTUS on Friday, July 18 to discuss the matter and she needed to be briefed by us. I have suggested to Francis and he agrees that we call a temporary moratorium on all gain of function research on influenza and the MERS virus involving increasing pathogenesis and increasing transmissibility by the respiratory route. Also, Francis and I brought up (clearly my idea for some time now) to re-invigorate the NSABB and get them much more in the mix of recommendations and involvement. We had a good meeting with Sylvia Burwell in her office tonight that lasted from 7 PM to 9 PM. Francis and I will be talking over the phone tomorrow with Richard Roberts and Paul Berg about a plan for the future. Also, today Barry Bloom called me from the Harvard School of Public Health to ask whether or not he could help us in addressing this new and emerging political problem. In addition, I received a call from Michael Osterholm to warn me, as he is often doing, that there will be problems "for me" that he wants to help. I get concerned when Michael wants to "help" me. He generally gets hysterical about microbial threats and loves to be in the press.