A single line often inverts meaning once you see what it
answers, so neighbouring messages are always shown.
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Sept. 3, 2014 - Big meeting at World Bank Headquarters on 18th Street, N.W. to exam and discuss the response to Ebola. Jim Kim (President of World Bank) specifically invited me (as did Paul Farmer), Discussed the WHO Roadmap and David Nabarro's UN Plan. Present at meeting were: Tom Frieden, Jim Kim, Tim Evans (Senior Director, GHNDR), Jan Eliasson (Deputy Secretary General, UN), Margaret Chan (DirectorGeneral, WHO), Gayle Smith (by phone - Special Assistant to the POTUS at NSC), Mark Dybul (by Phone), Keiji Fukuda (WHO), Raj Panjabi (Harvard), Ariel PablosMendez (USAID), Jimmy Kolker (HHS), Joia Mukhajee (PIH)Sri Mulyani Indrrawati (World Bank), Olusoji Adeyi (World Bank), and other World Bank people. Jim Kim took the lead and emphasized that we need to translate "planning" into action and took Margaret Chan to task for not exercising her authorities under the International Health Regulations (IHR) to take the lead. Despite Jim Kim's strong urging, it still appears that we are not headed to great action. David Nabarro had some action items with no way to actually act. I mentioned gently to Margaret that she should not say that "We plan to have to Epidemic under control in 6 months" since this would signal to the world that we actually have a way of ending it in 6 months, when in fact we have no idea when it will end given the exponential nature of the increase in cases. I also told story of when Colin Powell and I went to the UNGASS in the early 2000s and he declared the AIDS pandemic a global security threat and this got the attention of everyone. We should do the same thing with Ebola. Press - MSNBC with Peter Alexander; Fox News with Lou Dobbs.
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Sept. 4, 2014 - After discussions with me and having me see and edit his column, Mike Gerson wrote a scorching editorial in today's Washington Post criticizing the world and the White House for not doing more for the Ebola situation. In my discussions with Mike, he indicated that when he was in the WH with Josh Bolton as Chief-of-Staff, they would have pushed George W. Bush and he would have responded to do something dramatic to help West Africa. Mike sent me a note that Denis McDonough (Obama Chief-of-Staff) sent to Mike in response to Mike sending Denis a copy of the article. Denis note to Mike below: y the following: Tony, In confidence, this is the note Denis sent back to me when I sent him the link to the column. I thought you might be interested. Thanks, Michael. It is good to hear from you, and I look forward to reading your column (which I have not yet had the chance to do but will soon). I did think it was worth mentioning that the President had a good - if alarming - discussion with Dr. Frieden on Monday after Tom returned from the region where he went to get a candid view of how this is progressing. Tom was concerned with what he saw, and the President was concerned with the same. As a result, POTUS directed even more aggressive action than we have been taking so as to treat this like the national security challenge it is. Lisa, who is leading this effort, and John may have additional thoughts. But we feel this urgency - deeply. Thanks again for the note, Denis. Press - MSNBC with Ronan Farrow,
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Sept. 5, 2014 - Got note from Tait Sai saying that my interview in Newsweek where I said that the Epidemic was "completely out of control" was "10% too hyperbolic". Lots going on. USAID assigned Nancy Lindborg to run their shop. She is pretty good. Jim Kim is exercised that WHO is not doing enough. Tom Frieden says that the DoD is useless since they can never commit to anything. This is interesting since Cliff Lane thinks that they are the only ones that can control this with Command, Control and Communications. Jim Kim wants to engage me, Paul Farmer, Mark Dybul to see to the clinical care issue and incorporating clinical trials into the picture. Spoke with Tom Frieden today and Tom feels better those things are now moving with the $75 million that USAID is putting in. I believe that Tom was told to tone down the rhetoric about this outbreak being totally out of control and that is why he is saying that things are on track. This coincides with Tait telling me that I am 10% too hyperbolic Did boat-load of print media today.
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Sept. 7, 2014 - POTUS said on Meet the Press today the following: POTUS on Ebola on Meet the Press, 9/7/14: *Americans should not be concerned about prospects of contagion here in US, shortterm, because it is not airborne disease like the flu. *No public health infrastructure in Liberia/SL/Guinea. *What should be containable problem is breaking loose, because people aren't being quarantined properly, people aren't being trained properly, not enough public health workers. *We have to make this a national security priority. Mobilize international community, get resources in there, get US military assets just to set up isolation units and equipment, and provide security for public health workers surging from around the world. *If we do that, still going to be months before this problem is controllable in Africa. But it shouldn't reach our shores. *If we don't make that effort now, and this spreads, not just through Africa, but other parts of the world. There is the prospect the virus mutates, it becomes more easily transmittable. And then it could be serious danger to US. *This is example of where US leadership is important in dealing with crisis. But, also argument for when I go before Congress, and say let's give some public health aid to Liberia. Short term investments now, pay off in the future. It now remains to be seen what actually happens. The POTUS is getting beaten up in the polls and by the GOP for his inaction. He let the Left down by delaying action on immigration reform until after the November Congressional elections in a purely political cave-in. He is paralyzed in inaction on bombing ISIS in Syria and in doing nothing to stop Putin and the Russians from taking over part of Ukraine. He is having a bad summer. Yesterday, Mike Gerson contacted Francis Collins in the same manner that he had contacted me, asking Francis what he thinks should be done. Francis responded as I did that we should bring in the DoD for their Command, Control and Communications capability. Also, someone needs to be in charge. John Podesta (Counsellor to the POTUS) contacted Mike Gerson asking him what he thinks we should do. John was taken aback by Mike's Post editorial the other day. Mike asking Francis/me who should be put in charge at the WH. I suggest any of the following: David Petraeus, Stanley McCrystal, Colin Powell, and Bill Frist. I doubt if they will choose any of these. They probably will ask Lisa Monaco - head of NSC. We really need a General. I believe that we are missing the boat. USA is missing an opportunity of saving many lives and coming across as the savior of West Africa, much like George W. Bush saved all of Africa with PEPFAR. Am getting e-mail from Jim Kim and Paul Farmer asking for my help/advice should they get more heavily involved.
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2014-09-08 00:00
Anthony S. Fauci
Sept. 8, 2014 - The situation is evolving rapidly where the Department of HHS is now telling us (NIH and others) that things are now going in the right direction and that we do not need to have daily phone calls anymore and could probably move them to every week or every other week. This is stunning to me since I do not see that anything has really changed and it appears to me that they are trying to paint a rosy a picture when things are actually getting worse. The reason for this is unclear. It could be that the White House has told them to tone down the rhetoric since they do not want to put pressure on the President. Also amazing is the fact that even Tom Frieden has told me on the phone that things seem to be going in the right direction now and they have work streams and points of contact and he is much more optimistic. I cannot believe that he has completely changed from the passionate person demanding an overwhelming amount of resources and beds to someone who now says everything seems to be going okay. There is something very fishy here. I suspect that HHS has promised him that resources are on the way and have told him to cool it. I will find out what is going on. Appeared on Diane Rehm show today with Sheri Fink from the New York Times as well as Sophie Delaunay from MSF and Mvemba Dizolele from the Democratic Republic of the Congo. Dvemba said that he has been reading about me since he was 16 years old and that I was his hero. He made me feel rather old despite the flattering comment (he is right about the age ). The host was Steve Roberts and we spoke about the drastic situation in West Africa. Also appeared on BBC radio. WTOP radio and Reuters TV. Although the President has said on Meet the Press that the military will now be involved, reports and news outlets such as Reuters quote officers at the level of Colonel saying that the military will deliver the 25 bed hospital to Liberia; however, there will not be "boots on the ground" of military personnel staffing the hospital. As far as I can see, this is no different than what was going on before the President's announcement. There were already plans to get a 25 bed hospital shipped by military aircraft to Liberia. I think this is a smoke and mirror game in which nothing will get done.
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Sept. 10, 2014 - The debate still continues as to whether or not we will have military assistance in dealing with the Ebola epidemic in West Africa. There is a disturbing lack of transparency between HHS and us here at NIH in that they are obviously negotiating at the level of the National Security Council and the Department of Defense about what to do in the epidemic without telling Francis Collins or me what is actually going on. In the meantime, Cliff Lane as a long-term member of the Medical Defense Board of the Department of Defense has met with Gen. Martin E. Dempsey, chairman of the Joint Chiefs of Staff today. Cliff relates to me that Gen. Dempsey seemed quite receptive to Cliff's pleading for a massive military logistic support for the Ebola situation in West Africa. Also at that meeting with the Joint Chiefs was Laurie Garrett, because of her prior experience with Ebola epidemics. According to Cliff, Laurie also pleaded for a massive military effort. It should be noted that today another important event occurred in which the President announced at a TV appearance that he will initiate a scaled up military attack on ISIS (he calls it ISIL) including their assets in Syria. He declared that ISIS is a threat to the Middle East, the surrounding regions, and the United States and Europe, largely due to the fact that they have publicly said that they will attack Western nations. This is a particularly important problem because many Westerners with Western passports and Visas including those from the United States have joined ISIS. The President stated that he would not include ground troops in this effort. However it is clear that Special Forces will be needed to guide the air attacks. The press is sharply criticizing the POTUS for having no plan, missing prior opportunities, and now doing too little, too late. More later. I bring this up because this is certainly a complicating issue when you are also asking the military to help with Ebola outbreak. Had a momentous evening today in that I gave a keynote lecture at the PhRMA Research and Hope Awards Gala at the Mellon Auditorium on Constitution Ave. It was particularly important because the other speaker was former Pres. George W. Bush. We resumed our warm personal relationship in that when he entered a small room of VIPs to shake hands and take pictures as soon as he walked into the room he caught my eye and said out loud for everyone to hear: "Hey, Tony it's great to see you". He gave me a big hug; we took pictures; chatted a bit and then when he was on the stage for his talk which was actually a conversation with a moderator, the first thing he said is that: "We have with us tonight my friend Tony Fauci. I gave Tony the Presidential Medal of Freedom several years ago. I did that because you should know that he is one of the most important American heroes of our time." It was extraordinarily flattering, but this is exactly the way he has been treating me for years. The talk that I gave was entitled ending the HIV-AIDS pandemic: a realistic goal. Overall the evening was very pleasant. I sat down next to my old friend form NIH director Elias Zerhouni and the evening was full of warm praise by many people for me and what I have been doing with HIV over the last many years.
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Sept. 14, 2014 - A lot has happened over the past few days. There has been a considerable amount of disorganization, diffusion, and lack of direction at the level of HHS as well as the rest of the USG (USAID, DoS, etc.). It has been announced that the President will visit the CDC on Tuesday, September 16. It is anticipated that he will announce that the United States military will get heavily involved in the response to Ebola by providing up to 1700 hospital beds as well as the logistics for transportation and provision of equipment. However, it is very clear that they will not provide medical personnel in the form of doctors and nurses. This might leave us with the situation in which we have equipment but the inability to implement it. HHS (Leslie Dach) is desperately trying to figure out ways to recruit and train medical personnel to man the hospitals. Of note, it might take up to 8 weeks to get these hospitals operational, if in fact, the US military decides to send them. The situation in the West African countries is still dire. I have been on the phone discussing this on multiple occasions over the past few days with Paul Farmer and Mike Gerson. Paul will be leaving tomorrow, September 15, for Liberia in order to set up hospitals under the auspices of Partners in Health, the organization that Paul and Jim Kim founded many years ago. Francis Collins, Cliff Lane, and I are still pushing HHS to suggest that there be a person in the White House who would be the overall Director and point person for the government's Ebola efforts. I have suggested to Francis and Francis has suggested to the secretary that that person either be someone like Gen. David Petraeus, Gen. Stanley McCrystal, or even former majority Senate leader Bill Frist. Again, I am concerned about the lack of organization, direction, and commitment on the part of the department as well as the White House. The President is having a very difficult time in that he is being pressured to respond firmly to the threat of ISIS in the Middle East. I feel that this pressure may make him and the administration less enthusiastic about getting heavily involved with the Ebola issue. Nicki Lurie, who is a good person and a friend, is making things more confusing by trying to suggest how to do clinical trials, train people and other tasks when she knows little about these issues. She is an Assistant Secretary and so officially she outranks us all (me, Peggy Hamburg, Francis Collins, Tom Frieden); yet, she gets in the way more often than not. Had a long conversation about this with Peggy Hamburg on the phone today. Paul Farmer is encouraging me to continue to push the envelope to get the USG to do more. Paul is showing an amazing amount of faith in me that I can fix this. He is basing this on his experience with me with PEPFAR. However, this is different since there are so many "cooks" in this process.
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Sept. 15, 2014 - Mike Gerson called me up again this AM wanted to find out if I knew anything more about the POTUS planned announcement at CDC tomorrow regarding increased resources (DoD) for Ebola. Mike is driven by his deep humanitarian values and wanting to nudge the administration to do more. Mike will speak with Lisa Monaco today about administration plans. I gave him a few questions to ask Lisa, i.e. who is in charge?
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Sept. 16, 2014 - I helped Mike gerson last night on certain elements of his column which appeared today in the Washington Post. Mike used several of my phrases and called for an escalated effort in various areas of need including US Military command-and-control, transportation, logistics, and supplies. Last night the White House sent out an embargoed fact sheet about what the President will announce today at the CDC. He will make the announcement at 4:45 PM. I will be testifying before the Senate HELP committee and the Senate Appropriations Subcommittee from 2:30 PM until about 4:30 PM. There are a large number of press including CNN with Wolf Blitzer,Hhardball with Chris Matthews, an MSNBC who want to speak to me about the President's announcement and the implications of the announcement. As usual the White House is very nervous about having anybody speaking to the press before or on the day that the president makes an announcement. Therefore I am getting a lot of grief from the communications people downtown and at the White House about all of the requests for me to appear on the media. By grief I mean that they are not clearing me nor are they refusing me. They are just keeping me hanging, which usually means that the requests will be withdrawn by the media people themselves and they will find someone else. This is typical stupidity on the part of the White House and HHS. With regard to the announcement of the President, he is proposing many of the things that I and several of my colleagues have been pushing for. This includes 3000 personnel, a command-and-control center in Monrovia, Liberia, a US Army general in charge of the process. The supply of 17 Ebola Treatment Units consisting of 100 beds per unit, much personal protective equipment, an education program, home health care kits, home test kits, among many other things that are much needed. Hopefully, this will turn around the trajectory of the epidemic. However it will depend on how quickly they get this material on the ground. I am off to the congressional committees. More later.