Diary Prequel Package — page 243

May 11, 2011 - Senate Appropriations Subcommittee Hearing for the 2012 NIH budget. Really bad budget times with the feeling that we are doing really well with only a 1.9% increase from 2011 for the PB. Republicans (most Tea Party people) trying to cut discretionary spending back to 2008 level, which would be devastating for NIH. Francis Collins trying to push the NCATS (National Center for Advancing Translational Science). I think this is a big mistake ("everybody wants to be somebody"). This is no time to initiate this, but some of the pols, some in the scientific community who are clueless, and others think this is a good idea. Harold Varmus and I have grave reservations about this (me particularly) since I believe that it will have the unintended consequence of sucking money away from standard NIH research to out into a Center that is Francis's baby. We are already doing $6 Billion in translational research at NIH. May 12, 2011 - Big announcement of early stopping of HPTN 052, which is randomized trial among 1763 heterosexual discordant couples to see if immediate treatment with ARVs (350-550 CD4 counts) versus delayed treatment (wait until fall to 250 or AIDSdefining illness) has an effect on transmission. Overwhelming response. 27 infections in delayed arm and 1 transmission in immediate arm (p <0.0001). I held press briefing and got front page in all major papers - NY Times.Wash Post, WSJ; appeared on NBC Nightly News, CBS Evening News, CNN International, etc. May 17, 2011 - The press, scientific, public health and general public interest in the HPTV-052 results in becoming huge. I appeared on New Hour (interviewed alone by Ray Suarez) as well as NBC Today Show. Have done taped interviews with Mark Schoofs that will appear on the Website of WSJ. May 18-26, 2011 - Much activity and interest (real buzz) on part of global activists to use the 052 data to pressure the USA (Obama and USAID/PEPFAR) to increase funding and re-prioritize the emphasis on treatment since it is also prevention as well as emphasis those prevention modalities that have been scientifically proven to work such as circumcision (which is now effective at 68% at 40 months into the follow-up study in Rekai, Uganda). I am speaking mre openly on interview about pressing the administration to give more money. Feels like the old days of the beginning of PEPFAR when OMB ridiculed me for asking for so much money and then everything broke lose with PEPFAR. On May 26, I met at the headquarters of the WH Office of the Global AIDS Coordinator (OGAC) with Eric Goosby, Reinhard Schwartzlander (UNIADS), Carl Dieffenbach, Tom Frieden (by phone), Debbie Birx (CDC- GAP Prgram), people for USAID, and State. I made the argument that there is an elephant in the room and that is that we MUST put more resources into treatment since we now know that it is in fact prevention and we will either pay now or pay more later. Eric Goosby was so pleased that I backed what he really wants and needs but since he is a POTUS appointee, he cannot be too up front about. See below his email of May 26, 2011 to me after the meeting: