Diary Prequel Package — page 366

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. September 9, 2019 - There is a considerable disagreement going on about the role of randomized placebo-controlled clinical trials (RCTs) in determining the efficacy and true safety of the GSK/NIH chimp adenovirus vaccine. The British in the form of Jeremy Farrar Head of Wellcome Trust as well as the WHO (Marie-Paule Kieny) seem to want to distribute the vaccine outside of a clinical trial. They are responding to what is an emotional need to get some intervention out there even though we have experience to indicate that the worst thing that can happen is the widespread application of the vaccine or other interventions that either do not work or actually paradoxically make things worse as we have seen with the HIV vaccine experience where a HIV vaccine that looked good in preclinical as well as in phase 1 actually increased the risk among the vaccinees of HIV acquisition by up to 41%. This is the worst thing that could happen in the Ebola situation. Cliff Lane and I are trying hard to strike a delicate balance between making our vaccine available following phase 1 trials which have just started here at NIH and continuing to pursue the scientific path of determining if it works and is safe without a paradoxical effect of harming.