Anthony S. Fauci

Virtually every important government official (the entire Cabinet, military leaders, etc) was there.

Diary Prequel Package, p.43 · original PDF · in context

After the meeting he called me into his office to speak in private (Bob Woods (Chief of Staff) and Brett Davis (Special Assistant to the Secretary) were there.

Diary Prequel Package, p.3 · original PDF · in context

April 4, 2001 - I was asked to prepare talking points on AIDS for Secretary.

Diary Prequel Package, p.3 · original PDF · in context

Thompson's staff was so impressed with 3ome comments. the talking points that they mentioned that Thompson wanted me to accompany his staff to the White House the next day to develop a white paper for Powel and Thompson to use in upcoming meeting with the POTUS.

Diary Prequel Package, p.3 · original PDF · in context

It was clear that much of the paper included material from my talking points for Thompson (see above).

Diary Prequel Package, p.4 · original PDF · in context

We will require demonstration of local leadership and adherence to international standards of financial accountability and transparency.

Diary Prequel Package, p.4 · original PDF · in context

We are committed to a policy of promoting intellectual property protection, including for pharmaceutical patents, because of its critical role in the rapid innovation, development, and commercialization of effective and safe drug therapies and vaccines.

Diary Prequel Package, p.4 · original PDF · in context

With more than 50 years of experience with health projects and a proven institutional capacity to manage large financial transactions, the World Bank should serve as the fiscal agent for the Fund.

Diary Prequel Package, p.4 · original PDF · in context

A small Executive Secretariat housed at the Bank and jointly staffed by the Bank, UNAIDS and the World Health Organization would undertake the day-to-day management of the trust fund, including soliciting grant proposals.

Diary Prequel Package, p.4 · original PDF · in context

The Council would fully control all fund decisions, including determining programmatic allocations, operational rules and procedures, policies and strategies, approving financial plans and work programs, and attracting additional donations.

Diary Prequel Package, p.4 · original PDF · in context

Goals • Prevent new infections, treat those already afflicted, build infrastructure for health care and disease control, and develop and train medical personnel. • Identify the needs of affected areas and allow communities themselves to develop an appropriate, comprehensive set of medical, social and support services. • Build on already established institutions and networks in local areas, including research relationships to ensure countries can sustain the fight on their own over time.

Diary Prequel Package, p.11 · original PDF · in context

In other words, if a vial of measles vaccine contains 10 child doses, if should be vaccum sealed to a slab of cardboard on which are 10 autodestruct syringes.

Diary Prequel Package, p.18 · original PDF · in context

The reasons were not so much about the likelihood the vaccines would work (nobody thought they would), but concerns that people who received the vaccines would then put themselves and their partners at higher risk, based on the assumption that they were at least somewhat protected.

Diary Prequel Package, p.18 · original PDF · in context

NIH and CDC have spent loads of money trying to figure out how to counsel vaccine volunteers, what to say about safe sex, etc.

Diary Prequel Package, p.18 · original PDF · in context

It has been an ENORMOUS concern in the vaccine arena --- well in advance of actually having a product worth testing.

Diary Prequel Package, p.18 · original PDF · in context

This was an extremely important trip for me in that it gave me a first-hand appreciation of the dire situation in Africa, not only with regard to HIV/AIDS, but also with regard to heath care in Africa in general.

Diary Prequel Package, p.27 · original PDF · in context

UN Secretary General Kofi Annan will come out with a proposal for a Global Trust Fund for AIDS in Africa in June at a Special Session of the UN General Assembly.

Diary Prequel Package, p.28 · original PDF · in context

Bill is an old and good friend who frequently includes me in social events.

Diary Prequel Package, p.29 · original PDF · in context

He is interested in diabetes and brought people from the American Diabetes Association with him.

Diary Prequel Package, p.30 · original PDF · in context

August 2, 2001 - Had meeting at NIH (Building 31, 7A-24 Conference room called by Richard Falkenrath of the National Security Council who is Ambassador to the Biological Weapons Convention.

Diary Prequel Package, p.31 · original PDF · in context

The lines were growing robustly and were established according to the 4 points that President Bush mentioned in his speech, i.e. they had to be in vitro fertilized embryos that fulfilled the following criteria: 1) informed consent; 2) in excess of clinical need; 3) not done as a result of financial inducement; 4) embryos not established for the purpose of research.

Diary Prequel Package, p.31 · original PDF · in context

Present at meeting was Ambassador Donald Mahley, Special Negotiator at State Department for Chemical/Biological Weapons, as well as representatives from Justice Dept., State, DOD, DHHS (me, John La Montagne, William Steiger), etc.

Diary Prequel Package, p.32 · original PDF · in context

Purpose was to review document that the group put together (White Paper) as a policy that the President will articulate in association with the USA refusing to re-certify the Biological he Weapons Conference.

Diary Prequel Package, p.32 · original PDF · in context

Best regards, Tony September 17 - 20 , 2001 - I have been called to several top secret meetings over a 4 days period at the White House with the National Security Council (NSC) in a group chaired by Richard Falkenrath (see other notes) to discuss short and long range plans for how to handle a bioterrorism attack, particularly one of smallpox.

Diary Prequel Package, p.33 · original PDF · in context

People at the DHHS meetings include Stewart Simonson (Chief of Staff to Claude Allan), Scott Lillibridge, Claude Allan (deputy Secretary), Tom Month of Acambis company that is making smallpox vaccine, D.A.

Diary Prequel Package, p.33 · original PDF · in context

We discussed and provided 'White Papers" a) to justify our not agreeing to the renewal of the 1992 Bioweapons Convention because it is un enforcible and would also hinder our legitimate scientists workiing on biomedical research on these organisms. b) justification for not destroying the smallpox stores since we need them to do research to counter effects of a smallpox terrorism attack with diagnostics, vaccines, and therapy.c) Short and long range plans for countering an immediate or distant bioterrorism attack.

Diary Prequel Package, p.33 · original PDF · in context

I felt that particularly budget and to a lesser extent HR centralization would not work; 5) $300,000.00 salary ; 6) Continue to do editing with royalties (especially HPIM) and remain on Board of Trustees of the Doris Duke Charitable Foundation.

Diary Prequel Package, p.34 · original PDF · in context

Attending the meeting were: Robert Joseph (WH), Avis Bohlen (State), J,D, Crouch (DOD), Kenneth Juster (Commerce), Claude Allen (DHHS), Tony Fauci (NIH), Bill Steiger (DHHS), John La Montagne (NIH), Kevin Chilton (Joint Staff), Ken Baker (DOE), Alan Foley (CIA), Don Mohley (State), Michael Chertoff (Justice) September 24 - Oct.10 - Multiple meetings at White House and DHHS regarding response to Bioterrorism.

Diary Prequel Package, p.34 · original PDF · in context

I refused to comment; however, off the record I mentioned that the FBI was not in the room at that meeting and that I was trying to get Sec.

Diary Prequel Package, p.36 · original PDF · in context

I will prepare a vaccine report for anthrax similar to the one that I prepared for smallpox (see above).

Diary Prequel Package, p.36 · original PDF · in context

Issue was whether it was a good idea to put it out right after HRC's speech since it already got great PR and so why waste a Fauci Op-ED.

Diary Prequel Package, p.262 · original PDF · in context

Tommy also informed me that a few people in OMB were very pissed off at me because I testified at the 2 Senate Hearings (especially the Specter Appropriations Hearing) that we needed $200 million more in FY2002 for BT.

Diary Prequel Package, p.39 · original PDF · in context

At the time there was the beginning of a moratorium by President Reagan and later Bush on the use of fetal tissue for transplantation into humans.

Diary Prequel Package, p.40 · original PDF · in context

Dec. 16-19, 2001 - Much controversy and last minute scrambling in getting the consent form and the protocol out for the discretionary use of anthrax vaccine in exposed people who had been receiving antibiotics, but who are coming off their 60 day course.

Diary Prequel Package, p.41 · original PDF · in context

I had been working all day and into the night on Dec.16-19 revising the consent forms and helping people get straight why DHHS is offering the vaccine to people.

Diary Prequel Package, p.41 · original PDF · in context

I have exhaustively reviewed the data (with Cliff Lane as a great help) and come to the conclusion that vaccine + antibiotics is no better than antibiotics alone for post-exposure.

Diary Prequel Package, p.41 · original PDF · in context

John Eisold (the Navy physician who takes care of Capitol Hill people) is insisting that the Senate staffers also get the vaccine.

Diary Prequel Package, p.41 · original PDF · in context

Laura Petrou from Senator Daschle's staff on Dec. 19, 2001 enraged that we were taking so long in getting the vaccine to the staffers.

Diary Prequel Package, p.41 · original PDF · in context

Therefore, we are offering, but not recommending the vaccine for any of the 9000 people who were put on 60 antibiotic course.

Diary Prequel Package, p.41 · original PDF · in context

They completely miss the point that no one really is telling them that they should take the vaccine.

Diary Prequel Package, p.42 · original PDF · in context

In contrast, the staffers from Daschle's office have a high % of people who are taking the vaccine.

Diary Prequel Package, p.42 · original PDF · in context

It is tough for me to figure out just how much the Social Conservative/Sen.

Diary Prequel Package, p.44 · original PDF · in context

Mar. 27, 2002 - Went to NYC for Press Conference for the announcement of my receiving the Albany Medical Center Prize in Medicine, which is the largest prize in Medicine in America and the second largest in the world to the Nobel Prize.

Diary Prequel Package, p.45 · original PDF · in context

We have CIA intelligence that Iraq has smallpox and everyone in DHHS and the WH are scrambling to get together an immunization plan that will go well beyond what the ACIP is recommending (i.e. pre-emptively vaccinate only about 10,000 - 20,000 health workers and rely on ring vaccination in the event of an attack).

Diary Prequel Package, p.50 · original PDF · in context

TGT will present our plan to Cheney within a few days, which recommends a staged (1,2,3) process that vaccinates about 500,000 health workers from Oct. 02, to December 02 and then from Jan. 03 through the end of 03 vaccinate up to 10 million responders (phsyicians, nurses, police, firefighters, EM people, primary care personnel).

Diary Prequel Package, p.50 · original PDF · in context

After that and depending on the adverse event rate and the perception of threat, we will make vaccine available for the entire USA population on a voluntary basis.

Diary Prequel Package, p.50 · original PDF · in context

There will be very intense discussions over the next couple of weeks with the WH and DHHS that involve me regarding smallpox vaccine policy.

Diary Prequel Package, p.50 · original PDF · in context

The House and the Senate Committees have adapted the language that I had suggested to Richard Falkenrath.

Diary Prequel Package, p.51 · original PDF · in context

We are advancing towards the 3 stage policy that ultimately would allow voluntary vaccination for anyone who wants it.

Diary Prequel Package, p.53 · original PDF · in context

INCREDIBLE evening - Bono the lead singer of U-2 and the best selling musician in history had called my office yesterday (his chief-of-staff) to say that he wanted to talk to me by phone or preferably in person to discuss how we could partner and how he could help me in my work on trying to get AIDS treament and care and prevention to subSaharan Africa.

Diary Prequel Package, p.53 · original PDF · in context

Sept. 24, 2002 - Had CIA briefing and overall review of smallpox plan in Secr.

Diary Prequel Package, p.54 · original PDF · in context

We reviewed the pre-emptive plan for vaccination that will be presented to Pres.

Diary Prequel Package, p.54 · original PDF · in context

Carol was concerned that she was getting different signals from different people about varying toxicities among children versus adults, primary vaccinees versus re-vaccinees.

Diary Prequel Package, p.54 · original PDF · in context

My reference is Lane JM et al: Complications of smallpox vaccination, 1968.

Diary Prequel Package, p.55 · original PDF · in context

The rate of complications in the 2 groups were as follows: <1 - 9 y.o. 10 - 20+ y.o. per million Postvaccinial encephalitis 3 1 Vaccinia necrosum 0.4 4.0 Eczema vaccinatum 10 14 Generalized vaccinia 22 26 Accidental inoculation 26 10 Deaths 1 1.44 Therefore, one can conclude from this analysis that the younger group has a higher incidence of encephalitis, but the older group is similar, if not slightly worse off, when compared to the younger group with regard to the other complications of primary vaccination.

Diary Prequel Package, p.55 · original PDF · in context

HOWEVER, the critical issue as I see it is the major difference between previously unvaccinated and previously vaccinated individuals with regard to the frequency of vaccine-related complications.

Diary Prequel Package, p.55 · original PDF · in context

Routine vaccinations stopped in 1972 and most children would not have been vaccinated before age 5 and so 34 years old is the cut off point.

Diary Prequel Package, p.55 · original PDF · in context

There are several studies that indicate that previous immunization, even decades ago, provides real, but variable, degrees of protection against death (i.e. lower case fatality rates) compared to unimmunized individuals.

Diary Prequel Package, p.55 · original PDF · in context

It is my impression that the CIA information is really very soft.

Diary Prequel Package, p.57 · original PDF · in context

Of note, when we discussed briefly the policy for smallpox vaccination, it was clear that Libby is the driving force for mass vaccination sooner rather than later.

Diary Prequel Package, p.59 · original PDF · in context

The Pentagon will imminently announce that 250,000 to 500,000 troops will be vaccination with vaccinia (Dryvax).

Diary Prequel Package, p.60 · original PDF · in context

However, I feel that although we should make available the vaccine for the general public, given that the threat assessment is very soft, we should recommend that they not take the vaccine unless they feel very strongly that they do not want to take any chances.

Diary Prequel Package, p.60 · original PDF · in context

I have convinced them that we should not recommend to the general public that they take the vaccine give the non-quantifiable risk.

Diary Prequel Package, p.62 · original PDF · in context

Rather, we should say that as a group the vaccine should be offered to them, but since this is a heterogenous group, the actual recommendation to take it or not should rely on discussions between the CDC and the State and local public health officials in light of the particular needs and situation within a given jurisdiction.

Diary Prequel Package, p.62 · original PDF · in context

Clearly, the Stage 1 group (500,000 smallpox response teams) should have a recommendation to take the vaccine voluntarily. -ourt

Diary Prequel Package, p.62 · original PDF · in context

Nov. 26, 2002 - Briefing of Vice President Cheney at the White House regarding Project Bioshield (I made up the name) which is requesting his help in getting me special authorities for Countermeasure Advanced Development.

Diary Prequel Package, p.63 · original PDF · in context

Phone call with Jay Lefkowitz and Keith Hennessey and Doug Badger called wanting to know why we needed a vaccine trust fund as opposed to other mechanisms to guarantee purchase of vaccines.

Diary Prequel Package, p.63 · original PDF · in context

It will not be this week and so I will be able to go to Albany to give a talk associated with my Albany Prize from last Spring.

Diary Prequel Package, p.63 · original PDF · in context

At the same time there is a lot of buzz as to when the President is going to announce his vaccine policy.

Diary Prequel Package, p.64 · original PDF · in context

The vaccine policy roll-out is under very close hold at the WH.

Diary Prequel Package, p.64 · original PDF · in context

She knew nothing and immediately called Dan Bartlett (WH Press Office).

Diary Prequel Package, p.64 · original PDF · in context

I insisted that they emphatically emphasize that we do not recommend vaccine to the general public; however, we will make it available to those who feel they still want it even though it is not recommended.

Diary Prequel Package, p.64 · original PDF · in context

Big surprise was that we learned the President would get the vaccine himself since he felt that as Commander-in-Chief of the Armed Forces, he could not order the troops to do something that he himself would not do.

Diary Prequel Package, p.64 · original PDF · in context

Clearly, Scooter Libby and the VP are in favor of pushing for the Vaccine Trust Fund.

Diary Prequel Package, p.66 · original PDF · in context

The OMB had agreed several days ago to creating a "Permanent and Indefinite (first it was definite) appropriations authority to purchase vaccines for BioT for a total of $4.2 billion.

Diary Prequel Package, p.67 · original PDF · in context

I had to present to the group the background and. rational for the special authorities for the NLAID director as well as the Permanent and indefinite appropriations authorities to purchase countermeasures.

Diary Prequel Package, p.68 · original PDF · in context

Present were Admr Stephen Abbott, Tom Ridge, Tommy Thompson, Jim Capretta, Kristen Silverberg, Chris Cox and Ginger Poers (Special Assistants to the president for Leg Affairs), Sens Gregg, Congressmen Burr, Turner Cox, Tauzin, Sen Collins; Sally Stansfield, Stewart Simonson, Carol Kuntz.

Diary Prequel Package, p.72 · original PDF · in context

I have testified at >6 Congressional Hearings over the past few days on SARS, Appropriations, AIDS, Biodefense, etc.

Diary Prequel Package, p.75 · original PDF · in context

Went with Chris ( my father, Denise and Jack Scorce were also there) to Ellis Island to receive the Ellis Island Family Heritage Award.

Diary Prequel Package, p.75 · original PDF · in context

Other awardees were Jose Carreras (did not show), Hillary Clinton, Sen.

Diary Prequel Package, p.76 · original PDF · in context

May 14 - 20, 2003 - Continued doing Congressional briefings and Hearings on BioShield and SARS.

Diary Prequel Package, p.77 · original PDF · in context

May 31, 2003 - Extraordinary feature article on me in The Financial Times with full page picture and complimentary story.

Diary Prequel Package, p.77 · original PDF · in context

Constituencies still upset that NIAID will have to do advanced development and some procurement of rPA anthrax vaccine to the tune of about $250 million even though the Congress removed the $250 million from our budget that OMB put in to do this.

Diary Prequel Package, p.79 · original PDF · in context

Present at briefing were: Carol Kuntz, Stewart Simonson, Andrew Hallman (CIA), Heather Wingard (CIA), Dr.

Diary Prequel Package, p.79 · original PDF · in context

NIAID will be awarding 2 NBLs (BSL-4 labs) and 9 RBLs (BSL-3 labs) on Sept. 30.

Diary Prequel Package, p.82 · original PDF · in context

The contact was let to evaluate vaccine and antiviral candidates.

Reading Room Production, p.364 · original PDF · in context

Also, I was on conference call this afternoon with Secret Service, DHS, DHHS, FBI regarding a letter that contained ricin that was sent to Greenville, SC; however, now a letter addressed to the White House also containing ricin has been discovered.

Diary Prequel Package, p.84 · original PDF · in context

The discussions among the Secret Service, FBI, Department of Transportation, etc. is chaos.

Diary Prequel Package, p.84 · original PDF · in context

Nov. 28, 2003 - Significant Influenza A activity already with a variant strain (Fujian) that is not contained in current vaccine.

Diary Prequel Package, p.85 · original PDF · in context

Times that shows that high NIH officials including Steve Katz, John Gallin and others have made hundreds of thousands of dollars consulting for pharmaceutical and biotech companies.

Diary Prequel Package, p.88 · original PDF · in context

Vaccine has run out and people are panicking. 83 million doses distributed.

Diary Prequel Package, p.88 · original PDF · in context

These are just pockets of insurgents that rarely hit targets, the real targets are the convoys of troops accompanying cars (like ours) and isolated troops on patrol, as well as more recently, Iraqi police and officials who are trying to rebuild the country.

Diary Prequel Package, p.89 · original PDF · in context

I saw an Iraqi collaborator who was helping the Special Forces in the North and another Iraqi came up to him when no one was around and shot him in the back of the head.

Diary Prequel Package, p.89 · original PDF · in context

He knew me right away since his wife is a physician (Allergist/Immunologist) and always talks about me.

Diary Prequel Package, p.93 · original PDF · in context

Also, the NIH Ethics Advisory Committee (NEAC) is now reviewing all out side activity requests (as well as any already approved ongoing outside activities) for high ranking NIH officials such as IC Directors, Deputies, Scientific Directors, Clinical Directors, etc.

Diary Prequel Package, p.93 · original PDF · in context

Gary and I proposed the possibility of highlighting the HIV Vaccine Enterprise that Rick Klausner and I have been working on for the past year.

Diary Prequel Package, p.94 · original PDF · in context

We will work with Gates (Patty Stonesifer) to endorse this, but the Gates Foundation is going to want us to promise even more money for an AIDS vaccine.

Diary Prequel Package, p.95 · original PDF · in context

First regarding the issue of the HIV Vaccine Enterprise and whether we should make this an initiative for the POTUS to present at the upcoming G-8 Summit in Sea Island, GA.

Diary Prequel Package, p.95 · original PDF · in context

We discussed the PEPFAR and the issues associated with it; and the new G-8 proposal that I was working on with Gary Edson.

Diary Prequel Package, p.97 · original PDF · in context

May 4, 2004 - White House (West Wing) - Me with Gary Edson and Patti Stonecifer regarding the HIV Vaccine Enterprise and the upcoming G-8 meeting in Sea Island, GA.

Diary Prequel Package, p.99 · original PDF · in context

The USG will not promise an new money over and above the $500+ million that we already spend on HIV vaccine research (this is about 5/6 of the world's total of $640 million).

Diary Prequel Package, p.99 · original PDF · in context

The White House (Gary Edson et al) wants me there to answer press questions regarding the HIV Vaccine Enterprise Proposal that the President will make to the G-8.

Diary Prequel Package, p.99 · original PDF · in context

The other surrogates on the Team were: Elliott Abrams (Special Assist.

Diary Prequel Package, p.100 · original PDF · in context

Present at the briefing were Ken Bernard, Bob Kadlec, Larry Kerr, Kate Spitler (CIA) and some others.

Diary Prequel Package, p.101 · original PDF · in context

Purpose was to brief Fran on the experiments that were being proposed regarding genetically engineered monkeypox virus to duplicate what was shown in the mousepox model where inserting the IL-4 gene into mousepox made it lethal and elusive for both vaccine and therapy.

Diary Prequel Package, p.101 · original PDF · in context

It was a very friendly hearing and very complimentary to me and the others.

Diary Prequel Package, p.105 · original PDF · in context

I favor Option #3 which is to conduct the research on IL-4-altered monkeypox in monkeys and do it as classified research.

Diary Prequel Package, p.106 · original PDF · in context

We would keep the design, details and results classified since if we found out that it did work in monkeys , but did not yet have a countermeasure for it, then we would expose our vulnerabilities.

Diary Prequel Package, p.106 · original PDF · in context

Oct. 4, 2004 - Meeting in the Situation Room of the White House to brief Ken Rapuano (Deputy to Fran Townsend) on the IL-4 - monkeypox experiment that is being proposed as a classified experiment to be performed by DHS.

Diary Prequel Package, p.107 · original PDF · in context

We heard about this abruptly this AM as we (Julie gerberding and I) were getting ready to testify at House Hearing on Thimerasol in Influenza vaccines.

Diary Prequel Package, p.107 · original PDF · in context

We further discussed other issues about how we can get more vaccine from AVP or from Canada or from anyone else.

Diary Prequel Package, p.108 · original PDF · in context

President Bush in turn is claiming that liability issues are the cause of Pharma not getting into the vaccine business and that Kerry supports trial lawyers who are the problem (VP candidate Edwards is a liability lawyer).

Diary Prequel Package, p.109 · original PDF · in context

Major points are what we have been discussing for the past few weeks about providing incentives for PHARMA to get involved and stay in flu vaccine field.

Diary Prequel Package, p.109 · original PDF · in context

We (DHHS team) are proposing back end guaranteed purchases for overflow doses; liability protection, tax breaks, research to develop cell culture based and recombinant DNA approaches to replace egg-based approaches; advanced purchase and stockpiling of vaccine for children.

Diary Prequel Package, p.109 · original PDF · in context

We're improving the safety of the food we eat and import. * We're developing the new medicines and vaccines to protect our citizens from disease or bioterrorism. * Our children are healthier than ever, with health coverage and immunization rates at record highs and childhood drug usage going down. * We turned America's attention to disease prevention, motivating Americans to eat better and exercise more in order to improve their health and quality of life. * And we're waging a bold new global fight against HIV/AIDS, committing an unprecedented $15 billion toward eradicating this scourge.

Diary Prequel Package, p.110 · original PDF · in context

I qually puts out ht found out that years ago the OGE ruled and the DoJ confirmed that royalties collected by government employees on patents owned by the government on which the employee is an inventor cannot be considered as a financial interest and so cannot be a conflict.

Diary Prequel Package, p.113 · original PDF · in context

First vacation that I have had unassociated with a lecture or other business in 20 years since our honeymoon.

Diary Prequel Package, p.113 · original PDF · in context

Nonetheless, the press has jumped on this and I have been on CNN a few times, Jim Lehrer Newshour, Lou Dobbs (CNN) and CSPAN for a Congressional Hearing on Flu (Energy and Commerce with Chairman Deal).

Diary Prequel Package, p.117 · original PDF · in context

We are trying to reconcile the budget projects for FY 05 and 06 and 07 with the purchase needs for stockpiles of H5N1 vaccine and tamiflu.

Diary Prequel Package, p.117 · original PDF · in context

We already have 2 million doses of vaccine in bulk and we plan to buy 20 million more vaccine doses.

Diary Prequel Package, p.117 · original PDF · in context