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 solicit letters of intent from governments and non-governmental organizations (NGOs), especially faith-based groups, that describe plans to implement one of more of our core models in local areas. ?

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

Financial incentives are needed to develop new medications.

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

Much like a university endowment, the fund would have a two-tiered financial structure.

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

Others might want help with such programs plus training for physicians, lab workers, nurses, community health volunteers, and pharmacists.

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

April 11, 2001 - Attached below is what is to be the final document: Draft Privileged and Confidential For Official Use Only Infectious diseases, including HIV/AIDS, malaria, and tuberculosis, are ravaging developing nations, causing 25 percent of all deaths worldwide and eroding recent gains in economic growth, education, and life expectancy.

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

We will give preference to comprehensive plans that involve governments and civil society working together. • We will link our efforts in health to expanded programs in the areas of education and nutrition in an international parallel to the Administration's campaign to "Leave No Child Behind." • 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.11 · original PDF · in context

Financial incentives are needed to develop new medications.

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

Much like a university endowment, the fund would have a two-tiered financial structure.

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

Others might want help with such programs plus training for physicians, lab workers, nurses, community health volunteers, and pharmacists.

Diary Prequel Package, p.11 · 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

What really, truely, is the statistically valid efficacy of HAART? - In terms of the pentultimate concern that I believe (I hope) is the bottom line for all sides --- SAVING LIVES --- what would be the impact of a massive spending commitment aimed at: - cleaning up the blood supply (less than 10% of which globally, according to WHO, is currently screened for Hep B, C and HIV) - global large scale distribution of autodestruct nonreuseable syringes and MANDATORY coupling of all injectable drug and vaccine products with such syringes.

Diary Prequel Package, p.18 · 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

How in the world can ANY humanitarian, medical or UN agency POSSIBLY justify distributing vaccines in countries with greater than 5% HIV rates without attaching enough autodestruct syringes to ensure that EVERY SINGLE CHILD receives a sterile injection?

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

Many believe it has little to do with prevention programs or drug access, and everything to do with male/female power balance issues and female access to the cash economy.) Jon Mann for ages had a mantra: if a prevention effort works, why? and why isn't it immediately replicated elsewhere? - Why were all the questions raised in opposition to phase 3 vaccine trials not raised for largescale HAART?

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

Remember when NIAID decided to can Phase 3 vaccine studies?

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

We were shown around by Laura Guay and Phillip Musoke Mudido, a Ugandan physician.

Diary Prequel Package, p.23 · original PDF · in context

Like Nelson Sewankambo, Peter is clearly an important physician in Uganda and the JCRC does much clinical research on HIV/AIDS.

Diary Prequel Package, p.23 · original PDF · in context

Most Staff (PH.Ds, MDs, MPHs and even technicians have spent some time learning techniques and theory in the USA.

Diary Prequel Package, p.23 · original PDF · in context

The site was inspiring, particularly the dedication of the staff who were mostly young Ugandan MDs, PH.Ds, technicians, nurses, etc.

Diary Prequel Package, p.23 · original PDF · in context

I was told that among their other diseases such as HIV and TB, the majority of the people in the wards, especially the children, had malaria.

Diary Prequel Package, p.23 · 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.

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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.

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May 18, 2001 -- Had important meeting with Adel Mahmoud in my Conference room regarding future collaborations with Merck on an HIV Vaccine.

Diary Prequel Package, p.29 · 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

We crafted something that was a "high road" approach indicating that since we cannot enforce restrictions among committed users and abusers, then at least we can support biomedical research to provide better diagnostics, therapeutics and vaccines.

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

This was in association with Time Magazine naming me one of 18 scientists as "America's Best in Science and Medicine".

Diary Prequel Package, p.32 · 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

As you probably know from the News, the FBI now knows that there are several cells of terrorists still in the USA with plans to execute terrorist attacks, and Washington, D.C. is the prime target.

Diary Prequel Package, p.33 · 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

Ridge the truth or he is masking the truth.

Diary Prequel Package, p.35 · original PDF · in context

Someone at that meeting leaked this to the NY Times and Sheryl Stolberg called me and heard that I had "angrily confronted the FBI for withholding information".

Diary Prequel Package, p.36 · 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

For some reason, the CIA and the FBI are not making public (probably for forensic reasons in tracking the perpetrators) the true nature of the threat.

Diary Prequel Package, p.37 · original PDF · in context

If the person has large amounts, he would have to have special facilities or would have to have gotten it from a rogue state or covertly from USA .

Diary Prequel Package, p.37 · 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

In any event, Gayle assured me that the Op-Ed was not "off message" in the substance of its content.

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

Also at the table was CIA Director George Tenet and Sen.

Diary Prequel Package, p.38 · 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.15, 2001 - Sat. meeting at NAS regarding recommendations of giving anthrax vaccine to people who were exposed to anthrax and who are just finishing their 60 course of antibiotics.

Diary Prequel Package, p.41 · 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

It is true that there is a "theoretical" reason to make the vaccine available in that animal studies show persistence of spores weeks after antibiotics and there is a fear that after antibiotics are discontinued the disease will occur.

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

However, Eisold and the Senate Staffers are demanding that they get the anthrax 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

Henderson and Tommy Thompson had told Daschle that the vaccine would be available 2 days ago.

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

I have insisted that if I am going to help we must not "recommend" the vaccine since the data in animals show that it is not better than antibiotics alone.

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

She states that the White House says that the reason is the objection to the 2 jobs, while the social conservatives say that my views on abortion and stem cells make me unacceptable to them.

Diary Prequel Package, p.44 · 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

Also, in same issue of NEJM was my editorial calling for an open dialogue as to whether there should be pre-emptive vaccination of "first responders" or even of the enitre population on a voluntary basis.

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

Have been working very hard with Terrell Halaska and Mark Dybul in getting the Pres. speech written and his talking points arranged for the announcement.

Diary Prequel Package, p.47 · original PDF · in context

Josh asked whether we should do a Manhattan Project for a vaccine and not invest in international prevention and treatment.

Diary Prequel Package, p.47 · 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

Cheney is pushing for a much wider vaccine plan.

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

Our plan for "staged" smallpox vaccination of immediate first responders to broad first responders to voluntary vaccination of general public is ready to go.

Diary Prequel Package, p.52 · 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

The differences are even more impressive in the Table from the 2001 MMWR (attachment #3) 2) Since the differences are so striking between previously unvaccinated and previously vaccinated individuals with regard to the incidence of serious adverse events associated with smallpox vaccination, I calculated the percent of people in the work force that we could predict would be previously vaccinated or not.

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

Oct. 4, 2002 - Engaged with Julie Gerberding, Jerry Hauer, Kevin Keane in a briefing of State and local Public Health officials on the likely roll out plan of smallpox vaccination in3 stages (500,000 smallpox response teams and emergency personnel, then 10,000,000 health care workers, primary care people, police and fireman, etc. followed by making vaccine available to general public after the Acambis product is licensed in early 2004.

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

I mentioned that we should have a fund to purchase vaccines and drugs so that the pharmaceutical industry would have an incentive to get involved.

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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

This is different from the situation with the anthrax vaccine where the DHHS said that had no recommendation either way; they just made the vaccine available if people wanted it.

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I am relieved that we decided to wait since I would have had to cancel my going to Los Angeles to receive the RAND Prize ($10,000.00) in order to remain in DC for the Press.

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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

The VP wants to come to NIH and have me show him around the Vaccine Research Center (VRC) in the context of the "Advanced Project Development" of Project Bioshield.

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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

George pointed out that the President gave an interview with Barbara Walters to view on Dec. 13 in which he said that he would allow vaccination of the entire population on a voluntary basis.

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

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

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