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control.
Despite reports that the number of cases in Liberia are decreasing rapidly, new reports
today indicate that the cases in Sierra Leone are sharply increasing. I have warned that
Ebola comes in waves and that we should not be complacent and the WH should refrain
from saying that things are “turning around”.
Nov. 3, 2014 – Ron Klain visited NIH today (He had visited CDC last week). He
wanted to familiarize himself with what the various components of government were
doing in Ebola. I made a presentation to him in the VRC, showed him the lab where
Nancy Sullivan works and where she developed the ChAd3 Ebola vaccine. Then we
took him over to the Clinical Center to see Julie Ledgerwood’s vaccine clinic where the
phase 1 trial took place. Then we showed him the SCSU and the room where we took
care of Ron was impressed and wants me to come to the WH on Friday to
give a shortened version of my presentation at a meeting where the POTUS is hosting
certain Congressional leaders.
Tom Frieden spontaneously called me up to thank me for being so supportive of him. I
have been continually serving as a late night (by phone or e-mail) sounding board for him
in his attempts to negotiate his having to deal with some many factions (ASPR, HHS,
USAID, etc.) Last night I helped him out by strongly suggesting that he not listen to the
modelers who tell him “exactly” how many news cases of Ebola to expect in the USA
over a period of time. I warned him that the models are based on assumptions and
multiple variables and can be very misleading and he should not “own” data that comes
Released by Chairman Rand Paul
409from models or else it will come back to bite him. I urged him to totally resist such
predictions. He was very grateful for my advice.
Nov. 4, 2014 – GOP takes control of the Senate in today’s elections. Frenzy calming
down. Little press interest – like shutting off the faucet.
Nov. 5, 2014 – Preparing for Hearings of the Senate Full Appropriations Committee
(Mikulski). Tom Frieden and I will testify together with Sylvia Burwell. POTUS
publicly requests $6.18 Billion in “emergency” funds for Ebola. We will dwefend this at
Hearing on Nov. 12.
Nov. 6, 2014 – Still calm. No Ebola Press. Did Hearing prep by teleconference with
Sylvia.
Nov. 7-11, 2014 – Still calm. Mostly preparing for Senate Appropriations Hearing on
Nov. 12. POTUS asking for $6.18 Billion in emergency funding for Ebola (Domestic
and International). NIH portion is $238 million. Went to EEOB on Nov. 10 to rehearse
for Hearing with Ron Klain.
Nov. 11 – very good meeting in Building 10, 4th Floor Medical Board Room with clinical
investigators who took care of Ebola patients at Emory, Nebraska, NIH. Also, DoD and
HHS present with presentation of individual clinical data from the USA patients. It
became clear to me that it is impossible to determine if any of the experimental drugs
given to the patients (ZMapp, Brincidofovir, favipiravir, convalescent sera, TKM-Ebola)
helped or did harm (likely did some harm. Decision was to develop a clinical protocol
for future USA patients and also to be used as prototype for Africa. Protocol should be
RCt with standard medical care (fluid and electrolyte replacement) as the control arm.
The data also suggested to me that if you keep patients alive with medical care, that the
body’s immune system will almost always clear the virus (likely without experimental
drugs).
Nov. 12, 2014 – Successful Hearing today before the Full Senate Appropriations
Committee chaired by Barbara Mikulski with Richard Shelby as Ranking Minority.
Sylvia Burwell, Jeh Johnson (DHS), Michael Lumpkin (DoD), Heather Higginbottom
(DoS) testified and then accompanying witnesses went to the Table. Tom Frieden and I
were the “accompanying” witnesses for Sylvia. All went well. About 18-20 Senators
appeared. Tom Harkin made a statement that this was his last official Hearing and he
wanted to specifically call me out as a great public servant with whom he has worked on
this committee for 30 years. This elicited a round of applause from the audience.
Patrick Leahy also remarked that he has been working with me “forever”. All-in-all, a
very good Hearing.
Nov. 13, 2014 – Difficult situation arising regarding the conduct of the Phase 2/3 trials of
Ebola vaccine in Liberia/Sierra Leone. The companies (first GSK; now also J & J, who
do not even have a candidate ready) are balking at going ahead with the trials unless they
get “global indemnification”. This is unprecedented to demand for a Phase 2/3 trial
Released by Chairman Rand Paul
410since we (NIH) are the sponsors and we are liable. Nonetheless, GSK feels that although
the PREP act would protect us and indirectly them, they feel that in international courts
GSK (even though they are not the sponsors of the trial) could be sued given the sensitive
nature of the situation (African countries, instability in the countries, brand new vaccine
platform for them –Cad3 vector -, accelerated development with questions regarding lot
consistency (because of the fast pace of development). This would be terrible if the trials
are stalled because of this. I have phone call today with Moncef Slaoui, Chairmen of
GSK for Global Vaccines.
Also, despite our conclusions from meeting on Nov. 11 (see above) the Oxford/Wellcome
Trust people are working with MSF to start “open label” trials with various therapeutics
without a control arm. What the hell is going on here? I am very disappointed in the
Brits, especially the Wellcome Trust and Oxford people who clearly are grandstanding.
Call with Moncef Slaoui went well. Reasonable discussion. I stated that the USG could
never give “global indemnification” since it would invite frivolous lawsuits. Moncef felt
the same about our providing insurance for them since it would also invite lawsuits. We
agreed upon some form of a process that provides for limited liability and cpas on
settlements. I will follow-up with summary e-mail to Moncef with copy to Ron Klain
with who I spoke tonight and relayed to him the conversation with Moncef. Ron is
flexible, but said that we cannot “guarantee” anything to Moncef, but we will proceed in
good faith to find a solution.
Nov. 15, 2014 – Sierra Leone surgeon, resident of Maryland, green
card resident, married to US Citizen hospitalized at University of Nebraska having gotten
infected in Sierra Leone. He is critically ill and may not survive. He entered Nebraska
Hospital with Creatinine of 16, pH of 7.1 and K+ of 2.0. NIH is thus up next for a
patient.
Nov. 17, 2014 – dies at Nebraska Medical Center.
Nov. 19, 2014 - Today I testified before a Congressional Hearing of the House
Committee on Commerce and Energy, Health Subcommittee chaired by Congressman
Pitts from Pennsylvania with Dr. Burgess of Texas as the vice chair, and Mr. Henry
Waxman of California as the ranking member. It was a lively hearing that went very well
but with some interesting sharp interchanges between me and Dr. Cassidy from
Louisiana. He is a physician who tried to show off about his medical knowledge in the
hearing; however, during the exchange it became clear that he really did not know what
he was talking about. In addition, Congressman Tim Murphy somewhat attacked me
saying that I have been condescending to people who question the issue of conmtrolled
trials with placebo limb, transmission, patient isolation and quarantine. I did not have the
opportunity to refute him; however, after he had left when Mr. Burgess who took over the
chair of the committee when Mr. Pitts left gave us the opportunity of a summary
statement, I question Mr. Murphy's characterization of me as being condescending and
clearly stated that our most important goal with interventions is to first do no harm and
then hopefully benefit people and although many individuals feel that this is insensitive,
Released by Chairman Rand Paul
411in fact it is not insensitive, but is the time-honored way of determining the safety and
efficacy of interventions. In addition, after she had left I countered the somewhat snide
remark of Mrs. Blackburn who had also made a statement without giving me the
opportunity to respond. She said that we were negligent in not getting countermeasures
done quickly and that industry can do better than we can. I stated after she left that we
have been trying to get partnerships with industry for over 10 years in the development of
Ebola vaccines and that only recently were pharmaceutical companies willing to partner
with us.
All in all it was a very positive Hearing.
Nov. 20, 2014 – Did Newsmaker Luncheon talk at the National Press Club on Ebola.
Got much play in the printed press. Things still calm regarding Ebola with attention
switching from the threat in the USA to background issues like the $6.18 billion request
from the POTUS (see above Senate Hearing). Also, some increasing noise from
Congressman Tim Murphy (R-PA) regarding his pushing for the leaders of the 3 Ebola
hospitals (NIH, Emory, Nebraska) to quarantine for 21 days their staff that took care of
Ebola patients and not allow them to see other patient for 21 days. We are all adamantly
against this and I have been the vocal one saying that we must stick with the science and
the CDC recommendation of stratification of risks to HCWs balanced by the stratification
of monitoring and restrictions. Murphy is not happy with me.
Had dinner with Danny Hultzen and his father Chris. Discussed the situation with his
shoulder injury. He feels good and looks great. I have a strong feeling that if his
shoulder holds out, he will make it to the MLB with the Seattle Mariners.
Nov. 25, 2014 – Did Webcast for Harvard School of Public Health on Ebola. Panel
discussion with Barry Bloom and others.
NEJM paper to come out of Thursday (Thanksgiving) reporting on the results of the
phase 1 trial of the NIAID/GSK Ebola vaccine (Ledgerwood et al). Embargoed until
Wednesday (Nov 26) at 5:00 PM. And so press starting to get excited about it.
Thus, did CBS Evening News tape for Friday PM? Also, Medscape Interview. And
plenty of embargoed print interviews. As expected, the Brits (Wellcome Trust, Adrian
Hill from Oxford) are downplaying the study saying the required dose is too high and the
durability is low without a booster. They are amazing.
Nov. 26, 2014 – Much press associated with the NEJM paper. Did AP TV, BBC TV,
Cox TV, Bloomberg print, Reuters print, BBC radio and then later at night BBC TV
again.
POTUS comes out with White House statement congratulating “Francis Collins and Tony
Fauci and their teams….” On the successful phase 1 trial of an Ebola vaccine and
announces that he will visit NIH on Dec. 2 to congratulate the NIH teams and to
emphasize the need for the requested $6.18 billion supplemental for Ebola.
Released by Chairman Rand Paul
412Nov. 27, 2014 (Thanksgiving) – Again, still interest in the NEJM paper. Did BBC TV
via phone plus my photo, CNN International via phone plus my photo. Also did
NewsHour with Judy Woodruff. WETA picked me up with an Uber car and promised to
take me to the studio in Arlington, do interview, and get me back in time for
Thanksgiving visit and dinner at 4:00 PM at Joanne and Jim’s house. They did it on
time.
Nov. 30, 2014 – Did CNN International discussing Ebola vaccine
Dec. 1, 2014 – World AIDS Day. Went to White House and gave main lecture at the
WAD ceremonies in the South Court Auditorium. My talk went over so well that they
started clapping at the final sequence of slides of the maps of USA and the world
becoming free of AIDS even before my talk ended. Also speaking were Susan Rice,
Secretary of State John Kerry (shouted out to me), Secretary Burwell (many shout outs to
me), Gayle Smith (also praised me), Bishop Yvette Flunder (gave moving
sermon/speech). Then panel with Debbie Birx, Mark Dybul, Greg Millett, Helene Gayle
– chaired by Sylvia Burwell.
Came back to NIH to do walk-through for the POTUS visit to NIH tomorrow.
Did CNN International and NPR Morning Edition radio with Scott Horsley.
Dec. 2, 2014 - Today was most extraordinary day. Began with a presentation that I made
together with Debbie Birx (PEPFAR) at the Russell Senate office building. We made a
dual presentation in celebration of world AIDS Day to a group of Senate and House
staffers. It went over very well. I rushed back to the NIH in time to do an interview with
Andrea Mitchell on MSNBC about the successful phase 1 Ebola vaccine trial conducted
here at NIH that was recently published in the New England Journal of Medicine. When I
got back to NIH we began the preparation for the 4:00 PM visit by Pres. Obama. It was
an extremely successful visit. I led him on a tool of the Vaccine Research Center, gave
him a brief introduction of the history of the center, telling him the story about my
conversation with Pres. Clinton in December of 1996 when Clinton promised me that he
would have a vaccine center built for us on the NIH campus. Nancy Sullivan presented to
him on the 2nd Floor of the VRC her work on the development of an Ebola vaccine. We
then took him to the 5th floor where Mario Roederer showed him the intricacies of the
FACS machine. The President was very relaxed, warm, and highly complementary of me
and the NIH. Following the tour of the VRC, I rode with the president in the presidential
limousine from the VR across campus to Building 10 where he addressed an overflow
crowd of the entire NIH community in Masur auditorium. He thanked me specifically
several times during the talk and he thanked various components of the NIH community
for their work on Ebola and other important diseases. He specifically gave a shout out to
the VRC people, the people who conducted the phase 1 trial, and to the nurses and staff
who took care of in October. During his talk to the NIH community, the
president gave me many compliments and shout outs. In particular he joked about how
had told me how to use FaceTime. In addition, he joked that "Tony and I were
findly reminiscing about SARS and H1N1". He then said after a big laugh "that's what
Released by Chairman Rand Paul
413these guys do for fun". The President mentioned my name multiple times during the talk.
It was a great day for NIH.
Following the visit, I rushed downtown to the Mellon Auditorium on 13th St. and
Constitution Avenue to participate in the dinner given by the Friends of the Global Fight,
chaired by Mike Gerson (Washington Post). On the panel with me were Mark Dybul and
Deborah Birx. I ran into many people who I know and like at the dinner. These include
Peter Staley who I am very fond of from our many experiences over the years in the
activist days. Peter looked bright and alert but rather thin and drawn likely due to his
many years of being on antiretroviral therapy. They showed a short clip of his icon
speech at the International AID Meeting in San Francisco in 1990 when he said that
someday people will speak of the deadly plague and how some stood up to confront it. I
cry every time I hear that speech. In 1990, I gave a speech at the meeting right after
Peter. Former Sen. Chris Dodd gave me several shout outs about the work that I have
done over decades, calling me a national hero. Nancy Pelosi gave a talk in which he
mentioned several times our extraordinary relationship over the years in fighting HIV
AIDS. All this praise was quite moving and gave me an added perspective about the
many years (decades) that I have been involved in this struggle. All in all it was a great
evening. The following day the story with my picture (with the POTUS, Nancy
Sullivan, and Sylvia Burwell) were in the Washington Post and New York Times as well
as on the Evening News programs.
Dec. 3, 2014 – At his request, went to the Rayburn Office Building office of Chairman
Timothy Murphy (R-PA). Murphy was upset with me at a recent Hearing (see above)
when he said that I was making condescending statements about quarantine and why we
should not have quarantines. He invited me down to his office to discuss further at a
10:00 AM meeting. With him was Committee Staffer Alan Slobodin (of past outside
activity investigation fame) and Murphy’s Chief of Staff Susan Mosychuk and his
legislative Director Brad Grantz. Murphy had also been giving Tom Frieden grief about
the same issue. Meeting actually went well – cordial, respectful. The underlying theme
was still the need in his mind for quarantining of all West African entrants to USA or
better restrict travel of West Africans (3 countires0 to USA and provide an “air bridge” to
bring in USA HCWs. Also, he was concerned that with the latest proposal for 32
additional Ebola-ready hospitals in the USA that we should quarantine the USA HCWs
after seeing Ebola patients. He was OK with just direct, active monitoring of the NIH,
Emory and Nebraska HCWs, but he felt that since the other 32 hospitals were less trained
and so would likely have a greater chance of getting infected, then they should be
quarantined since (as a former Clinical Psychologist) he feels that people deny sxs and so
he does not trust them. He is against the part of the $6.18 billion supplemental request
for Ebola on the grounds that we do not needs all the additional hospitals (I actually do
not entirely disagree with him as I have expressed to our own people). The meeting
ended cordially.
Dec. 4, 2014 – Gave Ebola talk at the new FDA facility in White Oak. Quite a place!
Huge! They loved the talk. Also, new infectious diseases issue. The H3N2
component of the 2014-2015 influenza vaccine is mismatched to the early circulating
Released by Chairman Rand Paul
414strain of H3N2, which is predominant over H1N1 and B, the latter of which match the
vaccines. The match for H3N2 is only 48%. I was on WTOP explaining this. Could
be a bad influenza winter.
December 5, 2014 - I participated with Ron Klain at a Georgetown University event
chaired by Pres. Jack DiGoia in Gaston Hall at the Healey Building. We discussed
various aspects of the Ebola outbreak. I have grown to become truly fond and respectful
of Ron Klain since he assumed the position as the Ebola Response Coordinator for the
USG. He will be leaving the USG employment and will return to his position as CEO of
Case Holdings and General Counsel for Revolution, L.C.
Also did some press with the London Times print and Bloomberg TV today.
Had a call with Jack Whitescarver. I am concerned with him since he does not appear
well. His hematocrit is low and he is short of breath. I believe he is having a slow
gastrointestinal bleed and is likely experiencing mild to moderate congestive heart
failure.
December 6, 2014 - I participated at the PRIM&R conference in Baltimore where I gave
the keynote address on ethical considerations in HIV/AIDS. This was on a Saturday
morning. Christine is a major player in this organization and spent the weekend there. I
drove to Baltimore on Friday night and had dinner with Chris at the Baltimore Hilton
Hotel Bar (lots of fun) and stayed with her in her hotel room that night. The following
morning (Sat. Dec. 6) gave my talk to an audience of around 2500 people and got a
standing ovation.
Drove back to DC and had dinner with Alec Whyte at Matisse restaurant. Caught up on
stuff. Always great to see Alec
December 8, 2014 - I am getting particularly concerned with what I feel is noncollegial
behavior on the part of the UK, particularly Dame Sally Davies (Chief Health Officer of
UK) as well as the Oxford group personified by Adrian Hill and Jeremy Ferrar who are
bad mouthing our randomized controlled trial idea behind our backs. However, this is the
stuff that we deal with all the time.
I am also getting concerned that the incidence of infection of Ebola in Liberia is so low
that this may have an issue with our conduct of the randomized controlled trial in Liberia.
Cliff will leave Dec. 10 for Liberia for the third time in 5 weeks. We have to consider the
possibility of doing a trial also in Sierra Leone.
Had contentious IC Director meeting concerning the issue of presenting reports (that I
believe are flawed) to the Advisory Committee to the Director (ACD) on the Intramural
research Program (IRP) and the AIDS Portfolio. Issue is that some outside group (ACD)
want to homogenize the IRP to make it “trans-NIH” as opposed to being directed to the
mandate of the IC in question. I am totally against this since this flies in the face of the
NIAID mandate of being a “strike force” for emerging IDs such as AIDS, SARS, and
Released by Chairman Rand Paul
416Susan Rice, Denis McDonough, Ron Klain, Sylvia Burwell, Chairman, Joint Chiefs
Martin Dempsey, Tom Frieden by teleconference from Atlanta, Samantha Powers by
teleconference from NYC – UN, Assistant Secretary Heather Higginbottom from State,
Nancy Lindborg from USAID, Raj Shah – USAID. Ron Klain asked me to review for
the POTUS the status of the vaccine plans as well as to explain the situation with the
VSV adverse event of arthritis (see above). POTUS asked a few other questions of me.
He referred a few times to his trip to NIH. Good meeting
Did WTOP today
December 12 – 14, 2014 – Cliff Lane has now gone to Liberia for the fourth time in
order to set the stage for the upcoming randomized, placebo controlled, double-blind,
clinical trial for the GSK/NIAID and the VSV vaccines. We are still getting nefarious
comments and undermining of our efforts by the people from the UK, particularly Jeremy
Farrar and Adrian Hill among others. They continue to inappropriately talk about the
inadequacy of our vaccine efforts even though they are working with the same vaccine. It
is unbelievable to me how nefarious they can be when the main goal should be to develop
a vaccine to save the lives of so many unfortunate people in the West African countries.
Nonetheless we will forge on and hopefully prove the safety and efficacy of this vaccine.
December 15, 2014 - traveled to George Washington University to give a lecture for
Bopper Deyton’s course given at the Marvin Center at GW. It was an inspiring crowd of
first-year medical students who were very excited to hear from me about the history of
HIV and my involvement in it. That afternoon I participated by teleconference in an
Ebola meeting that took place at the IOM sponsored dually by the IOM and the
Rockefeller Foundation. The meeting was chaired by Secretary-General of the WHO, Dr.
Margaret Chan. Many players were there in person or by phone including Paul Farmer
from Liberia, as well as several Liberian and Sierra Leoneon and Guinean health
officials. I presented the efforts in the development of vaccines and therapeutics
December 16, 2014. Participated in a panel discussion on Ebola vaccines and
therapeutics at the Center for Strategic and International Studies (CSIS) at 1616 Rhode
Island Ave. NW. The panel was chaired by Steve Morrison. Other panelists included
Julie Gerberding of Moncef Slaoui of GSK, Johan Von Hoof (Janssen and J & J), and
Rohit Malpani (MSF). Good discussion about response to the epidemic.
December 17, 2014 - Feature article about me including a picture on the Federal Page
of the Washington Post. I gave credit in the article to many of the people involved in
Ebola effort. It is noteworthy that although I saved Tom Friedman's job by convincing
Sylvia Burwell not to fire him during the missteps by the CDC, Time magazine included
Tom Friedman as one of the Persons of the Year in their “Ebola Fighters” issue. They did
not even mention my name once. Years ago – Time did the same thing with making
David Ho “Man of the Year” and now this. Such is life…
December 19, 2014 – The puzzle of why Adrian Hill (and Jeremy Farrar) have been bad-
mouthing the NIH/GSK approach of a high dose prime without the necessity of a boost.
Released by Chairman Rand Paul
418early years (1981-1984) when he was Director. He was gay, but closeted. KLarry
Kramer outted him and said that his closet status prevented him from asking for more
AIDS money. I succeeded Richard and immediately asked for more money.
Jan 8, 2015 – Did a 1 hour interview of a prolife on me by Brian Lamb to show in 2
weeks on C-SPAN.
Jan. 15, 2015 – Number of cases very low in Liberia. Surge in cases in Sierra leone
starting to come down. Liberian vaccine trial getting ready to start at end of January,
beginning of February. Cliff Lane in Liberia now. I will go within a few weeks (likely
early February).
Received award today at the Willard Hotel of 2014 Washingtonian of the Year from
Washingtonian magazine. Seven other winners including Gerry Sigal and Arch
Campbell.
To White House tomorrow to update the “Deputies” on the upcoming vaccine trials in
West Africa.
Over past week terrible tragedy of terrorism in Paris with Jihadists murdering 12 people
at the Charlie Hebdo satirical magazine offices. Today another thwarted terrorist attempt
in Belgium. Europe on high alert.
Jan. 16, 2016 - White House (EEOB – 374) meeting with Deputies chaired by Ron
Klain. Subject matter was vaccine trials and if there is any change in approach now that
infections are so low, particularly in Liberia. Also discussed indemnification, liability
and compensation for trials. Also discussed the need (or not) for 46 hospitals to be
“ready” to receive Ebola patients (see above). I have always been against this since, in
my mind, most of the hospitals that have volunteered to be “Ebola treatment Units” in the
USA are really after the government funds that go with it. The Deputies group was
discussing reluctance to tell other hospitals that 46 is enough and we will not support any
more. I made myself clear that we should just stop recruiting hospitals that we do not
need and that could likely not be able to handle an Ebola patient if they had to.
Also, met in the AM with Delegation from India (“Vijay) to discuss NIAID – India
collaborations, particularly the Vaccine Action program (VAP), which has been onging
for many years. and importantly, a delegation from Liberia and Sierra Leone. The
deputy Minister of Sierra Leone (SL) is Dr. Madina Rahman. She definitely “gets it”
about the advantage of a RCT and wants to have us conduct such a trial in SL. This is
key, since SL is where all the infections are right now with very few in Liberia. I will
hook her up with Cliff Lane who is on his way back to USA from Liberia.
Jan. 17, 2015 – Writer and photographer from Financial Times (of London) came to my
home today (Saturday) to do story on personal aspects of me.
Jan. 20, 2015 – Visit to NIH of Chairman Tom Cole (R-OK) of the Appriopriations
Subcommittee. Accompanied by Rosa DeLauro, Nita Lowy, Andy Harris , Dent,
Womack. I presented work on universal flu vaccine, Ebola, Antimicrobila resistance.
Released by Chairman Rand Paul
420Jan. 29, 2015 – Here comes a sticky issue. The CDC (Anne Schuchat) give press
conference updating on measles situation. Today I got several requests to go on TV with
CNN (Anderson Cooper), Bloomberg, other networks such as CBS Morning Show. Sara
Baldauf at HHS tells Patty and Courtney to hold on all TV appearances since “CDC has
the lead”. Yet, I have been on multiple shows over the past couple of weeks on measles.
This idiot Sara is stuck on the Obama Administration theme that you can only have one
message and one Federal official talking about anything. She does not understand that
the press want me.
Jan. 30, 2015 – Happens again. Martha Raddatz wants me for ABC This Week on
Sunday and other Sunday shows. She says no. Courtney calls up and asks for an
explanation. Sara says CDC has lead. As usual, Courtney says but the Shows are
asking specifically for Tony and there was an agreement between Francis Collins and Bill
Corr that when networks and cable ask for me they can get me. Sara says she does not
know anything about this agreement. Sara also says, I am not really saying no to Dr.
Fauci, I am just saying that you should give it to CDC. Courtney insists that “You are in
fact saying no to Dr. Fauci”.
I must include in my book this unbelievable controlling theme for the Press of the HHS
and Obama Administration. They would rather have a jerk out there than violate their
inexplicable rule of various lanes for various topics. Truly a bunch of assholes.
Jan. 31 – Feb. 1, 2015 – Francis Collins sent an e-mail to Sylvia Burwell explaining the
situation with ASPA and my media appearances. Sylvia says that she will ask Leslie to
take care of it and that there should not be any restrictions on me. However, over the
weekend, approval for several requests for me are delayed making it very inconvenient
for Patty Conrad to arrange them, and some requests are denied. Also, Sarah Baldauf
now sends me talking points on things that are actually scientific issues!! Unbelievable.
She monitors my TV appearances and comments on them to me via e-mail. She even
makes suggestions on scientific issues. I told Francis and he agrees that this must stop.
He spoke to the ASPA today and he will speak with Leslie Dach.
(Feb. 1) -The big feature on me in the Sunday “Home” section of the Financial Times
came out today. Many tweets and e-mails from people all over the world who loved the
piece. It was a feature about me as a person and my home with great pictures of the
various rooms in the house and the deck, which they described as my favorite
“object/thing”. That is what they do with all of these features – they ask the “celebrity’
what his/her favorite thing is. Mine was my deck.
Also, today (Sunday – Feb. 1) the crew from “CBS- Sunday Morning” visited my
house and filmed the last part of what will be an hour feature on me within the next few
weeks. Producer is Emmy-nominated Sari Aviv and famous NPR correspondent (now
doing CBS) Scott Simon. They filmed Chris and I running on the track at American
University and then back in the kitchen making a typical Sunday breakfast.
Also, BBC is doing a feature on me similar to the CBS feature. Theirs will show
globally. They followed me around NIH and interviewed a bunch of people including
activists.
Released by Chairman Rand Paul
421Feb. 2, 2015 – Now Governor Chris Christie is saying that parent should have the choice
of not vaccinating their children. He said this juxtaposed against the POTUS saying on a
Sunday Morning Show that parents should vaccinate their children and “there really is no
good reason not to”. Now the media are playing up the conflict between Christie and the
POTUS similar to the quarantine for Ebola issue. Everyone wants me on the press to
comment. I am picking and choosing with whom I speak since the press definitely wants
to put me between Christie and Obama.
Was on NBC Nightly New and NPR with Richard Harris about the measles issue.
This is becoming the media hype similar to the Ebola issue. Now Rand Paul is weighing
in saying parents should decide about vaccinations. Mike Gerson did a great job in his
Post column describing the issue. He quoted me directly. Chris Wallace of Fax News
Sunday wants me to debate Rick Perry or Carla Fiorina. We shall see.
Cooked dinner tonight at my house (Linguine with scampi and marinara sauce) for
Harold Varmus and Chris. I have Harold over the house and cook dinner for him about
4X per year. Also, used to do this with Gary Nabel when Gary was Director of VRC
before he went to Boston to Sanofi to be with his wife Betsy Nabel who is CEO of
Brigham and Women’s Hospital. I do this since Harold is alone in DC without his wife
Connie who stayed in NYC when Harold came down to be Director of NCI. He stays in
DC in an apartment on Connecticut Avenue near the Zoo on Monday-Thursday and then
takes Amtrak back to NYC for Thursday night through Sunday night. Always an
enjoyable evening.
Feb. 3, 2015 – Testified today at Congressional Hearing of Commerce and Energy
oversight Committee (Tim Murphy (R-PA) Chair on Influenza and why the match of
vaccine was wrong. Multiple things putting me at the forefront – measles, Ebola, bad flu
season.
Will do Rachel Maddow Show tonight. Measles is all over the news. Also, ISIS sent a
video where they burned alive a captive Jordanian pilot.
See e-mail below from Cliff. Serious problem with integrity of the Welcome trust
people and Chimerix. The Welcome trust Oxford group were the ones that criticized us
for wanting to do RCTs. We insisted that it was the safest and best way to determine
efficacy or harm. They said we were unethical. They are unethical and we cannot say
anything because of “confidentiality”.
From: Lane, Cliff (NIH/NIAID) [E]
Sent: Tuesday, February 03, 2015 5:08 PM
To: Borio, Luciana (FDA/OC); Fauci, Anthony (NIH/NIAID) [E]
Cc: Margaret Hamburg
Subject: Re: Daily Mail: Low infection rate halts Ebola vaccine trials in Liberia
Confidential -
Released by Chairman Rand Paul
422This is a complete distortion. The trial was stopped because patients died and the FDA
sent a threatening letter to the company. Questions on this will undoubtedly come up as
we launch the ZMapp trial. These same individuals accused us in print of being unethical
for doing RCTs.
Lu - I need to know what I (or Tony) can say publicly. For the first time in a 35 year
career at the NIH I am taking my gloves off.
Tony - I intend to severe any and all collaborations we have with the Wellcome Trust
over what I consider to be completely unethical behavior and lack of integrity.
Peggy - if I had not worked with you when you were a special assistant in Tony's off ice
there is no chance I would see such a note to the FDA Commissioner. I apologize in
advance.
Somewhere in HHS we need to move from political correctness and deference to our
colleagues in other agencies to doing the right thing and trying our best to identify
effective countermeasures for Ebola virus disease. It is possible my judgement is being
skewed by spending too much time in West Africa. In fact, however, it I think it has
been honed. I think we need a blunt meeting with the Secretary and Leadership of FDA,
CDC and NIH to put the cards on the table face up.
Cliff
On Feb 3, 2015, at 7:27 PM, Doepel, Laurie (NIH/NIAID) [E]
<[email protected]> wrote:
Low infection rate halts Ebola vaccine
trials in Liberia
By Afp
Published: 14:17 EST, 3 February 2015 | Updated: 14:17 EST, 3 February 2015
Britain's Wellcome Trust said that clinical trials it was funding for a new
Ebola vaccine in Liberia were halted on Tuesday due to a fall in new
cases.
"The current position is that there is no realistic prospect of the trial
enrolling sufficient patients to be able to reach a conclusion about the
Released by Chairman Rand Paul
423efficacy of the drug," the Wellcome Trust, Britain's biggest scientific
research charity, said in a statement.
"Therefore the trial has been terminated," it added.
The Wellcome Trust said the decision was taken on Tuesday after the
pharmaceutical company Chimerix, which manufactures the brincidofovir
vaccine, said it was withdrawing from the trial on Friday.
The first large-scale trials of two other Ebola vaccines --
GlaxoSmithKline's Chad3-EBO-Z and rVSV-ZEBOV, manufactured by
Merck and Newlink -- began in Liberia on Monday.
Tuesday's decision was taken by the Trial Steering Committee, which
includes scientists from Liberia, the University of Oxford and Medecins
Sans Frontieres.
"We're delighted that infections are falling, but fewer patients makes it
more difficult to carry out the robust scientific studies needed," Peter
Horby from the University of Oxford, who was leading the trial, said in a
statement.
Jeremy Farrar, director of the Wellcome Trust, which is funding a multi-
million pound therapeutics platform for experimental Ebola treatments,
said it was "disappointing" that the trial could not continue.
"It is essential that other studies of potential treatments and vaccines
continue and hopefully will still be able to deliver meaningful results for
this and the inevitable future epidemics of Ebola," he said.
Stephen Kennedy, a study investigator from the Pacific Institute for
Research and Evaluation in Liberia added: "The scientific community will
move on without any clear evidence regarding the role of brincidofovir in
the management of Ebola."
Weekly Ebola infections in west Africa have dropped to below 100 for
the first time in more than six months, the WHO said last week, raising
hopes the worst-ever outbreak of the virus is coming to an end.
Released by Chairman Rand Paul
424The World Health Organisation said it had now shifted its efforts in
Guinea, Liberia and Sierra Leone -- the countries worst-hit by the
epidemic -- from slowing the spread to stamping it out completely.
Feb. 4, 2015 – Max Cooper gave WALS Lecture at NIH. Went to dinner with him and
Chris last night at Cesco Osteria on Woodmont Avenue in Bethesda. Still great press
interest in the Measles situation now that Presidential hopefuls Chris Christie, Rand Paul
and others have commented on it. Rand Paul put his foot in his mouth by saying that
there are reports of children who walk and talk normally before MMR and then
immediately after, they can no longer walk, talk, and are autistic.
Good experience on Rachel Maddow Show last night. We stuck to the science and did
not get involved with the politics, although she dumped all over Christie and Paul. Ran
into Gov. Howard Dean in the NBC Green Room and he was very critical of Paul.
Did Geraldo Rivera Radio Show today and Jose Diaz Belart on MSNBC. The Sunday
Shows want me on several times. Let us see if HHS allows it vis-a-via prior discussions.
ISIS burns alive and shows the video on the internet a Jordanian jet fighter pilot shot
down over Syria. The Jordanians are outraged and execute Al-Qaeda prisoners in
retaliation. Big news
Feb. 5, 2015 – Media continues over measles. Was on Fox National news. Also,
Buzzfeed print; Wall Street Journal. Gave talk on Ebola at the Columbia Country Club
in Bethesda on Connecticut Avenue. Biggest crowd they have ever had at these events
(Distinguished Lecture Series)
Feb. 6, 2015 – HHS approving all my media now. Today did CNN New Day; The Hill.
Also did radio interview with John Castamidas for his NYC Sunday Show. Was
supposed to do MSNBC with Andrea Mitchell and another ABC Show but was cancelled
because Jordanian aircraft bombed ISIS in Syria and the ISIS claims that the bombs
killed and American woman whom ISIS had kidnapped and was holding hostage. Now
all news stations are covering this.
Feb. 7, 2015 – Measles still hot. Emerging reaction by press and bloggers against
mothers who do not vaccinate their children.
I appear on CNN with Poppy Harlow about measles
Feb. 8, 2015 – Appear on Sunday TV “Face the Nation” with Bob Shieffer. Appear with
CBS Dr. Jon LaPook.
Fly to Austin, TX for LaMontagne Lecture tomorrow.
Feb. 9, 2015 – Give Inaugural John Ring La Montagne Lecture at University of Texas.
John did undergraduate and Masters at U of T. His widow Elaine was present and his
brother Greg. Freezing weather in DC and major historic snow storms in New England
Released by Chairman Rand Paul
426I so rarely go out to lunch -- so I was completely crushed that I
missed the extraordinary moment when one of the world's leading doctors
paid me a house call. Thank you so much for the wonderful letter and
incredible gift. I can tell people now that while infamously do NOT
have a medical degree I DO have a certificate from the NIH!!!!
On a serious note, I cannot tell you how grateful I am personally for
your counsel, candor and wisdom during my tenure at the White House.
And as an American, I can't tell you how grateful I am for your
leadership for our country and the world.
I hope our paths cross again some day. Until then, I am your greatest
fan and admirer....
With thanks,
Ron
Sent from my iPhone
Feb. 20, 2015 – Outbreak of CRE (Carbapenem-resistant enterobacteriaceae) infections
at UCLA related to a contaminated duodenoscope for ERCP (endoscopic retrograde
cholangiopancreatography).
Went on WTOP to discuss the CRE situation at UCLA. Never a dull moment!
Feb. 21, 2015 – Went on CNN to discuss the 7 cases of CRE that occurred with 2 deaths
at UCLA in association with contamination of duodenoscope used for ERCP. Press is
trying to blame FDA since FDA knew about the problem with duodenoscope
contamination for a few years. I did not throw FDA under the bus since there is not
much they can do about it except to alert hospitals to clean the instruments as best as
possible. Cannot pull the 20,000 or so instruments (made by Olympus) since 500,000
procedures are done in the USA each year and many are life-saving and avoid serious
surgery. It is a risk/benefit issue. Peggy Hamburg ran into Chris in Safeway and Peggy
must have seen the CNN interview since she told Chris to thank me for not throwing
FDA under the bus.
Feb. 23, 2015 – I am finally convincing Tom Frieden not to oppose the therapeutic RCT
for ZMapp that Cliff wants to expand from Liberia to Sierra Leone since there are very
few cases of Ebola in Liberia and still several new cases each day in Sierra Leone. The
RCT for the vaccine trial is coming along well in Liberia. I was supposed to go to
Liberia yesterday, but have postponed the trip since my back is hurting badly and also
because the president of Liberia (Ellen Johnson Sirleaf) is visiting HHS and I need to be
there to help greet her.
Measles still in the press. Will discuss live tonight on BBC TV with Katty Kay
Feb. 24, 2015 – Went to NYC for the DDCF Board of Trustees Meeting. Good to see the
Board. Have missed a couple of meetings due to the Ebola crisis.
Released by Chairman Rand Paul
427Big breakthrough in food allergy published in the NEJM. NIAID funded the study.
Showed that early age consumption of peanut products in children with diathesis for
allergic reaction significantly decreases incidence of peanut allergy after 60 months.
I appeared and was interviewed by Jeff Green on The NewsHour to discuss it.
Feb. 27, 2015 – Still in an amazing cold wave in Washington, D.C. A few days ago it
was 2 below at IAD.
Went to Humphrey Building today at 8:00 AM to meet with Liberian President Ellen
Johnson Sirleaf. Hosted by Sylvia Burwell. Her staff included Liberian Minister to the
USA, among others. On our side was Peggy Hamburg, Cliff Lane, Francis Collins, Tom
Kenyon (CDC). Has good conversation about our efforts in Liberia, particularly the
vaccine trial and the ZMapp trial that was announced today in Liberia. The President
profusely thanked us for helping out with their Ebola issue. She is a very sharp lady.
Feb. 28, 2015 – Had another one of those great dinners hosted by Catherine and Wayne
Reynolds at the Book Room of the Jefferson Hotel. Freezing weather. Great guests
including Vernon Jordan and his wife Ann; David Petraeus and wife Molly, Jim Johnson
and his date Heather (?), Buffy Cafritz. Interesting discussions by Jordan on the political
arena of Hilary Clinton and her candidacy. Petraeus spoke about the ISIS treat, Iraq and
the Middle East. One of the best of the Reynolds’s dinners. Chris could not be there.
She was in Northern California cheering on Ali who was running a marathon in the Napa
Valley.
March 3, 2015 – Testified before the House Labor – HHS Appropriations Subcommittee
for the NIH budget. As usual for the past few years, it was only a 2 hour Hearing with
Francis Collins testifying and me backing him up at the table together with Gary Gibbons
(NHLBI), Tom Insel (NIMH), Nora Volkow (NIDA) and Jon Lorsch (NIGMS). Hearing
started early (8:30 AM) since Benjamin Netanyahu was speaking before a Joint Session
of Congress at the invitation of Speaker Boehner and against the wishes of Obama. He
was making the argument that the USA was making a “bad deal” with Iran on nuclear
control versus sanctions.
During the Hearing Congressman Andy Harris (R-MD) made the point that he felt that
we were spending too much on AIDS compared to other diseases with much more of a
morbidity and mortality impact on the USA. He wants to allocate money strictly
according the disease burden in the USA. Hence, this would destroy funding for malaria
and TB and greatly hurt funding for AIDS. Obviously, I will be opposing this.
Still record cold weather and lots of snow in DC.
March 5, 2015 – Was supposed to go to Boston yesterday evening in order to speak at an
Ebola Forum at Harvard today. However, a big snow storm was forecast for DC for
today and I was afraid that I would get stuck in Boston. I wisely, did not go and actually
gave my talk and Panel discussion via “GoToMeeting”, which worked very well. Paul
Farmer was on the panel in Boston. Good thing that I did not go since DC got 8 inches
Released by Chairman Rand Paul
428of snow and all flights were cancelled from Boston to DC. I would have been stuck
there.
March 6, 2015 – Met with Nina Russell and Emilio Emini from the Bill and Melinda
Gates foundation (BMGF), Emilio is taking over as the Director of Global Health for
BMGF and he wanted to review our mutual commitments for the AIDS vaccine plans
(i.e. the P5 follow-up of the RV144 study). He wanted to re-examine the criteria for
moving forward with candidates. Emilio generaly thinks that he knows everything;
however, on this one he has a valid point and so we will do this together.
Cliff Lane in Liberia (also Sierra Leone) now for the 7th time in a few months trying now
to expand the RCT vaccine trial to Guinea and also expand the therapeutic trials with
ZMapp to Sierra Leone and possibly Guinea since there are virtually no patients in
Liberia. Cliff and I had phone call early (6:30 AM) with Cliff in Sierra Leone, me in DC
at home, and Yves Levy and Jean-Francois Delfraissy in Paris to try and get a
collaboration going in Guinea for the trials since the French have a presence in Guinea.
March 9, 2015 - Went downtown today to be the BBC studio to do the final taping of
the segment that they will be doing on HIV/AIDS were I am the moderator and narrator.
In the afternoon, I attended the FDA/NIH Leadership Council meeting to discuss better
ways of collaboration between the NIH and FDA.
March 10, 2015 - Gave the after dinner talk at the Project Hope Board meeting at the
Willard Hotel in Washington DC. I spoke on Ebola: The Perfect Storm. It was extremely
well received and the evening was pleasant. Ran into former Secretary of HHS Louis
Sullivan.
March 11, 2015 - Was Visiting Professor at the John's Hopkins Hospital and Medical
School. Gave two major talks: 1) a formal lecture on Ebola, and 2) a lecture to the
students and fellows on my career as a scientist, clinician, policymaker.
March 12, 2015 - There was a considerable misunderstanding involving a situation in
Sierra Leone. Cliff Lane is trying to expand the randomized controlled trial of ZMapp
versus standard of care in countries in addition to Liberia with the protocol he has already
started. As it turns out the commanding general in charge of the British military hospital
in Sierra Leone, Brig. Gen. Tim Hodgetts, was under the misimpression regarding the
protocol was standard of care to see ZMapp + standard of care versus standard of care
alone . And so he said that this trial was unethical and refused to participate in it. The
reason why this is important is because an American citizen who works for Partners in
Health became infected while working in Sierra Leone. We had made arrangements to air
evacuate the patient to the NIH clinical Center as soon as possible. Because the patient
was in the British facility, we wanted to start the randomization to one or the other arm of
the protocol while the patient was still in Sierra Leone before flying back the United
States. Brigadier General Hodgetts stated that he would give ZMapp as a compassionate
use but would not participate in the randomized protocol. He felt it was unethical to delay
the flight to the USA by giving the person a placebo if in fact the person randomized to
Released by Chairman Rand Paul
430did not see any droplets coming out of his mouth as he coughed; however, I remember
thinking thank goodness for the PPE. This experience brought into sharp relief for me the
reason for the high case fatality of Ebola and why so many HCWs get infected. If were in
West Africa, would be dead and Rick, Anthony and I would have gotten infected
taking care of him if we did not have the state-of-the-art PPE. After an hour and 45 min.
we doffed and waited for his parents.
They came with Bible in hand to visit their son. Rick Davey, Cliff
Lane, and I spent well over an hour with them explaining the situation and the
seriousness of it. We then brought them into the nurse’s station where they were able to
speak with their son through video link. They could see him but he could not see them.
Of note before we brought them into the nurse’s station to see him through the video, we
mentioned to that we were going to bring them into the room. He got very
concerned that he wanted to get cleaned up from the diarrhea that soiled his bed and was
over parts of his leg. In addition, his PIC line was bleeding around site and so that needed
to be cleaned up. It took the nurses about 45 min. to an hour to get him perfectly clean so
that he could feel comfortable talking to his parents even though his parents would not be
able to see any of the soiled linen or pajamas from the distance that they were at the video
link. It was a very moving conversation between the parents and
ended up the conversation by reading a passage from the Old Testament. And then he
turned to us in the room and said “what a wonderful country we live in that would put so
much effort into the saving the life of one person - our son. There was not a dry eye in the
room.
I went home that night completely exhausted and went with Christine to Bourbon Steak
bar and restaurant at the Four Seasons Hotel in Georgetown to unwind.
March 15, 2015. Came into work again today which is Sunday. The day has turned into a
very bright sunny day with a brisk wind. Again, I went to the SCSU and Rick Davey and
I went in together to take care of . Some lab parameters are better and some are
worse. The most worrisome of all is his respiratory situation. We have corrected what we
believe is over hydration by cutting down on his fluids and giving him a diuretic.
However his temperature is still 39 and he is still breathing at 35 to 40 breaths per
minute. Of particular concern is the fact that on 2 L/min of nasal oxygen, his oxygen
saturation is still only about 88%. Also, on call is Bob Danner from the ICU. Bob
increased the nasal oxygen to 4 L/min and we had a discussion about the possibility that
we might need to intubate the patient since he will likely soon get soon very tired from
breathing at 35 to 40 breaths per minute. Cliff Lane was on a phone conversation with the
people from Emory and Nebraska and they mentioned that even when they thought that
they had very good control of intake and output of fluids, around day 8 to 10 of illness,
patients often had unexplained accelerated respiratory difficulty requiring prolonged
intubation. I hope that it does not come to that with however, it is entirely
conceivable that it will. I will go over to the SCSU again tonight for a conference with all
of the team to make these decisions.
Drama tonight in the SCSU. Some change in status. All metabolic
numbers, BP and cardiovascular, kidneys etc. were fine and even improving. However,
Released by Chairman Rand Paul
440Larry Kramer’s Novel ‘The American
People’ Adds a Gay Dimension to History
By ALEXANDRA ALTER APRIL 7, 2015
Photo
Larry Kramer, the author of a hefty new novel (or, as he would have it, history) of the
United States. He is working on a second volume. Credit Todd Heisler/The New York
Times
Fourteen years ago, the playwright and activist Larry Kramer was preparing to die. His
liver was failing, and the prognosis was grave.
Released by Chairman Rand Paul
441He summoned an old friend, Will Schwalbe, editor in chief of Hyperion Books, and made
him the steward of his novel in progress, a rambling history of homosexuality and AIDS
in the United States. He told Mr. Schwalbe to self-publish it if necessary, using money
from Mr. Kramer’s estate.
It didn’t come to that. Mr. Kramer survived a liver transplant and finished the book, a
project he had begun more than 30 years ago. Now, at 79 and against all odds and
expectations, he has lived to see it published. The first volume, “The American People,
Volume 1: Search for My Heart,” weighing in at 775 pages, comes out Tuesday from
Farrar, Straus and Giroux. Mr. Kramer has already thrown himself into finishing the
second volume, which is to come out in 2017.
“Larry lives to write,” said Mr. Schwalbe, who is now an executive vice president at
Macmillan. “There’s no doubt in my mind that Larry’s writing is what keeps him alive.”
Photo
Mr. Kramer, 79, defied the odds and lived to see the publication of “The American
People.” Credit Todd Heisler/The New York Times
“Magnum opus” doesn’t seem like a robust enough phrase to describe the scope of “The
American People,” which stretches back to the prehistoric swamps of the Everglades and
concludes, in the second volume, in contemporary New York City. When Farrar acquired
the two volumes in 2010, the narrative had swelled to around 4,000 pages.
Blending farce and tragedy, autobiography and fiction, it opens as Fred Lemish, a stand-
in for Mr. Kramer, is struggling to finish writing a book titled “The American People,” a
far-reaching historical exposé that describes Alexander Hamilton, George Washington,
Abraham Lincoln, Mark Twain and other major historical figures as gay. “He’s been
struggling with this history for many years,” Mr. Kramer writes of his fictional
counterpart.
Released by Chairman Rand Paul
442Mr. Kramer said he was driven to write the book because he had long felt that gays had
been excluded from history books, written out or ignored. “Most history is written by
straight people, and they don’t have gaydar,” Mr. Kramer said during an interview at his
apartment in Greenwich Village. “People say, ‘Can you prove to me that George
Washington was gay?’ and I say, ‘Can you prove to me that he wasn’t?’ ” (As evidence,
Mr. Kramer notes that Washington “was surrounded by men, and he designed all their
uniforms himself.”)
In the novel, and in conversation, Mr. Kramer criticizes historians and scholars like Stacy
Schiff, Ron Chernow and Doris Kearns Goodwin for glossing over homosexuality in
American history. If he had had his way, he would simply have called the book a work of
history rather than fiction, he said.
“Farrar Straus said call it a novel, that way the lawyers will leave you alone,” he said.
“But I believe everything in the book is true. It may look like fiction, but to me, it’s not.”
Mr. Chernow, the author of a well-regarded 2004 biography of Alexander Hamilton, said
he was surprised to be called out in Mr. Kramer’s novel, particularly as he brings up in
his book the possibility that Hamilton might have been bisexual. “I’m glad that Larry
Kramer is raising the issue, I’m just mystified at why he’s attacking me, when I thought
he would have applauded the fact that I take this seriously,” Mr. Chernow said. “It’s a
legitimate issue for historians or novelists, but we also have to be careful not to ransack
history in service of a political agenda.”
As for Mr. Kramer’s theory about Washington, Mr. Chernow countered that it was
common in that era for generals to design soldiers’ uniforms. If conflicting early reviews
are any indication, “The American People” is likely to be as polarizing and controversial
as Mr. Kramer’s other works. While Kirkus Reviews praised the novel as “breathtakingly
well-written,” others have taken a dimmer view. “To call it a rough read at times would
be an understatement,” a reviewer wrote in Publishers Weekly.
“It’s like being hit by a truck, the book is so all over the place,” the novelist Andrew
Holleran, who has known Mr. Kramer since the 1970s, said of the book. “What I admired
as a writer was the imaginative energy and the amount he takes on.”
Jonathan Galassi, the president and publisher of Farrar, Straus and Giroux, said the book
struck him as ambitious and provocative, both as a work of literature and as an act of
protest.
“This book is, in a way, a culmination of all his artistic activity,” he said. “Larry is a great
polemicist and a fighter, and this book is part of his polemic about gay history and the
roles of gays in our society. He’s still fighting and he’s using art to do it.”
Mr. Kramer never set out to be a political activist and said that in some ways he was ill-
suited to the role. “They say I’m obnoxiously noisy and angry, but I’m actually a bit of a
shy person,” he said.
Released by Chairman Rand Paul
443Early in his career, Mr. Kramer wanted to write comedy. After graduating from Yale, he
worked in the film industry, and was nominated for an Oscar for his screenplay
adaptation of the D. H. Lawrence novel “Women in Love” (1969). In 1978 he published a
controversial novel, “Faggots,” a satire of rampant drug use and promiscuity among gays
in New York. “It’s meant to be a comic novel — it made me laugh,” he said.
His mission changed in the early 1980s, when H.I.V. and AIDS began spreading rapidly
among gays and claimed the lives of two friends. He was a founder of the Gay Men’s
Health Crisis, a nonprofit support organization for those affected by the disease, and later
started Act Up, a protest group that brought attention to the AIDS crisis. His activism
spilled into his writing, with plays like “The Normal Heart” and “The Destiny of Me,”
which center on gay characters confronting the AIDS epidemic and take aim at
indifferent politicians and institutions.
Mr. Kramer’s activism was closely and messily intertwined with his personal life. In
1989, he learned he was H.I.V. positive and suffering from liver damage, the result of
hepatitis B. He credits Dr. Anthony Fauci, director of the National Institute of Allergy
and Infectious Diseases, for being among a handful of doctors who saved him by giving
him experimental drugs. Mr. Kramer once vilified Dr. Fauci in print, calling him “an
incompetent idiot” and a murderer, for his early approach to fighting the spread of AIDS.
“The man who I criticize for allowing the virus to spread is the man who saved my life,”
Mr. Kramer said.
Mr. Kramer’s acerbic and belligerent style has often alienated friends and supporters. He
and the playwright Tony Kushner had a blowout over Mr. Kushner’s screenplay for the
Steven Spielberg movie “Lincoln” (2012), because Mr. Kramer felt that Mr. Kushner
should have depicted Lincoln as a gay man. “He and I had a major falling out over this,”
Mr. Kramer said. “I so wanted him to put that in the movie.” (In “The American People,”
Mr. Kramer strikes back with his own fictional Lincoln, who has a male lover and often
lustily utters “mighty fine” after their encounters.)
These days, Mr. Kramer seems much less bellicose, though no less passionate. He speaks
in a tremulous near-whisper and relies on a hearing aid and a cane. He spent much of last
year in hospitals being treated for abdominal infections and almost died twice, he said.
He was bedridden in 2013 when he and his longtime partner, the architect David
Webster, were finally married in the intensive care unit of NYU Langone Medical
Center.
Mr. Kramer’s writing has taken on a greater urgency lately. He has been writing for five
or six hours every day, seven days a week. His progress is visible in the towering stacks
of manuscript pages that cover a large table in his living room, which doubles as a work
space. He is also working on a screenplay for a sequel to “The Normal Heart” and is the
subject of an HBO documentary, “Larry Kramer: In Love and Anger,” which will be
shown in June, just after his 80th birthday.
Released by Chairman Rand Paul
445take them back to Dallas, TX. He could have flown commercial; however, we wanted to
avoid the ignorant panic if anyone found out that he did so.
Very cold day here in Bethesda/DC. Went doe to HHS to reception honoring retiring
Deputy Secretary Bill Corr. He was very pleased that I came down there. Bill was
Chief-of-Staff to Donna Shalala for 8 years and then 6 years with this administration as
Deputy Secretary. A fine man and excellent Public Servant.
Amazing thing happened to Dan Chertoff who has been a leading player in the care of
Dan wore himself out taking day call every day in the SCSU (as well as coming
in at night during the crisis periods). To make matters worse, his father passed away
during all of this. And so now that it is over, he took his wife Jessica and his child for a
vacation in the Dominican Republic. His went through all of the appropriate
notifications of travel via our OMS, the State of Maryland, the CDC, and the embassy of
Dominican Republic. Somewhere along the way, someone, including the CDC, dropped
the ball and did not inform him that the DR has a policy of not accepting people who
have taken care of Ebola patients even though by our criteria, he is “low, but not zero
risk” and so should have no travel restrictions. Bottom line is that the DR kicked him
out of DR soon after he landed. They were waiting for his at his hotel and with
apologies, put him and his family on a plane at their expense and sent him back to the
USA. Amazing bullshit! Truly unbelievable how stupid they are and how incompetent
were the people that should have warned Dan.
April 10, 2015 – Jack Whitescarver and Wendy Wertheimer sent in to Francis Collins
their letter of resignation from the OAR. Jack is 78 and wanted to stay until he reached
80. However, he and Francis have not been getting along since Francis feels that Jack
has been too slow and non-specific in shifting the AIDS money to focus on the high
priority areas such as vaccine, prevention, cure and co-morbidities. The relationship has
soured and so Jack feels that it is time to go. I, myself, love Jack, but am not satisfied
with how they are handling the re-distribution of the AIDS money. Clearly there is too
much AIDS money in NIDA and in NCI that is not being used for AIDS projects and to
call it AIDS-related is a stretch. We had a meeting in my library today with Larry
Tabak, Wendy W. and Jack to discuss this issue. I got pissed off at Wendy since she
essentially accused me of saying (which I did not) that behavioral research grants were
not good science. That is not what I said. I said that we were doing proportionately too
much behavioral research out of NIDA and that the Congress (Rep Andy Harris R-MD et
al) are trying to decrease the AIDS budget (see above) and we had better be spending it
all on research that is high priority such as vaccine and cure; otherwise, they will have an
excuse to cut the budget. Larry Tabak is totally in my corner and even Jack admitted
that he agreed. However, the behavioralist community keeps pushing to do a lot of
behavioral research. Clearly, the studies might be sound, but they do not contribute to
the end of the pandemic. You can study behavior when it comes to AIDS; however, it
has been very difficult to “change” behavior.
April 11, 2015 – Went to Reception/dinner at Jamie Gorelick (former assistant attorney
general in Clinton Adm) and Rich Waldron’s home in Chevy Chase in honor of Roger
Released by Chairman Rand Paul
446Glass winning the Sabin Medal for developing a rotavirus vaccine. Mostly NIH people
and some of Roger’s old friends.
April 13, 2015 – Washington Nationals getting off to a very bad start. Many errors and
no hitting. Also, their excellent pitching staff is getting blasted.
Went to Tyson’s Corner Ritz-Carlton at invitation of David Rubenstein (CEO of Carlyle
Group) to talk to their annual meeting (~600 top CEO managers of Carlyle activities).
Format was David interviewing me on Stage 1-on-1 right after lunch. David obviously
is very taken up by me and really likes me (likewise). Remember, he tried to recruit me
to Carlyle several years ago for $1 million flat salary plus commissions. Many in the
group said to me that I was the best invited speaker at any of the former annual meetings.
Besides, they pay the others a handsome honorarium.
AAAS (new CEO Rush Holt) chose me to be one of a couple of people to give the
laudation for Alan Leshner who is retiring as CEO of AAAS. Very elegant function at
the Women’s Museum of the Arts on New York Avenue and 12th Street, N.W. Alan was
very moved by my remarks.
April 15, 2014 – Testified at a House Appropriations Subcommittee Hearing at 10:00
AM in Room 2358B of the Rayburn Building. Topic was Ebola response. I represented
NIH. Also testifying was Nicki Lurie (ASPR), Tom Frieden and Robin Robinson
(BARDA). I did well, but Nicki and Tom caught some criticism for the fact that the
ETUs that they recommended got built and only 2 of 11 actually admitted a patient and of
the 2 that admitted patients, only 25 patients were seen. Criticism was the lack of
flexibility to stop the building when it became clear that the epidemic was decreasing
rapidly as they were building the ETUs. Committee nevertheless complimented us on
the Ebola response. Rep. Harris (R-MD) was a bit snarky with Tom Frieden saying that
his daughter is an ICU nurse at Hopkins and she does not know how to don PPE and that
reflects a lack of planning on the part of the USG. He is misguided.
Had disturbing meeting with Francis Collins, Larry Tabak, Jim Anderson, and Kathy
Hudson in Building 1, Room 116 concerning the re-prioritization of the AIDS budget
through OAR. It is now clear that Francis not only wants to assure that the highest
priority AID research is done with AIDS dollars, he actually wants to decrease the
amount of money going for AIDS research and redirect it to non-AIDS, i.e. decrease the
AIDS allocation. He is using the review of the AIDS portfolio as an excuse for this. I
warned him that this is not a good idea and will be met with pushback from the
community. I also believe that Francis might be trying to ingratiate himself with the
GOP since he may be covering his bets in case a Republican becomes POTUS and he
wants to keep his job as NIH Director. Just a thought.
April 17, 2015 – Had meeting at HHS in Room 305A in Humphrey Building with the
Presidents of Liberia (Ellen Johnson Sirleaf), Sierra Leone (Ernest Koroma) and Guinea
(Alpha Conde) to discuss the status of the Ebola outbreak. Much good will with
expressions of cooperation and collaboration. The Presidents insisted (appropriately)
Released by Chairman Rand Paul
447that we cannot rest until the cases go to zero. Also, they spoke of developing sustainable
infrastructure that will be available for the next outbreak of Ebola or any other disease.
President Koroma spoke of his desire to establish an African CDC. I described for
President Sirleaf the successful implementation of the RCT for vaccine (in Liberia) and
the RCT for ZMapp (in Liberia and Sierra Leone). She obviously already knew about
this since we had briefed her previously and she knew that we were also helping to
renovate clinics in Redemption Hospital and JFK Hospital in Monrovia. Of note, when
President Conde heard that we were doing these trials in Liberia he expressed (through a
French translator) his strong desire for us to do such trials in Guinea. Obviously, this is
good news for Cliff who is trying to get around the nonsense of the Norwegians and
WHO regarding their trying to stop us from doing the trial (see above). Meeting ended
very well.
April 19, 2015 (Sunday) – Was inducted in the Washington, D.C. Hall of Fame
(Historical Society of the District of Columbia). Category of Science and technology.
Black tie affair at the Liason Hotel on New Jersey Avenue, N.W. DC Mayor Muriel
Bowser was present and ceremony MC’d by Former DC mayor Sharon Pratt. Of note is
fact that I was the only white person to be inducted (total of 12 inductees for various
categories (arts, literature, law, business, etc.). Also, of the approximately 300 people in
the ballroom, except for one other person, Chris and I were the only white people – all
were African-American.
April 21, 2015 – Pat White who now works for “ACT for NIH” got Chris and I invited to
an affair at the Eisenhower Theater at the Kennedy Center. It was an interview
conducted on stage by Bob Shieffer (CBS Face the Nation) with Bill Clinton and Colin
Powell. The evening was MC’d by Norah O’Donnell (NBC). Great interview. Elegant
dinner followed upstairs in the Atrium. Had opportunity of nice conversations with
President Clinton and especially Colin Powell who is always extremely friendly with me.
Also chatted with Nancy Pelosi, Majority Whip Kevin McCarthy, Mack McCarty, Sen.
Richard Durbin among others. Really a fun evening.
During the day, met with Mike Gerson who is interested in partnering with a producer to
make a documentary of the global response to HIV, concentrating on the PEPFAR story.
And so he met with me in my office for 1 hour to discuss various aspects of the historical
evolution of PEPFAR.
April 23, 2015 – Conference call with MSF (Joanne Liu and Sophie Delaunay), Tom
Frieden and Cliff Lane about”BioBank” and study of specimens that had been stored
from Ebola patients. Interesting that MSF, who has never been interested in research
and who often put down research since that focused on care now want to lead the effort.
Joanne and Sophie are good people and this manifests the dichotomy and heterogeneity
of MSF. Many conflicts within their ranks. Bottom line is that we agreed since we all
are interested in this that we do the best possible science with true transparency and that
above all, the data belong to the West Africans.
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448April 25, 2015 – Went with Chris to the Annual Garden Party at the Beall-Washington
House at 2920 – R Street, N.W. that precedes the White House Correspondents’ Dinner
tonight. Usual DC scene of TV stars and Hollywood stars such as Michael Kelly from
“House of Cards” among others. Many people commented about my performance on
TV during the Ebola crisis this past Fall. The Brunch was sponsored by Steve and Jean
Case, Tammy Haddad, Mark Ein, etc..
That evening went to WH Correspondents’s Dinner at the Washington Hilton on
Connecticut Avenue and Florida Avenue. Was guest of Tom Burton and the Wll Street
Journal. President Obama gave good comedy show followed by Saturday Night Live’s
Cecily Johnson. She was not particularly funny, but OK.
April 26, 2015 – Went to the Annual NAS Garden Party at NAS Headquarters on C
Street and 22-23rd Street, N.W. Usual scene of seeing old friends. As always, great to
see Max and Rosalie Cooper.
April 28, 2015 – Wonderful evening at the home of Ambassador Esther Coopersmith
(2230 S Street, N.W.) who gave “A List” party in honor of Barbra Streisand who is a
strong advocate of the Women’s Heart Alliance, an organization calling attention to the
unrecognized burden of heart disease among women. Beautiful DC Spring evening
(magical) – perfect temperature, crystal clear sky. I had the pleasure of spending much
face-to-face time with Barbra. She clearly knew who I was when introduced. She knew
the connection to Larry Kramer as she was supposed to produce “The Normal Heart” for
Hollywood, but did not as it went to HBO. I was seated directly across from her at a
narrow table and right next to Esther Coopersmith, the hostess. Amazing crowd with
many politicians – Nita Lowy and Rosa DeLauro (who kept shouting me out in their
remarks); Ed Markey who gave a short speech and said “Wow, what a party – I am sitting
here with Tony Fauci!”; Sen John McCain, Chris Dodd, Lloyd Hand, James Brolin
(Barbra’s husband and father of Josh Brolin), Kathleen Kennedy Townsend, Gary
Gibbons (the only other NIH person), Catherine and Wayne Reynolds, Diane Rehm,
henry Waxman, Irene Pollin, Anita Mcbride, Rima Al-Sabah, Sen. Franken, Debbie
Dingel, and many other notables. Barbra was amazingly nice – warm, sincere, funny,
friendly. I was surprised since Harold Varmus had told me that on a prior visit by
Barbra to NIH when he was Director and I was not present, Harold said that Barbra was
aloof and not friendly. Totally opposite tonight. You get the feeling you could really be
her friend.
April 30, 2015 – testified before the Senate Appropriations Subcommittee with Francis
Collins, Gary Gibbons, Tom Insel, Jon Lorsch, and Doug Lowy. Committee now
chaired by Roy Blount (R-MO). Hearing went well. Concomitantly with Hearing has
been the drafting and revising of the 21 Century Cures Act developed by Fred Upton (R-
MN) and Diane DeGette (D-CO). Clearly, Francis Collins (who denies it) had a lot to do
with this since it authorizes (and appropriates – weird for an authorization committee) $2
billion per year for 5 years to NIH Director to ONLY be spent on Precision Medicine,
young investigators, and “other research” TBD. This is a bad idea to earmark that much
money in the NIH budget.
Released by Chairman Rand Paul
449May 2, 2015 – Went to Children’s Inn Gala at the Ritz-Carlton at Tyson’s Corner. Big
shout out for me by the MC for my Ebola and other work.
May 5, 2015 – Dedicated Building 4 today as the Lowell Weicker Building. I gave the
main laudatio and Lowell loved it as did his wife Claudia, who I knew from the old days
when she was his staffer. He divorced his wife to marry Claudia. Nice ceremony
attended by Sen. Tom Harkin, Rep. Dave Obey, Tim Schriver.
Was visited today by Harry Jaffe the National Editor at The Washingtonian. Harry
wants very much for me to write a book. Says he has been following my career and that
I have a “couple of books in me”. He wants to help as an editor, co-writer and/or agent.
He has written several books himself, including the best seller “Dream City” about
Marion Barry.
May 6, 2015 – Went to Detroit to receive honorary doctorate of LAWS from Wayne
State Univerity. President Roy Wilson whom I know from his years ta NIH and he was
on the Search Committee that I co-chaired with Gary Gibbons for the Director of
NIMHD. Very nice trip. Absolutely beautiful weather – 50-60 and bright sun. Had
very pleasant dinner in Roy spectacular apartment near Wayne State Univ. Roy was
born in Japan of African-American father (officer in Air Force) and Japanese mother.
He is fit and handsome guy. His apartment was a combination of modern American and
Kyoto-like Japanese décor. Really nice.
May 7, 2015 - Received degree today from WSU. On plane back, zsat behind an
African American man and his wife/girlfriend. He looked around 60 years old and in
great shape. I helped him open the upper luggage bin and our eyes met. He looked
straight at me and said with a big smile: “Did you dye your hair gray so that a young man
like you would look more distinguished?”. I told him that unfortunately it was age. He
asked me how old I was and I told him 74. He smiled and said he was 69 and gave me a
fist pump. I noticed a massive diamond-studded ring on his finger. He pointed to it and
said: “Do you know what this is?” I said no and he said it was a Hall of Fame Ring. I
looked at him and apologized and said I am very sorry, but I do not recognize you. He
said: I am Lem Barney, Hall of Fame cornerback for the Detroit Lions from 1967
through 1977, and you are that wonderful doctor who does so much for the world. I told
him how much I admired his play over so many years with the Lions. We hugged and
shook hands for a long time. Wonderful encounter!
May 9, 2015 – Chris has been in Zimbabwe and South Africa for the past 2 weeks giving
lectures on Ethics. She wrote me a wonderful 30th Anniversary letter:
Dear Tony.docx
May 2015
Released by Chairman Rand Paul
452May 14, 2015 - I am very disturbed by the situation regarding the conflict of principles
between scientists (ourselves) and certain health officials in Europe concerning the
conduct of randomized controlled clinical trials in the Ebola outbreak in West Africa. I
am absolutely astounded by the lack of scientific rigor demonstrated by people like
Jeremy Farrar the head of the Wellcome Trust and certain scientists at Oxford University
including Peter Horby and Adrian Hill. I am also surprised that Peter Piot is also sharply
criticizing any placebo-controlled trials particularly of drugs. We have considerable
experience with HIV and in other arenas where the artificial show of compassion in a
serious disease that results in wide distribution of unproven drugs leads to a double
jeopardy of never proving that an intervention works or not, and more importantly misses
the possibility that they are actually harming people. The British and as well as people at
WHO and Doctors without Borders by taking somewhat of a self-righteous approach that
any research done in the setting of an Ebola outbreak is unethical are actually hurting
people. The Oxford group actually covered up that several patients given open access to
Brincidofavir died and they never reported it. They said that the study was stopped
because there were no more infections, when this was a blatant misrepresentation. There
have been dueling criticisms in the press between our approach and theirs about this. A
recent Wall Street Journal article by reporter Tom Burton analyzed this carefully and
blasted the Europeans for giving out medicines in an open access manner while likely
hurting people with drugs that have clear toxicity that have really no pre-clinical
indication that they would work. In my mind Cliff Lane is a true hero in this as he is
designed and implemented randomized controlled trials for vaccines in Liberia as well as
controlled randomized trials without a placebo for certain drugs like ZMapp.
I am terribly disappointed with Tom Frieden who continues to insist that you cannot do a
randomized controlled trial of the vaccine in countries like Guinea because this would
interfere with the public health effort of getting the epidemic down to zero. Clearly, as
well-meaning as he may be, he does not have a clue about how to design or implement a
clinical trial. Again I am really very disappointed with him, with the WHO, with the
Wellcome Trust, and with individual characters such as Jeremy Farrar and Marie-Paule
Kieny at WHO. They really should be ashamed of themselves.
May 17, 2015 – Received honorary doctorate of Public Service from George Washington
University in a beautiful ceremony on the National Mall right in front of the Washington
Monument. Commencement Speaker was Tim Cook, CEO of Apple. At the ceremonial
dinner the night before at the Corcoran Gallery of Art on 17th Street, N.W., a student
member of the Board of Trustees got a piece of meat stuck in his throat and was choking.
I did a Heimlich maneuver and dislodged the piece of steak. Obviously, the crowd was
delighted and gave me a big round of applause. The next day (today) at the graduation
ceremony, President Knapp mentioned this in his citation for my honorary doctorate. It
also got tweeted around.
May 19-21, 2015 - Honorary doctorates at Columbia University in NYC (Doctor of
Science) on May 20 and The Johns Hopkins University in Baltimore (Doctor of Humane
Letters) on May 21.
Released by Chairman Rand Paul
454Elijah Cummings – Congressman from Baltimore gave very moving comments (in his
wonderful preacher fashion) about the recent riots in Baltimore related to the police
killing of Freddie Gray. He spoke of his own growing up and still living in the
neighborhood where the riots took place.
Leon Fleisher – world renowned concert pianist. He was wonderful and they showed a
clip of his playing the piano. He gave words of wisdom. “Listen and do not be afraid of
silence.” Also, “Procrastination saves time”
Edwin Catmull, the CEO of Pixar Animation Studio. Produced the first computer
animated film “Toy Story” and also “Frozen”. Has won 5 Academy Awards.
May 21, 2015 – Received the Special Recognition Award for Science and Medicine at
the Sons of Italy Foundation Gala at the National Building Museum. Phil Piccigallo
gave a very nice and warm laudation of me with many old photos of me in different
“historic” situations. Also, met at the dinner; Anita McBride (former chief-of-Staff to
Laura Bush), General Ray Odierno and his wounded warrior son Anthony (arm blown off
by an IED in IraQ).
May 26, 2015 – Gave an “Interview” talk with Joe Palca (NPR) at the Ripley Center of
the Smithsonian. Good crowd, good questions.
May 27, 2015 – Hosted 30 Staff members from the Senate Appropriations and Oversight
committees at the Special Clinical Studies Unit (SCSU) at the Clinical Center where we
took care of and I did for them the complete donning and
doffing procedure, which they absolutely loved. Many questions.
Did a telebriefing for the release of the START study data (DSMB recommended
stopping the study due to highly positive results). Clearly starting ARVs at greater than
500 CD4+ T cell count was much more beneficial (p <0.001) than waiting until counts
drop to 350. Got much attention. Front page of NY Times with my picture in ONLINE
version of Times. Also the next night (May 28), I appeared with Judy Woodruff on the
NewsHour.
May 28, 2015 – Went to UN to participate in Panel at ECOSOC Council (Economic and
Social Council), chaired by Paul Farmer to discuss sustainable health systems in light of
the Ebola outbreak. Bill Clinton gave the Keynote and we shook hands and exchanged
pleasantries. On the panel with me was the actor Jeffrey Wright (“Angels in America”
“Boardwalk Empire”. He has won an Emmy, a Golden Globe and a Tony. Very nice
man. Says that he has been a fan of mine for years. He is working to improve the
conditions of miners in Sierra Leone.
June 1, 2015 – Gave lecture at the Sulgrave Club on Dupont Circle. Upper Crust old
women’s club. Quite charming and elegant Building between P and Massachusetts Ave,
right on DuPont Circle. Spoke on Ebola. Adoring crowd. Met John Quinnan with
Released by Chairman Rand Paul
455whom I did my first research project in the summer between my 1st and 2nd year at
Cornell – the summer that I met Lynne Williams.
June 2, 2015 – Spoke with Doug brooks (ONAP) about setting up a meeting with him,
me, Valeria Jarrett and Denis McDonough to discuss possibility of starting a PEPFAER
for the USA to end the AIDS pandemic here.
June 3, 2015 – Chris and I went to function in the Mansfield Room of the US capitol as
gusts of Wayne and Catherine Reynolds in one of their usual wonderful social events.
They were honoring Congresswoman Debbie Dingel, Sens. Roy Blount, Thad Cochrane
and Diane Feinstein for their contribution to the Arts. I introduced Debbie Dingel.
Great crowd. I chatted with old friends Fred Hiatt of Washington Post, Rick Atkinson,
Chris Matthews, Bob Barnett, etc. Great evening.
June 5, 2015 – Things heating up with MERS in South Korea. Now at 40 cases and 4
deaths – largest outbreak outside of the Arabian Penisula. Index case is a 68 year
Korean man who travelled in the Arabian Penisula (KSA, Qatar, UAE, etc) came back to
Korea was hospitalized and set off a chain of infections among people in same room and
even on same ward as well as family members and HCWs.
I appeared on Wolf Blitzer (CNN) to discuss the situation.
June 6, 2015 – Steve Holland admitted a patient (25 year old woman from India) with
XDR TB today. NSC heard about it and as usual pushed the panic button and wanted us
to provide a press statement and Qs and As. We did and this triggered much press
interest.
June 8, 2015 – Did my BSC presentations or LIR Overview and Immunopathogenesis
Section accomplishments. My primary reviewers were Arturo Casadevall and Larry
Corey. Review went extremely well.
Press interest now heating up for both MERS and the XDR patient here at NIH.
Did interview with Katty Kay for BBC on MERS.
June 9, 2015 = Did WTOP interview on MERS and XDR TB. Also, for XDR TB did
MSNBC with Andrea Mitchell, NBC Nightly News, CBS Nightly News and Telemundo
TV, Channel 8 News, ABC Nightly News
Harold Varmus came back to Bethesda and visited with me. He is doing fine at Weill-
Cornell. Came down for a dinner with Francis Collins, Shirley Tilghman, Marc
Kirschner, and Ron Daniels to discuss the systemic problems with the biomedical
research enterprise related to the paper that Harold, bruce Alberts, Kirschner and
Tilghman wrote in PNAS.
Released by Chairman Rand Paul
456June 10, 2015 - Long interview with me on XDR TB patient by Denise Grady appeared
today in the NY Times. Also, did FOX Channel 25 Local News this AM.
Got report from BSC and was told that “Outstanding” was not a sufficient adjective to
describe how good my laboratory and my section was. Praised my leadership and it was
the first time that every single person in a given laboratory got “outstanding”. Called the
lab a “National Treasure”.
June 12, 2015 – Did Bloomberg TV on MERS, which is still going on in South Korea.
Now up to 133 cases and 14 deaths. We here at level of HHS are already having the
usual conference calls of preparedness regarding development of therapeutics and
vaccines.
June 15, 2015 – had dinner over my house with Eric Goosby and Chris – the now
traditional sausage and rigatoni dinners that I have had with Eric, Harold Varmus, and
Gary Nabel over the years. Eric is in town for and IOM workshop. He also is seeking
my assistance in obtaining a grant from the DDCF and also NIH now that he is out of
government and pursuing global health issues. Of note, he has recently been appointed as
the UN Secretary General’s Special Envoy for TB.
Tom Frieden is balking at supporting the proposal for the IOM Study on lessons learned
in the Ebola response. I will be supporting the study with NIAID funds. Tom still is not
really on the same page with me about what went on during the response. He is still
fixating on have the IOM study focus on “alternative clinical trial designs” instead of the
RCT. Also, he is still against Cliff trying to extend the RCT to Guinea. Tom feels that
the Guineans will react badly to a trial and be paranoid that we are trying to kill them.
This conflicts with the fact that the WHO is already doing a ring vaccination (poor
design) study in Guinea. Anyway, conversation with Tom are still very cordial and I like
him – just disagree with him sometimes.
June 16, 2015 - I am in the midst of preparing my talk for the International AIDS Society
to take place in Vancouver. As usual I am taking this very seriously and doing multiple
drafts.
Cliff Lane and I had a teleconference with individuals from Drs. Without Borders (MSF);
in particular, we spoke with Sophie Delaunay along with Jennifer Cohen of MSF. The
discussion was the interest on the part of MSF to be a major player in the development of
a Biobank for specimens in West Africa related to the Ebola outbreak. Cliff and I are
somewhat skeptical about this issue since MSF rarely, if ever, gets involved in
biomedical research, and when they do, we have had concerns about their capability in
this regard. CDC (Tom Frieden) agrees completely with us on this and has skepticism
about their involvement. They are a wonderful organization when it comes to taking care
of patients; however, we have had some difficult experiences with their inability to really
appreciate the importance of the scientific method when doing research.
Released by Chairman Rand Paul
457Today I had the first meeting for the search committee for the director of the division of
intramural research to replace Kathy Zoon. The Committee is co-chaired by Cliff Lane
and Gary Gibbons.
June 17, 2015 - I gave a talk at the HPTN/IMPAACT meeting at the Crystal Gateway
Marriott Hotel on Jefferson Davis Hwy. in Crystal City, Virginia. This was an important
talk because I introduced to the investigators the difficulty that we are having now with
certain members of Congress wanting to decrease the AIDS budget and even move
money out of the AIDS bucket into other institutes. I showed the audience a C-SPAN clip
of my debating with Senator Cassidy (R-Tea Party) from Louisiana where he was talking
about matching allocation of funds with the number of disability adjusted life years
(DALYs) in this country. If this approach were followed, it would have a serious negative
impact on all global health research, particularly research on infectious diseases. I
articulated well my objection to this. Some people have picked this up and put it on
YouTube, and the clip has gone viral. In addition, I spoke to the group about future
directions of focusing the AIDS research specifically on ending the epidemic so that
ultimately we will not have to spend any money on AIDS. This would be an important
public health accomplishment, and it would silence the people who want to take money
from AIDS prematurely before we have ended the AIDS epidemic.
Tonight, I flew to Atlanta to participate in the Charles C Shepard Science Award
Ceremony in Atlanta at the CDC headquarters.
June 19, 2015 - I gave a lecture at the CDC on the subject of " Ending the HIV AIDS
pandemic: From scientific advances to public health implementation". The lecture was
extremely well accepted by the CDC community. I had time to chat with my dear friend
Tom Frieden about a number of issues of mutual interest. I was shown around the
absolutely beautiful new CDC campus that I had not been on for several years. The
campus has been completely transformed by beautiful, architecturally creative buildings.
It is very clear that I am highly respected and revered by the CDC community. Tom
introduced mew as a “living legend”. It was a great visit that I enjoy very much and it
cemented my relationship with our colleagues at the CDC.
June 20, 2015 - I viewed the preview of the soon to be shown on HBO documentary on
Larry Kramer entitled “Larry Kramer: In Love and Anger”. It was played at the Naval
Heritage Center on 701 Pennsylvania Ave. NW. The documentary is a moving story of
Larry Kramer's complicated life. I was prominently featured in the documentary
interacting on multiple occasions with Larry.
June 22, 2015 - I gave a lecture at Georgetown University O’Neill Institute at the Law
School on New Jersey Avenue, NW Summer Program on Infectious Diseases and the
Law. Again very well received by the group there.
We are in the middle of an extraordinary heat wave now in Washington DC with
temperatures reaching 95- 100° with sunny skies during the day and massive
thunderstorms at night.
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458June 23, 2015 - I had a very nice breakfast meeting at the American City Diner with Bill
Schultz who is the general counsel for the Department of Health and Human Services. I
met with Bill at the suggestion of Pulitzer Prize winning author and close friend of mine
Rick Atkinson. Rick was concerned if I got involved with Don Fehr, who offered to be an
unofficial agent for me and read over my manuscript as well as tell me how to write a
book proposal for an editor, that this informal arrangement could spell out to the a legal
issue later. This arrangement might also be something that is frowned upon by the
department. And so Rick recommended that I meet with Bill and get his legal advice. My
meeting with Bill was terrific. He was extremely encouraging to me about writing my
book. He agreed with Rick that I should hold off making even any informal arrangements
with anyone and I should just go ahead and continue to write my chapters and when I am
ready to leave the government to then put together my proposal and “shop” it around to
different publishers and agents. I will take his advice and go that way.
This evening I gave a presentation to the AIDS Clinical Trials Group (ACTG) annual
meeting at the Renaissance Hotel Downtown at 999 – 9th Street Northwest. The talk was
very similar to what I gave to the HPTN/IMPAACT group.
June 24, 2015 - I participated with the NIH and CDC team here at NIH in Wilson Hall
of Building 1 as well as in Room 151 in the meeting with the Vice Premier of China Jiu
Yandong. The meeting was hosted by Sylvia Burwell (Sec., HHS). I presented a talk on
the role of NIH in the response to the Ebola Outbreak. I interacted with several of my
Chinese colleagues including the Director of the Chinese CDC. An agenda of the
meeting is given in the PDF below:
draft agenda.pdf
June 25 – June 27, 2015 - I travel to Aspen, Colorado to be a participant in the 2015
Aspen Ideas Festival, Spotlight health. It was a most enjoyable experience as I attended
several of the panels on areas that were of my own interest and expertise, and even some
areas that are not my areas of expertise. With regard to my direct participation, on the
morning of Friday, June 26 , I participated in a “Tutorial Session” which was a panel on
the topic of “Be Preared: Infectious diseases are here to stay”. On the panel with me were
Larry Brilliant, Neeraj Mistry, and Storn Kabuluzi of Malawi. The Panel was chaired by
Judy Woodruff of The NewsHour (PBS). Judy is an old friend and it was a very lively
panel. An added plus for the experience was that I finally got to meet Larry Brilliant who
is one of the icons of global health, having participated actively in the eradication of polio
from India during his time at WHO. He is the kind of person who I think could be a really
good friend. He obviously has an incredible amount of respect for me. The panels that I
enjoyed watching were the health and Healthcare session on the morning of June 26,
which was a breakfast session right before my session. The speakers with Tom Daschle,
Henry Waxman, Bill Frist and the panel was chaired by Steve Clemons, Editor-at-Large
for Atlantic magazine. It was a most joyful time for so many of us in Aspen because the
Released by Chairman Rand Paul
459Supreme Court had voted by 6 to 3 to uphold the Affordable Care Act and the tax credit
for those who live in states that do not have their own exchanges. In addition, the
following day the Supreme Court ruled by 5 to 4 to strike down the prohibition on gay
marriage. The Obama administration has had an amazing couple of days.
On Friday evening of June 26 it was a wonderful reception at the home of Gail and Al
Engelberg who live on a beautiful mansion overlooking the mountains of Aspen and
Aspen Valley. The reception was in honor of former secretaries of Health and Human
Services. These included David Matthews, Kathleen Sebelius, Donna Shalala, Tommy
Thompson. It was great to see Tommy Thompson again as well as all of the others. Of
note Donna Shalala wanted to talk to me in her new capacity as the CEO of the Clinton
Foundation. Apparently Chelsea Clinton had been approached by people from MSF and
WHO to help fund the controversial “ring vaccination” study of the Ebola vaccine that
they are conducting in Guinea. As I had mentioned, both Cliff and I feel that this is a
flawed study since it has no control group. Donna wanted to know whether the Clinton
Foundation should get involved. I recommend strongly to her that they do not support
this study and if, in fact, Chelsea Clinton feels that she wants to support it, then it is
importantfor the Clinton Foundation to get an outside group to look seriously at the
design of the study, which I have a lot of trouble with, as well as to examine the data that
is a ready been collected. Donna thanked me for :”Covering my back as you always do”.
The reception was idyllic in that views were breathtaking, the skies were crystal clear and
the weather was warm without any humidity. I met many wonderful people at the
reception including a nice conversation with my old friend Ashley Judd, who looked
absolutely beautiful. She complimented me on “how great I looked” and on the
important work that I have been doing for so long. She was with a little dog and was
barefoot. She is an amazing looking woman and a really devoted global health advocate.
She was there to talk about her reflections on global health on the following day. One of
the people I ran into who was very complimentary was a Zoe Baird, who called me the
epitome of the true public servant. She said that I was incomparable in what I have done
over so many years for the people of the country in the world. It was a very moving and
sincere compliment to me. The following day on Saturday, June 27, I participated in a
panel on the “Looming Antibiotic Crisis”. On the panel with me was Peggy Hamburg
and Ramanan Laximinarayan, who heads the Global Network for Neglected Tropical
Diseases. He is a terrific guy with whom I had the opportunity to fly back to Denver
with that same morning. All in all it was one of the best trips that I had taken in that the
atmosphere was beautiful, the social interactions were in extremely positive, and I got the
opportunity to do my thing in front of a lot of important people who have also become
over the years good friends.
June 29, 2015 - I had two interesting encounters today by telephone with very interesting
people on very interesting subjects:
1) Mark Zuckerberg, the CEO and founder of Facebook was introduced to me a few
weeks ago by e-mail by Susan Desmond Hellman, the current CEO of the Bill and
Melinda Gates Global Foundation. We arranged to have a teleconference between
Mark and me today to discuss the issue of Mark wanting to get involved in a
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460philanthropic way with promoting biomedical science. The call lasted one hour
from 4 PM to 5 PM on an absolutely brilliantly beautiful day in Washington with
clear skies and relatively no humidity(an unusual event in the summer in
Washington). Mark was very engaging and we went over the multiple possible
ways that he may contribute. He asked probing, highly insightful questions about
how we fund biomedical research through grants in the extramural program and
by funding the investigators in the intramural program. He was very interested in
the concept of funding projects versus funding people. We went over several
models of how research is funded. We discussed the issue of creating an institute
that is an infrastructure with walls like the Rockefeller University. We also
discussed the possibility of an institution that makes grants like the Howard
Hughes Medical Institute. He asked a lot of questions about the NIH and he
wanted to continue the conversation at a later date after he thought a bit about
what I had told him. I found him to be a very engaging, highly intelligent young
man.
2) Gary Nabel, who is currently at Sanofi in Boston, called me on my cell phone to
tell me that he had just been in California and had a conversation with Gov. Jerry
Brown. The California State Assembly has put a Bill on the desk of Gov. Jerry
Brown that would prohibit exemptions from vaccinations on religious and
philosophical grounds. Gov. Brown had spoken to Gary when he was in
California today about this since he finds this to be a difficult decision as to
whether or not he should sign the bill. Gary spoke to him about me and my
knowledge of the subject and Gov. Brown gave Gary his cell phone number to
give to me to have me call him. I did so and had about a half an hour conversation
with Gov. Brown in which I explained to him the reasons why I feel that he
should sign the bill prohibiting religious and philosophical exemptions from
vaccinations in the state of California. He asked probing questions. We had a very
good conversation and he thanked me heartily for giving him the time. Based on
the discussion, I believe that he will sign the bill. We shall see.
The TedMed people got back to me and really like my draft. They have made some
suggestions that are easy.
June 30, 2015 – I must have been convincing to Gov. Brown yesterday – he signed into
law the California vaccine legislation (see above).
July 1, 2015 – The California law has attracted some attention. I appeared on CNN with
Jake Tapper to discuss it.
July 2, 2015 - Today I appeared on the Diane Rehm Show where I did somewhat of a
debate with Dr. Robert Sears, a pediatrician from California who was concerned about
the law recently signed by Gov. Brown in California. On the show with me was Liz
Szabo from the newspaper USA Today. In addition, there was a pediatrician who is an
expert in parental response to vaccines for their children. Her name is Dr. Allison Kemp.
The show went very well and it was clear that Dr. Sears misrepresented certain facts and
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461cherry-picked information for his own advantage. Following the interview, when I got
back to my office, I received several e-mails telling me that I did a very nice job in being
balanced in my approach.
There has been an additional case of Ebola in Liberia. A 17-year-old boy was found dead
and was shown by PCR to have had Ebola. Since then, there has been an additional case
or two. Therefore, we are concerned that this may be the beginning of another outbreak in
Liberia and perhaps in other West African countries.
Drew Faust, President of Harvard had e-mailed me a couple of days ago to ask me for
suggestions for Dean of Harvard School of Public Health to replace Julio Frenk who had
left to become President of University of Miami. I gave her several names and then she
responded this AM thanking me and telling me that she had just watched “Larry Kramer:
In Love and Anger “ (HB0) and this was her comment to me:
I spent the evening tonight watching the Larry Kramer HBO documentary in which you
figure so prominently—and impressively. The footage throughout is amazing, (I kept
thinking what it would be like to have such a record of the Civil War…), and the story
both tragic and triumphant. I was powerfully struck by your comment towards the end
about how Act Up permanently changed everything in how officials, the state and
organized medicine deal with patient communities. The film will remain in my mind for a
long time…
Very best, Drew
July 7, 2015 – Met with team from Gilead Sciences who presented data on their new
compound GS 5734 that has impressive preclinicakl activity against Ebola. They want
our help in testing it in West Africa. It is an RNA Polymerase with activity against
MERS, and likely RSV, Chik, and others. We will help them and do a trial in West
Africa after we finish the ZMapp trial that is moving along well (47 subjects thus far) in
Sierra Leone and soon in Guinea. Infections persist in both countries. Also, last week
there was an infection in Liberia with 2 secondary cases.
The Gilead people were: Andrew Chang (Head of HIV Therapeutics & Development
Operations; William Lee (Head of research); Howard Jaffe (Senior Advisor); and Tomas
Cihlar (Head of Discovery Virology).
Also, Cliff is back from Guinea and it looks like (despite the continued objections of tom
Frieden), we will expand the RCT Vaccine trial into Guinea where there are persistent
cases.
Had diner tonight at Grapeseed restaurant in Bethesda with the BMGF people who are in
town for our yearly joint gates/NIH meeting. Francis Collins and I and Doug owy were
the senior NIH people there and Trevor Mundel, Emilio Emini, Chris Carp, Chris Wilson
were senior Gates people among others.
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