Thursday, July 17, 2014

Francis Collins and I had conference call with Richard Roberts and Marc Lipsitch regarding the above issues. Great conversation. We told them that changes were going to occur and that we cannot give details, but we are going to look carefully at all the issues. In particular, I told them that we were going to re-examine the risk/benefit ratio of doing gain-of-function research in influenza, in particular. They were pleased. July 17 – July 23, 2014 – Attended the 2014 International AIDS Society Meeting in Melbourne, Australia. Before I left, I became aware of a terrible tragedy that had occurred on July 17 the day that I left the NIH to travel to Melbourne. Malaysian Airlines flight 17 from Amsterdam to Melbourne via Kuala Lumpur was shot down by a surface to air missile likely fired by Ukrainian separatists/terrorists. This was to totally dominate the international news over the next days to weeks. I was quoted in most outlets. 297 people were killed including over 100 Dutch. Lost on the flight were six individuals who were flying to the meeting that I attended. Prominent among them was my longtime friend Joep Lange an Infectious Diseases/AIDS researcher from Amsterdam and his wife Jacqueline van Tongeren. In addition, well-known public health advocate and WHO spokesman Glenn Thomas and AIDS action group activist Martíne De Shutter were also on the plane in addition to AIDS activist Pim deKuijer and Dr. Lucie van Mens. I gave a number of media interviews discussing the terrible tragedy and the loss of our colleagues. This appeared in multiple media outlets. In particular, I was interviewed by David Gregory on Meet the Press on Sunday, July 20. The topic of the interview was the mood of the meeting and some personal reflections on Joep Lange. My Plenary Lecture was extremely well received and from my own vibrations of how the audience reacted, as well as how I felt, it clearly was one of the best lectures that I had given. The subject of the lecture with the scientific challenges of an HIV Cure and an HIV vaccine. There were a number of events of note throughout the meeting. Saturday, July 19 – Stayed at Crown Metropol Hotel (very elegant – on of nicest and most confortable hotels on all my international trips). I attended a dinner at a place called Rasheen which is an old and historic building in Melbourne that was formerly the residence of the Archbishop of Melbourne. The dinner was given by the Pratt foundation and the host was Ambassador John Berry, the United States ambassador to Australia. With him was his husband Curtis. I have to leave towards the end of the dinner in order to give an interview live on WTOP radio that was broadcast back in Washington. The interview was about the plane tragedy. Sunday, July 20 - I made a presentation on TB HIV followed by a panel discussion at the Crown Promenade Hotel where I was staying during the meeting. In addition, on that Sunday I made some opening remarks at a Point of Care Symposium that discussed rapid point of care diagnostics for viral load. That evening I went to the Opening Session of the conference which was really not very well done since there were many boring speeches. I had to leave towards the end in order to do the taped version for Meet the Press. Of note, Melbourne is 14 hours ahead of Washington DC. Therefore, even though I taped the Meet the Press session on what was Sunday evening in Melbourne, it was actually early morning in Washington DC. Went to Global Leaders reception at The Cargo Hall on the Wharf after the Opening Ceremony Monday, July 21 - I gave my plenary lecture. In addition I did a filming in celebration of the opening of the Doherty Institute for Infection and Immunity. This is an Institute named after Peter Doherty, the Nobel prize-winning Australian immunologist. Peter was the other speaker at my symposium earlier that day. On Monday night I went to a reception at the Red Desert Dreaming Art Gallery at the Hilton Hotel. The reception was co-sponsored by CSIS with Stephen Morrison, together with Amb. John Berry. That night on Monday, July 21, I went to dinner with Mark Dybul at the Spice Temple Restaurant along the wharf. We discussed broad aspects of the AIDS pandemic and I came up with an interesting idea of providing resources to do phenotypic tracing of virus in hotspots in various regions including southern Africa and Washington DC. The purpose of the phenotypic tracing of viral transmissions was to determine if you test and treat and completely control the epidemic in any given region or location, would virus spill over back into that region and if so could one trace where it was coming from. This has particular relevance with regard to whether or not we would truly be able to end the AIDS pandemic and if we do would, we be able to end it in one region at the same time that it is raging in another region. I will go back to Washington and discuss with Carl Dieffenbach the possibility of funding such studies. Tuesday, July 22, 2014 – I did a Voice of America panel at the Convention Center on HIV AIDS stigma which was in association with a documentary film that was narrated by Elton John. I had a number of other meetings that dayincluding with Wayne Koff who tried to convince me to give major support of NIAID to his “Human Vaccines Project”, which I am very skeptical about since it smacks of the old HIV Vaccine Enterprise. The latter was nothing more than a time sink. I was straight with Wayne and told him of my skepticism. I told him that I would watch to unfolding of the “project”, but I cannot lend NIAID support at this time since I do not know what “it” really is and I really do not see any purpose for it. He understood, but he needs NIAID support for it to work. We left it amicably. Of particular note was a reception at the Club 23 in the Crown Towers Southbank of the Crown Hotel. The reception was hosted by the Kirby Institute and discussed the Test and Treat in Indonesia concept which Cliff Lane and I had been working with and have convinced the Minister of Health Dr. Mboi of Indonesia to go ahead with the study. In her remarks at the reception, Minister Mboi credited me with this idea and said it would not have happened had I not brought it up to her. This was very nice of her. On Tuesday evening we had the international AIDS Society Dinner at this Stokehouse City Restaurant, an elegant location in downtown Melbourne. The dinner was sponsored by Sharon Lewin and Françoise Barre-Sinoussi. It was an excellent time. After that I went to a birthday party for Jen Kates and Judy Auerbach in a saloon in the Provincial Hotel. Wednesday, July 23, 2014 - Departed on the extraordinarily long 26 hour trip back to Washington DC. I went from Melbourne to Sydney, Sydney to Los Angeles, and then Los Angeles to Washington DC. I traveled with Richard Koup and it was an uneventful trip. The day that I left, President Clinto arrived for his keynote. Thursday, July 24, 2014 – Continued press on the MH17 tragedy mixed with interest about the IAS Meeting in Melbourne. I appeared on NPR Radio “Tell Me More” with Michelle Martin. Of note, there has been a recent recommendation from WHO and prior to that from CDC that certain groups (MSM at high risk; discordant couples; heterosexuals who practice risk behavior) should use PrEP (Truvada), which has recently been approved by FDA for PrEP. There is a growing controversy about whether use of PrEP will actually lead to more risky behavior. Data say that it will not. Recent study presented in Melbourne by Bob Grant from UCSF (the OLE study – Off Line Extension of iPrEX) indicated that there was no increased in risky behavior with PrEP and people who took PrEP had less infections that those who did not and use condoms only. I appeared on NPR “Science Friday” to discuss this and other topics. July 25-28, 2014 – Major expansion of problem with Ebola outbreak in West Africa. Cases now up to >1100 with over 600 deaths in Guinew, Sierra Leone and Liberia. Of note, 3 MDs (one died) and one health worker (1 MD and health worker from USA) have been infected. Clearly there is breakdown of PPE even among good people who are trained. One patient left Liberia after his sister died of Ebola and he got on plane to Lagos, Nigeria and got sick and died in Nigeria. Massive presss interest now going on. Al networks (CNN, George Stephanopoulos, etc.) wanted me on TV but the ridiculous HHS and White House wanted to “define the message” before they let me or CDC on the air.