U.S. Participation in the World Health Assembly
Media Roundtable with
Michael O. Leavitt,
U.S. Secretary of Health and Human Services
Geneva,
Monday, May 14, 2007
Voice: Good afternoon. Welcome to this press briefing with U.S. Secretary of Health and Human Services Mike Leavitt. He is joined by Dr. Julie Gerberding, the Director of the Centers for Disease Control and Prevention; Admiral John Agwunobi, the Assistant Secretary for Health; and Ambassador John Lang, who’s the Special Representative for Avian and Pandemic Influenza. The Secretary’s going to begin with a brief statement and then will take your questions. Following the briefing we will have a transcript available for you.
Mr. Secretary?
LEAVITT: Thank you, and good morning. In the past few years the Assembly’s leading issue has been the threat of Avian Influenza, Pandemic Influenza. In the past few months the media buzz about the Bird Flu has died down a little, but the H5N1 strain of Avian Influenza has not. It remains a serious danger that all of us must face together.
Last year President Bush mobilized the United States to begin preparation for a pandemic. Because the threat is global, our response also must be global. The United States strongly supports this organization’s effort to meet the global needs of an influenza vaccine. We have provided $10 million to the organization to help other countries produce more vaccines. We’ve also been investing heavily in vaccine research and in expanding our own production capability.
The United States also works with partners throughout the world to monitor the spread of disease and to prepare for possible pandemics. We collaborate based on four principles. The first is transparency; the second is rapid reporting; the third is data sharing; and the fourth is scientific cooperation.
We continue to call on countries everywhere to share influenza samples openly and rapidly and without preconditions. No nation can go it alone. All nations have a responsibility. We have responsibilities to participate fully in the Global Influenza Surveillance Network. We have a responsibility to work together toward universal implementation of the International Health Regulations.
The United States is also responding globally to other health threats. We have committed $15 billion to fight AIDS around the world. This is the largest commitment ever, by any nation, for an international health initiative to combat a single disease.
We’ve pledged an additional $1.2 billion to fight malaria, and we remain committed to the organization’s campaign to eradicate polio.
We’ve also embarked on a new initiative in Central America, a Health Diplomacy Initiative. The Initiative has three elements. The first is direct patient care that will be provided by U.S. personnel, particularly dental care. The second is training of local health workers at our regional training center in Panama. And third is closer collaboration with non-governmental health care providers.
I might add that we’ve just completed the first course at this regional training center in Panama and it was on Avian Influenza monitoring. The class was very successful. We anticipate there will be more.
The Initiative is not only bringing our countries together closer, but it’s also making a dramatic difference in the lives of literally millions of people potentially.
Lastly, I’d like to mention a success that we have enjoyed at home. We recently began offering senior Americans a prescription drug benefit. We could have done this through a single government-run drug program, but instead we gave seniors a choice between a government-run program and many different insurance plans. Ninety-two percent of seniors have now chosen a private plan. As a result, the cost of the benefits, both to the seniors and to the United States government, have been far greater than we expected. The costs have been far lower, I should say, than expected. This success speaks, in our assessment, to the proper role of government in health care.
Governments can and should organize health care systems that allow markets to provide care, but they should not be the proprietors of those systems. Government isn’t the source of the innovation that gives us new cures -- the private sector is. Government can’t provide the best care at the lowest cost to the most people -- only the free market can. That’s a lesson of the 20th Century and we look forward to discussing these items with other delegates during this meeting and to find ways that we can work together to address every nation’s concerns.
That concludes my opening statement and I’m happy to be responsive to questions.
QUESTION: I’d like to know where you come down on the debate between public health needs being paramount over intellectual property. Some countries will argue, some governments will argue that intellectual property protection is more important than public health, and the other side says public health is more important than intellectual property.
And relating that to the Avian Influenza Pandemic, it’s my understanding that one of the reasons, maybe the primary reason, that Indonesia is not sharing its virus samples is because it fears that any vaccine that will emerge from this will be too costly for developing countries.
LEAVITT: We believe intellectual property is a fundamental principle. We also understand, we all share an interest in public health. We do not believe they are mutually exclusive.
With respect to sample sharing, as I indicated in my opening statement, a fundamental principle of our mutual protection is sample sharing, and that it should be done without pre-condition, and that working together we can assure that we both have adequate public health but maintain the importance of innovation, or maintain the momentum of innovation that comes through intellectual property protection.
QUESTION: May I just quickly follow up? How do you answer to the concern by Indonesia that if Pfizer or another company invests a lot of money in a vaccine that it’s not going to charge prohibitively high prices?
LEAVITT: We need to work as a global community, we need to work together to assure that there is ample vaccine manufacturing capacity and that those of us who are investing heavily in the technology to provide adequate supplies of vaccines should be willing to share and to work together as a world community to accomplish that. But we all benefit from the innovation and the safety that comes from sample sharing.
QUESTION: I was wondering, sir, if you could elaborate a bit on the latest revelations by the New York Times on the antifreeze found in cough syrup that has led to hundreds of deaths in Panama and possibly thousands around the world. What precautions is the United States taking to avert intermediates ending up in the product?
And secondly, if we could have your agency’s assessment about the toxic filler used in animal feed in China which has found its way through the food chain. And do you share the assessment of USDA that it’s safe for humans to eat meat that might have been affected by these toxic --
LEAVITT: First, let me say that I do share the view of the FDA. It’s been a matter of focused concentration on their part. Food safety is a matter of --
QUESTION: USDA, sir?
LEAVITT: I’m sorry, USDA as well. The FDA in the United States focuses on the feed and the USDA would be the certifying body for the meat itself.
Food safety is, again, because of the nature of the market, a global concern. It is a matter of high focus right now in the United States to assure that we’re doing all we can to assure its continued safety.
I met earlier today with the Minster of Health from China. We’re going to be meeting next week in the Strategic Economic Dialogue. This topic will be a matter of conversation at that time. We are cooperating. China has been very helpful in admitting investigators and working hand in hand to determine the source of the feed and we anticipate that we’ll see continued cooperation in that way.
QUESTION: What about the antifreeze in the cough syrup? What precautions is the U.S. taking to assure that this intermediate doesn’t find its way into U.S. manufacturing? I understand there was a case in 1995 where it was just stopped at the last minute.
LEAVITT: I am aware of that case generally, and I’m also clearly aware and we all have concern about the use of intermediaries. I don’t, that’s a topic of general conversation and specific concern right now in the United States, but I don’t have a lot to add to it today.
QUESTION: Mr. Secretary, I wonder if you can comment on [inaudible] for membership of the WHO? And secondly, how can Taiwan gain integrity into the new framework under the new revised IHR?
LEAVITT: Nothing has changed with respect to the position of the United States on this matter. We believe that we have a One China Policy. We do believe that there is value in technical experts from Taiwan being included in discussions. But nothing has changed on our policy from previous WHO gatherings.
QUESTION: Following up on that, is this an issue that you raised with your Chinese counterparts today at the meeting?
LEAVITT: I did not raise it.
QUESTION: Did he?
LEAVITT: He did, and I stated to him precisely what I’ve just stated to you.
QUESTION: How can you be talking about transparency? And also how would you be able to control, I mean take the case of Indonesia is now refusing to collaborate. If tomorrow Taiwan [inaudible] because now we are seeing what Taiwan has introduced, but they told us last week, but we have to ask five weeks in advance for a technical invitation and we can’t attend sometimes some important meetings. I mean [inaudible], they don’t wait for these other [inaudible]. How can you expect Taiwan to have a very good health policy to be [inaudible]?
LEAVITT: As I indicated, we believe that there is virtue in having technical experts from Taiwan included. We do not support their petition for membership for reasons that have been publicly stated before and nothing has changed with respect to our view on that point.
QUESTION: Are you aware of the Memorandum of Understanding that’s currently being signed between WHO and China which regulates WHO’s relationship with Taiwan? And if so, how does this square with transparency as a sort of watchword in global health?
LEAVITT: I am not familiar enough with the specifics of any such arrangement that I’d feel comfortable commenting on it. I just don’t have the personal knowledge. There may be others that could comment from the United States but I’m not sufficiently briefed to do that.
QUESTION: Would you like to see this memorandum?
LEAVITT: Given the fact that I know nothing about it would be a speculation I won’t enter into.
QUESTION: I was wondering, sir, if in your visit here in Geneva you would be discussing with WHO and fellow Ministers any contingency plans in the event of a bio-terror attack in a major city anywhere around the world. And what are the preparations in the United States at the moment on this issue?
LEAVITT: I’m able to speak more about the United States than I am about any conversations that are occurring here in Geneva during this meeting. It’s a mutual concern, I suspect, that any nation has.
The Department of Health and Human Services under our National Response Plan does have the duty for any medical response and we are constantly updating and improving our capacity to respond through our emergency management and response operations.
I will say there is a nice corollary between preparation for a bio-terrorism event and Pandemic Influenza. The surge capacity that’s necessary is similar in both cases. It’s also true that the distribution issues with respect to medications and other treatments are the same. One thing they have in common is that the preparation has to be done at the state and local level. That national governments have a very difficult time reaching deep enough into every community simultaneously. That they’re able to prepare adequately. So we’re emphasizing state and local preparedness as opposed to national execution of a plan.
Each of our states have created response plans. They are exercising them on an ongoing basis. That would apply both to Avian Influenza as well as a response to a bio-terrorism event.
QUESTION: Following that, there is this ongoing debate as to whether the Smallpox virus should be destroyed or should e kept. What do you think about that?
LEAVITT: I’ll ask Dr. Gerberding to respond to that, and then I’ll follow.
DR. GERBERDING: The United States and the CDC take very seriously the trust that we hold in being the custodians of the Smallpox virus. We also take very seriously our responsibility to conduct the research that the global community has deemed necessary to be sure that we have the best possible means of protecting people should that virus ever be re-released into our society.
QUESTION: But do you think it’s better to destroy it? What is really the argument for keeping it?
ASSISTANT SECRETARY AGWUNOBI: If I may, my name’s John Agwunobi, I’m the Assistant Secretary for Health. I recently had the opportunity to put some of our thoughts in writing in the British Medical Journal.
In answer to your question, we believe that there are great opportunities, continued opportunities for research and science to be advanced by the presence of this virus in the settings where it currently exists of the CDC and our counterpart lab in Russia. These include one, improved diagnostics. The ability to better diagnose this virus should it ever recur in our communities, in our society. Two, improved therapeutics. The need to find treatment modalities that are better than what we have today and offer us the ability to save lives should this ever become present in the community. Lastly, improved vaccination opportunity, improved vaccines. It would appear, there is consensus across science that there are opportunities to further, using science and research, to further at least along those three lines.
I hope that answers your question.
QUESTION: The follow-up is, I have heard that it is possible to do computer modeling of the Smallpox virus so that it’s not necessary to really keep the live virus around.
GERBERING: I don’t think that is adequate to accomplish the three primary reasons for the research that Dr. Agwunobi just addressed. It’s not possible to demonstrate immunity, for example, if you don’t have the virus. So you can model it, but it’s in no way predictive of what you might see in the community. This is a high-risk situation with a virus that no one is currently protected from in most parts of the world, so we have to be sure that we have the means to develop vaccines that will protect people
LEAVITT: You asked, and my colleagues have given you a clear statement of our policy, but let me just say that while the world believes at this moment that the virus is, that the samples are restricted to the U.S. and Russia, but we don’t know with certainty that there are no other samples. So that’s a precaution that we continue to believe is necessary and important.
QUESTION: Do you trust Russia to keep it safe?
LEAVITT: We have no reason to believe otherwise.
Thank you.
