top federal officials testified at a senate homeland security hear on u.s. defense against biological threats like the zika virus and bioterrorism. this is an hour and 50 minutes. good morning.

this hearing will come to order. i certainly want to thank all the witnesses for taking the time to attend, for taking the time to write your thoughtful testimony. we appreciate it. it will all be in the record. this is an important hearing. i would consider this our second hearing on the subject. we had governor ridge and senator lieberman here earlier with their blue ribbon panel on biodefense. kind of a very well thought out document, a lot of detail, probably the number one takeaway from that was the fact that we just have no central authority to kind of accumulate all the data, accumulate the budgets and really direct potential activity, particularly in the event of a significant outbreak, whether it's -- and we dealt with ebola, avian virus, zika.

and then there's one i can't pronounce. i appreciate the work the cdc has already done on that, responding very quickly to a letter i sent. it sounds like you've taken that very seriously and tried to find what is the common caution. very interesting, i guess. troubling in many respects. anyway, this is an important hearing. i do ask consent that my opening written statement be entered in the record. but as any hearing, the main goal of these things is to lay out a reality. so we all understand really what we're facing here. and when it comes to the different types of biothreats, these can be very serious. maybe the good news about all of them is the same types of procedures and processes and kind of management structure can be put in place to respond to just about any of them because the threats are always changing as we're seeing the different type of pathogens, different

biological threats i just listed out. i appreciate all of your work and efforts in all of this and with that i'll turn it over to senator carpenter. >> i understand there's one vote at 10:30. do you want us to keep rolling or to recess for the vote? >> it would probably be nice to keep rolling if we could. we'll trade off. thanks. >> so when the vote starts, i will leave with the chairman's c concurrence and go vote right away and you guys can keep talking and then we'll start asking questions. thank you all for coming. thanks for bringing us together. this is an even more important hearing given what's going on with the zika virus. but as the chairman has said, last fall we convened the hearing to examine a report on this blue ribbon channel chaired by a couple of our good friends,

joe lieberman and tom ridge. one of the main points in their report was somebody in the administration, one searinior person to lead it, we thought the vice president would be a pretty good one. we had a meeting with the vice president and two co-chairs and we'll see where that leads. but there's a lot of work to be done. the pan today we have the opportunity to discuss recommendations with the heads of several agencies, senior people in several agencies who will be responsible for implementing some of the recommendations of the earlier panel. i'm eager to hear your thoughts and hear how you believe we can further improve our country's biodefense systems. this is an important conversation to have.

ebola continues to threaten west africa and the threat of the virus has declined significantly, thanks in no small part that the investment mesh has made. it's a proud chapter in our nation's history of late. with that said, the recent news of more cases in guinea and liberia underlie the need to support our national partners and their efforts to combat this disease. we're almost one year removed from a significant outbreak of a highly pathologic avian flu, which devastated some parts of our poultry industry. and while infections of poultry have been limited in number so far this year thank god, we must remain vigilant and to enforce good biosafety standards across

the country. meanwhile, we're quickly approaching the mosquito season. and this presents us with a new threat, one in the form of the zika virus. the virus has spread and is spkd to spread further as the weather warms. the researchers continue to learn more about the virus every day but it's clear that the health impacts can be devastating, particularly for pregnant women and their unborn children. we all heard the cdc has confirmed this week something a lot of folks have speculated for a while that the zika virus is the cause of severe birth defects. while most of the cases diagnosed in american citizens today have been traced to travel abroad, we must be prepared for

the virus to present itself locally to us. it has been encouraging to see a pro active, coordinated response to the threat. there are significant mosquito control efforts under way in areas most at risk. we know medical countermeasures are being vigorously pursued. the administration announced last week its intent to redirect almost $600 million from other programs, including funds originally designated from ebola. i believe the president has made the right call in this instance. i'm glad he's done this. congress should continue to carefully consider the president's request for additional resources to combat this threat. in addition we must ensure that our public health officials have the tools that they need to protect us from and prepare us from zika and prepare us from

future threats but at the same time we should not let our foot off the gas when it comes to containing dangerous diseases. with that we welcome each of you. thank you for your service and testimony today. >> it is tradition of this committee to swear in witnesses so if you'll all rise and raise your right hand? >> do you swear the testimony you give before this committee will be the truth, the whole truth and nothing but the truth so help you god? please be seated. >> dr. richard hatchet is the acting director of the biomedical -- from the department of health and human services. tease a big title. dr. hatchet served on the white house national security staff

and homeland security council as director for biodefense policy. dr. hatchett. >> chairman johnson, ranking member carpenter, distinguished members of the senate committee on homeland security and governmental affairs. good morning. thank you for inviting me to testify on the state of our nation's biodefense. i am dr. richard hatchett. we'll focus on steps taken to strengthen our nation's health security and the contributions of my own office toward thatnd. we have made substantial progress in the past ten years to advance the state of our national biodefense. thanks to the support of this committee and others in congress, we have established barreda a barda. as highlighted by recent

challenges, there remain gaps in our preparedness. as this committee is aware, a recent report by the blue ribbon panel has indicated that the united states is underprepared for biological threats and the nation is dangerously vulnerable to biological threats. where the civilian public health and medical response to such events is concerned, the as per serves and chairs the hhs days t -- disaster leadership group, which coordinates development

methods. it focuses on protecting public health during an emergency and it overseas two critical program that support medical response. the first the hospital preparedness programs through support of health care coalitions. the second the national disaster medical system deploys medical personnel and related assets when local resources are overwhelmed. the fimcy promotes measures for chemical, biological and diseases. they identify requirements and develop product profiles through product development through distribution and they have an outstanding record of success and is now being studied as a model for global preparedness.

to date at least 23 medical countermeasures that barda has supported have been approved, licensed or cleared by fda under their purview. 17 products ranging from anthrax anti-toxin and smallpox vaccines have been added to the bioshield with nor seven anticipated between now and the end of fy 2018. overall since the year 2000, fda has approved 89 countermeasures for threats and pandemic influenza as well 17 separate changes to already approved applications. this has already paid dividends.

because of the workforce and capabilities we have developed over the last ten years, we are much better to respond quickly to emergency threats. the fimcy is now fully engaged in the response to zika. we know from experience that a well-coordinated fimcy response is a critical naebler of a rapid science and agency response. it succeeds not because a set of government offices succeed but because response efforts across the whole of society are supported and coordinated to respond effectively to threats as diverse and unpredictable as the biological threats that we face. thank you again for the invitation to speak with you and i'd be happy to address any questions you have. >> our next witness is

dr. steven redd, who has been part of the public health service. is it dr. redd? great. thank you. dr. redd? >> chairman johnson, ranking member carper and distinguished members of the committee, my name is stephen redd, i'm director of the office of public health preparedness and response at cdc and it's my pleasure to appear today to discuss the work cdc is doing to prepare and respond to threats to the health of the public. as you know, cdc works to protect the public's health by helping communities improve readiness and response. this is for chemical, biological, radiation emergencies, whether those are intentional, naturally occurring events like the ebola epidemic or the zika virus epidemic or accidental.

there are two key programs at cdc that enable us to prevent, detect and respond to public health threats. the public health emergency preparedness program and the strategic national stockpile. both had their origins before september 11th and anthrax attacks of 2001. they were greatly expanded after those events in recognition of the need to improve the ability of the public health system to respond in scale and in speed. the public health emergency preparedness program's overall aim is to prepare the nation to prepare for public health emergencies. since 2002, $10 billion has been devoted to this effort. the program funds 62 award years, all states four large cities and eight territories. what it actually funds are staff. epidemiologists, laboratory experts, risk communication experts, emergency operation

centers, laboratory equipment, planning and exercising and efforts to respond or to correct things that are identified in exercise as natural events. the strategic national stockpile is the national repository of life saving medicines, vaccines and medical supplies such as mechanical haven't lventilator currently $7 billion in assets. it operates as part of the emergency medical countermeasurement nt prize. it stores and delivers supplies in times of emergencies. both the public health emergency preparedness program and the strategic national stockpile were instrumental in the ebola response and are being used as part of the zika response. so let me now turn to zika. as of yesterday, 41 countries have reported local transmission of the zika virus. in the continental united

states, over 300 cases -- travel associated cases have been reported, about one in ten of these are in pregnant women. seven have been sexually -- acquired through sexual transmission. there is currently no local transmission by mosquito, but the problem exists here because of these travel-associated cases and sexual lily transmitted cas. in pouerto rico there is transmission from mosquito, in 300 cases, 1 in 6 are in pregnant women. to talk about some of the things we're doing in the zika response, you heard from senator carper that yesterday cdc authored a publication that concluded that zika virus causes severe birth defects and identified a number of outstanding scientific questions. on april 1st we convened the zika action plan summit in

atlanta. this brought together state and local health officials to review the latest scientific ns information and to jump start planning at the state and local level. we also issued travel guidance for women who are pregnant within 72 hours of identifying the virus in the brains of children and fetuses that have died. we have developed laboratory tests, we're working closely with local health departments and were implementing mosquito control michiganieeasures with government of puerto rico to prevent transition to pregnant women. public health threats are ever present. duri at cdc we are on the front lines to protect americans from health threats wherever those threats

occur. from recent experience we know that we'll be called upon to respond in the future. thank you. >> thank you, dr. redd. our next witness is mr. kevin shea. mr. shea is the administrator of the animal and plant health inspection service. he carries the agency's broad mission of protecting american agriculture, straighting the animal welfare act and carrying wildlife damage management activities. mr. shea. >> thank you, mr. chairman, senator carper, senator booker, i appreciate you all being here today to hear us. over 8,000 men and women work around the world to protect american agriculture and natural resources against plant and animal pest and diseases. we want to keep them ot of the country, but if they do get into the country, we have the expertise and the tools to detect them and to control them

and hopefully eradicate them. although the crux of our mission is plant animal health, we stand that there of course is a crucial link with human health. our partnerships with the cdc and other federal and state agencies emphasize this one-health approach. animal health can affect human health. and human health can affect animal health. that's why it's so important that we communicate and coordinate with each other. that's why the emphasis on one health in the national blueprint for biodefense is so important and why we strongly support it and appreciate that they emphasized it. i want to highlight just a few examples of what afis does with our partners. one, we created within our veterinary services program a one health coordination center. the center works closely with our internal veterinarians to make sure they are considering human health aspects of animal health programs. at the same time, they work with their counterparts in the human health arena to make sure those

agencies have an understanding of how what they do can affect agriculture and animal health. because this communication is so important, we have embedded an afiv veterinarian in atlanta with cdc to exchange information literally every day. we always share was in with our partners about our well established of thes and when we have information about potentially damaging diseases, we share them quickly. of course this committee knows as the chairman and senator carper alluded to earlier, you all know the devastating impact the avian influenza had on producers but also on the availability and price of eggs and turkey. 1,000 employees and contractors and state employees did the work behind the scenes but behind the scenes the groups in partnership with us today were there and are

very important. our scientists shared information with the cdc. we had no reason to think that it was going to be human health threat but avian diseases mutate. we, working with colleagues in the fish and wildlife service to test wild birds. the good news is we tested 43,000 wild birds over the last nine months and have found no more examples of high path avian influenza in those birds. we spent a lot of time controlling our efforts in controlling avian influenza last year and our ability to detect it and compiled a very substantial, large new planning document on what we can do to

prevent it from becoming a huge plan again. we had a chance to test that out already in indiana, in january, there was one case of highly path ogenic influenza and nine cases of low pathogenic avian influenza and we were able to get on top of that immediately and wipe that out and have no cases since june 17th. something we slerlearned is we to rebuild our response to animal health emergencies. we need to rebuild that workforce. secretary vilsack certainly recognized that and in the budget request for fiscal year '17 there is a proposed $30 million increase for animal health emergency response.

we realized how lucky we were to get on top of the avian influenza after all the damage it did do. that here. i'll certainly answer any questions. >> thank you mr. shea. our next with the is dr. aaron firoved. it's kind of pronounced -- yeah, whatever. firoved. director of the national immigration center in the office of affairs in homeland security. he served as the biodefense adviser and chief medical officer of the department. dr. firoved. pretty close, huh? >> sir, we've got generations of people being called firevoid. in my family. so -- chairman and members of

this committee, i want to thank you for this opportunity to speak today. i appreciate the opportunity to testify on the homeland security role's in biodefense. with my colleagues. as you mentioned i'm the director of the national biosurveillance immigration center. i'm a microbiologist by training and work at the national institute of health. these experiences have given me a broader understanding of the biological threat to our homeland. the threats and risks posed by emerging infectious diseases and the use of biological agents by terrorist organizations, violent extremists and rogue states will continue to challenge our ability to warn, prepare and protect the homeland. in the quake of these threats the department of homeland security remaining completely engaged in providing the

emerging of imminent diseases and making sure the department is looking unabated should a biological terror occur. dhs provided intelligence to the inneragency, states and local governments. and the threat of ebola existence and operational responses and coordinated and implemented the enhanced screening for five airports. continue, we continue to build on the lessons learned from the responses from ebola and provide all the other biological threats as we tackle the re-emergence of virus like zika, to make sure we have timely information and in the health interest of detainees in our care and custody as provided for. we must remain vigilant and

innovative as biological threats continue to evolve and new threats emerge. the dhs office of health affairs coordinates the department of biodefense activities to understand and meet these threats today and to be ready for the threats that will emerge tomorrow. ohs has advice from multiple sources. for large-scale biological events knowledge as quickly as possible allows informed decisions that can save american lives and to this end the department's bio vital. the national biosurveillance immigration center is situated to provide a fusion of human health, animal health and date to ensure decision makers have timely and actionable information. to accomplish this, we monitor thousands of data sources and leverage expertise of 14 federal departments and agencies who are members of our charter.

including those that you see at this table here. and integrate this information into reports of biological incidents that can potentially cause economic damage, social disruption or loss of life. reports by my good colleagues at gao and the blue ribbon panel on biodefense has acknowledged the progress we've made in delivering situation wall awareness to our partners but we still have a lot of work to do to fully realize the vision that this committee helped to start with the comprehensive biosurveillance integration. to address this, we're developing new collaboration tools pursuing innovative methods and fostering better stakeholder engagement. dhs' biological program provides federal and state and local leaders with actionable information on detection of a biological agent to coordinate an effective response. one importantly overlooked benefit of the biological program is how we work with each

local jurisdiction to ensure that the decision makers are familiar with how the coordinated and responsible and full should the detection of one of those agents occur. there is no other program that provides this layer of biological defense. the dhs science and technology dreshlgt is currently collaborating with oha that will shorten the time to detect biological agents as well as other short and long-term capability needs. one of our most critical roles with the integration with local public health management and community partners in prosecution and response to biological events. one initiative we're developing in coordination with hhs is the first responder vaccine initiative. we're evaluating the program for first responders using an

anthrax vaccine. i thank you for your time and look forward to answering the questions. >> thank you, doctor. the following witness is mr. chris currie at the government office where he leads the agency's work in evaluating emergency management, national preparedness and critical protection issues. in this role mr. currie has led the roles of numerous programs to respond to natural and man made disasters and attacks. >> thank you mr. chairman and members of the committee here today. i really appreciate the opportunity to be here. today, i'd like to talk about gao's work on biodefense. defending the u.s. from naturally occurring and man made defense is a critical effort. a large and fragmented effort not only at the federal level but across levels of government and the private sector. the number of federal departments at this table debate

alone demonstrates this point. in a hearing last fall, your committee heard the findings of recommendations of the blue ribbon study panel on biodefense. our work through the years has come to many similar conclusions and recommendations. today, i'd like to talk about this work, ranging from coordinating the entire biodefense enter pricing, down to improving very specific programs. at the highest level, the blue ribbon panel concluded that there is no central leader, no comprehensive national strategic plan and no all-inclusive dedicated budget for biodefense. our work is also found that there's no national strategy or single focal point for biodefense. as an illustration, there are over two dozen presidentially appointed officials with biodefense roles. over five years ago, we recommended to homeland security council within the white house develop a strategy and designate a focal point for coordination. they did issue a strategy if 2012 and designated offices within the white house as afocal

points. and this is progress and shows commitment coordinating biodefense efforts. however, it just doesn't go far enough. the strategy does not identify resource and investment needs which is critical to help prioritize across such a complex enterprise. we've heard that the national security staff complae created a more specific implementation plan to the strategy, however, we don't know the strategy to which it's actually being used across governments and departments. thus, we don't know if it will operationalize as we think it should. we've also identified challenges of specific agency biodefense programs such as those within dhs. a report last october found that 12 years after the by lodgic program was first deployeded there are still not we also

found because it's not fully tested its uncertainties and recommendations are unknown. we recommend that dhs do not establish upgrades until it performs performance tests i'd like to talk about our work. it was set up to be the integrator, analyzer of information across the federal government. however, it's never fully met this bar. it's met the recommendations with collaboration with cdc and hhs and usda. however, we reported last year that persistent challenges still get in the way. for example, most of the primary partners like cdc and hhs told us that products didn't add value, did not provide new meaning or did not help them identify biological events quicker. and also still has difficulty getting the data it needs

because partners won't share it or there are restrictions to sharing that date. the challenges that it faces is not easy to address. we've identified policies. however, these options may require changes in law. and it's not clear that even these will address the challenge. this brings me back to the bigger issue. as we in the blue ribbon panel noted investments and specific programs should be evaluated in terms of costs and benefits but they should also be prioritized across other programs of government as part of the national biodefense strategy. another critical part of this prioritization should be and important to ensure that the limited resources are directed. it's difficult for decision makers and congress and those in executive branch to make resource decisions above the traditional agency by agency

approach. and this concludes my prepared remarks. i'd be happy to answer your questions. >> thank you, mr. currie. i want to kind of go back to this. within the specific agencies talking about sort of an update on exactly where we are. i want to start with the usda. mr. shea, the avian outbreak occurred between december and june. and that was basically migratory birds flying south, correct? but also in june, air obviously flying back i just want to get -- to what extent have we dodged this bullet. have we gone through two additional migratory patterns without that? >> mr. chairman, it's still difficult to say. what ended up being the final end to the outbreak last year really was the on set of warm weather. once the temperatures get consistent above 70 degrees. the virus pretty much won't

survive. >> very similar to human flu then? >> yes. >> we were getting it coming and going, might go combra tore birds coming and going and then the temperature got to a point and that outbreak ended? >> exactly. what happens with might go gra forebirds when they're flying south, they pretty much have a clear path. they keep going. heading north, they can slow down. for example what happened last year, the reason we felt it was so bad in iowa and wisconsin was that the birds were heading north and the weather was still too cold, it got to a spot where the lakes were still frozen. >> i live near one of those lakes. okay, i've got it. that's pretty good news, though. the outbreak in indiana, is that typical where on occasion we see these small little outbreaks and stuff and we can respond quickly, is that -- >> it's typical to find low-path influenza outbreaks. what we believe happened is

probably a low-path virus that mutated in one farm. the surrounding area were low-pathogenic. >> that was just spread within that localized flock hopefully? >> it may have started with the might go g migratory birds but as you suggest. >> i want to talk about ebola. we'll go to dr. firoved. has that been wiped out, contained? are there any cases in africa that we're aware of? >> unfortunately, we have seen cases re-emerge in guinea and liberia. there is active tracing going on. >> doctor, tell me what happened, did we get to a level of zero and it's coming back or why not? >> so the widespread

transmission that we've seen in 2014 and 2015 has been contained. what we have seen repeatedly in liberia, sierra leone and guinea are slow responses. very much bringing it like under control when it was wide ved. unfortunately, this is not unexpected. the latest case we believe is from sexual transmission. a person that had ebola in the past transmitted that disease through the route of sexual transmission. and then a small cluster occurred. and i think that this outbreak is now being worked very hard, both in guinea and in liberia. amend those cases in liberia are connected to the ones in guinea. the thing that's different now is that the response is very vigorous, large number of contacts being identified and traced to be sure if one of those people does become sick, they'll be put in isolation and

given treatment very quickly. >> so, because of the tragedy that occurred there, is the general population that is far more educated on this as well, in addition to the public health and safety officials know how to respond? i mean, is it a combination of that -- or primarily -- what worked what lessons were learned? >> well, i think to go back to the lessons the situation that occurred right now is not that different than what occurred in march/april 2014. in terms wr s of where the dises occurring and the location. the thing that's different we have a much more vigorous response. both in guinea and liberia, there's the potential to identify those cases quickly and respond. and there's an international presence to respond. to go back to 2014, the things that didn't happen that need to happen were the ability of those governments to rapidly identify cases to respond effectively to

them. and when the response wasn't going well torsion call for help. and for the international community to be able to respond. that is basically the structure of the global health security agenda which is being blemented in those countries. and in other countries in africa. asia. and the americas. >> so, you're basically describing a real -- you know, a real progress in terms of public health and safety officials. has there been any progress just in emergency room its of information to the general population where these thing's let's face it ebola breaks not these african countries? >> i think that there has been. and i think particularly at that inflexion point, depending on the country, 2014 and 2015, it's likely that a lot of the control was actually implemented outside of official channels that communities understood the risks that ebola caused. and took measures into their own

hands in terms of isolation facilities, local care. i think this is actually a really important question that we need to have kind of better hard data on. but it appears that that was an important part of the response. in addition to the community mobilization and communication efforts that took place. >> i hate to ask this, but what was the final mortality rate? i mean, how many people were really affected? you know, when this first broke out, we were projecting literally a few months from in, 1. people. >> yes, sir. >> how did we finally contain this? >> it didn't reach 1 million people. that estimate of 1 million people was in the absence of any control measures. i think in some ways even better the number was mafs, it wasn't -- >> it didn't hurt to get the public's attention to respond. so did we end up with tens of thousands? >> tens of thousands of cases, 10,000 or so deaths. and just for context, the total number of cases in all the

outbreaks up to that point was and 2 tha,500. so around 10,000 more cases than ever occurred. one of the things thinking about the sexual transmission side of it, we probably have twice as many male survivors as there were total cases before this outbreak. >> is that pretty unusual? i mean, was that because of additional treatment? hydration? i mean -- so, how many people were infected, how many people died? what was the survival rate? >> roughly, i can give you the exact number -- >> i'm just looking at -- >> 25,000. >> from how many people? >> 25,000, 12,000. i have to say the quality of that information particularly when medical services were

overrun, many deaths occurred. >> i understand. where are we in terms of development of a vaccine. ebola has been around. we were working on a vaccine that was not top priority. i would imagine it's a priority, have we made progress? >> yes, sir, i'll answer that question and turn to my colleague from barta. the vaccine is being used now to contain the outbreak in guinea and liberia. there were three different trials of different vaccines, the ones in liberia and sierra leone, the vaccine got there after the disease was on the downtrend. so they were not able to show effectiveness. they were able to measure the safety of the vaccine. a trial conducted in guinea using a different strategy to use the vaccine and to measure its effectiveness did find a vaccine to be effective. this was a containment strategy, where a case was identified.

and then the cluster of contacts and the contents of the contacts were administered. >> what value of effectiveness? >> on the exact number, i think there's questions whether a person was exposed or not. not sure to be effective or it wasn't tested to be effective before the period of six days after exposure. so, after that period of time, it did demonstrate effectiveness. i can come back to you with the exact number. >> i actually have the luxury. i'm here by myself and keep asking questions. did we ever get to the bottom of those nurses in texas? again we were assuming that we kind of had this understood. and we were going to take precautions. and yet we still had -- you know -- >> yes, sir. >> -- did we ever solve that mystery in terms of how that -- >> i'm not sure we totally solved it. what we did do is put in place a different plan for personal

protective equipment which included very specific guidance on what types of protective equipment were needed. and also put in place a strategy to train, to use that personal protective equipment, before needing it. then additional specificity of when a person is being treated for ebola, including things like observers to make sure that a person didn't accidentally, when they're taking the equipment off, kind of a risk period, something didn't happen. and they're also following those individuals after the person was gone. similar to the returning travelers that dr. firoved mentioned. tracking them daily until the potential incubation period was over. >> so, from the start of that outbreak to, you know, kind of the final conclusion of it, it seems like certainly the procedure was, you know, we can handle this in hospitals to the point where, no, let's do it in very specialized hospital snaps kind of the process of

procedures in place now? that we're going to have basically centers of excellence here. and maybe hostals are going to be ready because they had to respond properly. but then transport individuals that prove positive? >> so, for ebola, that's the system in place. i think a lot of the discussion is about other diseases that there might be more cases and in trying to adapt that system so we have the right care for people who have these very clear effects. and make that -- >> by the way, ebola is obviously unique disease. but procedures in place, those are procedures for a number of different situations, right? >> yes, sir. i think there are a couple characteristics about ebola that are different. but i think the main one is the small number of cases and the need for very rigorous infectious control procedures. if there were a large number of procedures, the system we have in place would have to be changed. >> right.

>> and kind of a dozen of cases level of capabilities. >> dr. hatchett, can you speak to the progress of the vaccine, the ability -- obviously, the eb effectiveness and the ability to produce it? >> sure, would like we to touch on the treatment facilities? >> sure. >> just to answer that question. through the preparedness program with the assistance provided by congress and the ebola supplemental, we have established a tiered system nationally of ebola treatment centers. there are now real nagional ebo treatment centers and there are three at the pinnacle. and feeding hospitals, i believe the number is 73 state or local ebola treatnt centers that can manage patients temporarily before they can be transferred to the nine centers that are fully equipped. and then there's a larger system of assessment hospitals.

i believe the number is over 200 nationally. >> i've got to go. i'm going to turn it over to senator carper. >> mr. shea, unfortunately, i had to leave as soon as you started. it wasn't cause and effect. we trade off on this, we have 15 minutes in which we can vote and keep things rolling. and don't ever delay you on that. just take a minute, like the house of representatives, people give one-minute speeches. give us your best one minute, please. >> i'll do my best, sir. i think from my oral statement there were two big places i wanted to focus on, one was i call the 66,000-foot level. the coordination across the bottom enterprise. and the second piece was looking at some specific programs at dhs that we've looked at. of course, we've done a lot of work at hhs and usda as well.

let me focus on the 60-000 foot level, one the areas we've identified over the years and so has the blue ribbon panel is the lack of unified strategy at the top to guide all of the department and resources and all of the departments work hard in doing a good job to their individual missions. the problem is there's no one above who has the authority or ability to actually drive resource decisions and priorities. so is that makes it very difficult to know if we're addressing the top priorities. so that was a key point from my opening statement. >> all right. as we talked a little bit about it, i mentioned the blue ribbon study panel co-led by joe lieberman and tom ridge. and one of the recommendations spoke or at least attempted to speak to the point you just made. let me just ask you, ask all of you, with respect to the

recommendations -- i think you made 33 recommendations one was the biggest one should be the person to lead this, what current activities are we taking or planning to take to address the recommendations contained in the report? what do you think about the recommendations that the vice president, in this case, joe biden to lead us for the next nine months and presumably whoever succeeds him? >> i can start. >> yeah, please. >> so, we have not taken a formal position on whether the vice president is the right place to place that responsibility or not. but what we do understand is why the blue ribbon panel made the recommendation that the vice president serve that role. because it needs to be somebody in a position of authority that can dictate all of the federal departments each with their own powers and responsibilities to do things and spend money a certain way. we made our initial recommendations along those lines to the national security staff and the white house. and so, i think our goal there was, again, to put it at a level

that was above the departmental level. so far, i think we've been a little underwhelmed at the efforts that have come out of the response of that recommendation. there's been some strategies developed. the problem is, even in those offices they still have trouble dictating what the other federal departments are doing. what it is, i'm not sure but the problem is consistent across our work and panel's work. >> dr. hatchett, what current planned activities are you all planning to take to address the recommendations contained in the report? >> so -- thank you for the question. we certainly participated in the process that led to the development of the report, we participated in the meetings. we read the report with interest when it came out. we feel that we have actually undertaken practiveties in some

of the reports of the ebola treatment center and management of diseases that require high containment. that in some ways is similar to one of the recommendations within the report. we are not responding directly to the report. but we certainly feel it's been a valuable contribution to the national discussion on this issue. >> do you think, mr. currie, the point the blue ribbon panel recommended the vice president be anointed to follow or implement the recommendations of the report, if not, the vice president would have the junior sort maybe from new jersey, there's not much going on now, he's finished his book tour? i'm just kidding. >> so, we feel that we have effective cross-government mechanisms in place already to ensure that threats can be identified and responded to

appropriately within this -- the statutory sphere of the secretary for preparedness and response. we actually have mechanisms in place which reduce the need for a central oversight sfig. we have two very effective coordinating bodies that are bodies that work within the cdc, and department of defense, et cetera. the first is the disaster leadership group which the assistant secretary convenes in response to complicated emergencies. that address is policy issues that will arise in recent months. for example, we have convened two different disaster leadership groups one to address the front crisis and the other to address the emerging zika crisis. within the domain of countermeasures we have a very effect tiff coordinating body enterprise. i cited some of the successes that we have demonstrated.

that entity has really evolved -- >> i'm going to ask you to hold it right there. otherwise these guys will never have a chance to say a word. dr. redd. microphone. >> sorry. there are a number of recommendations that pertain specifically to cdc. i could go through those now. or we could submit written answers to that. just quickly, recommendation 15 is a collaboration with the department of homeland security on anthrax vaccination, we're providing that vaccine that would from the strategic national stockpile. there's a recommendation to develop or implement a counters measure response work. we're actually working with our state partners countermeasure enterprise to implement improvements on the distribution and dispensing of the stockpile. and there's a recommendation to allow for forward deployment of

s and s assets. that was number 23. we're working closely with new york city on really kind of a project management formula, that when they're ready to administer from the stockpile, that we get it there that quickly. so, matching the delivery from the stockpile to the local capacity. we'll be working with other held jurisdictions to marry that their capability and our capability. there's a recommendation to overhaul the select agent program. i think that will kind of fall into the overall category of high level policy decision. we're doing a lot of work to improve the select agent program, within our authority. improving the inspection process. the process to report incidents that are identified at the facilities and to improve the communication and transparency

aspects of that. there actually had been three recent -- >> dr. redd, i'm going to ask you to hold it right there. what i think i'm going to do is ask you each an answer for the record for the status of your implementation. those of you've begun implementation, those that you've completed and those that have no intention of implementing. use that as a response of important you think the vice president is a better person to oversee the implementation or senator booker as i suggested a possibility. when we ask those questions maybe we can cast some light. just raise your hand, how many think we need somebody like the vice president who can sort of oversee the implementation, that without that, we're not going to make the kind of progress that we otherwise would need? how many thinks, if you do, raise your hand. and if you don't, raise your hand. all right. thank you. let the record show booker, two,

joe biden, zero. i saw joe bide n leaning, too. >> senator booker. i want to thank you very much for holding -- cut in now. it's a little incongruous to me, because as the risk profiles are

calculated by the department of homeland security, we've actually seen increases in some areas. for example in fiscal year 2016, department of homeland security recognized new jersey's vulnerability to a targeted violent attack and heightened the state's risk score to threat. and the dhs also raised our grants or urban area security initiative vulnerability, moving in from 11 to 7 on the risk index. so, we see that new jersey, when it comes from risks, terrific attacks, bio attacks and the like is getting more severe. but yet, somehow, in the formula, we're being cut from the hpp program. i'm just wonder what's the reason for the cut given the department of homeland security sees us and you understand, new jersey is -- i live ten miles from manhattan. we are a -- in fact, manhattan's

moving their back offices and a lot of their infrastructure to new jersey. which, again, as dhs sees as heightening our risk. so, i'm wondering, is this, in your opinion, problematic? is it incongruous as i see it or a different way? >> so, i can't speak to the particular case of the new jersey allocation. but i can say that the urban area security mission of risk scores are figured into the hpp, the hospital preparedness program formula. and that that formula sand those allocations are reviewed annually. so they are adjusted annually. there are many other factors other than risk score which go into the formula, certainly, population, et cetera. given that i am not myself personally responsible for the hospital preparedness program, we can certainly get that to you with a more detailed response. >> yeah i would really appreciate that. maybe we can even meet on it.

if it's population, new jersey is the most densely populated state in america. if it's critical infrastructure, we have the most dangerous, they say, couple miles. there is chemical companies, you name it. i just don't see how we can be going down especially when areas of the federal government see this as a higher and higher risk. i would appreciate that. >> yes, we'd be glad to do that. >> thank you. thank you very much. let me go over real quick, just some of my concerns about, in general, about zika and some of the other elements. so, first, dr. redd -- is it red or reed -- >> redd. >> forgive me. you can explain to me, the process for the new jersey emergency health program, the fep program, because the federal

government has allocated for zika, that we've seen monies taken away from states including new jersey. it raises concerns that we're moving around a finite pool that has urgent needs as opposed to money. and that might be weakening our progress. were you explain the cuts? were they blunt cuts across the board? or are we looking at safety and concerns for security? >> let me start by saying that i agree with your underlying point which is this is a new threat and we need supplemental appropriation to be passed. that would address the program. >> that's a very profound statement that i want to repeat one more time. you agree this is a new threat that we should be making supplemental new funding as opposed to taking away from current dollars? >> yes, sir. >> thank you. >> that is definitely an important statement, thank you. >> so, in the absence of that, there is a very difficult

decision that the administration had to make. whether we would respond to the current threat or not. and the only way to respond to the current threat was to identify funds that could be used now. i think your description of blunt instrument is construct. that there was an across-the-board cut to the hospital emergency prepared program. it was a little complicated as to how each dollar was arrived at for every grantee. every grantee lost funding. >> maybe somebody would like to chime in. we seem to be off the reactive. do we have analytics on what's coming? could we be doing a better job heading some of these crises off? >> i think that's a very big challenge and one that we

continue to work on. to take the particular case of zika, there are many aspects of this that are unprecedented. it's been 50 years since an infectious disease has been identified as the cause of the birth defect. there's never been a birth defect caused by a transmission transmitted by a mosquito. if we can to use the historical record this is not something that we would have predicted. i think that there is a need to be able to forecast more effectively than we've been able to do. totally different problem with ebola, although the event that occurred in west africa was also not predicted. i think that event, had we had in place the systems that are being put in place now, we wouldn't have had the event that we had. we might have had something that's similar to what we're seeing now with the very rapid detection and response to a problem. >> okay. then i'm going to submit one more question for the record because i have to go.

but it's more about just general preparedness. i like the idea that you said in testimony, that preparedness is not an event, it's an ongoing process. but i do worry about the states having run a lot of tabletops for a lot of things. i worry about our overall state. and federal working coordination in preparing for a lot of the problems that i think are going to become more and more unfortunate. i think there are going to be more and more seen, not just here in the united states. but threats coming from overseas. so, thank you. >> thank you so much, senator. senator booker. senator peters. >> thank you, senator carper. and thank you to our panelists for the testimony here today. i certainly concur with our colleagues, we appreciate you being vigilant and on the job every day. these are serious threats and appreciate your dedication to it. in addition to being on the homeland security committee here i also serve on the commerce committeeing and i'm currently

the ranking member on space, science and compeltiveness. i'm currently working with senator cory gardner on a group that's going to be recognizes the americans compete act. from my perspective if we're going to increase our bio preparedness that we need to fund basic science research and consider it both a national and really a homeland security priority for us. last year, the hearing examining the blue ribbon study panel on biodefense, this committee heard that report found that federally found scientific investigators are more likely to engage in early stage research versus private sector focus on specific product goals and end user needs. and this was the cause for ebola medical countermeasures not to be available when they were needed. in looking at the americans

competes act the working group examined global bio research and found that private investment in the united states correlates very closely with government investment. when government investment and r & d shrink or stagnates, the private sector pulls back as well. when government grows its investment, the private sector tends to follow suit. and yet funds has fallen below 1% of gdp which i believe is unacceptable for our future and important for biodefense as well as the seed coin for innovation. given the correlation between federal and private sector investment i'm a big supporter of robust federal funding for basic research. and believe that research can certainly contribute to the next big thing. whatever that next big thing is. but it also sparks industry, creates jobs, builds the economy. but as discussing today it also improves our biodefense preparedness as well.

so the challenge is deciding the right ratio of basic and applied research and the appropriate funding levels for each and the proper and private role of the public secretary per. first for dr. hatchett and dr. redd, you can explain how the agencies make use of your research, kind of the sense of where our needs are and what you would like to see? >> sure, sir. thank you for that question. just to be clear, so, i am the acting director of the biomedical development as our name implies we work in the area of research and development. as we understand that term, it means when we're working on medical countermeasures, these are medical countermeasures that have reached the clinical stage of development and many of the problems relate to the clinical testing of the product, as well as to scale up and working up manufacturing issues so we can conclusion the products at large scale. we have to depend on our colleagues at the national

institutes of health and the department of defense to fund that basic research. we don't fund the basic research. and it's very important for us to coordinate our efforts, with them, so as they cultivate products and bring products forward to the earlier stages of discovery and development we are ready to transition those. in the case of ebola vaccines and ebola they'rapeutics for th part. ebola has been our threat list for some time. it's one the material threats that the department of homeland security has identified nih and basically searched counters measures and have been moving those countermeasures forward through the cycle. when the ebola cycle started in 2014, none had reached the stage where our organization -- that they were ready to be developed

within our organization. within a very short span of time, within a year, we were able to transition 12 products from that precourse development and many of those products have been actually tested in west africa. we do have a strong system in transporting product. and i couldn'tal agree with you more in the importance of basic research. >> thank you. dr. redd. >> if we had a panelist from ni hi you'd had a proportion of applied research and practical application. so we do some basic research ourselves but predauominanpredor goal is to make sure they're used and identified. we're more on the end user side with respect to research and use. >> do you believe we need to put more in research as the threats

seem to be developing and at some ways in an accelerating rate? and that we're probably doing ourselves a disservice by not putting ourselves in the basic foundational level? >> i think we do. and a bottleneck to get through the system to find out if they're going to be useful in large populations and be effective. and some of those questions are not possible to answer at the basic level. >> anybody on the panel like to weigh in. >> sure. at the department of homeland security, we have a science and technology directorate, and it's critical to helping the department meet the needs of the stakeholders, whether first responders helping to make improvements to the biological program, and it relies on the diverse program. with excellence. just recently since we've been talking about ebola, some basic understanding that have significant ramifications for biodefense have to be answered

still. so one of the questions is how persistent is ebola on surfaces? how long did it remain infectious? so one of the studies that was conducted with our partners was trying to understand what does it do on the carpets of an airport, or on surface that an employee might encounter in an airport. so this kind of basic research has real serious implications for our day-to-day operations. so it's critical. >> right. thank you. appreciate it, thank you very much. >> thank you, senator peters. looking at the list of folks here. when the gavel came down, and then it came back next on the list as senator earnstein, looking for somebody with previous medical experience, a colonel. and maybe you could be next for us. >> okay. thank you ranking member, i appreciate it. thank you, gentlemen, for being with us today. and this question is for anyone on the panel, please. and i want to follow up on a

question that was asked earlier by ranking member carper. one of the blue ribbon study panel's top recommendations was the development and implementation of a comprehensive national biodefense strategy. this administration has failed to failed to present a comprehensive strategy in a number of areas, whether it's defeating isis or countering the using of social media that lacks access. agency the blue ribbon study concluded the u.s. is unprepared for biological threats. and it's critical that the u.s. develop a comprehensive biodefense strategy. could mr. currie or anyone else on the panel speak to the importance of this recommendation? >> yes, ma'am, absolutely, we think it's important. and our findings and

recommendations were similar to the blue ribbon panel's finding and recommendations. it's important to note it's not easy. and one of the reasons why it's so significant to do this and the recommendation to provide the vice president the authority do this because it has to come at a level that's in the cabinet at the department level. because the departments cannot tell other department what is to do. it's very difficult to allocate resources between the department. for example, deciding we want less resources in one department's program versus more in another. that's exactly why such a global national strategy across the federal government is so important. but it's very difficult to do. >> yes, and we understand the difficulty. but also the importance and necessity of doing that. would anyone else like to respond? >> yes, ma'am. >> thank you. >> thank you for the question. while the office of the assistant secretary for preparedness and response has not developed a strategy of the

parameters that are described in that report, i do think it's important to point out that they did lead to development of a national health surety strategy. the first national health security strategy was completed in december of 2009. an updated version of the strategy was completed in december of 2014. the national health security strategy is a broader strategy. it doesn't just look at biodefense. it also focuses on securing the nation's health security as the title implies. it has five major strategic objectives. the first is to present the development of resilient communities that are capable of responding to all kinds including bio threats. the second is promote enterprise. the third is to provide health situational awareness so

decision makers can responsibility appropriately. the fourth is to provide integration of health care across the in addition at the different levels of government. the last strategic objective is to promote global health surety to address issues like the ebola epidemic. so that is an overarching strategy that governs a great deal of what we do in biodefense. in developing that strategy, we did work with stakeholders in all levels of government and inneragency partners. >> that's wonderful. very good first step. for the administration, thank you very much for being here. how do we integrate information about animal and human health without creating or perpetuating misunderstandings and fear and consumers both here and abroad? we do see this where perhaps the chinese or other governments will push away any commodities, produce that they feel, you

know, might do them harm. or they can make that up. so, your thoughts on that. >> i think one thing that's very important that we stick to the science and we work with our colleagues on the human health side to be clear about the science. a really good example of that, of course it affected your state is what was being called swine flu in about 2009. when we should have called by its proper scientific name novel h1n1. and it's important to do that, industry is so important in iowa, of course, to put it at a disadvantage because of the fear of an influenza that really shouldn't have been attributed only to swine. so that's why it's so important that the science be integrated and that we speak with science. i think that's why it's important we have someone embedded at cdc which we do, and work on a daily message to make sure that the messages go back and worth.

>> also, you spoke about the swine flu, we can talk about the avian flu, go ahead, sir. >> thank you. i can to point out there are robust communications that go on. within our center we actually have a liaison with aphis. just this last fall, we're seeing erroneous news reports come up about resurgence of avian influenza that just were not install accurate. but working through the national wildlife health center, also with the department of interior, as well as our colleague at aphis and usda, you know, we're really able to push through those agencies and able to tamp down these stories. and really preventing a story from gaining legs, that could have economic consequences. so, i think that the one health

approach is so critical to everything that we do. we need to continue to bridge this divide. >> great, yes. >> just briefly, to support the administrator here, we have a very intense scientific interchange with usda on an influenza and on also for food-borne diseases. so there are some pockets of just very, very close collaboration. >> very good. well i appreciate that so much. and we spoke about this earlier, or we heard about it earlier. but as you know, last year, the poultry secretary was rocked by the avian influenza. or hpia commonly called bird flu. and this was very december statistat devastating in iowa where it infected over 1 billion birds. and it was one of the most foreign animal disease outbreaks

in nation's history. and the wildlife sector is impacted with these diseases and they struggle to control them, with new ones popping up each other. it's not inconceivable that an ill intentioned actor could purposefully a pathogen in the u.s. to mess with our trading relationships and economic security. i know i'm going a little over time. but to that end, what is the usda doing to prepare for the theft bio terrorism? you can give us i broad overview on that? >> mr. chairman, i'm going to ask you to suspend your answer. i'm interested in your answer. senator pullman has -- if we could yield to him. >> senator carper, thank you for having this hearing i've got a number of questions i'm submit for the record. probably to each of you, at

least to three of you that i see there. i want to focus on one issue, dr. hatchett, if we could. we talked a lot about ebola and the zika virus. and they're very different. and my understanding is the way in which someone becomes contagious with ebola creates a health problem in and of itself. whereas, with zika, it's not as easily transmitted from person to person. however, it's transmitted from mosquitos to people, very easily. and i just wonder what you think we could do in terms of leveraging all of our assets, including one that happened to be situated in youngstown ohio. which is the 910th. it's the airlift wing that provided work for our firing ranges, they do work with regard to oil spills but they also do work with regard to mosquito infestations. do they have a role here with regard to zika, particularly in the spring in the southern part of the country where ke can see unfortunately a movement from latin america up to the united

states? >> senator, thank you for that question. that type of control, vector control, is an area of the cdc i'll direct that to my colleague. >> it's hard to give a global answer to that question. the variability of mosquito controlled districts in the u.s. is remarkable. some localities have really finely honed enterprises. others, hardly at all. i think that there could be a role for that air wing in locations that don't have the capability and need it. one of the things that we think is really important that the zika virus outbreak is pointing out is the need to really revitalize those mosquito control efforts. not only for control but really to understand what's going on. part of what those mosquito district controls do is capture

mosquitos and we just don't have the information that we need right now in the u.s. to make the best decisions. >> well, thank you, dr. redd. and thank you senators. i understand want you to know the 910th is ready and willing. and, again, do outstanding work. and i think it would be a way to leverage some of those dod assets to address a very real potential biological issue that we're currently facing as we did with ebola over the last couple years. thank you. >> senators. >> thank you, ranking member. i will go ahead and just submit the questions for the record in the interest of time. >> go ahead respond. >> i have a hard-stop also. >> i'd like to hear it. >> bio terrorism efforts. >> of course, we work very closely with our colleagues in homeland security, border protection, we actually conduct inspection gz of things coming into the country.

so that's very our first line of defense, looking for things. but after that, what's important, of course is finding an outbreak quickly. so surveillance is really the key. we have surveillance on farms, in markets, feed lots, everywhere. and surveillance comes not only from usda people but more abundantly from state people and from private veterinarians who we accredit at usda. and when they find a disease, they are duty-bound to report that to us. so, that's really the key surveillance, prevention, keeping these thinking out of the country and getting it right away. some other things on the course of dhs, they are developing measures at the disease center soon could be relocated. but they are working very hard there to find countermeasures, detection methods, so all of those things are in place now. >> just to follow up with that then, as we're prepare for a

potential incident, is it important that we have stock miles of vaccinations or other veterinary supplies then to safe guard? >> absolutely. we do veterinary stockpile. but it certainly isn't robust enough to handle a really huge outbreak of foot and mouth disease for example. we do have a good capacity now for avian influenza vaccine. but we don't have a huge stockpile of some of the others. >> senator mccaskell? >> thank you. i understand that there are several advisory committees involved in the material threat assessment and material threat determination process that include non-governmental experts. these determinations are, in fact, the guidance that dhs considers a particular chemical biological or raidio logical

weapon to be a threat and allows the dhs to use the bioshield funding for countermeasure procurements. so my question to you, doctor, is is anyone on these committees associated with any of the companies that are actually getting the funds for the research and development for possible countermeasures? >> the science and technology directate is the organization that runs the terrorism risque cessments and the terror threat assessments. while i have been involved in the process, i'm not knowledgeable as to the membership that they rely on when they put together those. >> if you would get that for the record. >> i will, absolutely. >> that would be helpful. i had a hearing on this in previous years with the person that i just referenced and was frustrated with what i

thought -- i'm going to go into that a little bit because i think it's relevant to the hearing today, about what we are warehousing and why, and what they are spenlding money on. if you look at the funding decisions and the priorities and the trade-offs, we spechbt $1.4 million on anthrax countermeasures alone. two are were for anthrax antitoxins that cause $3100 and $8200 per dose. we also bought $10 million doses of biothrax which only has a four-year shelf life. we bought that vaccine in 2005. and then we bought another 18.75 million doses two years later. now all of that money is -- i mean, i understand you have to spend money to be prepared even if you don't use it. i get that process. but it appears to me that anthrax investment is crowding

out other countermeasures in terms of funding. and i would like someone to address that because while we d one anthrax attack, it seems to me that the cupboard is bare in a lot of other areas where we need to have bioshield funds being used. and i would appreciate if someone would address that, especially since dr. lurie when i talked to her about anthrax basically said that it's therapeutic to potentially could be effective against an antibiotic resistant anthrax infection. there wasn't assurance that it would be. dr. hatchet. >> yes. good to see you, ma'am. thank you for the question. your question has multiple parts. i'll try to be brief and address all of them. with respect to the anthrax antito be ibs, we do have very limited treatments for anthrax disease.

we now have three licensed anthrax antitoxins. the fda has judged based on the best available evidence the products are approved against anthrax. anthrax is certainly one of our top threats and we have made substantial investments to secure the nation against future anthrax attacks. to address your question about whether it's crowding out other products, i have to say it is not. we as the office of the assistant secretary for preparedness and response, as you know, are the stewards of the project bioshield funding. over the last 12 years, we have added 17 products to this strategic national stockpile using project bioshield funding. those products include products yes to treat anthrax. vaccines and antitoxiens and also antivirals and vaccines to treat smallpox, antitoxins to

treat botulism, drugs and treatments for radiation. acute radiation syndrome, exposure to chemical nerve agents. and moet recently we have added four products to the strategic national stockpile to address the risk of thermal burns that could be associated with explosions, bombings or at explosion of a improvised nuclear device. we anticipate adding as many as five new products to the strategic national stockpile this year. only two of those are for anthrax. but they also include treatments for smallpox, and acute radiation syndrome and we may add as many as five new products next year. so we have been able to build up a diverse portfolio of medical counter measures against cbrn threats. >> does the smallpox purchase include invamune. >> we have purchased significant

amounts of that over the last several years. >> is it a problem that the scientific journal said unequivocally there is no use for this vaccine at this time? in fact, seven years after the initial procurement it's not recommended. the advisory group, the world health organization's advisory group says it is not recommended for emergency use? >> i would respectfully disagree with the statement that it has no programmatic use. the product was created specifically to be a vaccine that would could use to immunocompromised persons or persons who had that includes persons with atopic dermatitis, that's a number of people who could have a potentially severe reaction to the smallpox. >> that makes sense. i'm just concerned when the who

group of experts noted in 2014 that it was not recommended for emergency use. and we've spent $650 million on it. i hope that would always raise the hackels of somebody who sits in this chair trying to figure out what is going on. i mean, why are we spending that kind of money when, clearly, there is real questions about its efficacy and it's safety. >> we also have substantial stockpiles of the ecampus vaccine which can be administer in an emergency use seth. the concern about the invamune vaccine is that it requires two doses to achieve immunity. for those persons who have been exposed to persons with known smallpox there is no absolute contraindication for the existing vaccine. it can protect individuals who have been exposed to smallpox. that may be the basis of that

discussion. but invamune clearly is he have kaeshs and clearly meets a need for a lanch large part of the population. >> i know i'm out of time. i have one more. do you mine. >> you are doing a good job. >> i want to make sure that we have time. i get that we are reliant on small start-up companies for developing some of these drugs because of the nature of the market and the nature of the research. and i -- the economics don't make sense for some of the big guys. so i get that we've got to fun a l -- fund a lot of it. what i don't get -- take anthrax for example. we gave human genome science $130 million for late stage development activities to support approval of the product including support for clinical, non-clinical and manufacturing facilities as well as funds for licensing and approval process. mean, we really -- this was our

baby. the taxpayers' baby. well, then we have to turn around and buy it from them for $3,000 a dose. most people in missouri don't understand that. why we would pay for the development of a drug, and then have to pay $3,000 a pop for the drug after we paid to develop it. >> so -- >> good question. >> yes, it is a good question. i will say that the pricing of medical countermeasures is complex. one of the factors that we have to take into consideration is that because niece products do not have commercial maskts we have to have provide a sustaining revenue that will allow for the manufacturing base to remain intact. and the price that you quoted for a monoclonal antibody therapeutic is very clearly in the middle of the range. there are dozen of licensed products like that for many other indications the prices for

those products range from slightly less to the amount you mentioned to substantially more. so i would argue that it is a fair price for the product. >> have we explored it would be cheaper to do this ourselves? you know, i mean, we are paying them to develop the drug, and then we're the only customer. and we're continuing to pay them. i mean, it seems like to me that we are guaranteeing a profit for something that is wholly owned by the government. >> if i could say that we do look at different business models for how we support biodefense countermeasures. in a related domain for emerging infectious disease we have a similar market failure problem, and we are thinking through different potential approaches to how we can support companies and how far we would like the private sector to carry products and potentially what options we may have to ensure that we can have those products when we need

them, which might include the scenario you mentioned. if i could mention one other thing i think you might be interested in. in framing your question initially you talked about the shelf life of products. barreda does have a life cycle cost containment initiative that we have been supporting many years we look at the products that we are developing and trying to find ways to reduces that long term cost to the taxpayer. for example, you mentioned the invamune product. the smallpox vaccine. barreda has supported a freeze dried version of that product which will help the shelf life. >> help the shelf life. that's terrific snik we are looking across the portfolio to see how we can reduce those costs. >> i'm involved in this other investigation where a guy named martin shrekelly figured out there was a limited market for a certain drug. he went out and bought it and

jacked the price up. maybe we need to jack the price down. maybe we buy -- figure out what the price is to buy the drug that we paid to develop, and continue to manufacture it ourselves and drive that cost way down. because now we are taking out the profit that the private company is making from our investment. i mean, believe me, i do not quarrel with a private company being able to make money off their investment. but it seems weird that we are making the investment, and then they profit off of theirs for the life of the company. that's the kind of deal that any businessman would like to get. >> yes, ma'am. thank you. we are always looking at way that we can be better stewards of the taxpayers' money. we recognize our responsibility and we recognize that we do provide a great deal of that up front investment. and we can take that into consideration. >> i would love you to take a look at that. i'm not sure this business model makes a lot of sense for the taxpayers. thank you. >> senator mccaskell. senator carper?

>> thanks mr. chairman. just briefly i want to follow up on that question with respect to avian influenza breaking out. senator johnston's state was hit hard arc number of other states in the midwest were hit hard. turkeys, laying hens. and we saw that happen i think between november of 2014 and maybe may-june of last year. we fully expected on the east coast to be hit this winter. and it just hasn't happened. and we have been pretty good on biosecurity. but why do you think we have escaped this blow? >> of course all the scientists will tell me it's all speculative but some of the reasons seem to be something like this. one, the virus circulating in the water foul may have mutated to a less vir you lent form.

therefore when they are drooping the virus it is simply not catching on like it did last year in highly pathogenic form. that's one possibility. another possibility is that the the biosecurity has improved. i think it has improved dramatically. certainly throughout in midwest and all the places where poultry is. and poultry is in many places. biosecurity is much better. those are some of the things that seem to have led to it. >> thank you. i don't know who to ask this question to you, i'll start with you dr. reddin. would you talk to us about what is the difference between the difference of how ebola is transferred from one human being to another as compared to the zika virus? >> sure. i'll start with zika. it can be transmitted by infected mosquito, bisexual --

by sexual action. and probably through blood transfusion. ebola is not transmitted by mosquitos. can be transmitted by sexual transmission. its primary route is contact. coming into a physical contact of body or discretions of a person who is infected. really just that direct contact. >> cdc announced kshls thank you. cdc announced this week as we described earlier that the zika virus is now confirmed to be a source of significant brain damage to developing fetuses. and there are a lot of policy consequences that flow from that. but just take a minute or two and talk to us about what actually happens to the brain

of -- and does it all in all pregnant women? maybe why or why is that? but what is actually happening in the brain of the developing fetus? and what is the capability if a child is born and alive -- what are some of the consequences there? >> so a couple of points. this declaration is not changing what we're doing. actually, one of the machines to make this declaration was to make it easier to move quickly and particularly to take away any of the confusion people might be when they are zooiz deciding whether -- for example, whether they should put insect repellant on. there is no question now that those preventive measures are very important to prevent something that is confirmed. what happens when a fetus is infected is that the brain is actually infected. and that was one of the early

findings was actual, on micro skomscopic slides, you can see brain tissue and virus right there. what we think happens is that the brain actually, because of this infection, actually shrinks. so that you have a naturormal f, there is an infection, the brain gets infected. it gets smaller and that's what causes the small heads. it's actually -- even though the term microcephaly just means "small head" the kind of -- in these severe cases it's actually a very particular ind kind of malformation, very, very rare up until this point where the plates of the skull of the fetus are actually overlapped because of that collapse. the skin has ridges in it. and that's not part of kinds of regular microcephaly. so it's actually a very specific

finding. now, even though there is evidence that zika virus causes this malformation, there are many many questions. and you actually pointed out several of them. doesn't seem that every pregnant woman who gets bitten by a mosquito has this very severe adverse affect. we don't know why that is. we don't really know -- you know, there is a likelihood there is a certain time during pregnancy that's the greatest risk. but that's a little bit of speculation. we also suspect that there are other adverse events that can occur, which is typical of other birth defects. they rarely are just a single thing. and we don't really have good information on that entire spectrum of disease. >> do we have any idea to what degree a baby is born with this disease, this brain disease that you described? to what extent does it impair

their ability to function. >> it really depends on severity. that's the question of the spectrum of illness. for the ones that are very severely affected -- i mean there are deaths right at the time of birth. that would be kind the extreme. or deaths before birth. and i think you can go, you know, all the way down the line, that there may be much less severe findings in what right now look like normal births. >> okay. and for the panel, last question, what good common sense advice, practical advice can you give to people who are going to be traveling to parts of this country or other countries and are concerned about possible infection? what good advice can you give people? >> well, our advice that is expanded to include more places where the virus is actively being transmitted is if you are pregnant, it's probably not good idea to go. if you do go, use the mosquito prevention measures, an

effective insect repellant. insecticide on our clothes. long sleeves, light colored clothing. do what you can to avoid being bitten by a mosquito? any other advice from anybody else. all right thanks. >> senator carper. just quickly, there is on one species of mosquito that carries this? >> there is one investigator that is predominant. a aidese egypti is known. another aidese mosquito is proposed to be a vector. >> can you make the population sterile to reduce the population of those? >> i'll have to get back to you with the specifics on that. i think there is a number of -- well, there is a programmatic approach of indoor residual and

outdoor residual spraying that's being used in puerto rico for pregnant women to prevent skoitsz -- basically killing mosquitos right there. also, putting laugh have a sides in potential breeding spaces of those mosquitos and removing potential breeding spaces. there are a number of kind of experimental less widespread uses. i think we really -- in all of this, woe really need to learn the effectiveness of these measures because this is a very difficult mosquito -- not to kill at an individual level but to assure there are enough mosquitos being killed to reduce transmission. >> can anybody else speak to the standard of using genetically modified? it's experimentate al best. based on the blue ribbon's panel's conclusion that he don't have a strategy, don't have any kind of, you know, functioning leader here, both budgetary as well as operationally, i just

want -- you are all involved in these organizations. i've been in organizations that have a very well defined strategy and you know it. i've been in organizations that don't have a strategy. i'm kind of in one right now. where you also know it. so i want to get your evaluation and you know, if you are saying you agree with gao, if you agree the blue ribbon panel. you don't have to say a whole lot more. if you disagree, quickly tell me what at&t is the disconnect about what the gao and the blue ribbon panel talking about the lack of strategy and the lack of unification efforts. i'll start with you dr. hatchet. >> thank you. i think the problem of biodefense is tremendously far reaching problem and it stretches to all sectors of society and into -- actually into all parts of government. within the domain that we work in, which is public health and medical preparedness and response, i feel that we do have

strong strategies. we do have strong collaborative mechanisms and we have adequate plans in place to respond with the emergencies that we are presented with. >> dr. reddin? >> so i think there is a policy process to make the kinds of changes that are being proposed. and that involves the legislature and the executive branch. and this is a recommendation that needs to be looked at very carefully. >> mr. shay? >> i certainly agree with them i would say so many great things are going on between our respective agencies. and i think if those could all be blocked together it probably certainly would be to an advantage. >> okay, doctor firova did. >> sure. i think we are certainly taking to heart the blue ribbon panel recommendations and trying to implement as many as we can. i think there are strong strategies. i think there are strong coordination mechanisms. we touched on a few of them today. but there's many more.

we're never going to be done. i think one of the things that strikes me is after 9/11 when we were talking about interagency coordination to address it so that we could connect the dots, you know, there was one anecdotal story that someone stood up and said i thought we were going to do this after pearl harbor. so this is a task that's never done. and we will always have to strive. and we're always going to have to grow and build these capabilities. >> listen, i come from the manufacturing back ground. it gets into your dna, continuous improvements. everything can always be improved. mr. kerr, just a finalent custom. the gentlemen here think there is strategy, certainly areas for improvement. is that a accurate assess men. >> not surprised that they see strategy is important. i don't want to take away from some of the efforts that have been done. the public health strategy that dr. hatchet mentioned i think is probably the closest thing to such a comprehensive strategy. if i had to nail one one key thing is this idea of being able

to prioritize investments and prioritize efforts. within each area you can do that because the agencies have control. but across you can't. >> at the agency level you think you are doing a good job prioritizing. but it's that top-down allocation of resources. again, thank you all forks again, your time, your testimony, your answers to our question. the hearing record will remain open for 15 days until april 29th for the submission of statements and questions for the record this. meeting is adjourned.

>> announcer: tonight on the communicators, george ford, chief economist for the phoenix center for advanced legal and economic public policy studies, and mark cooper, research director for the consumer federation of america debate the fcc's proposal allowing consumers to buy their own set top boxes instead of renting them from cable providers. a move to open up competition in the set top box market. they are joined by lydia beyoud from bloomberg saus. >> we think we need competition in the set top