in his direct line question and answer program. that is followed by remarks from republican candidates at a new york republican party dinner. >> the cdc director of public health preparedness and response, dr. stephen redd, says the zika virus is a new threat. he made the remarks over the senate homeland security and governmental affairs committee on the state of the nation's defense against biological threats. some category here -- from capitol hill, this is just under two hours. >> good morning. this hearing will come to order. i want to thank the witnesses for taking the time to attend, for taking the time to write

your thoughtful testimony. we appreciate it being on 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 with their pal -- their panel on bio defense. document,ught-out lots of detail. the number one takeaway was the fact that we have no central authority to kind of accumulate all of the data, acute late the budgets, and direct activity, particularly in the event of a significant outbreak. whether it is, and we have dealt with ebola, avian influenza, we have had hearings on those. now, the zika virus. in wisconsin, weeks -- we have something i can't pronounce, i think i may have gotten that right. it has infected 59 people, 18 people in our state. i appreciate the work the cdc

has done on that, responding .uickly to a letter i sent it sounds like you took that seriously in trying to find, what is the common cause. interesting how my guess, in many respects. anyway, this is an important hearing. i asked that my opening written statement be entered in the record. as any hearing, the main goal is to lay out a reality, so we understand really, what we are facing here, and when it comes to the different types of bio threats. these can be serious, and maybe the good news about all of them is, the same types of procedures and processes and management structure can be put in place to respond to just about any of them, because the threats are always changing. we are seeing the different type of pathogens, biological threats i listed. again, i appreciate all of your work and efforts in this.

i appreciate you coming here. sen. carper: there is a vote at 10:30. do you want to keep going yucca or do you want us to recess for the vote yucca -- recess for the vote? when the vote starts, i will leave. i will go vote. i will come back right away. you can keep talking. and then we will start asking questions. thank you for coming. mr. chairman, thank you for bringing us together. this is an even more important hearing, given what is going on with the zika virus. as the chairman said, we convened last fall in hearing to examine the report on this panel chaired by a couple of our friends, joe lieberman and tom ridge. one of the main points in the report was, there has to be

somebody at the administration to lead it. he thought the vice president would be a good one. so we will see. we have had a meeting with the vice president and two cochairs, and we will see where that leads. but there is work to be done, and fortunately, the panel provided a recommendation to further enhance the ability to prevent, to detect, and respond to and recover from a biological incident. today, we have the opportunity to discuss those recommendations with several agencies come a senior people in several agencies would be responsible for implementing the recommendations in the early panel. i will hear your thoughts, and i am eager to hear how you believe we could improve our country's i/o defense system. bio defense system. this is an important conversation due to global events emerging as we speak. ebola continues to threaten africa. after claiming thousands of lives, the spread of the virus has declined thanks in no small

part to the investments that america has made. and this -- the health systems .f those country it is a proud chapter in our nations history of late, and i am proud of the work that was done, including by some of you and the people that you lead. that said, the recent news of more cases in guinea and liberia underlining the need to support international partners in their efforts to combat that disease. we are one year removed from an outbreak of avian flu, which decimated parts of our nation's poultry industry. the industry was affected and a number of others in the midwest. while infections of poultry have been limited in number so far, this year, thank god, we must remain vigilant and continue to enforce good biosafety practices at poultry farms across the country to safeguard against another epidemic. meanwhile, we are approaching the beginning of mosquito season. in most hearts of the u.s., this

presents us with a new threat, in the form of the zika virus we your a lot about. has spread explosively through central and south america. it has reached puerto rico and other u.s. territories and is expected to spread further as the weather warms. the world health organization estimates as many as 4 million people in the americas could contract the zika virus by the end of the year. researchers continue to learn more about the virus every day. healthis clear that the impacts are devastating, particularly for pregnant women and unborn children. we have heard that the cdc has recently confirmed this week that something we have speculated for a while, the zika virus is the cause of severe birth. -- severe birth defects. american cases have been linked to travel abroad, but we must he prepared for the virus to present itself locally. it has been encouraging to see a proactive, coordinated response

from the administration, the president and the administration, to this threat. federal agencies are helping state and local governments enhance their capacity to track the virus, and there are mosquito control efforts underway. we know medical countermeasures and vaccine developments are being rigorously pursued and we applaud that. to help fund these efforts, the administration announced its intent to redirect $600 million from other programs, including funds originally designated for ebola, and spend it on zika response efforts. president has made the right call in this sense. i am glad he has to miss. these efforts continue, congress should carefully consider the president's request for additional reef -- resources. we must ensure that public health officials have the tools they need to protect us from, and for paris four, zika -- prepare us for zika. we should not let our foot off the gas when it comes to our efforts to contain dangerous

diseases. thank you for your service and thank you for your testimony today. >> it is the tradition to swear in witnesses. if you will rise and raise her right hand. do you swear the testimony will give before this committee will be the truth, the whole truth, and nothing but the truth, so help you god? thank you, please be seated. snappy tune there. our first witnesses dr. richard tt, director of the bio research and development authority, and acting deputy assistant sec you did -- secretary for the department of health and human services. that is a big title. he served as the national institute of allergy and infectious diseases, the national security staff, and the homeland security counsel. doctor.

dr. hatchett: chairman johnson, ranking member car per, distinguished members of the committee and homeland security and governmental affairs. good morning, thank you for inviting me to testify. atchett. in myrd h focus on today, i will steps taken by the office of the assistant secretary for preparedness and response to strengthen our nation's health security and a contribution to my own office to that end. theave made progress in past 10 years to advance the state of our national bio defense. thanks to the support of this committee, and others in congress, we have established barta, and continue to make investments in bio defense and health care. however, as highlighted by recent challenges such as ebola, gaps in, there remain preparedness. as this committee is aware, the recent report by the blue-ribbon study panel on bio defense is

indicated that the united states is underprepared for biological threats, and the nation is dangerously vulnerable to biological events. whether natural, intentional, or unintentional in origin. where the civilian public health and medical response is concerned, it is charged by statute to play a strong leadership role. the asper serves as prisoner paul advisor -- principal advisor in matters including public health emergencies. we ask for chairs and leadership groups, convening in response to come located emergencies, and the public health emergency medical countermeasures which coordinates medical countermeasures development efforts across the agencies. the asper is the -- the author and custodian of the national health security strategy which focuses on protecting public health during an emergency. the asper oversees two critical

programs that support medical response. the first, the hospital preparedness program enhances radical preparedness and resiliency of the community level. through its support of health care coalitions. the second, the national disaster medical system, employees medical personnel and related assets for local resources when they are overwhelmed. the other organization promotes acquisition of medical countermeasures for chemical,, radiological, and nuclear threats, and infectious diseases. the coordination and decision-making encompasses all medical countermeasure lifecycle, from identifying requirements and developing target product profiles, through product development to distribution. they have an outstanding record of success, and is being studied as a model for global preparedness against emerging infectious diseases. to date, at least 23 medical countermeasures that barta has supported have been approved,

licensed, or cleared by the fda under this purview. 15 have been approved since 2011, five have been approved in the last 12 months. ranging from anthrax anti-'s and smallpox vaccines, dumb -- radiation sit symptom medicines, have been added to the national stockpile. with another seven anticipated between now and the end of fiscal year 2018. overall, since the year 2000, fda has approved 89 medical countermeasures for cbr threats and pandemic influenza, as well as 17 supplemental changes to already approved applications in 71 modifications to diagnostic devices. this investment in preparedness has paid dividends. because of the workforce and capabilities, we have developed over the last 10 years, we are better prepared to respond

quickly to emerging threats. facilitates the deployment of vaccines, therapeutics, and diagnostics during the ebola epidemic and is engaged in the responses he got. we know from experience that a well coordinated mc response is a critical enabler of a rapid science and industry response. it succeeds not because they set of government offices succeed, but because response efforts across society are supported and coordinated. to respond effectively to threats as diverse and unpredictable as a biological threat, nothing less than the whole of society response will work. thank you again for the invitation to speak with you. i would be happy to address questions. sen. johnson: our next witness , director ofn redd the centers of disease control and prevention. he has been part of the public

health services regarding years and is responsible for all of the cdc's public health response activities. dr.. great, thank you. dr. redd: chairman, ranking member, and distinguished members of the committee, my , directorephen redd of the office of public health preparedness and response at cdc and it is my pleasure to appear today to discuss the work of cdc to prepare and respond to theats to the help of public. as you know, cdc works to protect the public costs helped 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 benke programs at cdc that enable us to prevent, detect, and response to health

threats. the public health emergency preparedness program and the strategic national stockpile. originsgrams have their before september 11, and the and the racks -- the anthrax attacks. they were expanded after those events, and recognition of the need to improve the ability of the public health system to .espond in scale and in speed the public health emergency preparedness program's overall aim is to prepare the nation to put -- respond to public health emergencies. since she thousand two, $10 million has been devoted to the effort. the program funds 62 awardees, states, all -- eight territories. ,t funds our staff epidemiologists, lab experts, communication experts, emergency operations centers, laboratory equipment, planning and exercising and efforts to things, or to correct

that are identified and exercised as a natural event. stockpilegic national is the national repository of life-saving medicines, vaccines, and medical supplies, such as mechanical ventilators, currently, the stockpile holds over $7 billion in assets. it operates as part of the public health emergency medical countermeasure enterprise, which you have heard about. the stockpile stores and procurers and delivers supplies in times of emergency. but 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. let me turn to zika. 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. one he intended these are in pregnant women. seven have been sexually acquired, sexually transmitted. there is currently no local transmission by mosquitoes, but the problem exists here because of these travel associated cases and sexually transmitted cases. in puerto rico, there is transmission from mosquitoes. over 300 cases, one in six of these are in pregnant women. about somed, to talk of the things we are doing in the zika response, you heard from senator carper that yesterday, cdc operative publication that concluded that zika virus infection causes severe birth. asked outstanding questions. on april 1, we convened the zika action plan summit in atlanta. this brought together state and local health officials to review the latest scientific information, and jump start

planning at the state and local level. 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 are working closely with local health departments, and we are implementing mosquito control measures with the government of puerto rico to prevent transmission to pregnant women. risks are ever present. due to investments from congress , the nation is better prepared to prevent, detect and respond to help emergencies than we were before the events of september, 20 -- 2001. the cdc is on the front lines to protect americans from health risks, wherever those threats occur. we know that we will be call of pond to respond -- called upon

to respond in the future. thank you. sen. johnson: our next witness , administratorea of annual -- animal, plant and inspection services. he promotes american agriculture, regulating genetically engineered organisms, administrating the carryinglfare act and out wildlife damage management activities. you, senators. i appreciate you being here to hear us. over 8000 men and women work around the world to protect american agriculture of -- and pestsal resources against and diseases. we want to keep them out 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 understandealth, we

there is a crucial link with human health. our partnerships with the cdc and other federal and state agencies emphasized this one health approach. animal health can affect human health. human health can affect at -- animal health. that is why it is important that we communicate and coordinate with each other. that is why the emphasis on one health in the national blueprint for bio defense is so important, and why we support it and appreciate that they emphasized it. i want to highlight a few examples of what we do. better create within our -- veterinary services program a one health coordination center. it works closely with internal veterinarians to make sure that 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 do can affectey

agriculture and animal health. because this communication is so important, we have embedded a veterinarian in atlanta with cdc to exchange information, literally every day. we always share information with our partners about our well-established disease surveillance efforts. when we have information about damaging diseases, we share them quickly. this committee knows, as the chairman and senator a lead -- alluded to, the dem -- the devastating impact avian influenza had on producers, and the impact on the availability and price of eggs and turkey. thousands of contractors, state employees did the important work to control that disease. behind the scenes, our partnerships with the groups with us today were there and were important. our scientists shared information with cdc about avian influenza, about the virus. we had no reason to think that

that fire us was going to be a human health threat. but avian influenza viruses mutate. supplyingnstantly information to cdc so they could develop candidate vaccines if indeed it ever should have jumped over to the human health problem. we are working closely with colleagues in the fish and wildlife service to test wild birds. the good news, we tested 43,000 wild birds over the last nine months and have found no more examples of avian influenza in those birds. that is helpful information. we spent a lot of time assessing our efforts in controlling avian influenza last year, and in our capability to detect it. we compiled a very substantial, very large new planning document on what we can do to prevent avian influenza from becoming a huge problem. we had a chance to test it out in indiana in january.

there was indeed one case of highly pathogenic influenza, and nine cases of low pathogenic avian influenza associated with that. we were able to get on top of that immediately, white it out. we have had no cases of avian influenza other than that since last june 17. something we learned in all of our review was that we need to rebuild our capacity to respond to large animal health emergencies. we have 200 fewer animal health professionals, veteran aryans come and take -- veterinarians and technicians. we need to rebuild the workforce. they recognized that in the president cost budget request. there is a proposed $30 million increase for animal health emergency response. werealize just how lucky were to get on top of the avian influenza after all of the damage it did do.

mr. chairman, this concludes my testimony. i appreciate the opportunity to be here. sen. johnson: my next witness is firoved. there we go. it is kind of pronounced, yeah, whatever. he is the director for the national bio surveillance integration center and the office of health affairs of the department of homeland security. he previously served as the senior bio defense chief medical officer of the department, dr.. we have generations of people being called firewood in my family. chairman, ranking member. distinguished members of the committee, i want to thank you for inviting me to speak. i appreciate the opportunity to testify on our role in bio

defense. it is an honor to sit beside my colleagues. i am the director of the .ational integration center i'm a microbiologist by training. i work with anthrax at the national institute of health. -- bio defenseo policies. i have a broad understanding of the biological threat to our homeland. i have a strong commitment to improve bio defense progress. and risks posed by emerging infectious diseases and weapons bybiological terrorist organizations and rogue states will continue to challenge our ability to prepare and protect the homeland. in the wake of these threats, the department of homeland security remains fully engaged in proactive characterizing of the threat, providing warning of emerging and infectious diseases, and ensuring our critical missions will continue should a biological event occur.

our recent ebola virus disease outbreak in africa, dhs divided intelligence analysis of state and local governments and first responders, directed research to characterize the threat of ebola persistence until public health and operational responses, and coordinated and implemented advanced screenings for 42,000 international passengers at five airports. the day, we build upon these lessons learned from the responses to ebola. we apply them to other biological threats as we tackle the reemergence of viruses like zika, where we ensure our partners continue to have timely information, our work versus informed,-- force is and employees are provided for. we must remain vigilant and innovative as biological threats evolve and new threats emerge. the dhs office of health affairs coordinates the department costs

activities to understand the threats today and the threats of tomorrow. the biological threat information comes from multiple sources and takes a true one health approach to bio health and emergency response. for large-scale biological knowledge means important decisions that can save lives. operationalnt's programs are critical to our nation's bio defense. the national bio surveillance detection center is situated within dhs to provide health and environmental data to ensure that decision-makers have timely information. to accomplish this, we monitor thousands of data sources and leverage expertise of 14 federal department and agencies were members of our charter. including those you see at this table. we integrate this information into reports of biological

incidents that could cause economic damage, social disruption, or loss of life. my colleagues and the blue-ribbon panel on bio defense having knowledge the progress we have made in delivering daily situational awareness to partners. we still have a lot of work to do to fully realize the vision that this committee started with a comprehensive bio surveillance integration. to address this, we are developing new collaboration innovative data sources, and fostering greater stakeholder engagement. the hs's bio watch program provides leaders with actionable information on detection of a biological agent to enable an effective response. is how weoked benefit work with each local jurisdiction to ensure that the decision-makers are familiar with how the coordinated unfold. will on ford --

there is no other program that provides this layer of defense. dhs science and technology director is collaborating with oha on a program that will shorten the time to detect biological agents as well as address capability needs. one of our most critical roles is integration of local public health with emergency management, law enforcement, and intelligence partners in their preparation and response to biological events. one initiative we are developing and coordination is a vaccine initiative. we are evaluating the feasibility -- the feasibity of an anthrax detection program. a vaccine is scheduled to rotate out of the strategic national stockpile. i want to thank the committee whomoving, senators, legislation authorizing the program. i thank you for your time and look forward to answering your questions. sen. johnson: mr. chris curry is

the direction -- director of heeland security where evaluates emergency management, national preparedness, and critical infrastructure issues. he has led reviews of federal programs in efforts to prevent, plan for, and respond to natural and man-made disasters. mr. currie: thank you, chairman, ranking member, other members of the committee. i appreciate the opportunity to be here. i would like to talk about the work done by a defense. defending the u.s. from naturally occurring or man-made biological events is a difficult effort. leadership and coordination are fragmented a large, effort, not only at the federal level, but across levels of government and the private sector. a number of federal departments at this table today alone demonstrates this point. in a hearing last fall, your committee heard the findings and recommendations of the

blue-ribbon study panel on bio defense. our work through the years has come to many similar conclusions and recommendations. today, i would like to talk about this work. ranging from coordinating the entire bio defense enterprise, 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 bio defense. our work is also found that there is no national strategy or single focal point for bio defense. as an illustration, there are over two dozen presidentially appointed officials with bio defense roles. five years ago, we recommended that homeland security, within the white house, develop a strategy and designated focal point for coordination. they did issue a strategy in 2012, a designated office within the white house. this is progress, and shows commitment to coordinating bio defense efforts. but it doesn't go far enough.

the strategy does not identify resources and investment needs, which is critical to prioritize resources across such a complex enterprise. we have heard the national security staff created a more specific implementation plan to the strategy. however, we do not know the extent to which it is actually being used across government and across these departments. thus, we do not know if it will operationalize coordination and prioritization of resources. we have identified challenges with specific agency bio defense programs, like those within dhs. our report in october found that 12 years after the bio watch program was first employed, their is still not information about its capabilities. this is because it was put in the field so quickly without performance requirements. we have found that because bio watch was not fully tested, it its uncertainties are unknown. we recommend dhs not pursue

upgrades until it establishes system performance requirements and tests those. i would like to talk about our work on the national integration center. within dhs. be theset up to integrator, analyzer, and innovator of bio surveillance information across the federal government. however, it has never fully met this bar. they have implemented recommendations to collaborate with the cdc and hhs and usda, however, we reported last year that persistent challenges get in the way. for example, most of its primary federal partners, those like cdc, told us that image product and activities and add value, did not provide new meaning, did not help them identify biological events quicker. they still have difficulty getting the data they need, because partners won't share it -- thererestrictions are restrictions. the challenges are not easy to

address by dhs alone. we have identified options for policy or structural changes to help the organization fulfill its mission. changes inequire law, and it is unclear that these would address the challenge. to the biggerack issue, the blue-ribbon panel specificestment in programs should be evaluated in terms of cost and benefit. they should also be prioritized against other programs across government, as part of the national bio defense strategy. another critical part of this prioritization should be using the most recent threat and risk information to guide decisions. thatis important to ensure our limited resources are directed to the most important areas. without a strategy that bridges across the departments, it is difficult for decision-makers in congress and those in the executive branch to make resource decisions. this concludes my prepared remarks on behalf -- and i am happy to answer your questions.

back,ohnson: i want to go within the specific agencies, talking about an update on exactly where we are. i want to start with the usda. outbreak occurred and june.cember that was basically migratory birds flying south, correct? but obviously, in june, they are also flying back. i want to get, to what extent did we dodge a bullet? have we gone through basically two additional migratory patterns without this hitting us again? mr. shea: it's too soon to say. what ended up being the final end to the outbreak last year was really the onset of warm weather. once the temperatures get consistently above 70 degrees, the virus pretty much won't survive. sen. johnson: similar to human flu? mr. shea: yes. sen. johnson: we were coming and going then, migratory birds

coming up, coming back, temperatures that we certain point in the outbreak ended? mr. shea: exactly. when migratory birds fly south, they have a clear path. they keep going. when they are heading north, they can slow down. year, and thelast reason we thought it was bad in iowa and wisconsin, is that the birds were heading north, but the weather was still too cold. they got to a spot where the lakes were frozen. on onehnson: i have been of those lakes. got it. that is good news. the outbreak in indiana, is that typical? on a location cb small outbreaks and stuff and we can respond quickly? findhea: it is typical to low pathogenic avian influenza outbreaks. what we believed happened here, is probably a low pathogenic virus that may have mutated on just one farm. the local surrounding area, where we had nine or 10 other

infected premises, were low pathogenic. sen. johnson: but that was spread not by migratory birds, just within the localized flock? mr. shea: it may have started with migratory birds, but it spread as you suggest. sen. johnson: i want to revisit ebola. hasll go to dr. firoved. that been wiped out? has it been contained? are there any active cases right now in africa that we are aware of? dr. firoved: unfortunately, we have seen cases reemerging, getting -- beginning in liberia. to my colleague from cdc, but there is active tracing going on. sen. johnson: tell me what happened there. did we get to a level of zero and it's coming back? dr. redd: the widespread transmission that was seen in 2014 and 2015 has been contained . what we have seen repeatedly in liberia, sierra leone, and

ginny, are small clusters identified after a few cases, rapid response, and implementing the measures that brought the disease under control when it was more widespread. notrtunately, this is 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 a small cluster occurred. and i think that this outbreak is now being worked very hard, both in guinea and liberia. the cases and liberia are connected to the ones in guinea. now, the response is very vigorous. large numbers of contacts being identified and traced to be sure that if one of those people does become sick, they will be put into oscillation and given treatment quickly. sen. johnson: because of the tragedy that occurred there, does the general population, are

they more educated as well? in addition to the public health and safety officials, do they know how to respond? is it a combination of that? tell me what worked. what lessons we learned. dr. redd: i think, to go back to the lessons, the situation that is occurring right now is not that different than what 2014red in march, april of , in terms of where the disease is occurring, and the location. the thing that is different is, we have a much more vigorous response. and liberia,a there is the capacity to identify cases quickly and respond, and there is an international presence that is able to respond. to go back to 2014, the things that didn't happen that needed to happen work, the ability of those governments to rapidly identify cases, to respond effectively to them, and when the response wasn't going well, to 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 implemented in those countries and in other countries in africa , asia, and the americas. sen. johnson: so you are describing a real, you know, a real progress in terms of public health and safety officials. has there been progress in terms of information to the general population? ebola breaks out in these african countries. think there has been. particularly at that inflection the country,ing on twice 14-2015, it is likely that a lot of the control was actually implemented outside of official channels, the communities understood the risk 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 better data on. 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? how many people really were affected? wen this first broke out, were projecting a few months from there, a million people. how did we contain this? dr. redd: it didn't reach a million people. the absencee was in of any control measures. i think, in some ways, although the number was massive, it wasn't -- sen. johnson: it got the public's attention. it went up tens of thousands? dr. redd: tens of thousands of cases. 10,000 or so deaths. totalor context, the number of cases in all the outbreaks up to that point was around 2500.

so around 10 times more cases than had ever occurred, and one of the things, just thinking about the sexual transmission side of it, we probably have twice as many male survivors as there were total cases before this outbreak. sen. johnson: is that unusual? was that because of additional treatment? hydration? i mean, how many people were infected, how many people die, what was the survival rate? dr. redd: i can give you the exact number. a 5000, 12 thousand deaths, something like that. sen. johnson: how many people infected? 25,000.: 50 percent mortality rate. when i give those numbers, i have to say, the quality of the information, particularly early in the outbreak, when medical services were overrun, many deaths occurring -- sen. johnson: i am trying to get magnitude. where are we in terms of

development of a vaccine? ebola has been around. we were working on the vaccine. i imagine it has become a priority. are we making progress? dr. redd: yes. i will answer that question then turned to my colleague. the vaccine is actually being used now to control the outbreak in liberia and guinea. clinical trials were undertaken of different vaccines. there was one in liberia and sierra leone, the vaccine got there after the disease was on the down trend. they were not able to show effectiveness. they were able to measure the safety of the vaccine. a trial conducted in guinea using a strategy to measure effectiveness found the vaccine to be effective. strategy, containment where a case was identified, and then the cluster of contacts and the context of the contacts were

vaccinated. that study showed effectiveness. sen. johnson: i realize this is a ballpark, but what level of effectiveness -- someedd: there is questions about whether he person was exposed or not. it wasn't tested to be effective after exposure. timeframe, it them in for -- demonstrated effectiveness. i can give you an exact number. sen. johnson: i don't have the luxury. did we ever get to the bottom of the infection of those nurses in texas? again, we were assuming we kind and wethis understood, were going to take precautions, and yet, we still had, did we ever solve that mystery in terms of how those -- dr. redd: i'm not sure if we totally solved it. we put in place a different plan or personal protective veryment, which included specific guidance on what types of protective equipment were

needed, and also put in place a strategy to train, use the personal protective equipment, before needing it. then, additional specificity about when a person is being treated for ebola, including things like observatories -- observers to make sure he person did not accidentally, when they are taking the equipment off, alsoof a risk period. following those individuals act or the person was gone. similar to returning travelers that the doctor mentioned, tracking them daily until the potential link you bashan. was over. -- until the potential incubation period was over. sen. johnson: it seems the procedure was, we can have this in hospitals to the point where, let's do it in specialized hospitals. is that the process and procedures in place right now? we will have centers of excellence here, and maybe,

hospitals have to be ready. they have to respond. but then, transport individuals that prove positive? theredd: for ebola, that is system in place. a lot of the discussion is about other diseases. there might be more cases. trying to adapt the system so that we have the right care for people who have these very severe effects. the way, ebolay is obviously a unique disease, but the procedures in place are good procedures for a number of types of situations? yes.edd: there are a couple characteristics of ebola that are different. the main one is the small number of cases, and the need for the very rigorous infection control procedures. if there were a large number of cases, the system we have in place would have to be changed. cases, the level of capability. doctor, can you

speak to the progress of the vaccine, the effectiveness, and our ability to produce it? dr. hatchett: would you like me to touch on the ebola reconsiders? sen. johnson: sure. hospitalett: through preparedness programs, with the assistance of the funding provided by congress and the ebola supplemental, we have a tiered system nationally of ebola treatment centers. there are now nine regional ebola treatment centers. education ande training centers at the pinnacle of that system. and then, there is a system of eating hospitals, i believe the local is 73 state or ebola treatment centers that can manage patients temporarily before they can be transferred to the nine centers that are fully equipped. then, there is a larger system of assessment hospitals, i believe the number is over 200 nationally. sen. johnson: i will turn it over to senator carper.

hopefully, i can get back here and we can follow up. i had to leave as soon as you started to speak. it was not cause and affect. we trade off like this. we use 15 minutes when we can vote. so we keep things rolling and don't delay you. , the housete and representatives, people give one minute speeches. give us your best one, please. bigcurrie: there were two places i wanted to focus on. one was, the 60 thousand foot level. the coordination across the bio defense enterprise. the second piece was looking at some of the specific programs at dhs we have looked at. we have done a lot of work at hhs and usda, as well. let me focus on the 60,000 foot level. i think one of the problems that we have identified during the years, and so has the blue-ribbon panel, is the lack

of a unified strategy at the top, the federal level, to guide efforts and resources. all of the departments work really hard and do a good job of doing their individual missions. the problem is, there is no one above that has the authority or ability to actually drive resource decisions, and priorities. that makes it difficult to know if we are addressing the top priorities. and so that was a key point from my opening statement. sen. carper: we talked a little bit, and i mentioned the study panel led by joe lieberman and tom ridge, and the recommendation that attempted use the -- to speak to the point you made. let me just ask all of you. with respect to the recommendations, i think they made 33 recommendations, and one was that the vice president should personally lead this.

what current plan activities are you taking are planning to take to address the recommendations contained in the report? what do think about the recommendations of the vice president, in this case joe biden, to lead the effort for the next nine months, and presumably whoever precedes him? >> i can start. we have not taken a formal position on whether the vice president is the right place to put the responsibility. we do understand why the blue-ribbon panel white -- made the recommendation of the vice president serve in that role. it needs to be some of you 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 in the white house. therehink, and our goal was again, to try to put it at a level that was about the departmental level. so far, i think we have been a little underwhelmed at the

efforts that of come out of the response of that recommendation. there have been strategies developed, but the problem is, even within those offices, they still have trouble dictating exactly what the other federal department or doing. so with the right entity, what the right entity is, i'm not sure. but the problem is consistent across our work and the panel's work. sen. carper: thank you. what current or plan activities are you taking, or planning to take, to address the recommendations contained in the report? dr. hatchett: thank you, sir, for the question. 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 activities that address, or parallel, some of the recommendations in the report. i mention the establishment of the ebola treatment centers, and the national hospital system for managing 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 has been a valuable contribution to the national discussion on this issue. the carper: the re-think, -- do you think, the point, the -- the blue-ribbon panel recommended the vice president follow-up and implement the recommendations of the report. president, howe about the junior senator from new jersey co? he finished his book to her. he needs stuffr. to work on. dr. hatchett: we feel we have effective cross government mechanisms in place to make sure threats can be identified and responded to a broke -- appropriately. within the statutory spear of the assistance tech -- secretary

for preparedness and response, which is public health and ethical preparedness and response, we have mechanisms in place which reduce the need for an oversight figure. we have too been very effective coordinating bodies that are interagency bodies, but we work with the fda and the department of defense. the first of these is the disaster leadership group, which the assistant secretary for preparedness and response can be -- convenes and -- in response to issues that arise in recent months, for example, we have convened two different groups, one to address a crisis, the other to address the emerging zika crisis. within the domain of medical countermeasures, we have a very effective coordinating body, the public health emergency medical countermeasures enterprise. i cited some of the successes we had demonstrated. that entity has evolved. sen. carper: all the right there, otherwise these guys

won't have a chance to say a word. dr.? are a number of recommendations that pertain specifically to cdc. i could go through those now, or we could submit written answers that, just quickly, recommendation 15 is a collaboration with the department of homeland security on the anthrax vaccination. we are providing the vaccine for the pilotould if started from the strategic national stockpile. there is a recommendation to develop and implement a medical countermeasure response framework. we actually are working with state partners or the public health emergency medical countermeasure enterprise to theement improvements on distribution and dispensing of the stockpile. is ae, there recommendation to allow for deployment of sns assets. that was number 23. we are working closely with new york city on really, kind of a

project management formula that, when they are ready to administer product from the stockpile, that we get it there that quickly. so, matching the delivery from the stockpile to the local capacity. we will be working with other health jurisdictions to marry their capability and our capability. there is a recommendation to overhaul the select agent program. i think that that would fall into the overall category of a high-level policy decision. we are doing a lot of work to improve the select agent program within our authority, improving the inspection process, the incidents thatrt are identified at the facilities, and to improve tcomy aspects of that. there actually have been three recent -- sen. carper: hold it for a

moment. , ther for the record status of your implementation. those of you with -- to have begun and completed him lament -- implementation, and those of you who have no intent to implement. you can respond to whether or not the vice president is a better person to oversee the implementation, or senator booker, as i suggested. cast some light. raise her hand, how many think we need somebody like the vice president to oversee the implementation, and without that we will not make the kind of progress we need. how many think, and if you do, raise your hand. if you don't, raise your hand. all right, thank you. let the record show booker 2, joe biden zero. there are several people leaning towards joe, as well. senator booker. sen. booker: i have lost many

votes before. iis is when i am happy -- one am happy to not win if possible. i want to thank you very much for holding this. i think this is an urgent hearing. there i a lot of consequential realities at stake. i want to thank the people before me. your dedication to the health, safety, strength and security of our country is admirable. concernsw jersey-based , and perhaps i could start with that. , so, a lot of the dollars received for our state for homeland security are based upon formulas. the hospital preparedness is one that recently, new jersey has seen a significant cut in. incongruous to me, because as the risk profiles are calculated by the department of homeland security, we have actually seen increases in some

of our areas. for example, in fiscal year one, the homeland security record might -- recognized new jersey's bold rebuild the to a -- vulnerability to an attack. grants,also raised our our urban area security initiative vulnerability, moving on the risko seven index. we see the new jersey, when it comes to risks, terrorist attacks, bio attacks and the like, is getting more severe. but yet at the same time, somehow, it in the formula, we are being cut from the hpp program. i am wondering, what is the reason for the cut, given that the department of homeland security sees us, and you understand the new jersey is, i live 10 miles from manhattan. series, manhattan is moving their back offices and a lot of their infrastructure to new jersey. asch, again, as dhs sees

heightening our risk. in -- in your opinion, is this problematic? or do you see it in a different way? >> i can't speak to the particular case of the new jersey allocation, but i can say that the urban area security initiative risk scores are , hospitalto the hpp preparedness program formula. that formula, and those allocations, are reviewed annually, so they are adjusted annually. there are many other factors other than risk, which goes into the formula. certainly, population. given that i am not myself personally responsible for the hospital preparedness program, we can certainly we can certainly get back to you with a more detailed response. sen. booker: new jersey is one of the more densely populated

states in america. companies, imical just don't understand how we could be going down, especially when other areas of the federal government are seeing us at a higher risk for these problems. i would appreciate it. let me go over my concerns in zika and some of the other elements. redd, can you explain to me the process for the new jersey health preparedness program. the award was increased this year, but because cdc is looking for additional money for zika, we have seen money taken away from states, including new jersey. that raises concerns for me that we are rate -- going around

instead of raising new money and increasing our preparedness. can you explain to me the process for cuts, and are these ornt cuts across the board, are these crises and concerns for security? dr. redd: let me start by saying i agree with your underlying point, that this is a new threat, and we need supplemental appropriation to be passed. that would address the problem in a way that it needs to be addressed. sen. booker: that is a profound statement that i want to repeat. you agree it is a new threat and we need supplemental, new funding, instead of taking away urgent dollars from existing programs. dr. redd: yes, sir. sen. booker: thank you, that is an important statement. of redd: in the absence that, there is a difficult decision that the administration had to make, whether we would respond to the current threat or not.

the only way to respond to the current threat was to identify funds that could be used now. i think your description of a blunt instrument is correct. there was an across-the-board cut to the health emergency preparedness program. it was a little complicated as to how each dollar amount was arrived at, but each group lost funding. sen. booker: there is obviously a better way to do it. , we seem tok about be often very reactive to a crisis. we have predictive analytics to know better about what is coming, before it dominates the headlines and fear -- could we do a better job heading these crises off? dr. redd: it is something we continue to work on. to take the particular case of zika, there are many aspects of this that are unprecedented.

it has been 50 years since an infectious disease has been identified as the cause of a birth defect. there has never been a birth defect caused by an infection transmitted by a mosquito. the historicalse record, this is not something we would have predicted. i think there is a need to be able to forecast more effectively than we have been able to do. i totally different problem with ebola, although, the event that occurred in west africa was also not predicted. that event, had we had in place the systems that are put in place now, we would not have had the event that we had. what we arer to seeing now, with similar detection and response to a problem. -- toooker: i want more submit one more question for the record about preparedness. i like the idea that preparedness is not an event,

but an ongoing process. about the states running a lot of tabletops for a lot of things. i worry about our overall state and federal working in coordination and preparing for that will become more and more unfortunate. not just here in the united states, but threats from overseas. so, thank you. sen. carper: thank you, senator peters. thank you for being vigilant and on the job every day. in addition to being on the homeland security committee here, i serve on the commerce committee and am currently the space,member on sick -- science, and preparedness. we are working to reauthorize

the america competes act. from my perspective, if we are going to increase our biodefense preparedness and work to counter diseases which can pose a threat either intentionally or naturally, then we need to fund basic science research, and consider it both a national and a homeland security priority for us. laughter, and a hearing examining the blue-ribbon panel on biodefense, this subcommittee heard that report found that federally funded scientific investigators are more likely to engage in early-stage research, versus private sector focus on specific product goals and user needs. this was a cause for ebola countermeasures not to be available when they were needed. when looking at the america they examined global biomedical research, private investment in the united states, correlates very closely

with government investment. when government investment and research and development string, the private sector pulled back as well. grows, thement private sector follows suit. but research and development spending has fallen below 1% of the gdp, which i believe is unacceptable for our future, and is important for biodefense and innovation. betweene correlation spending and basic science, i support robust federal spending for research, and believe the research can contribute to the next thing, whatever that next big thing is. it also sparks new industries, creates jobs, bolsters the economy. as we discussed today, it improves our biodefense preparedness as well. the challenge is in deciding the right ratio of basic, to apply research, and appropriate funding levels for each, and the

roles of private versus public sectors. could you explain how your agencies made use of basic science research, your sense of where we are, where our needs are, and what you would like to see? dr. redd: thank you for the question, just to be clear, i am the head of the advanced itearch and development, means when we are working on medical countermeasures, these are measures that have reached the clinical stage of development. dr. hatchett: as well as scaling up manufacturing, if you have manufacturing issues. depend on colleagues at the national institutes of health and defense to fund that basic research. we do not fund basic research.

it is important for us to coordinate our efforts with them a products and bring them forward to the earlier stages of discovery and development, we are ready to transition those products. in the case of the a bola -- those had been on our threat list for a long time. threats thef the department of security -- defense had identified. they have been working on countermeasures, and moving them forward through the development cycle. epidemic started in 2014, none of the products have reached the stage where our organization was ready -- where they were ready to be developed by our organization. within a year, we were able to transition 12 products from preclinical to advanced

development. many had been tested in west africa. we had a strong system as a relates to supporting product development. i could not agree with you more about the importance of basic research. sen. peters: thank you. dr. redd: if we had a panelist from nih, you would have a proportion of basic research and applied research and practical application. we do some basic research ourselves, are predominantly, we protect the public and use the tools available to make sure they are affected. -- effective. follow-ups: the western is, do you believe that we need to be putting more into basic research. do threats seem to be developing ?n accelerating rates are we doing ourselves a disservice if not putting in

more research at the foundational level? dr. redd: i think so. we need to get through the system quickly to find out if there -- they will be useful in large populations and effective. some of those questions are hard to answer at the basic level. sen. peters: other panelists would like to weigh in? >> it is critical to helping the department meet the needs of the stakeholders, whether they are first responders, helping make improvements to the problem -- program. it relies on the university program, as well, to help us meet the needs. we have been talking about ebola. we have a recent understanding that significant ramifications for biodefense have to be answered, still. one of the questions was, how persistent is ebola on surfaces,

how long does it stay infected? understand howto it does on the carpet of an airplane, or services employees might encounter in an airport. this kind of basic research has a serious implications for our day-to-day operations, so it is critical. appreciate it, think you very much. >> when the gavel come down -- came down, they may be next on the list. be next for us. thank youkill: gentlemen for being with us today, this is for anyone on the panel. i want to follow-up up on a question that was asked earlier by ranking member carper. study the blue-ribbon

panel top recommendations with the development and implementation of a competence of national biodefense strategy. this administration has failed to resent a comprehensive strategy in a number of areas, whether it is defeating isis, or countering the use of social disparatech are efforts that lack focus. as the blue-ribbon study panel concluded, the u.s. is underprepared for biological threats. it is critical that the administration establish a comprehensive biodefense strategy. could mr. currie or anyone else on the panel speak to the performance of this recommendation? >> absolutely, we think it is very important. it is similar to the blue-ribbon panel findings and recommendations. it is important to note that it is not easy. one of the reasons it is so andicult to do this

providing the vice president the authority to do this, is that it must come at a level above the am a because departments cannot tell other departments what to to it is very difficult allocate researchers between the departments and identify resources, for example, when we want less resources in one program versus more in another. it is very very difficult to do. we understand: the difficulty, but also the importance of doing that. would anyone else like to respond? >> yes, senator. thank you for the question. -- hashe office of the not developed a strategy for the parameters described in the report, i think it is important to point out that we do believe

the development of a national , oneh security strategy was completed in december of 2009. an updated version was completed in december of 2014. the next is a broader strategy, it does not just look at biodefense. securing security, as the title implies. it does this through major strategic objectives. at community is capable of responding to incidents of all kind, including bio threats. third, is promote health situational awareness, so that decision-makers can respond appropriately. the fourth, promote integration of public health care and emergency management systems

across the nation at the different levels of government. the last strategic objective is promote global health security. that is an overarching strategy. a great deal of what we do in biodefense and in developing strategy, we read with stakeholders at all areas of the government. sen. mccaskill: that is wonderful, very good. great first step. thank you very much for being here. integrate information about animal and human health without creating or perpetuating misunderstandings and fear among consumers both here at home and abroad? do see this, where perhaps the chinese are other will push away any they feels or produce might do them harm, or they could make that up. your thoughts on that?

weit is very important that stick to the science, and work with our colleagues on the human health side. a good example of that, is what is being called swine flu in 2009. we should have called it by its proper scientific name. it is important to do that, because industry is so important in iowa, and it was put in a ofl this advantage because the fear of an influenza that really should not have been attributed only to swine. that is why it is important that the science is integrated and we speak with science. it is important we have someone embedded at cdc, which we do, and work with a daily -- on a daily basis to make sure messages go back and forth. you spoke about the swine flu, we can talk a little bit about the avian flu.

>> i also wanted to point out that there are robust communications that go on between these within our center. we have a liaison within the usda, that has proved to be critical for producing health messages. in one case this last fall, we are seeing erroneous news about acome up resurgence of avian influenza that was not at all accurate. but working through the national wildlife health center, also with the department of interior, as well as our colleagues at usda, we are able to push through those agencies and camp these storiest that could have economic consequences. the one health approach is so critical to everything that we do. we need to continue to bridge this divide.

>> just briefly, to support the administrator here. we have a very intense scientific interchange between usda on influenza, and also food-borne diseases. there are pockets of collaboration. sen. mccaskill: very good, i appreciate that so much. we heard about this earlier, last year, the cultural secretary was rocked by the callednfluenza, commonly bird flu. this was devastating in iowa, where it resulted in the death hit0 billion birds, and a to our economy and iowa. the livestock sector is also regularly impacted by these diseases. they struggled to control them with new ones popping up each

year, we have talked about some of that. anis not inconceivable that ill-intentioned actor could purposely introduce an equally dangerous and contagious , toogen into the u.s. really mess with our food security, our trading relationships, and economic security. i know i am going a little overtime, but to that end, what is the usda doing to prepare for this type of bioterrorism? can you give us a broad overview on that? much interested in your answer, but if we could just yield to him for a moment, we will go back. >> thank you, senator carper. this is an important area. i have a number of questions i will be submitting for the record. probably to each of you, at least three of you. i want to focus on one issue, dr. hatchett, if i could.

we talked a lot about ebola today and the zika virus. they're very different. my understanding is, the way in which someone becomes contagious with ebola, its a health problem in itself, but zika is not as easily transmitted from person to person. however, it is transmitted from mosquitoes to people very easily. what do think we can do in terms of leveraging all of our assets, including one situated in youngstown, ohio -- iowa. they do incredible work with regards to oil spill's and mosquito infestations. do they have a role here, with regards to seek a? especially in spring, where we could see a movement from latin america into the united states. >> senator, thank you for the question. the control of mosquito

populations is an area that the cbc has primary responsibility for, so if i could yield to my colleague for this question. dr. redd: it is hard to give a full answer to that question. some localities have finally honed and her others, hardly at all. i think there could be a role for that in locations that don't have the capability, and need it. one of the things we think is really important that the zika out, outbreak is pointing we need to revitalize mosquito-control efforts. not just for control, but to understand what is going on. what they do is capture --quitoes and speciation speciate them.

>> thank you, senators. i want you to know that we are ready and willing. you do outstanding work, it would be a way to leverage some of those assets to address a very real, potential biological issue that we are currently facing, just as we did with ebola. >> senators. thank you, il: will submit the questions for the record, in the interest of time. i would like to hear the answer. [laughter] >> just breathe. brief. >> we worked closely with our colleagues, to conduct inspections of things and people coming into the country. that is our very first line of defense, looking for things. after that, what is important is

finding an outbreak quickly. surveillance is really the key. farms, surveillance on markets, feed lots, everywhere. the surveillance comes not just from usda people, but from state people, and private veterinarians who are accredited at usda. theshea: if they find disease, they are duty bound to report it to us. that is the key, surveillance, prevention, getting on this right away. some other things are going on of course. dhs is developing at the animals disease center, soon to be relocated. they are working very hard to find countermeasures, detection methods. all those things are in place now. just toaskill: follow-up with that, as we are preparing for potential is it important we have stockpiles of the

vaccinations or other veterinary supplies to safeguard? mr. shea: absolutely. we do have a veterinary stockpile, but it is not robust enough in the face of a huge outbreak, like foot and mouth disease, for example. we do have a good backstop for an influenza vaccine, but not for some of the others. >> senator mccaskill. sen. mccaskill: thank you. i understand there are several advisory committees involved in the risk assessment and determination process. that includes non-governmental experts. these determinations are in fact, the guidance that dhs considers a particular biological weapon a threat, and use bio shield

funding for countermeasure procurement. my question to you, dr., is is anyone on these committees associated with companies that are actually getting the funds for the research and development for possible countermeasures? >> it is the organization that runs terrorism risk assessments. involved in been the process, i am not knowledgeable as to the membership that they rely on when they put together those. sen. mccaskill: if you could get that for the record, that would be helpful. i have had a hearing on this in with the person you just reference, and was saw.rated with what i i will go into that a little bit because i think it is relevant to the hearing today. about what we are warehousing

and why, and what we are spending money on. look at the funding decisions and the priorities and the trade-offs, we spent one point $4 billion on anthrax countermeasures alone. two of the investments were for toxins that cost $3200 per dose. we also bought 10 billion doses of bio-threats, which only has a four-year shelflife. in we bought that vaccine 2005. then we bought another 18.7 5 million doses two years later. 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. i would like someone to address

that, because while we had one anthrax attack, it seems to me that the cupboard is bare in a lot of other areas, where we need to have bio shield funds being used. i would appreciate if someone that, especially since when i talked to a doctor about anthrax, they said it is therapeutic, and potentially effective against an antibiotic-resistant anthrax. it was not even a certainty that it would be. dr. hatchet? dr. hatchett: thank you for the question. your question has multiple parts. i will try to be brief and address all of them. with respect to the anthrax antitoxins, we have limited treatments for anthrax disease. judged based on the best

available evidence to be safe and effective and produce survival benefits against anthrax. anthrax is certainly one of our top threats, and we've made substantial investments to secure the nation against future anthrax attacks. to address your question of whether it is crowding out other products, i have to say it is not. office of preparedness our funding over the last 12 years, we have added 17 products using product bio shield funding. include products to treat anthrax, but also antivirals and vaccines to treat smallpox, botulism, radiation

syndrome, exposure to chemical nerve agents, and most recently, burnsoducts for chemical associated with explosions and nuclear devices. we have a number of products we will be procuring this year. we anticipate adding as many as five new products to strategic national stockpile this year. for two of those are anthrax, but they also include treatments for smallpox and acute radiation syndrome. we may add as many as five new products next year. we have been able to build up a diverse portfolio of medical countermeasures against them. sen. mccaskill: does the --llpox purchase include we have purchased significant amounts over the years. sen. mccaskill: is it a problem

that the journal says unequivocally there is no apparent use for the vaccine at this time. in fact, seven years after the it is notocurement, recommended. they say it is not recommended for emergency use. dr. hatchett: i would respectfully disagree with the statement that it has no use. be anzyme was created to vaccine for immunocompromised individuals, or for contraindications against the existing smallpox vaccines. there are a substantial number of people who could have a potentially severe reaction to other available smallpox vaccines. sen. mccaskill: that makes sense. but i'm concerned when their experts noted in 2014 that it was not recommended for emergency use, and we have spent

$650 million on it. i hope that would avoid raise the hackles of somebody who sits in this chair, trying to figure out what is going on. while we spending that kind of money, when clearly there are real questions about its thickest seat and safety. dr. hatchett: we also have a substantial stockpile of vaccines that can be administered in an emergency setting. is that ital concern requires two doses to achieve immunity. for those people who have been exposed to persons with known smallpox, there is no absolute contraindication for the existing vaccine. if it is given up to three to thatdays after exposure, may be the basis of that discussion. it clearly is efficacious and

meets an unmet medical need for a large part of the population. sen. mccaskill: i know i am out of time, i have one more, do you mind? i get that we are reliant on small startup companies for developing some of these drugs because of the nature of the market and the nature of the research. the economics don't make sense for some of the big guys. so i get that we have got to fund a lot of this. what i don't get, take anthrax for example. science is 130 million, to include approval of the topic. including facilities as well as funds for licensing and approval processes. this was our baby. around ande to turn buy it from them for $3000 a dose.

most people in missouri do not understand that. why we would pay for the development of a drug and then have to pay $3000 a pop for the drug after we paid to develop it. -- hatchett: >> good question. yes, it is a good question. i would say the pricing of medical counter measures is complex. -- we havetake into a sustaining revenue that will allow for the manufacture -- manufacturing base to remain intact. it is very clearly in the middle of the range. there are many therapeutics for other indications, and this price is for those products ranges slightly less than the amount you mentioned, to slightly more.

i would argue that it is a fair price for the product. sen. mccaskill: have we explored if it would be cheaper to do this ourselves? we are paying them to develop the drug, and then we are the only customer, and we are continuing to pay them. it seems to me, that we are guaranteeing a process for owneding holy -- wholly by the government. hishatchett: we do look at -- different business models for countermeasures. problema similar market , 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 productstially, what -- assurance we have that we will have the products when we need them. i would like to mention one

other thing you would be interested in. in framing your question, you talked about the shelf life of products. has an initiative we have been supporting for many years, where we look at the product that we are developing, and trying to find ways to reduce that long-term cost to the taxpayer. for example, you mentioned the enzyme product for the smallpox vaccine. we have supported a freeze-dried version of the product with will help the shelf life, across the board. we'll look at our entire portfolio to see how we could reduce the cost. sen. mccaskill: i was involved in another investigation, where martin shkreli found a limited market for a drug, and jacked the price up. maybe we need to take a page out of his book and jack the price down. figure the price of

the drug we pay to develop, and continue to manufacture it ourselves, and drive the cost way down. because now we are taking out privateess that the company is making from our investment. i don't think the private company should be able -- it seems weird that we are making the investment, that is the type of deal -- deal that any businessman with like to get. dr. hatchett: yes, we are always looking for ways we can be better spending the taxpayers money. we recognize our responsibility, and we do provide a great deal of that on -- upfront investment. sen. mccaskill: i would like you to take a look at that, because i'm not sure that makes sense for the taxpayers. carper: i want to come back to mr. shea briefly.

with regards to the avian influenza outbreak. a number of states were hit especially turkeys, and lay hands. we saw that in november of 2014, and last year. to beected the east coast hit this winter. it just has not happened. we have done pretty good on bio security. why do you think we have escaped this blow? >> all the scientist will tell me it is speculative, but some of the reasons seem to be something like this. the virus circulating in the waterfowl may have mutated to a less severe real and form. and when they dropped the virus, it is simply not catching on

like it did last year, and a highly pathogenic form. that is one possibility. another, is that the bio security has improved, and i think it has improved dramatically, certainly where poultry is so important throughout the midwest. i think bio security is much better. mr. shea: so those are some of the things that seem to have led to it. i don't know who to ask this question, but i will start with you dr. read -- redd. can you explain the difference between how ebola is transferred to a human being to another versus zika. seeker can be transmitted by a mosquito, bisexual transmission, or possibly by blood transfusion. there is no incidents where that has occurred, but it could be a possibility.

is not transmitted by mosquitoes or it it can be submitted bisexual transmission, but its primary route of transmission is contact. --coming into physical, physical contact with bodily fluids of someone infected. sen. carper: the cdc announced this week that zika virus is now to be a source of significant brain damage to developing fetuses. of consequences from that. just take a minute or two and talk to us about what actually happens to the brain. does it affect all pregnant women?

what is actually happening in the brain of the developing fetus, and what is the bornility if the child is alive? what are some of the consequences there? a couple of points. this declaration is not changing what we are doing. dr. redd: this declaration was , whether people are deciding whether they should there is no question that those prevented measures are very important to present something as confirmed. fetus isens when a infected is that the brain is actually infected. that was one of the early on microscopic slides

you can see brain tissue and virus right there. what we think happens is that , because of this infection, actually shrinks. , theu have a normal fetus brain gets infected, it gets smaller, and that is what causes the small heads. even though the term microcephaly just means small cases, itthese severe is a very particular kind of malformation. it is a very, very rare thing up until this point. of thetes of the skull fetus actually overlap because of the collapse. the skin has ridges in it, and that is not part of regular microcephaly. so it is actually a very specific finding. even though there is evidence

that the zika virus causes this malformation, there are many questions. and you pointed out several of them. it does not seem that every pregnant woman who gets bitten by a mosquito has this very severe, adverse effect. we do not know why that is. there is a likelihood that there is a certain time frame during pregnancy that is at the greatest risk. we also suspect there are other adverse events that can occur, typical of other birth defects. they are rarely just a single thing. informationve good on that entire spectrum of disease. sen. carper: do we have any idea to what degree of a beat is born disease, how does it impair their ability to function? dr. redd: that depends on the severity.

there is a spectrum. there are deaths at time of birth, that is the extreme. or before birth. i think you can go all the way down the line, that there may be much less severe findings that appear like normal births. sen. carper: for the panel, the last question. what common sense, practical advice can you give to people that will be traveling to these countries, and are concerned about possible infection? our advice has expanded to include more places where it is being transmitted. if you are pregnant, not a good idea to go. dr. redd: if you do go, use the mosquito prevention measures, and effective insect repellent, insecticide on your clothing, long sleeves, light colored

clothing. do what you can to avoid being bitten by a mosquito. sen. carper: any other advice? dr. redd: no. really quick, only one species of mosquito carries that, is this true? they are both aedes mosquito. pti is expected to be one. >> and the program to use ,enetically modified mosquitoes to reduce the population of those? dr. redd: i will have to get back to you on the specifics of that. approacha programmatic , indoor residual, and outdoor residual spraying that is being used in puerto rico for pregnant

women, killing mosquitoes right there. larvacides sides -- to remove potential breeding spaces. there are also less widespread uses. in all of this, we need to learn the effectiveness of these measures, because this is a very difficult mosquito. not to kill at an individual level, but to be sure, there are enough mosquitoes being killed to reduce transmission. sen. johnson: can anyone else speak to genetically modify? ok, experimental at best. let me close the hearing, i will go down the panel. based on the blue panel ribbons conclusion that we don't have a strategy, or a functioning leader here, budgetary as well as operationally, you are all involved in these organizations that have well-defined

strategies. i have been in organizations that do not have a strategy, i am kind of in one right now. i want to get your evaluation. if you agree with the blue-ribbon panel, you don't have to say a whole lot more. but if you disagree, tell me what is the disconnect in terms of what they are talking about, a lack of strategy, lack of community effort. i will start with you, dr. hatchett. dr. hatchett: thank you. think the problem of biodefense is a tremendously far-reaching, and it stretches to all sectors of society, and all parts of government. the domain that we work in, public health and medical preparedness and response, i feel that we do have strong strategies. we do have strong collaborative measures.

and we respond to the emergencies we are presented with. redd.ohnson: dr. dr. redd: there is a policy process, and that involves legislature, and the executive branch. this is a recommendation that need to be looked at very carefully. i certainly agree with them. many great things are going on between our respective agencies. i think those could all be bought together, for an advantage. i think that we are certainly taking to heart the blue-ribbon recommendations, and trying to implement as many of them as we can. i think there are strong strategies, strong coordinations. we discussed a few of them today, but there are many more.

we are never going to be done. one of the things that strikes me, is after 9/11, when we were talking about agency coordination to connect the dots , there was one anecdotal story that somebody stood up and said i thought we were going to do this after pearl harbor. this is a task that is never done. we will always have to strive and grow and build these capabilities. >> i come from a manufacturing backer, a gets in your dna, the urge to improve. sen. johnson: again, the gentleman here think there are strategies for improvement. is that an accurate assessment from your standpoint? >> i don't want to take away from some of the efforts that have been done. the public health strategy that is thechett mentioned, closest thing to a comprehensive strategy. if i could say one key thing that is not being done, is this idea of being able to prioritize investments and efforts. within each area, you can do that.

across, you cannot. sen. johnson: at the entry level you think you're doing a good job prioritizing, but from the -- down allocation resource once again, thank you everyone for your time, your testimony. the hearing record will remain open for 15 days until april 29 at 5:00 p.m. for statements. this mission is adjourned. -- this meeting is adjourned. [indiscriminate chatter]

>> the campaign 2016 process continues its travels to the student cam competition. they recently visited spanish springs high school in sparks, nevada. she won a third prize documentary on the wild horse population in the united states. california,aded to where othervisit students are recognized for their winning documentaries. california, judy joins friends, family, and

classmates to recognize other classmates for their winning documentary on social security. official thanks to our cable partners for helping to coordinate these community visits. remember, every weekday this month, be sure to watch one of the top winning entries before washington journal. >> c-span the road to the white house coverage continues in hartford, connecticut. donald trump will address supporters at a campaign rally. voters in connecticut cast their tuesday, april 26. we will take you there live on c-span. >> russian president vladimir putin posted his annual question answer committee.

texts, with-mails, very questions. he also commented on relations with the u.s.. the program ran about four hours, this portion is about one hour and 45 minutes. ♪ [speaking russian]