mr. blunt: the appropriation subcommittee on labor, health, related education

will come together. i i'm glad to be here this morning colleagues, some of whom are joining us from their offices or from some other location. is the first appropriations hearing being held in person and and want to thank chairman shelby and his staff for letting us try this and see kind of information gathering works for appropriators. it's not a markup. will be no voting today, but we're going to get some important information. yesterday, the new coronavirus passed 50,000 for the first time, making it a single day record. morning, 128,000 americans 2.7 milliond nearly have tested positive for covid-19. of course, the thoughts of myself and everyone on this ommittee are with those individuals and those families who've been affected. called this hearing really to look at an update on the efforts

that the administration's put frankly members of this committee were very involved in to see if we establish a new way to responding to pandemics. i think we have the chance to new important a hapter in what that response looks like. developing the right vaccine, therapeutics, the right testing is important. to talk nk we're going today about ways to try to have ll of the safeguards in developing all of those things, federal partner going forward more quickly than we ould have ever gone forward today. saw in reporting this morning pfizer just passed an important mark with the vaccine they're working on. the most significant thing

i saw in that article was that believes they may have 100 million doses of that available by the end of the year. that would be an extraordinary thinkif it happens, and i what we're going to hear from ur witnesses today is that there are other companies that would be developing different to ines that also would add that figure that might be vailable late this year or early next year. i think the administration's illingness to take this new initial philadelphia -- initiative, the willingness of the administration and, frankly, appropriations committee and the congress in what we did in act to put some behind -- taking a chance, not a chance with an effective vaccine or a test but a chance may move forward with something that doesn't work more also allow us to move forward

early with something that does work. committee, the full ommittee and the congress has provided nearly $10 billion for this overall effort and the vast investment will support the research and development of vaccines and treatments. are over 100 vaccines in development worldwide. operation warp speed is focusing we would n that encourage the advancement of and he clinical trials and further development. importantly, as n.i.h. and the biomedical research development oversee continue to the development of these to bees, we're also going talking today about how the acturing for maybe first time ever would begin while the vaccine is still going other process and maybe while tests are still process.ough the other

year withearlier this diagnostic testing research at n.i.h., the current processes make them amlined to faster. just because something is new doesn't mean it's better. is a time to try things and to see what we can figure work. make under the n.i.h.'s shark tank rogram, program that particularly senator alexander and i spent a lot of time table to people at this about, principally dr. collins, ut people at this table, manufacturers and others, we're track diagnostic tests to have tests that are easier to take with a quicker millions hat frankly of people can take dozens of times. the ng school started in fall at residential campuses and schoolsry and secondary and all other campuses having a a big ailable will make

difference. some people have warned that the to develop both tests and vaccines next year is far fast. others have said, maybe means ating the process that regulatory corners will be cut. we're going to be working really hard to be sure that's absolutely not the case and i hink our leaders here today will help reassure us of what they're doing to see that that happen. this is an opportunity for our witnesses to explain to our and the american people how the development rocess works, how they'll ensure the vaccine will be safe, and even with an accelerated esearch and development timetable how the vaccine will be distributed across the as possible.ickly i said to several people lately topic of vaccine and distribution that obviously developing the vaccine is the priority, but right below

hat top priority is having a plan that distributes that vaccine in a way that people and equitable and meets the standards that we establishing right now. there are clearly concerns about the vaccine. half of americans are either reluctant. about one out of five americans going to take t the vaccine. to.rtainly intend and i think most americans will. about thisure people about small think ox and polio and many things vaccines have been able to move outside the system because job and kids heir in the fourth and fifth grade don't line up any longer so that person takes their smallpox shot like they did when kids.f us were i hope today's hearing really

makes an impact on those concerns. believe it will. nd look forward to our witnesses. senator murray is here and i'm going to recognize her for her statement. senator murray, thanks for being with us today. thanks for working together to hearing. senator murray: well, thank you very much, mr. chairman. to thank you and chairman shelby for allowing our embers to participate in this hearing virtually today. i want to thank all our committee staff for setting up.ything i want to thank all of our witnesses who are joining us today as well. play a critical role in the development of some tools most important against the covid-19 pandemic. effective diagnostics to identify the cases, therapies to help patients and frontline to fight this disease, and ultimately a vaccine to move crisis.ending this that is why congress has

ppropriated more than $6.5 billion to barta and $3 billion on medical r work countermeasures against covid-19. nd we know we'll need more funding, particularly to distribute and promote a safe nd effective vaccine down the line. and we also know we're going to need to hold this administration repeating to avoid the mistakes and delays. the trump administration put ahead of public health by promoting unproven treatments steering p.p.e. contracts to allies.ied a plan in a comprehensive way nationwide testing and and exacerbated existing health disparities that left lack, latinos, tribal communities to face the worst of this crisis. if we want to get out of this the trump e soon, administration has to do better,

articularly when it comes to developing a safe, effective vaccine that's widely available. from experts is that while we all want a vaccine vaccine that is fast but sharp of e will fall what it is needed to turn the tide on this pandemic. hat is why it's more than concerning that the trump administration sidelines our scientists at c.d.c., removed the head of barta reportedly for putting science public health over allegiance to president trump, nd took barta experts off leadership of contracts related o the search for a covid-19 vaccine. i also have concerns about why arta has chosen to invest solely in new vaccine beenologies that have only studied experimentally and never while not market

pursuing older, proven technologies. meanwhile, the administration has not provided any explanation of how it is candidates, cine what the risks are of narrowing down that short list, or address concerns about potential conflicts in contracts that crisis. this and it still has not provided a vaccine sive national plan. e saw with testing how the administration's suborange refusal led to totally avoidable delays. so congress clearly needs to act and hold president trump ccountable when it comes to vaccines or risk another nadequate plan that offer too little, too late, or offers no plan at all. to working on a proposal require the trump administration to provide a comprehensive plan will make sure we get a vaccine that is safe and produced at scale,

and distributed nationwide and to everyone lable in a way that addresses the health disparities this pandemic has made worse. this plan has to ensure that is arch and development rigorous, science-driven and must lay out it specific standards, timelines and milestones, a commitment to fully transparent about the linical trials data experts will use to evaluate safety and effectiveness and strategies for combating vaccine hesitancy and misinformation. hen we finally develop a vaccine, we will need to safely manufacture hundreds of millions for the u.s. alone and as ions globally as fast possible. and that means just as many pecialized glass vials, syringes, stoppers, and a lot more. aking all of that happen

requires planning to manage the supply chain and navigate like potential bottle necks. we also need a plan for when we to distribute vaccines. to guide critical decisions gets the vaccine first, like frontline health are workers, high-risk groups, and tackle barriers that could otherwise limit access by making for the vaccine is free everyone. and addressing health disparities which have already worse is crisis so much for communities of color. and while we need this plan as we also need le, to be clear about what scientists and clinicians have autioned which is that while there is no guarantee a vaccine will be ready by the end of this fall, uch less by this there are people suffering with who need ight now proven therapeutics to help them beat this disease. vaccine is our best hope for stopping this virus, it's only means of fighting

it. us all.t a panacea on while i am alarmed that this administrati administration is treating other priorities as an afterthought by better g far less in diagnostics that can identify course ns early in the of the illness and prevent further spread. nd pulling the plug on therapeutics that could provide lifesaving relief for hospitalizations at the greatest risk of dying or suffering long-term health effects. funding for ided h.h.s. to invest in a spectrum to edical countermeasures fight this virus, not just vaccines. e need to invest in every type of medical countermeasure and to do it in a way that benefits our country equitably because we know right ow this virus is disproportiona disproportionately impacting communities of color. pressing for

comprehnsive demographic data -- graphia data dem on positive testing, hospitalizations, intensive care fatalities.ons, and and i'm frustrated that we don't have all the data we need yet. we do have is s alarmingly clear. people in the black community, community, and tribal communities are three to five to be ore likely hospitalized for covid-19 than white people. for people ofrate color is two to three times that people.e those devastating health disparities are a symptom of a systemic tern of racism and underinvestment in communities of color. need to ning that we work as fast as possible on an additional relief package to those disparities before they get worse to protect our workers, our students, our to lies, and continue support our communities as they this historic crisis.

e can't know exactly how long until a safe and effective vaccine is widely available or how long before we can all back to work, back to school, greet our friends with a hug.hake or a we do know the decisions that we make today, whether we not, itize science or whether we plan ahead or not, whether we care for every will make a not huge difference in terms of now. we are a year from so it's absolutely critical we get this decision right. hank you very much, mr. chairman. i look forward to the testimony and to our questions today. blunt: well, thank you, senator murray. got a great panel today. collins, the director of the national institute of health. r. robert redfield, the director for the center for control. the acting director of the biomedical advanced research and

development authority. barda. referred to as this is his first time to testify but our other two have been before this committee many times. it's possible that dr. collins set the record as a witness before this committee. r. collins, why don't you start? we have your statements. try to limit your opening comments to five minutes each. you can do that however you want to. but we're glad all three of you are here. we're eager to ask questions. director collins: well, thank you. blunt andng, chairman chairman murray and distinguished subcommittee members. i want to thank you for your commitment to the national institutes of health. enabled n.i.h. to be at the forefront of research to address the covid-19 public health emergency. i'm grateful for this opportunity to update you on that work. you should have it in your place you're on the video connection, maybe an electronic version of a couple of images i you to in a

moment. over the last six months, covid-19 has spread around the with frightening speed. to respond to this crisis, we many o find answers to rgent questions about how to diagnosis, treat, and prevent. at n.i.h., we need to use the and technology in the world to find those answers. a critical question is to understand what we are up against. comes to new infectious disease, knowledge is power. the image on on page 2 of your handout and also model i -d printed brought along with me which happily was not confiscated by the security people when i entered the building even though i guess you could say i brought virus to your hearing room, this cause you illness. this model shows you the cause of covid-19. coronavirus called covi-2. otice the spiky things on the

surface. hen they get into your body, they act as keys that fit into specific cells. virus side the cell, the takes over the machinery, begins replicating, producing thousands itself and goes have other viruses that causes pneumonia. better means of treating covid-19 than just a few months ago. remdesivir and declaration have proven beneficial in rigorous trials and are now standard of care for patients but we have much more to do. let me say something about testing. testing in the u.s. has come a way. more than 30 million tests for presence of the virus have been administered in the last few months. than in any other nation. et, these tests, most of which rely on nasal swabs and processing in centralized labs not satisfactory for the needs at hand. point to rapid routine of care testing would be a major

advantage but that requires new technology. mind, congress, on april 25, provided additional resources for development of new covid-19 tests. just four days later, n.i.h. acceleration apid rad-x nostics, or initiative. if you turn to the next page ou'll see an innovation funnel which includes a shark tank component. this basically is an opportunity for those who've invested and invented new kinds of put their ideas forward and have them evaluated a distinguished team of business, engineering, scaleup experts. in just two months, we have eceived more than 2,400 expressions of interest. and over 560 completed of these weremost small businesses. tests useese proposed convenient samples like saliva,

which would be better than a because you can self-collect. of these 23 have already made it are gh the shark tank and undergoing intense validation and what you see here as phase for possible massive scaleup in phase two and e expect to have at least one of these technologies within phase two within the next week. by fault, we expect that the technologies will make it possible to deploy several week.n more tests each in fact, i would say maybe more than a million more each day. enough to diagnosis the disease. we must treat it as soon as it.ible to prevent to that end, on your next page ou'll see n.i.h. has launched the accelerating covid-19 therapeutic interventions and vaccines. an acronym, activ, initiative. shown here ine is the handout provides a high-level overview of the organization of this remarkable unprecedented public-private

artnership involving 18 biopharmaceutical companies, academic experts and multiple federal agencies. months, avtiv has developed five master protocols will hasten f.d.a. review and possible approval. hese will rigorously test a eries of anti-virals, monthcal antibody treatments in both in-patient and outpatient settings. four treatment trials to get under way in the next six weeks and we're quite excited potential for potential success. the ultimate tool that we need pandemic is vid-19 a vaccine. peration warp speed is working together on vaccine development. a scientific review of more than 0 candidates has already been conducted. the furthest along in u.s. testing, shown on page 5, is an vaccine from n.i.h.'s vaccine research center moderna.rship with his vaccine features a small,

noninfectious snippet of messenger r.n.a. injecting this m.r.a. into a person's own body to make the viral spike roteins, which in turn will encourage the production of against e antibodies sars cov-2. his vaccine candidate began on may 29. and this month we'll seek to enroll 30,000 volunteers with few ted expected in a months. so clearly, we've already learned much about this madetating virus and we've significant strides at unprecedented speed in diagnostics, their putics, vaccines. yet, far more work is needed to crisis. global with your support, n.i.h. is on the case. so thank you for this opportunity and i look forward questions. senator blunt: thank you, dr. collins. dr. red field. redfield: good morning, chairman blunt. members ember murray,

of the subcommittee. i'm pleased to be here with my h.h.s. colleagues. the her we're working on critical issues related to covid-19 vaccine development, anufacturing, distribution on the auspices of operation warp speed. of public e one health's greatest scientific achievements. with the support of congress, in c.d.c.'s domestic and global immunization programs diminish disease threats and advance the human condition. ost importantly, vaccines save lives. preparing for the implementation of the safe and effective vaccine program is a critical next step. influenza existing vaccine program, c.d.c. continues to work with state, health local territorial partners to prepare and maintain public health distribution pipeline. his includes training personnel, building strategic relationships, utizing data ystems, identifying the resources to sustain an efficient and effective infrastructure.

leveraging the existing systems, c.d.c. stands ready to support ur partners with the distribution of -- once a covid vaccine is available. c.d.c. safely distributes vaccine from manufacturers to nearly 40,000 and private health providers across the nation. and in a typical year, we vaccine for more than 80 million individuals. this systemergency, has the ability to scale and manage and distribute up to 900 million vaccine doses. his is possible because c.d.c.'s established an extensive integrated network health e public departments, public health providers and community groups wide.xtend far and drawing from the lessons of pandemic, we began covid-19 strategy. it will be based on many factors. one strategy likely look who is vaccinated.

the goal is to ensure that vaccine access for all americans can benefit from vaccination. to do this we must consider the of where spects vaccines are administered and is administering. we need to manage inventory, nationwide.e supply c.d.c. currently manages the vaccine rough its system and collects vaccine data to help them ions make informed decisions. .d.c.'s immunization safety office has a long standing history of monitoring the safety nd efficacy of vaccines and will take to provide leadership area.s scientifically based vaccine policies are the foundation of the u.s. immunization system. policies are formulated by recommendations from the advisory committee on practice, or acip, and then provided to me as director. another key component is the

efficient distribution strategy people have clear and accurate and ample information so they can make informed decisions about getting vaccinated. that ence has shown us vaccines are powerful tools and individual who could benefit from immunization goal.important successful vaccine program will require a combination of raditional and new innovative approaches to how to administer and deliver vaccines. harmacies and other complementary community locations will be more important response to this pandemic. finally, public health at iderations have to look the management of the vaccine itself. every vaccine has requirements handling that must be addressed for the accine to be effectively when delivered. from when e chain, the vaccine is manufactured to

when it's administered. to meet these aggressive goals important to enhance our nation's infrastructure. in the coming months, we will be the confluence of covid-19 and seasonal flu. c.d.c. is working to encourage americans to embrace flu vaccination with confidence. his is an important public health goal and serves two covid-19. purposes for first, increasing flu vaccine coverage can reduce the strain on our health system which we've already seen in some areas. from covid-19. flu vaccine takes another opportunity to test our systems and infrastructure that to be leveraged during a covid-19 vaccine delivery program. confront the fight the pandemic, it's important that in americans have confidence all vaccines. through the cares act, c.d.c. provided $140 million in funding to support states and local departments for early flu influenza

season and to enhance these immunization programs across our nation. covid-19 is the most significant public health challenge that our in more than a century. in the absence of a vaccine and today we are s, implementing effective public health measures and encouraging what i referred to as the powerful weapons of ocial distancing, face coverings and hand hygiene. in doing so, i'm confident that this l emerge from pandemic united together, stronger than ever. encourage you to see the possible as both the public and private sectors pursue a vaccine confrontwe as a nation this pandemic globally. thank you and i look forward to questions. senator blunt: thank you, dr. redfield. dispro. >> thank you, chairman blunt, murray, members of the committee. barda is tell you how

responding to the covid-19 pandemic. barda is a unique government bridge tion created to the valley of death between basic research and late-stage evelopments of products, vaccines, therapeutics and iagnostics, called countermeasures to address security threats. 13-year existence, 55 f.d.a. ot approvals. they are experts in government ontracting and pharmaceutical and diagnostic development, many with 25 years experience working industry.rmaceutical barda has a track record of public in response to health emergencies. ebola.had h 1 n, 1, barda's long standing expertise n accelerating the advanced research and development of candidates, diagnostics, their vaccines shows the

dedication of the team. i want to thank my barda colleagues as they work long and weekends to support this response. year, they iscal nvest $1.6 billion to address chemical, biological, nuclear threats and pandemic inflew endsa. addition in just three months, we have obligated over $3.5 billion as part of the response. barda has leveraged funds provided under the cares act and h.h.s. to invest in ultiple vaccine candidates, programs, diagnostics. grantedostics have been emergency authorization by the f.d.a. the portfolio now supports over 40 projects. h.h.s. secretary azar public health emergen emergency, we highlighted our of tegy for development accines, their putics, to -- therapeutics.

that same day barda opened a research accept market submissions from stakeholders seeing over 3,300 submissions to date. prior to receiving supplemental unds, we allowed for submissions for covid-19 specific products. 267 submissions easy b.a.a. and 426 to the b.a.a b.a.a.. this is what we do. engage innovative stakeholders, establish artnerships, develop medical countermeasures and bring them to the american people to save lives. barda n the outbreak, strategies to engage with vaccine manufacturers, different platform technologies, some already near ed by the f.d.a. or willure and had established anufacturing processes to manufacture large quantitities of vaccines. our therapeutics was similar. invest in multiple technologies increase our chances of

success. is to invest tic it in many areas. andsed our existing funding authorities. this early strategy has partially served as the basis or operation warp speed strategy or o.w.s. o.w.s. is an unprecedented collaborati collaboration between the department of health and human services and the department of expedite vaccines, therapeutics and bring them to the american people. bring up to 300 million doses for safe and 2021tive vaccines in early as part of a broader strategy to develop, manufacture, of covid-19 spraks vaccines, therapeutics to the american people. n.i.h., d.o.d.e he prior goal of o.w.s. is to

produce safe countermeasures. we need to take financial risks expedite the vaccines and therapeutics. the key to success is to invest n multiple candidates and support parallel development activities. financial. purely a financial risk of manufacturing large amounts of medical countermeasures while we're still determining the and efficacy. we will not risk the safety of these products. is necessaryl risk to ensure m.c.m.'s are available or use as soon as the f.d.a. has deemed them safe and effective. some of the investments will be in products that do not make it. financial risk we must take because the risks and lives lost and the impact to our greater. is far this committee and congress at large has been very supportive of barda in our mission and very thankful. today more than ever, we need your continued support and our staff to ensure can stay focused on the issue at hand. enator blunt: thank you, dr.

disbrow. we will stick to five minutes every member has. be a second round and everybody will be dissatisfied at the end of their first five what they didn't get to ask. the person that follows them satisfied ticularly they stayed close to the five minutes. collins, dr. disbrow said even would be no product produced would be available and safe, do you have any concerns vaccine side that f.d.a. going through every safety step they wouldn't normally go through? chairman, llins: mr. i have no concerns and i'm deeply engaged working in this warp s with operation speed. i think the ability to do things uickly is not compromising safely. it's -- safety. we can speed things up even involve doing manufacturing at risk when we don't know yet whether that vaccine will work and ultimately a lot what gets

manufactured if it doesn't work. compromise ll be no efficacy fety and of standards. that's clul. blu disbrow, you dr. mentioned the risk factor. outcollins said we'll throw anything that's produced that doesn't go through the final ertification of safety and efficacy. tell us a little more about that process. i also noticed you said we're testing and view, the approval phase. are we engaged with anybody in phase?ufacturing engaged.ow: we're we're investing in a diverse array of technologies, different technologies because we're which vaccine technology may produce a safe and effective vaccine. collins ng, as dr. mentioned, manufacturing at risk. to is a risk that we have take if we want to expedite the

timeline. so there is reason the f.d.a. is operation warp speed. they are an independent regulatory body and they will efficacy. safety and but we will manufacture at risk and volumes of vaccine there is the potential that if prove to ines do not be efficacious in phase three studies we will not move forward study.at senator blunt: every time i hear at risk and i am pretty peopleable with vaccine, hearing at risk, i don't think we can emphasize enough what some risking is losing money that we invested to move products forward so that when the products that did process gh the whole would be available at maybe time they're me finally approved for use. nothing will be more frustrating this moment than for f.d.a. to certify a product and then to be months g

before that vaccine would be available. i right in believing that's what you're -- those months with what you're trying avoid through barda? dr. disbrow: yes. investing in multiple vaccine candidates and you're exactly right. it is a financial risk. a safety risk. and we are manufacturing in the government-- and the is assuming that financial risk. you'll blunt: i'm sure talk about specific money later. e already invested $3 trillion to try to fight the virus and save the economy. we lose $3 billion in an effort to get both of those right place quicker, i think we all ought to be willing to eagerly talk about fact frankly if we didn't lose money we didn't try hard enough. f you choose six vaccines and they all make it, i think the question will be, well, why idn't you choose eight vaccines?

because, again, dr. disbrow pointed out, all of these vaccines will be slightly than the other vaccine. hen you get a vaccine for covid, am i right in assuming that people will not all get the vaccine for the -- in all covid ood for their vaccine? disbrow: we're hoping to develop one or more safe and effective vaccines. there are one or more safe and effectively vaccine, there one vaccine may work better in a certain population than the other. continue to value wait those -- evaluate those. senator senator who is -- senator blunt: who is for nsible for the plan distribution in the current structure? director redfield: thank you for the question, mr. chairman. space really the center for the c.d.c.

as i mentioned before, we're currently involved in the of a variety of vaccine programs throughout this nation. really the prime responsibility of the c.d.c. to work in coordination to take the tage of some of logistical capabilities of the department of defense. c.d.c.'s s really primary responsibility. enator blunt: thank you, dr. redfield. senator murray. senator murry: thank you to all our witnesses today. this crisis we will know will not end until we have a safe and effective widely and can be equitably distributed. n tuesday, you agree that we need a comprehensive national plan, implementation will hinge public health agencies to deploy vaccine to every is available. it c.d.c.'s decades of experience national immunization program has to be central to that planning. think i just heard you answer chairman blunt.

but under operation warp speed, c.d.c. leave the planning for immunization infrastructure or is in that n in any way the department of defense responsibility? redfield: thank you very much for the question, senator murray. again, it's leveraging -- we're leverage the logistical capability of d.o.d. with and usly the experience essential role that we play in distribution with the state, territorial , partners around the nation. again as i said to the chairman, lead with the s logistical support of the department of defense. the or murry: so has d.o.d. ever managed that same distribution at this kind of before? dr. redfield: i would have to the that question to department of defense, but i can i mentionedte which that c.d.c. has a system in place that we use routinely. senator murry: ok. to move on.

that's a question that's important here. let me ask. hasn't used funding for bills --e supplemental can you tell us why that is? redfield: sorry, senator. i didn't quite understand. enator murry: c.d.c. has not used any of the funding of the supplemental appropriations bill that you've been given to a mass vaccine distribution campaign. that was. to know why dr. redfield: senator, i'd have o have our group get back to you. we've expended a substantial amount of the money that congress has provided us. i moved over $12 billion territorial,local, tribal health department to augment their capacity. our team getto get it.he specifics of we -- senator murry: yeah. vaccine.that for flu

important. the lack of preparation for vaccine distribution is concerning to me. nd it doesn't sound to me like c.d.c. is given that effort. chairman, i do need an answer. that k we all do to question. r. disbrow, last month, h.h.s. announced a $628 million deal to emergent biosolutions help manufacture the eventual vaccine. deal -- st award, that at the highest paid contractor for he h.h.s. office assistant secretary of preparedness and response. a "washington post" revealed before they doubled after contracto y other

contractor -- of a biodefense company as founder and chairman, the way he fails to disclosed to the senate during his confirmation process 2017. so dr. disbrow, this is my question to you today. can you say with 100% confidence bardaompanies are awarded contracts based solely on scientific merit and not their relationship? i can.brow: yes, senator murry: it was reported yesterday 30 companies making oronavirus drugs and vaccines removed standard language from their contracts with barda that the government rights to ntervene in cases of unreasonable drug prices. i am very concerned that pharmaceutical companies have barda d the terms of contracts and watered-down the marching right protection. at a time when we're spending billions of dollars in vaccine did we weaken y

our ability to ensure fair vaccine pricing? disbrow: for the u.s. government to use marching high requires a very threshold. the u.s. government can ask the a der of the i.p. to grant onexclusive, partial exclusive or exclusive right to the license. however, the contractor has to they are not or expected to not, within reasonable time, achieve application. that is not occurring. we are all working very quickly o push forward with the development of vaccines and therapeutics. action is necessary to alleviate needs, not fety reasonably satisfied by the contractor. i also do not believe that threshold has been met. again, under barda contracts, we work under the regulations.sition we do have some contracts of which are called other transactional agreements which outside of the far. but we always -- everything is based on science and to protect he federal government's

investment. senator murry: i just want to say this. we are spending billions of dollars in vaccine development. weakening our e ability to ensure fair vaccine pricing for the people of this country. thank you. senator blunt: thank you, senator murray. senator shelby. senator shelby: thank you. i'll address this to all three of you. where are we today? american people are watching this hearing. that we have sent you enough money. not. haven't, tell us why but tell us where we exactly exact, on can be coming up with a vaccine? i know the vaccine, i know every approach in the world. you know, logical approach. you got a lot of people working on it. american people are sick and getting they're looking for results and magicw you can't wave the

band. dr. collins, i'll start with you. american u say to the people today where we are and when the timeline and what do where?nk we will be dr. collins: mr. chairman, this is the right question and all of us think working on covid-19 are obsessed about night and day because this one of those crises where science is not only important, and ever mistake we make would set us back and every wasted opportunity would for a consequence somebody's life. so i want to tell you, we are all in. everybody working on this warp team. where we are with the vaccine, remember generally it takes five to 10 years to develop a vaccine from a new infectious agent. we don't have that time. in record time, the very first vaccine went from knowing viral e sequence of this genome was to injecting the first patient in a phase one days.in 63 that's a world record by a long shot. because of new technologies that possible. and then going quickly from the

phase one which looks very promising to phase two, which on may 29, and phase three, which will begin this month. take?w long will that we need to enroll 30,000 volunteers and that should take some month. we are all optimistic that the goal we have set to have a is safe hat works and by the end of 2020 will be met. i just f the vaccines mentioned but there are several ll being conducted side by side. and that we would then have by early 2021, 300 million doses of vaccine that's safe and effective. so all that is where we're putting ourselves on the line think everybody at this table would agree that's really a stretch goal but it's the for the american people. senator shelby: dr. redfield. thank you, : chairman. two comments. first and foremost, the most move ant thing as we forward with these vaccines, as was said before, is that our c.d.c., again, along

with others that are here in safe. is to ensure they're and efficacious. where we are right now, the two areas where we have the most role is to figure out how to get that vaccine into the individuals that would benefit from there. two things there. building vaccine confidence. that's shelby: presupposing you come up with a vaccine, right? we have to work on that right now, chairman, just because the complexity of giving to the american ublic as we learned during the h-1-n-1 in 2009, it's seriously complicated. so we are working on that, if distribution mechanism now, and we're working on uilding the confidence of the american public now with the is p position that our -- supposition that our colleagues are evaluating the vaccine shots between the seven on goal or many vaccines they're developing now that one of those vaccines will come and show an and efficacy y

profile to go forward and be distributed. dr. disbrow.y: dr. disbrow: building on the we look at ments, incremental success as we're moving along. yesterday.e results pfizer. those are important to get out people.merican phase three clinical trials, that's been reported by one of the companies we are working with. energy-efficient their -- they'll initiate their phase three trial. phase three are trials that are staggered later in the summer. those are important milestones o let the american people know we are making progress. in addition is the scaleup in manufacturing and validating process. that is a critical milestone as well. o where we are right now is we're in the phases of the different clinical trials. phase one, phase two, phase and we're ramping up manufacturing. senator shelby: dr. collins, around the peration world since so many nations, so affected do re

researchers collaborate on and getting?they dr. collins: science has always been an international effort and never more so than we're faced global pandemic. i think a collaboration and cooperation is really excellent. one of the vaccines we're actually was originally developed in the united kingdom. has now been embraced in a way the u.s. can take advantage of it. also with support from barda's of doing lent way those negotiations. so, yeah, we are looking in for the k and krany kinds -- cranny for the kinds of collaborations that will go faster. that is our scientific tradition. senator shelby: thank you, mr. chairman. senator durbin: i want to follow up on senator murray's question. of a in the national national pandemic. we are in the middle of a national presidential campaign. think her question goes to basic desire for testimony here on where we stand political world

before we address the medical world. 'd like to ask the three witnesses here if any of them have felt any pressure, from the pressure white house or other agencies in of the selection of the companies to develop a vaccine, timing of the vaccine development, the announcement of any other aspect that is part of your esponsibility on the medical side? dr. collins: no. a s of internal pressure as physician and a member of the orld to try to find the answers. dr. redfield: senator, my answer is no. disbrow: the answer is no. i am a scientist, not a politician. senator durbin: thank you. hoping he answer i was for and what the american people are looking for. let me go to the next question and here's al side where i think we need to have some candor. when i am told that the phase clinical trial of the

maderna vaccine that's been onducted by the university of illinois at chicago will kick off in about a week and they will last that it years before -- two years before completed it, collecting information from all of the people who volunteered for the and the likeamples to determine the safety and effectiveness of that vaccine, i find it difficult to square that reality that's been announced in clinical trialee with the promises that i'm hearing over and over again that likely tomonths we're have a vaccine. it suggests to me that the phase which linical trial, ordinarily takes two years, is abbreviated.omehow now, i understand the emergency at f.d.a. thaton may be utilized to choose a production,going to distribution of such a vaccine. ut that has had at least some mixed results recently when it

ame to the hydroxychloroquine that was announced. so how do we maintain the confidence of the american and e of the safety effectiveness of vaccine if it shortcuttingwe are this phase three clinical trial that's usually required in these circumstances? >> senator, maybe i can explain two-year interval was there in terms of the assessment of the vaccine. e need to know as soon as possible is, does this vaccine, when administered to people who but ntly are not infected are likely to get exposed, does t protect them from becoming infected? dr. collins: so each of the vaccine trials will aim to enroll 30,000 participants. of whom will get the vaccine. half of whom will get a placebo. e'll watch, then, as these individuals, and they are going to be particularly recruited in areas where the vaccine is get ntly spreading, either infected or don't. it will only take about 126 theodes where somebody with placebo gets infected and

somebody with the vaccine doesn't to know this has worked. the point where you would be happy to say this now as efficacy and, of course, you'll have a lot of people to see if there is safety. prolong the sfudy after that has -- study after hat has been achieved is long-term side effects that weren't anticipated? we don't think so but you want able to follow. also, how durable is this particular immunity? is this vaccine will be that will work for need a booster in a year or two, hence the timetable. senator durbin: if i'm going to 126,a decision, good news, whatever it happens to be, in the span or three, four months, here's your vaccine. to make that decision, what you're telling me he phase three clinical trial still has important elements in my decision-making process to be esolved, which are going to take time in terms of long-term impact of the vaccine, is that correct? .

dr. collins: that's the way we do a lot of trials of drugs, not just have a scenes. whether you assess the drug is safe or effective. then you don't stop looking once f.d.a. has given an approval. you carry out long-term studies to make sure there is not some unexpected result or the drug stops working. that's basically the plan here with vaccines. we don't want to miss the chance to collect that down stream data. senator durbin: dr. collins, are you familiar with the cutter vaccine issue? polio vaccine? dr. collins: yes. senator durbin: did you respect on that for a moment what the world of vaccine development looks like today compared to then? dr. collins: yes. that was a terrible tragedy and circumstance where a vaccine actually turned out not to be fully inactivated and created the illness it was supposed to prevent. i think i could reassure you and the american people that that strategy of trying to administer a killed vaccine is not currently being pursued for sars

cov-2. because of the risks. instead the vaccines choose to produce just a small component of the virus. these proteins, these pike proteins that sit on the surface. that's what the vaccine produces. there is no intact virus there at all. the cutter experience, a terrible tragedy, is not possible with the way these vaccines are being designed. senator durbin: thank you. chairman blunt: senator alexander. senator depearned: we have been talking about vaccines. next year i'd like to talk about tests and treatments this fall which is only a few weeks away. let's start with tests. dr. collins, with all the depressing news we hear about covid-19 for the last several months, americans are hungry for sports. will there be enough covid-19 tests so we can watch some football this fall? or some basketball this winter?

i notice the national hockey league said it was going to test every player every day. the president of brown university told our committee she wanted to test every opportunity before they come back. it's been said the country will have 40,000 to 50,000 test capacity by september. that will probably be enough to have widespread testing to go back to school and work. but will it be enough for sports teams to take the field? probably the answer lies with your red x effort to make a new way of creating quick, reliable, diagnostic tests that can be administered frequently, maybe even every day. we'll be able to watch some football and some basketball this year. or do we have to wait until next year? dr. collins: i'm probablely the least qualified sports fan but i

do appreciate this is important to a lot of people. we want to see americans have a chance to have some normal experiences of enjoying life. i do believe this should be possible. what is being done and appreciate the strong support from this congress to make this possible is to speedily put together these kinds of point of care tests that can be done on site, can give you a result within an hour, and can tell you immediately whether that person is actually infected with the sars c 06789 v-2 virus which they can be immediately quarantined. the general sense is for athletic teams you need to know that. senator alexander: your goal is to have these tests available this fall. september? that's your goal. dr. collins: that is the goal. the path we are on right now and again this is a white knuckle goal because it's never been done in anything of this timetable before would be to have one million tests per day

available for the kind of point of care on the spot testing that's very much needed for going back to school and going back to sports events. senator alexander: these would not be the tests that have to be shipped to a lab. dr. collins: that's our goal. if they are going to be shipped to the lab the lab needs to be nearby. we are aware there are places where there are labs that have instruments that could be brought to wear on this widely distributed already but haven't been adapted to this purpose. that would be a next best thing to have them in your own local arena. the best is to have your gadget right there at the front desk when somebody shows up for practice and find out is this person somebody who is safe to send to the field. senator alexander: threat's go to treatments and medicine. senator kennedy may be here. he said in his way that he thinks what people are really afraid of with this virus is not just getting it but they might die. they might die or have a very severe illness because there is no medicine for it. except you mentioned two that

have been approved by the f.d.a. so as we go back to school, for example, 75,000 students going back to elementary and secondary school we are happy that covid-19 doesn't seem to affect children very much. or even college students very much. but there is the danger that there this might i effect their teachers or older administrators or they go home to their parents or grandparents and might infect them. what can you say to the teachers and administrators and parents and grandparents about medicines this fall will help them not die and not have a severe illness? what will be available this fall when the kids go back to school? dr. collins: there are intense efforts to expand that territory from the approved drugs to other kinds of ways to do effective treatment. a big promise here is the use of what you might call passive immunization where you basically provide to somebody who is ill

antibodies derived from somebody who has survived already. this is the idea behind convalescent plasma being rigorously studied and right now analyzed by the f.d.a. to see the results. more than that won could develop antibodies -- senator alexander: this is the antibody cocktail developed and approved by the f.d.a. with ebola. dr. collins: exactly. it worked really well. you have these antibodies taken from somebody who has survived the disease and you turn that into a product. those trials are going to get started this month. senator alexander: thank you, mr. chairman. chairman blunt: thank you, senator alexander. senator shaheen. senator sha mean: thank you for being here and your testimony and service to try and address what is obviously the worst threat to americans in my life time. i'm concerned about the impact on older americans and those in

long-term care facilities in new hampshire 80% of our covid-19 deaths have been in long-term care facilities. that's the highest percentage in the country. i'm concerned as you talk, dr. redfield, about how you prioritize who gets the vaccine when we have one. how do you prioritize these residents and those with underlying conditions like diabetes? dr. redfield: thank you very much, senator. very, very important question. bviously this is going to be discussed through our advisory committee on immunization practices. clearly the most vulnerable and those individuals at greater risk for mortality have to be highly considered. as well as those individuals at great risk for infection because of what they do. turns out among health care workers that get i effected we recently looked at it, turns out the most common health care

workers who got infected were the nonnurse, the sort of the caregiver in the nursing home. these are going to be critically important. i will say one thing. depending on which virus -- vaccine is approved, it may have particular characteristics that make it more or less appropriate to begin with in different populations. this is why i think it's hard for us to know exactly until we know which of the virus -- clearly the vulnerable will be, if not the top priority, one of the top priorities. senator shaheen: do you have a timetable when you make those decisions? obviously things are moving rapidly. dr. redfield: there is discussions already going on. but as i mentioned at the end of the day it's going to be dependent on the characteristics r characteristic of the particular vaccine product we are now planning to do. senator shaheen: staying with you, dr. redfield, last month the agency for toxic substances and disease registry issued a

statement expressing concerns about the relationship between exposure to pfas chemicals and the risk for covid-19 infections and complications. in new hampshire and in communities across this country we have a number of people who have been exposed to pfas who are very concerned about this statement. can you tell us what the agency is is doing what, c.d.c. is doing to assess the impact of pfas exposure on covid-19 risks? dr. redfield: we are currently working, both of our agency for toxic substances and flu division, are working together in a study to try to learn better about the interrelationship between the pfas certificate yum concentrations and the association between symtomatic covid infections. we do have a study ongoing to try to understand that

association. senator shaheen: do you have a timeline for that study? when you expect to have data that could give us some insights on that? dr. redfield: i think i really learned that i have to be careful in trying to predict. as my colleague, dr. collins said, science has its own timeline. senator shaheen: do you think we are talking months, years, decades? dr. redfield: we are not talking decades. but obviously we are trying to get that information as soon as we can. i really am not able to commit how fast the science will be done, senator. senator shaheen: seems to me that would speak to trying to address pfas exposure wherever we can. i think this is for you, dr. disbrow. as we are talking about the challenge in this pandemic, one of those testing, at least, has been trying to provide access to all of the ancillary supplies

that are required. i think that is probably going to also be true as we think about the vaccination plan and distribution. we have heard from one manufacturer in new hampshire who makes syringes that they need some certainty so they can order the equipment they are going to need to make those syringes that are going to be available for vaccinations. so can you give us any details on the anticipated timeline for the award of contracts for production and supplies? dr. disbrow: thank you for that question. as everybody knows making a vaccine is more than just making the bulk vaccine. there are multiple steps involved. you have to have finish capacity. barta is working hard with our partners, the joint program executive office, as well as under o.w.s. to reserve excess capacity for fill finish so you cannot overwhelm make the vaccine by fill it. we are working with j.p.o. to

expand capacity for vials. you need the vials for the vaccine. we have awarded contracts for needles and syringes aquiring needles and syringes. we are working with j.p.o. to expand capacity for needles and syringes so there are sufficient needles and syringes when the vaccine becomes available of the we are working on all aspects of the vaccine. there is also kitting, when you send out a vaccine you have to have the needles and syringes, alcohol wipes, band-aid. and then there is the distribution. as dr. redfield mentioned, it was important the people developing the vaccine and under warp speed we are are tied in with the group talking about distribute and kitting because they have to know what that vaccine will look like. is it a single dose, multidose vial? what is the cold chain requirement? we are working across operation warp speed and multiple different work streams that are fully integrated. blood pressure senator more ran.

-- moran. senator moran: thanks to you and the ranking member for having this hearing. thank you for joining us. dr. collins let me thank you for joining me on a phone call with the university of kansas health system in whichy report on a vaccine was the highlight of the day, month, and year. so i'm pleased to hear medical researchers and practitioners in kansas heard what you said and found it to be very pleasing kind of optimistic note. let me ask something that -- is covid-19, or is a virus so unique that there are not things that can be done to better prepare us for the next virus? the next pandemic? so that a vaccine development is developed, the development occurs in a shorter period of time? or is it just starting -- i don't know scratch is the right word, but starting from scratch each time? dr. collins: it's a great question, senator. yes, i enjoyed talking to the folks in kansas. wonderful bunch of scientists

and physicians. coronaviruses of which this is one have been around a long time. some of them cause the common cold. we still haven't cured that one, but it hasn't been such a high priority. and sars and mers were also coronaviruses. we learned something from them. if we not had already an effort to try to develop vaccines for sars and mers, we wouldn't have cov-2 le to jump on sars quickly. every time do you this you get better at it. plus the overall technology for how we develop vaccines has been advancing. the lead vaccine now in terms of its earliest out of the gate, which is the moderna vaccine, and the fisa one announced yesterday, utilizing r.n.a. as the thing you inject so you ask the body to make the protein which then backs the antigen your immune system reacts to. that's pretty new. we would not have done that years ago. we'll keep getting better at new

ideas. i do hope, maybe this is part of the question, we learn from this experience when we get through this, because we are going to get through this, we don't then go back into some complacency and say that's it. we won't ever have another one like that again. because we all know we will. what will it be? will it be another coronavirus? will it be that influenza epidemic we are worried we are overdue for coming out of somewhere that will be very dangerous? we should never again step back into the point of complacency with these kinds of emerging infections. i hope we will, therefore, from what has been built to deal with covid-19, sustain that. senator moran: i want to follow up on that but i want a question to dr. redfield. i'll try to get back to dr. collins. dr. redfield, thank you for the telephone conversation we had several months ago. i would highlight for you and others who might be listening that the issue of p.p.e., personal protection equipment, is back front and center. seemed to me in my life it had

diminished a bit. in conversation with community leaders, including hospital and public health officials, the concern is the supply is short once again as the numbers increase. and the potential of greater circumstance is more challenging circumstance comes in this fall. any suggestions that anyone who hears this statement of mine has on how i can get additional p.p.e. to kansas public health hospitals and employers i would welcome that. let me ask you, one of the things i take away from what's transpired is the importance of public health departments. i think generally we have -- until i served on this committee, i didn't realize the significant role that c.d.c. plays in support of our community and public health departments. what is it that needs to take place so that when the vaccine is developed our public health departments are prepared to administer that vaccine in the

distribution? how can c.d.c., this committee help make certain that occurs well? dr. redfield: thank you very much, senator. i think you heard me say before we had decades of underinvestment in our public health departments across this nation. this is the time now to correct that. you all have made great support, c.d.c. has already awarded $12 billion with a b to the local, state, territorial, tribal health departments in the last eight weeks or so to begin to give them the resources they need to begin to build up their capacity. human capacity usually takes longer than weeks to build up. we are obviously as you know c.d.c. has over 650 people embedded in the local health departments to help with that human capacity. we'll continue to work with them. recently with the resources did you with the carrots act, we were able to get a little over $-- with the cares act, we were able to get a little over $10 billion for plans how to expand

their testing, contact tracing, public health infrastructure. we are doing it on the run. i think you have heard me say before when it comes to public health, when it comes to public health, this is something we as a nation should plan to be overprepared not underprepared. and i do believe this is the moment in time when this nation can actually help put the public health infrastructure across this nation not only that we need but this nation deserves. as you mentioned, most of c.d.c.'s money actually gets distributed to the local, state, territorial, tribal health departments. some of these hept departments were 70% of their overall funding. we are the nation's funder through you of the public health infrastructure of this nation. we need to augment that to where we are now overprepared for the next pandemic. senator horan: mr. chairman, if you have a second round. blood pressure senator merkley. senator merkley: thank you very much, mr. chairman. dr. collins, i wanted to get

some sense from you of our understanding in a short and simple version of whether this coronavirus is such that we anticipate that its mutations will mean different vaccines may be effective against some versions of the disease but not others? and whether it means we will likely have to have an annual production of modified vaccines based on those mutations like we had with the flu? dr. collins: thank you. that's a very important scientific question that many of us are wrestling with to collect as much data as we k i think the somewhat reassuring news is that this particular virus, which is an r.n.a. virus, does not have a rapid mutation rate. it's not like influenza or h.i.v. where you know you have a tough time getting a vaccine to work or to stay effective. but it does change over time.

there is at least one significant variant in the virus that's already happened since it originally appeared about six months ago that may have made it somewhat more infectious than the original strain coming out of wuhan. we are not absolutely sure of that, but it looks like that might be the case. the good news is that though variants we detected do not seem to be those that would interfere with the effectiveness of the current vaccines being designed and tested. nor with the antibody strategies also being tempted. we are going to watch that carefully. the big question we'll have is whether this is a circumstance where once vaccinated you are basically protected for life or whether over the course of time this virus will change its coat enough that you will need to have a booster that's slightly better in its design for whatever it is that this turns into next. we don't know the answer to that. but i think the good news is this is not like h.i.v. this is not like influenza. it's a fairly well behaved virus

we think we ought to be able to tackle effectively with a vaccine strategy. mr. senator merkley: thank you very much. i want to turn to the question that senator murray raised about the elimination of thele safeguards. those safeguards for reasonable pricing when the government has invested in the development have never been implemented. many people feel they serve as an effective instrument of leverage should the american people be gouged after investing millions or now perhaps billions of dollars. was n.i. h. con. sulted about removing the safeguards from the contracts? dr. collins: we were not asked about that. we have been asked about those safeguards in other circumstances. senator merkley: do you support inclusion of those safeguards to keep the american people from price gouging after we invest in development of drugs? dr. collins: i certainly think the american people ought to have access to vaccines they are helping to play fomplet i think

the plan has been nicely made to be sure that is the case so nobody would be denied access to this regardless of their health care comple. the inshoes are complicated when you look at the original language t. does seem as dr. disbrow said earlier these were intended to allow the government to step in when there was a company that basically refused to try to produce a product to benefit the public. it does not look as if those particular parts of the bill were intended to do something where the price was considered to be unacceptable. we have been caught in this many times before and that's what the lawyers tell me. in this circumstance i have to defer to barreda, but my understanding -- understanding was there was no likelihood the product wouldn't be pursued. senator merkley: it would be ok to leave them in the contract. but it still has the marching rights and n.i.h. claims joint ownership of the moderna

vaccine. i find it interesting that n.i.h. wasn't consulted over the difference between that contract and some of these other contracts. dr. collins: i have to be careful here because it's possible somebody at n.i.h. was consulted. i was not made aware of it. i have to check on that. senator merkley: thank you. dr. redfield, the c.d.c. consulted over the contract and designed to ensure fair pricing? dr. redfield: not to my knowledge, sir. senator merkley: thank you. why suddenly eliminate this language in some of these contracts but not others? who was it who asked you to do this? and what did you include language in some contracts and not others? dr. disbrow: some of the confusion is in our far base contracts it is in there.

some of the documents requested by the group that asked for them under foia, freedom of information act, were other transactional agreements which are outside of the far. these are research and development contracts. we are not acquiring product under these contracts. senator merkley: recognize, too, its rich and development being funded by the american people with the vast potential for profit for the companies. so the american people have a stake in fair pricing. i think the american people are aware that they are gouged on drugs routinely. that we pay more than citizens in any other developed country. 80% of americans routinely respond they want fair pricing. they shouldn't be charged more than the citizens of other countries because we spend more in the development of the products. i think that plays double here. the reason i'm emphasizing this is we are going to spend billions of dollars in this development. and we should absolutely use

that investment to make sure we are not gouged on the back end. so i just want to say this conversation that murray initiated and i'm following up on here is an important one. i hope you are going to take thoughtful consideration of how to make sure that the americans do not pay more for these drugs through the government payment or through citizens having to pay for them, than do the citizens of any other developed country. in fact, i hope you'll make sure that's the case. blood pressure thank you, senator merkley. senator capito. senator capito: thank you, mr. chairman. thank you for not just being here today. i know you have been on political political many times but thank you what you have done and going to do to meet this crisis. dr. disbrow, i have a question. many of my questions hi initially you-all have answered on that.

efficacy and safety issues around the vaccine. as i recall back when we first started we had an issue with china making the p.p.e., with italy having the swabs. i might have had a little long. but the reagents in germany. there was a competition globally for all of these supplies. i imagine there is going to be a competition globally for the vaccine supplies and the vaccine itself. dr. collins mentioned that they have been working with u.k. in a collaborative way. how much of what you're seeing the development is actually manufactured in this country where we can sort of control our own destiny? dr. disbrow: thank you for the question. this global pandemic has highlighted the vulnerability in our supply chains for medical devices, raw materials, and active pharmaceutical ingredients for drugs. i can't give you the specific number of what percent of the products are manufactured here in the united states. what we are doing as i mentioned responded to one of the earlier

questions is we are working for a needles and syringes and vials to expand domestic capacity so we don't have to worry about this in the immediate future and near future. we are also working with all of our manufacturers to make sure they acquire the raw materials needed to manufacture vaccines and/or therapeutics because therapeutics are also important. so that they can manufacture at scale. senator capito: is this a question you ask when you are looking at giving contracts whether it's produced in the united states, where you can control your own destiny? dr. disbrow: we look at the raw supply material chain. we do that for all our manufacturers to identify risks early on and address those risks early on. senator capito: i would like to dig down on that. i think that that's concerning. obviously because this is a global issue. i think it sort of shook the american public when we realized we weren't controlling the ability to have testing supplies or the ability to produce our

own p.p.e. dr. collins, a question i have a little off topic but equally as important. you know that n.i.h. is invested heavily, so we hear on the opioid epidemic. but the latest stats coming out of our state of west virginia, senator manchin is here, and across the country is there has been a big spike in overdoses during this covid epidemic. i'm wondering -- i know you're fast at work on this in a lot of different various ways, how are you seeing that? and how might having a vaccine or having better therapeutics be able to help us meet this challenge of folks that are in therapy for addiction or had this addiction issue to be able to cope during these very stressful times? dr. collins: senator, i appreciate you bringing this up. it's not off topical all. it's a sear ewes national tragedy that has gotten even worse because of the coalescence

of the covid-19 crisis and the opioid use disorder crisis. i have seen those same statistics about maybe a 42% increase in overdoses in just the last three months. and deaths associated with that are going up. after we had started to make headway with this crisis, with all of the things that had been done with various programs and use of medications we know can work and yet now prescriptions for those medications have plummeted because people aren't able to get into treatment programs. we are doing everything we can at n.i.h. with supplements to some of our research programs to try to understand how best to intervene. how to provide people with support even if it has to be done remotely by telemedicine kind of interventions. we have been supporting the idea that methadone, which traditionally required people to show up every day in a crowded location, could actually be done in a fashion where people could receive this at home because otherwise the dangers are too great and people were simply

dropping out. i can't tell you how desperately we need to get back in a place where people can congregate together that. will require effective treatments and vaccines. that's on my mind every day as we are trying to accelerate that progress. this is a very serious situation, indeed. senator capito: really the counseling going on by telehealth initially was actually having greater -- they were staying more true to their appointments and going well and then it has gone back down. dr. collins: people need interaction more than just through a zoom call. that's hard to do right now. senator capito: dr. redfield, four seconds. our vaccineation rate in west virginia is falling. how are we going to do a p.r. campaign that this is important? dr. redfield: it's a critical point, senator. i always look at the consequences of covid as the second said. health versus health. 85% decline in pediatric vaccinations in individuals

under 5. we are obviously -- we are in the process of making a play with the miles per hour academy of pediatrics to respond to that. it's really important. globally it's a big issue, too. i try to say in sub-saharan africa, where covid is a significant problem. a much bigger problem is there is 120 million children who haven't gotten the measles vaccine. chairman blunt: thank you senator. senator bowman. senator bowman: thank you, mr. chairman. i have a couple of -- i hope quick questions. dr. disbrow, can you quickly prospectme the vaccine that are being invested in right now? you have narrowed it from many first it me forward

was 14, now fewer. can you list them and what type of vaccine it is? dr. disbrow: i appreciate the question, senator. can i not specifically mention some of the companies we are in active negotiation was many of them. one i can mention is as where we -- astrizinca already have a contract. we are in the process of moving forward with large manufacturing contracts and acquisition of vaccine for multiple other candidates. senator baldwin: those company names in terms of the vaccine prospects are not public? dr. disbrow: some of the companies originally funded by barda for advanced research and development, those are public who we invested in. i think your specific question may be the composition of the for the folio under operation warp speed. that can i not today talk about.

but we are very quickly moving and negotiating contracts and hopefully in the very near future we'll be able to make an announcement with the entire portfolio under operation warp speed. senator baldwin: how many have been finalized right now versus how many are you still in negotiations with? dr. disbrow: i already told you about the one which is the astrazenica. and we have others we are working with. senator baldwin: how many do you think you'll have in total? dr. disbrow: more than one. sorry. it really is procurement sensitive. these are market moving negotiations that we are having with these companies. i just need to be careful about that. again, we are happy to publicly announce. you will see the press releases when we award these contracts so that everybody is aware of what's being supported. senator baldwin: to have the intellectual property of

prospect you also have the manufacturing you want to make sure to fit timelines you'll be le to have dr. disbrow: i'm sorry you cut out for a little bit. is manufacturing going to be u.s. based? senator baldwin: yes. the speaker pro tempore: doip yes. 100%. are you looking at any vaccine rospects that you -- chairman blunt: let's go to senator kennedy and we'll come back to senator baldwin once we think that we have this technical problem worked out. senator kennedy. senator kennedy: thank you, mr.

chairman. thank you, gentlemen, for being here. gentlemen, i'd like your opinion on something. when the pandemic first became apparent in the united states, a number of busy and important people, senator people, in the federal government also in states -- state and local governments, told us, the american people, that we shouldn't wear a mask. that a mask would not protect other people. it wouldn't protect us. and in fact, in some case it is ight actually hurt us. when i heard that i thought to myself, you know, this is odd. because i turn on the television and i see doctors and nurses ear masks. when they are treating coronavirus patients. i remember thinking this is odd, i wonder where they went to med

chool or nursing school. next we were told by these busy, important people we were told, ell, you should wear a mask. the reason you should wear a mask is not for yourself but to protect other people who might et the coronavirus from you. then i turned on tv again and i saw these doctors and nurses wearing masks, treating people with coronavirus. and i thought to myself, this is odd. why are they trying to protect the patient? the patient already has a coronavirus, for god's sakes. then it occurred to me that maybe these busy and important people were drong and are wrong. so i talked to -- were wrong and

are wrong. so i talked to a lot of doctors and nurses, not the ones i saw on tv, others whose judgment i respect, and i read a little bit . and i came to the conclusion that a mask is very helpful. and it will protect us. it will protect other people, and it will protect you. and that's why i wear a mask. because i don't want other people to die, and i don't want to die. now, how come these busy important people who are smart people in the federal government told the american people this? dr. collins: may i, as becausey person. let me try as a physician to explain the history.

mask is not a mask is not a mask. the kind of mask i'm wearing that most people in this room are wearing, cloth masks or something like that, are pretty good at capturing any kind of droplets that might be coming out of your mouth while you're speaking, because i'm producing them right now. if i happen to have sars cov-2 you don't want those droplets near you. senator kennedy: i get all that. dr. collins: but we didn't really know that, senator, until march or thereabouts. this is a very unprecedented way for a virus to spread. to have asymptomatic people spewing out virus like this. senator kennedy: excuse me, but why were the doctors -- dr. collins: they were not wearing these masks. they are wearing n-95's. senator kennedy: we didn't have enough n-95's to go around. dr. collins: they should have. senator kennedy: could have, would have. dr. collins: this doesn't do a great job of protecting me guns

somebody else who is near me. it still allows -- senator kennedy: is some mask better than no mask? dr. collins: in part because -- senator kennedy: how come we didn't tell the american people that some mask is better than no mask? don't you think it would have been better to convince people now to wear a mask? dr. collins: at the beginning -- senator kennedy: you happen to be here. dr. collins: at the beginning, senator, i don't think we realized of asymptomatic people spreading this. we thought if you were around people who were healthy you weren't going to catch this. if you went into a sickbed you might need to worry about it. senator kennedy: doctors and nurses on the frontlines got it. let me ask you one other quick question. give knee a yes or no. i think you-all are going to say yes. is the expedited process for developing and testing therapeutics and vaccines safe? that we are using right now? dr. collins: yes.

dr. redfield: yes. dr. disbrow: yes. senator kennedy: how come we don't always use it, then? dr. collins: i'm not sure the question. senator kennedy: we are going faster than we normally do, right? how come we didn't always go faster? and will we go back to doing it the old slower way once we are past the pandemic? dr. collins: we talked about we are spending a lot of money by going really fast and doing things that are probably ahead of where they should be and running the risk therefore of needing to throw out a lot of materials we don't use. we can't usually afford to justify billions of dollars in the circumstance. this time we can given the public health emergency and people are dying. chairman blunt: thank you, senator kendy. back to senator baldwin. about half of your time is still left, senator. senator baldwin: not sure what happened. wanted to finish my question

with dr. disbrow and perhaps also address it to dr. collins. are we considering any vaccine candidates where the delivery method would be something other than syringe and needle? dr. collins: not at the current time. but there are products. senator baldwin: let me move to dr. collins. i know that a lot of the companies that are catching the most attention are very large with the capacity to produce in large quantities. some innovation comes from very small companies. i know wisconsin has a number of small biotech companies. working in both the vaccine space and the treatment space. what can you tell me about their opportunities to participate? dr. collins: senator, there were

more than 100 vaccine opportunities coming forward. of course we had to because of the public health emergency choose the one that is had the best chance of being able to scale up really rapidly. but there are lots of great ideas out there about vaccine development which might not be the ones you want to bank in for sars cov-2 right now because such a sense of urgency. this is not the last time we are going to face an infectious disease. i hope all of those ideas will continue to be developed for whatever comes next. or perhaps if we end up in a circumstance where this vaccine is needed to help a booster down the road, this virus doesn't seem to be completely vanquished. some of those ideas could be helpful. we just had to prioritize. finally i would say in terms of small businesses, senator alexander was asking earlier about diagnostics. for the radx program which aims to try to bring on great ideas about new ways to do diagnostics at point of care, of the more than 560 applications we have

gotten, 2/3 have been from small businesses virtually from every state in the country n that space there's been a wonderful opportunity for innovators to come in and have a chance to be scaled up rapidly. senator baldwin: final question for dr. redfield. for regard to a master plan vaccine development and production and prioritizing initial delivery, can you let me know how far along we are on a plan all of us will be able to review in writing? particularly with regard to the tail end of when it is available, who will it first be made available to? because i think that is something that we really need to see. i know there is an ongoing set experts who are

tying themselves to these decisions. i want to know the timeline for such a written plan. dr. redfield: thank you very much, senator. you are right. a number of us are working on this plan. unfortunately at this moment i can't tell you exactly when we are going to have a plan released, but i can commit to you that we will, when we have completed the plan, have a plan that will be released. as i said, part of the nuances of it will depend mon the actual vaccine as -- depend upon the actual vaccines. but the background plan independent of that is being developed and working through and being coordinated through operation warp speed. as i mentioned c.d.c. does have the lead on this distribution. as we get it completed we will make it available. chairman blunt: thank you, senator baldwin. i'm going to ask a question on the ethics and that discussion later. so you-all might be thinking

about that as you try to determine a priority of who gets access as access is available. go to senator murphy. senator shoths, and senator manchin in that order. then a second round. senator murphy. senator murphy: thank you very much, mr. chairman. thank you-all for being here. being so attentive to our concerns and questions. first let me just follow up on a series of questions that senator merkley raised. i don't have a question connected to it. puts me in an uncomfortable position with disagreeing with dr. collins. but the united states government has never exercised marching rights under contract. it is true there is a lot of question and dispute regarding exactly what the government is allowed to do, but the language in the underlying statute is in fact very broad. it requires companies, contracted to the u.s. government, to provide these drugs upon reasonable terms. and there are plenty of legal

scholars who read into that term price. that if you are gouging consumers, then you aren't offering the drug on reasonable terms. i would disagree with any guidance that's being given that said the government cannot use that underlying statute. as a mechanism to prevent price gouging. i think it's been a real success of the pharmaceutical industry to get lawyers to make recommendations that provide that kind of limitation. i at this think it's really concerning that that language is not in many of these contracts that are being sold, that are being signed by the government today. say.s important to but, mr. disbreaux, one particular question that arises out of concerns that have been presented to be by smaller and medium-sized drug discovery companies in and around the

northeast, i have had a number of smaller companies, but companies with track records of success who have tried to be in contact with barda and have received absolutely no response. and given these concerns about cronyism and the potential track record that i think deserves investigation regarding companies that are big and multinational and have connections to people inside barda getting preference, do you hink you have the resources to field inquiries and respond adequately to every company that may have a promising proposal to make to you? because it does concern me to have heard from many very good companies in my state and my region who have been, frankly, completely unable to get any response from barda. dr. collins: i appreciate the question and also the comment. dr. disbrow: as the new acting director of barda, i am

committed to doing a much better job. in a typical year we are able to interface with multiple companies. we hold approximately 150 to 200 tech watches each year where companies can come in and speak with us about their technologies. as i mentioned in my opening statement, to date we have received 3,394 submissions that we are trying to get through so that they receive a fair evaluation. and we are working as quickly as possible. so under normal circumstances i think the answer is yes, we are always looking to bring on new and bright and talented people. but we are a bit overwhelmed right now, but we are still working through the process. e have had over 391 tech watches. corona watches where -- it's a virtual tech watch not an in-person tech watch. we continue to strive to improve our best business practices. senator murphy: i appreciate

that answer and i hope you'll make recommendations to us on what additional resources we can give you. it would be absolutely tragic for a small or medium-sized company who might have the ski that unlocks treatment or vaccine to be left on the outside. in the remaining time, i'm going to take the bait from senator alexander. as he knows i care a lot about college sports. as a fan. but also as someone who wants to make sure we start playing games in a way that's safe for, especially college athletes who receive no compensation to go out there and make billions of dollars for other adults. my question is to you, dr. redfield, has the c.d.c. given recommendations regarding whether it is appropriate to have fans in attendance at either college sports games or professional games this fall? i can see having enough

resources to be able to test athletes, but we certainly don't have the resources to test every fan that walks into a crowded stadium. even a college stadium that's one quarter full still has tense of thousands of people in close proximity. has the c.d.c. any guidance with respect to attemptance at sporting events? dr. redfield: not directly. we have had interaction was most of the sports industries both at the professional, collegial level. senator murphy: why not? that's a really important question. should we put 20,000 people in a college football stadium? dr. redfield: i guess i misspoke then. i thought if you thought we directly recommended that we have fans. we have put our guidance several weeks ago on mass gatherings. which would include object combrousely those events -- obviously those events. we have commented directly in our guidance over the last three or four months on gathering size

and precluded fans from going to being recommended in these sporting events. i was looking at the other way around. did you think we made a positive recommendation to include them? clearly our mass guidance and all our previous guidance to slow the spread for the 15 and 30 days we have not recommended these gatherings to be such that you would have fans in the stands. chairman blunt: thank you, senator murfifment senator manchin. senator manchin: thank you for being here. it's good to hear from you. i'm just trying to, dr. disbrow, just a simple explanation of the money that we have invested so ar, i know -- my tally shows johnson & johnson got $456 million. moderna has 483.

emergent biosolutions, $620. that was all for developing vaccines. that comes out to $2.76 billion. and then for distribution and manufacturing, apple jack got 138. mallard, 164. sio-2 materials science 143. for a total of about $650 million. when you put it all together you $3.4 in that $3.3, neighborhood. what do we get back as taxpayers when this vaccines when cun one of these companies or all of them have a proven vaccine? are we a private investor? do we get something in return? do we get this value back as far as in the vaccine that can be distributed to all our health sensers? now we have to buy it back? dr. disbrow: there will be future procurements of the vaccine. to address your specific point, yes, we do receive -- when we

are doing contracting for acquisition, we seek consideration to the u.s. government for previous investment it's more than just a dollar per dollar investment. it is also the cost of capital, because the u.s. government took the risk to make that investment. senator manchin: we are taking the risk same as the private sector. so private citizen would take this risk, they get a bigger return for the risk. dr. disbrow: right. our investments would be taken off the -- senator manchin: our investments would be -- dr. disbrow: no. if the company was going to charge $10 for a dose of vaccine, this is an arbitrary number. i don't think anybody is charging that. for sale outside the united states, in the united states the u.s. government would buy it at a reduced price because we already invested $450 million to support -- senator manchin: we are going to get our value back. dr. disbrow: correct. senator manchin: are we able to

control the pricing or put pressure on them not to gouge? dr. disbrow: again, whenever we are negotiating, the best value to the u.s. government we seek consideration. these are hard negotiations. yes, we seek the best value. senator manchin: you already testified on. p.p.e.'sdown get out the way they were supposed to. and we are concerned about getting distribution. and i know you-all spoke about the community health centers. dr. collins and all that. i appreciate what you-all have done. i can tell you they are still hurting very much so because a lot of states have not distributed the money that they received as help from the cares package to keep them viable. there's money there that hasn't been distributed properly. we should be putting pressure on our governors to do their job to make sure our first responders and county health departments have the necessary funds. they are not getting it i can assure you. rural health. rural providers have been hit particularly hard bied epidemic across the united states.

covid-19 are growing faster in rural areas at 13% than national area of 9% for the second week in a rofmente rural counties have the highest number of new cases of covid-19 in a seven-day period since the pandemic began. west virginia saw a single day high just yesterday. we have 12 hospitals in all of our hospitals are rural. 12 hospitals already closed. three in west virginia, and we are concerned about the rural health care that we have to distribute. how's a vaccine going to be distributed in the rural areas to make sure we are able to meet the rising challenges that we have there? rural providers have the necessary equipment where they have the personnel to administer the vaccine. dr. redfield: thank you, senator. a really important question as you know. the broader question of how we maintain help capacity in rural america. as i said there is going to need to be a variety of innovative

strategies to ensure that we can get broad distribution particularly the groups that have been undervaccinated. you mentioned the rural. we had undervaccinations historically in african-american, hispanic populations. and we need to more aggressively and the h-1-n-1 there was reluctance to fully engage the pharmacies. as vaccine outlets we need to expand that in this distribution. there is going to need to be clear interlinkage with the community health is eners that are will along the with the local health departments n addition to that i think there will need to be mobile units that are going to be able to go and provide broader vaccination access, particularly in rural america. senator manchin: rural america is getting hit hard now. we knew it would be a delayed reaction how they are getting hit. we are the most vulnerable population in the country of

west virginia because of our age and type of hard work they have done. they have underlying health conditions, too. if it hits, it's going to be a disastrous proportions. we need to stay ahead of it. right now we had a hard time getting everything else. we have a hard time getting a vaccine or antibody when it comes, we are really up the creek. we hope you put the attention towards rural and make sure that your associates understand the need for rural. dr. redfield: we are committed to make sure that all those in need get access to this vaccine. chairman blunt: thank you, senator manchin. dr. disbrow, let's talk a little more about any obligation these companies we partnered with have to be sure that the vaccine is available at a reasonable price. if they fail, we underwrite their failure. i'm for that. i want to get plenty of opportunities out there on the

field advancing forward so that we have as many vaccines as we can have available as soon as of the individual vaccines available, as soon as we can. but if we are successful we basically get our money back plus interest. are there -- surely there are other obligations here in that partnership of the private -partner to make the vaccine available in a reasonable way. would you expand on that a little bit. dr. disbrow: sure. thanks for the question, senator. also remember that each of the companies that we are working with it's a true partnership. the u.s. government has assumed risk. many of the contracts that we have are cost shared contracts. meaning that the company also assumes risk. the companies while we are working on awarding the contracts that i mentioned earlier, are agreeing to proceed

at risk under operation warp speed. because they are committed to developing a vaccine. yes, the the goal is to negotiate the best price for the u.s. government. we would probably have to pay a slightly higher price for industry partners who chose not to receive government funding because they assumed 100% of the isk. senator blunt: dr. collins, and others can enter into this discussion if you want to, in terms of determining the health priorities, we should be doing this right now. we know we're eventually going to have a vaccine. therapeutics. let's focus on where we're going to be with the vaccine in terms of distribution an accessibility. who is talking about health priorities or ethical issues

that relate to the rapid opportunity for people who want a vaccine to get a chance to have the vaccination? >> very important question. one that is occupying the minds of a lot of us thinking about this future that we hope to have as soon as possible. redfield talk about what the c.d.c.'s role is but i think there may be an opportunity before we get to that moment before we have a vaccine that's been proven safe and effective to have a broader discussion that bring into this ethics, experts in public health, people who are particularly aware of challenges for reaching out to those who have suffered from health disparities for a long time and are being hit particularly hard by covid-19, another area where we want to be sure as far as priorities. bob redfield and i talked a bit

about this, this may be a moment to bring together a group of such big thinkers who could take a high level view of this and lay out a foundation of principles that could be utilized by his c.d.c. committee, the acip, when the moment comes to turn that into an implementation plan. we think that might be something best done in a circumstance by an organization that is not itself governmental because it's still the case, i think, that people are a little uneasy about the government calling the shots here. we are having a conversation very early on with the national academy of medicine about whether they would be the place to convene such a discussion. we can keep you posted on that, it looks promising. i think that would be a really good step right now. to do that quickly and have those principles laid out, say, before labor day. senator blunt: i'm confident we'll hear from others about whether the national academy of medicine is the best place to do

this or not, and that's good, that input will be good to have, and you may hear it before we do, but it does seem to me that this should be happening right now. just like every other plan about distribution of the vaccine, of therapeutics, of test, particularly the vaccine. i would think if we're going to have this discussion, let's not have it after we have a vaccine and we're waiting to distribute it because we haven't had a discussion of the ethics or health care priorities. dr. redfield do you want to talk about this? dr. redfield: i want to make one comment, mr. chairman, because i couldn't agree more. i want to say how important it is that we have it now because it's not just about who is going to get the vaccine. it's also about, we have a requirement to study the safety and eff ka soif the vaccine in these populations. historically if you have underlying me call conditions, significant, you don't get into vaccine trials. if you have pregnancy you don't get into vaccine trials. if you're a child you don't get

into vaccine trials. dr. collins and i discussed this, they're planning to make sure these populations are inclued because the last thing we want to be is trying to recommend who gets the vaccine and we don't have any data in how the vaccine works in the population that we really think this vaccine needs. clearly right now there's thoughtful thinking among the vaccine trialist, how do we make sure that we have good representation of african-americans, hispanics, children, pregnancy, women, individuals that are elderly that have multiple chronic medical conditions. that's where this vaccine needs to go. i don't know if francis wants to comment anymore on it but i know they are thinking how to move those populations into the phase trial efforts so that we'll have that data when we need it. senator blunt: dr. collins and then we'll go to senator murphy. -- murray. dr. collins: this may make it more challenging to run a phase

3 vaccine trial when you're trying to enroll a diverse soast volunteers, it would be easier to line up a bunch of 20-somethings who happen to be from the white population but that's not the only answer we need. we need to have this diversity. many of us are working hard to make sure as the trials get launched in the very near future they have that kind of outreach. senator blunt: let's be sure the trials aren't needlessly waiting because we haven't had this discussion as quickly as we need to have it. senator murray. senator murray: that's exactly what i've been talking about, why we need a plan and the public needs to see this plan. even if everything goes well, and we have a vaccine and it is safe and effective to the best of everybody's knowledge it isn't going to be available for everybody september 1 and we need to know how it's going to be distributed, where where it's going to go, what the priorities are. the public is good at dealing with facts. they're not good at dealing with

expectations that have no chance of being met and then we run into all kinds of problems. that's why i've been pushing for a public plan for us to be able to know how to -- how this is going to happen. i'm in that game. dr. disbrow, let me ask you. experts are saying clinical trials for treatment can move more quickly than vaccine trials and an effective drug that renders the virus less deadly could allow us to begin to return to normal faster. that about the concern barda notified researchers it was halting funding for treatment of severe lung ailments associate twhed virus as well as the immune response that causes the body to turn on itself. why did barda decide that the development of therapeutics for severe forms of covid-19 is not a priority and how did this --

how does it communicate that hange? dr. disbrow: barda continues to invest in therapeutics, including the large program you heard about before. over 24,000 people have been transfused. we are supporting globulin that you take pooled plasma and use that for antibodies. all of that is being done under operation warp speed similar to what we're doing for vaccines. we did close the immue no therapeutics portion because at the same time under operation warp speed in collaboration with dr. collins' active program, what we were receive wrg individual proposals with no clear identify case that the products would work as an immune modulator but requesting very large phase two or three

studies. under the active partnership with o.w.s. the decision was made to stand up large clinical trial a clinical network under a master protocol where you can evaluate multiple candidates for immune modulators and they will also be looking at anti-coing a lants as well in a very -- in a smaller cohort to determine if there's benefits. if any of these drugs are run through active protocols show clinical benefits we're happy to engage with those developers to help them with manufacturing. senator murray: it was reported that barda suspended applications for the treatment of covid-19, can you explain that. dr. disbrow: i didn't hear the question, the last part? senator murray: it was reported recently that barda is suspending applications for the treatment of covid-19 -- preventive treatment for covid-19. dr. disbrow: preventive

therapeutic treatment? senator murray: correct. dr. disbrow: i will have to look into that and get back to you. senator murray: vaccines are important and we all want that, but we don't want to put all our eggs in one basket. we all want it but can't put our eggs in one basket. dr. collins, i want to address a question to you. given the devastating impact of covid-19 on black, latino, tribal communities, it's important that we ensure equitable representation in clinical trials for vaccines and therapeutics, there was an internal analysis on inclusion that shows that only 29% of participants in n.i.h. funded clinical research were members of racial noshte groups. only 9% were ethnic minorities and initial reports suggest we're still not achieving adequate enrollment for these

groups in clinical trials for potential covid-19 treatments and vaccines. can you tell us what n.i.h. is doing to reduce the barriers for participation and recruit people for these? dr. collins: i really appreciate this question. this is an extremely high priority. as has been pointed out at this hear, the burden that has been laid upon the shoulders of minority group, particularly african-americans lark tinos and native americans from covid-19 has been extreme. with much higher rates of hospitalization an deaths in those groups. that means that the health disparities that we have known have been around for a listening time have a very bright light being shone on them. this is our opportunity and response to believe the take this on and with the greatest seriousness. certainly when it comes to running the clinical trial, both for vaccines an therapeutic this will be the highest priority. we want to work with the parts of n.i.h. that have expertise in this space like the national institute of minority health and health disparities but we also

want to work with institutions out there like the hbcu's that have that kind of credibility and capability. there's an irony here in that we're also at a moment, i think, where there is perhaps more suspicion about government involvement in such things and yet this is the very moment where we need to have the trust of those communities to reach out to them. that means we need to engage community leaders in that space. that means the churches that means the heads of various organizations that represent these underserved populations. we are building those bridges as fast as we can and i totally agree with you. if we fail at this, at this moment, where health disparities have emerged in such a dramatic way, we will have really failed to live up to our responsibility as stewards of the public trust. senator murray: let me ask one quick followup on that. there was a recent report from c.d.c. that pregnant women are more likely bob hospitalized with covid-19 than nonpregnant women and despite a lack of data it's clear women of color are

disproportionately at risk. i'm concerned about the lack of inclusion of pregnant and in clinical n in trial are you going to include them in clinical trials for covid-19? dr. collins: yes, we have been looking at ways to include pregnant and lactating women and it applies very strongly in this place. this is another high priority at n.i.h. dr. diana binaki is a leader, we're trying to put together a way to improve the ability to do successful outreach safely to pregnant women and lactating women. we have to have that included as part of the mission. senator murray: thank you. senator blunt: senator alexander. senator alexander: thanks, mr. chairman. dr. collins, i believe you said that you're considering

involving the national academy of medicine in determining the fairness of the distribution of vaccines. is that correct? dr. collins: that is correct. senator alexander: the national academy describes itself this way, if i remember it was founded by president lincoln, chartered by the united states congress to attempt authoritative, objective and science-based answers to difficult questions of national importance. "the new york times" called the national academy of medicine the united states' most esteemed an authoritative advisor on issues of health and medicine. 10 put me down as thinking that's a good idea. to involve. because it's people across the country look up at what's happening here they'll see agencies without the medical names and we may -- they may be greatly respected agencies or bodies but i don't believe they have the prestige of the

national academy of medicine. so in terms of the fairness of the distribution, i think the only downside i can think of because i've worked with the aexadmies many time, you may have to speed them up a little bit because the academies are accustomed to not moving at warp speed and you're trying to must've at warp speed. but we're not talking safety, we're talking about fairness. i think that's a good idea. i would endorse it. let me move on to something else, dr. collins. i want to pick up words you or senator moran said, something like sustaining what we've built. we had a whole hearing about this in our committee that senator murray and i chair, the health committee. for 20 years, we've had four presidents and several congresses pass nine laws and try to be prepared for pandemics and we thought we were, and then we get assaulted with this sneaky, dangerous, covid-19 virus and find gaps that didn't appen.

senator frist, former majority leader, testified before us and said he made 50 speeches as majority leader, die identifying what needed to be done, tried to do them but between pandemics we get our eye off the ball. we have other things to do. we don't do the hard things. so it seems to me that what i -- i'm going to work hard with senator blunt, senator murray, anyone else, senator shelby, others to try to make sure that we don't make that mistake this time. and that while we've got our eye on the ball, while we're paying attention, while we have these lessons in front of us, that we do them. for example, manufacturing. building up capacity. building up on shore capacity. barda says. are we going to sustain that? or are we just going to let happen to it what governor levitt testified happened with the last plan? stockpile. we know what happened with

stockpile they diminished. hospital and states sold them off. they didn't have the money to keep them up. data. we're not all happy with the way data is being aggregated by c.d.c. and need to take a look at that. are we going to wait until next year when we're worrying about something else are we going to do it now? hospital preparedness. we're getting our hospitals prepared again but are we going to sustain that for the next pandemic? this is not the last sneaky, dangerous virus that's going to assault our people. state and local support for public health. governor levitt, former secretary of health, former governor, said for 30 or 40 year, as dr. redfield said, we gradually underfunded public health. so we're not as prepared as we think we are. when we're assaulted by a virus like this. so i would like in my remaining moments, dr. collins, to have

your comment on the importance of in thed my tholve pandemic sustaining what we built up for the next pandemic because i'm pretty sure based on my experience that if we wait six months and everything is over and we're back to normal, we'll be worrying about something else and we won't make the difficult funding decisions, which most of them are, on manufacturing stockpile, data, hospital preparedness and state and local public health. dr. collins: i'd love to capture the words you've just spoken and try to be sure we all look at those every month or so after we get through this curn crisis which we will. but our track record is not so good here. we don't really think about this as sort of we need an insurance policy against the next pandemic. we would never think about going bare in terms of insurance for our homes or cars but we have gone bare too often in terms of insurance against pandemics which requires that sustained

investment. you've enumerated quite nicely the areas that have been alaaed to slip in between these episodes. we might have a covid 23. who know what is the next coronavirus is. or we might have an influenza which is sort of overdue now. my sincere hope would be given that this has been after all the most serious infectious threat in the lifetime of any of us that this time we would have a little sustained memory. i for one would like to help with that too. senator alexander: thank you. thank you, mr. chairman. senator blunt: thank you, senator alexander. senator moran. senator moran: thank you very much. i have been listening in my office to all of the hearing today but i'm glad i was here in person to hear what senator alexander just said and lamar, while your tenure in the united states senate is coming to an end, i hope your voice on this and many other things does not cease. what you just said is important

for us and the american people to hear and i appreciate what -- how you conducted yourself always but what you had to say today was especially valuable. dr. collins, i promised i would come back to ask you a question and it deals with the consequences of pandemic on research that was ongoing prepandemic. and so i'm worried, this subcommittee, this appropriations committee, n.i.h., our colleagues in congress have highlighted the importance of n.i.h. research and in many instances have put our money where our mouths are. and i'm worried that we have set the stage for a step backwards rather than a step forward as a result of the virus. so my question is, you can discount that if that's the -- if that's not true but my impression is that research that should be ongoing today is not. that laboratories are not at capacity. many are shut down.

people have not been able to come to work. i don't know how prevalent that is in university research versus institutions in maryland. but what is it that we need to know to make certain that we provide the resources perhaps in a phase 4 that would quickly restart the capabilities of n.i.h. to be on the path toward finding the cures to all the hings we want to cure? >> senator, i appreciate your asking the question. this is very much on my mind as i see the way which this -- in which by necessity for safety reasons so much of our research enterprise, not just at n.i.h. and our laboratories an defense but all over the country since that's where most of n.i.h.'s dollars go, has been very much scaled back. any research that involves something other than covid-19 was pretty much put into a very

slow pace because people needed to head home to protect against the further outbreaks. people were still able to do science and many of them have is worked incredibly hard doing what they can do but if you need a lab bench and you need some equipment and some supply, you can't do that in your dining room. it is fair to say we have lost a lot of time with research that required that kind of action whether it's in cancer research or something to do with gene therapy or diabetes project like in my lab because all my people had to go home too. this has been a major negative consequence among many others of covid-19. we do not want to see that have a lasting impact. i will tell you the universities who are major grantees are hurting bad right now because of the way in which this has hit them financially. they have the difficulty of not being able to conduct research they thought they were doing but many of them have medical centers that have been hemorrhaging money pause of the inability to do elective

surgeries and other procedures that would normally allow them to balance the books. they're in deep trouble. we have estimated yu on the basis of the research that's been lost, something in the neighborhood of $10 billion of federal funds that may be necessary to recoup if we're going to bring these institutions back up to where they need to be. on top of that, i think there's a wide variety of areas that n.i.h. -- my watch is talking to me, thinking i'm talking too long, a wide variety of areas that m.i.h. would like to put more effort into to compensate for this in terms of efforts in covid-19. so yes, we have been very interested in hearing what might be possible in terms of compensation and i know institutions are who are grantees are particularly so, probably including in kansas, i would be surprised if you have not heard from leaders there out the situation they're in senator moran: dr., thank you. i don't know how many times i've asked you when will we be able

to delay the onset? when will the research be sufficient to delay the onset of alzheimer's? when will we rid ourselves of diabetes? and you have in your ways have tried to tell thus time frame on which things seem to be on and i worry that if we ask the question today it would have to be a time frame that is much shorter and while the pandemic is certainly severe and serious, crisis in many way, the cure for cancer, ridding ourselveses of diabetes and alzheimer's is significant as well that we cannot now allow this circumstance to keep us from being on the path necessary to do the things that we set out. dr. collins: n.i.h. is doing everything within our power to allow flexibles among grantees in terms of ways to keep things going, young investigators can have an extension on their timetable for their career next step and all of that but it is still a heartbreaking situation to see the consequences.

senator moran: because i used most of my time to brag on senator alexander, i'm going to try to get another question in. we see and hear dr. fauci regularly. tell me about the other institutions at n.i.h. i don't mean to discount himming, my actual question is, what are the other institutions strog do with the pandemic? it wouldn't just be infectious diseases that are trying to help us solve this problem, i assume n.i.h. across the board is engaged fully. dr. collins: absolutely. i convened all the directors back in march and said what can e do collectively that one institute can't do, though dr. fauci's is in the lead. every single one of our institutes have a role they'd like to play, some of which they don't have resources for. the heart, lung and bachelor's degree institute, since this is

a lung disease, are running a trial of anti-coagulants because that's where the va the greatest expertise to help the most ill patients. the gee noemics institute to try to figure out what's the difference between individuals to predict who will get really sick after exposure and who will shrug it off, there's something that could be useful including who would be highest priority to get a vaccine. i mentioned child health and the importance of worrying about kids an pregnant women. certainly the health disparities issues you have heard about are absolutely pressing and we have expertise in that space as well. so it is all hands on deck with people designing programs, trying to figure out if there are ways they can reallocate dollars in the very rapid turn around and hoping there's a way they can expand that because of the great need. so thanks for the question. it is very important and very much on everybody's minds at n.i.h. senator moran: i've utilized more than my good will so i

can't ask any more questions, but dr. disbrow and dr. redfield, i have issues i'd like to discuss with you and look forward to doing that when it becomes possible. senator blunt: senator kennedy. senator kennedy: thank you, mr. chairman. gentlemen, i want to thank you or being here today. i want to thank you for your hard work. i know you've been under a lot of pressure. and i know this has been a learning process. and we're learning more each and every day. i don't know if we're in the middle of a new surge or first surge never ended, doesn't really matter. but the american people are scared, they're scared not just about their health and their family's health, they're not just scared about die, they're

scared about their job. they're scared about their country, they're scared about their world, they're scared about their church. this is overwhelming for all of us. but they are really overwhelmed. and they're not morons. they're very intelligent. they don't have time, of course, to -- because they're too busy earning a living, to read every day on the latest information. i want to echo my colleagues and strongly encourage you at some point to, if you haven't already, prepare a report but also with your other colleagues, perhaps dr. birx, dr. fauci, set aside some time to talk straight to the american people.

tell them the truth. i know you will. underpromise, overdeliver, no spin. explain where we are on vaccines. i'm encouraged by the progress that's been made. the speed is breathtaking. i'm impressed that the whole world is working together. and explain where we are in terms of delivering that vaccine if we develop it. you may have to do this on several different reports or press conferences, i know this is an easy thing for me to suggest, there are others that will have input in terms of you holding the press conference. i would do the same thing about therapeutics. as i've said a number of time, people aren't afraid of getting sick, they're afraid of dying.

nobody wans to get sick but people would feel better if they knew if they got sick they're not likely to die. i know they're not likely to die but many people don't understand that. and that's where the therapeutics comes in. i would also encourage you to talk frankly to the american people about what they can do to make themselves as safe as possible. there's been a lot of misinformation about social distancing and masks. i think the information has been pretty consistent about good hygiene. but you gentlemen and others have credibility. and i would strongly encourage you to do that. i want to thank you for your service. i mean that. give the american people some hope. but tell them the truth.

and i think there is hope out there. the other issue i wanted to talk about but i'm not, we'll save it for another day, we got to get our kids back to school. we've got to do it. and we need your help figuring out how to do it safely. thank you, mr. chairman. senator blunt: thank you, senator kennedy. a major pediatric group came out yesterday talking about for nutritional reasons, socialization reason, for the sanity of their parents, kids need to get back to school. it'll be the most likely touchstone that things are returning to normal if we can get that done. so dr. collins, on the testing area, i'm concerned the dates i'm hearing don't seem to quite match up with the millions of school kids and college kids taking tests multiple times when

school starts that would be easily taken and quickly responded to. do you want to talk about that for me a little bit more? dr. collins: i'll try. currently the way testing has been progressing, you've seen substantial increases across the country now to the point where more than 30 million tests have been administered and we're at the point now where between half a million and a million tests are happening each day. but as i said earlier, many of those are circumstances that require a central laboratory where the result mace not come back for a day or two or three. what we're trying to do with rad-x is to greatly enhance the ability for those kind of tests to be there. we are looking at platforms that go into the shark tank and then have the opportunity for rapid expansion. we're also looking at a few things that are a little more advanced but not advanced enough. they could sort of by pass the shark tank and go to the next phase in a program called rad-x

atp, advanced technology programs. some of those are looking promising. we're doing everything we can to pull them up into a high through put state. again, we have said if this went really well we'd have millions more tests per week by the end of the summer, beginning of the fall. i'm talking to bruce stromberg, the director of rad-x, a very gung ho engineer as you know, he believes we could get to the point of an extra million tests per day from the rad-x program by the first of september by lay dor day. that's a heck of a stretch since we started this program at the end of april but that's the trajectory we're on. that would go fairly steadily upward then over the course of the next two or three months so it might be more in the neighborhood of five million to 10 million additional tests per day by december. that's our current projection. again taking the exhortation from senator kennedy about

underpromise and overdeliver, i'm not trying to tell you what i think the most amazing outcome would be, i'm trying to tell you what we could achieve and hold us accountable and see if we can do it. senator blunt: from elementary school to big university to an employer, are you thinking about cost as one of the things you're looking at? i don't think these can cost $50 a test or $120 a test. i think we've got to be very cost conscious here in what we encourage. dr. collins: that is absolutely part of the way each one of these platforms is being assessed. if you have something that's really cool technologically but costs 100 buck, it's not clear this to -- it's not clear to me that's what we should be investing in sometimes people say it will cost 100 bucks but then the shark tank folks get involved and drive that price down.

senator blunt: dr. disbrow and dr. redfield, dr.s by brow -- disbrow brought up the reality that when you have a vaccine, you need a package to house that vaccine to be ad mred. i didn't imagine theout rage if we had a vaccine and we need, let's say, a handful of items to be able to give that vaccine and we only have four of them. i can't imagine how aggravated people would be starting right here if somehow we're not totally prepared for that. tell me whose job that is to be sure we have all of that in line so that not only can the vaccine be developed and delivered but we have everything we need to be sure it can be administered. dr. disbrow: it is important to have an end-to-end plan for vaccine, to delivery. right now the strategic national

stockpile is working on the kitting of the vaccine, sorry -- the components. senator blunt: go ahead. dr. disbrow: they're the ones doing it but again under operation warp speed it is a continuum. the people who are developing the vaccines, those working groups are letting them know, it's going to be a five-dose vile -- vial, so you'd need to send out seven needles, seven syringes, seven alcohol wipes. because you have to have excess. and we're all working together on that. but the are -- butter that puttinging to those kits -- but they are putting together those kits. senator blunt: who is doing that? part of barda? dr. disbrow: part of the institute for response. senator blunt: we're going to ask questions of them about this

topic. dr. redfield do you want to add anything to that? dr. redfield: the only thing i would add because it is important, we've done pandemic exercises to prepare for pandemics and identified as you pointed out that everything was fine but we didn't have enough needles or everything was fine but we didn't have enough vials. that's been taken into account here. senator blunt: i hope. so dr. redfield: but the other area i want to emphasize. don't underestimate the importance that we have the chain capability depending on what the restrictions are of the product, if it needs to be handled within that cold chain for that distribution. senator blunt: right. i believe i understand what we're trying to accomplish here, the various vaccines would have different levels of what they need to have to maintain their fficacy?

dr. redfield: some of them will require minus 0, a higher level cold chain requirement. some may require less. i think it's important that we are preparing to make sure we have redundancy in our cold chain capability. senator blunt: there may be more than one more covid bill. i think we should assume that between now and sometime late this year there's probably one more chance to get this right funding wise. ow much money do you need? dr. collins: i can't say how much -- dr. disbrow: i can't -- dr. disbrow: i can't say how uch we need but as we find kneads we'll bring those to you. ok.tor blunt: we need to work on that.

dr. redfield, do you want to talk about this topic? what do you need to enhance the flu vaccines to encourage people to take them that haven't before, what do you need to encourage a plan 60 days later for a vaccine network, what resources do you need that you will not have unless we provide them? dr. redfield: thank you, mr. chairman. i want to echo the sentiments of chairman alexander, just to go back to my view that now is the me to make the investment of capabilities in public health that this nation needs and deserves, it's a broad issue in terms of day-to-day modernization, the ability to have predictive data analysis, laboratory resilience in the public health work force. in terms of distribution of the vaccine largely one of our key responsibilities, i think it's important for people to realize that distributing a new vaccine to everyone in this nation is a complicated process and it is going to take resources.

it's not measured in the millions, it's measured in the billions. it's not like we're just going to send a vaccine off to a bunch of doctors offices and it's all going to happen. i think it's important that we make that investment so that just like we're developing the vaccine at risk right now, if it -- when it's finished, the company is going to have enough to actually start to give it to the american public. we need the exact same thing for the distribution strategy, commented by senator murray and others that process has to happen now. it is going to take resources to uild it. senator blunt: we know we need a vaccine. we need to know what the plan. is there's no reason for the plan to wait any longer than we have to. we ought to have that plan put together right now that has the flexibility that allows you to

deal with different vaccines from different locations in different ways. but this is, right now is the time that ought to happen. whoever you need to work through to get the information we need about what that's going to cost, we need to know that in the next couple of weeks. dr. redfield: yes, sir. senator blunt: dr. collins, i think we put a billion dollars in shark tank and other money in -- substantial money at n.i.h. for all of these various divisions to be looking at what they immediate to be -- what do you need next? dr. collins: i proosht the question. i'll consider this that you're asking for my professional judgment. senator blunt: i am. dr. collins: i mentioned in response to senator moran's question, the desperate need our granting institutions have slult of covid-19 and the loss in research capabilities adds up to about $10 billion. that's part of it.

we do have trans-n.i. h initiatives developed over the course of the last few weeks that i think would make major contributions to our advances here. there's about $1.6 billion in those projects that involve multiple institutes and another $2.2 billion for specific institute initiatives that i think have very high value. then on top of that we also are thinking about whether there are ways we could help with the economic difficulties in the country because n.i.h. every dollar we give out we know has a big stimulus -- stimulus for the economy and we have an additional set of ideas there for things that would be shovel ready that add up to another $5 billion. those are things we have been thinking about. senator blunt: i think on the grantee front, i know we've been talking about the grants that were going to run out this year, basically they lost this year an extension of those grants, some money to start laboratories back up. and some absolute authority that

the grants you didn't get to determine this year don't get lost in this process and you have more time to do that. would those three things all be correct? >> that is very much correct. appreciate you being so ton of those -- on top of those things they'll matter a lot. senator blunt: senator alexander. senator alexander: thanks, mr. chairman. it's been a helpful hearing for me, learned a lot. dr. collins, nashville metropolitan schools start august 4. so do a lot of other schools in the south. they start -- i know in the north they think that's uncivilized but that's what we do. so the relevance of that is to test and treatment. as i said earlier we had a lot of talk about vaccines down the road. tests and treatments are upon us. and i get a sense, i can't prove it, but i -- that we're going to really need those point of care

tests you're working on and we're going to need them quickly. i hear lots of anecdotal stories about lab technicians that are overworked, machines that are overworked about people who can even in our state where the governor has said if you want a test go down to your public health department and get it. i get conflicting rumors that some public health department says only if the doctor says so. i hear stories of delays, of three, four, five days before the diagnostic test comes -- comes back and of course it's not very useful when it comes back several days late. what i'm getting around to is i want to underscore the importance of your point of care tests and i hope you will let senator blunt and the rest of us know if there's anything that we can do to celebrate your rad-x effort because creating millions of new tests a day that are

point of care, rapid, quick, reliable, as senator blunt said our surest path toward normalcy is when 75 million students go back to school and college. and it will make -- it will build a lot of confidence in those schools and colleges if the schools and colleges can test as frequently as they want to. randomly or every class or every floor in a dorm or as the brown university president said she wants to test every student before they come back. ok. most campuses aren't going to do that but she want to. so if that's what builds the confidence to come back, your project is the answer to that. it seems to me. i have the same confidence in it that i did earlier when senator blunt and others worked on it. let me -- my final -- my other question is treatments. talk about going back to school. having the point of care tests.

so you can test any student, any class, any teacher, whatever you want is one thing. a second thing we'd be able to say as i mentioned earlier, and to say in the preliminary meetings, come back to school. we're going to try to be open five days a week and we want to assure that teachers, administrators and parents and grandparents at home that when you come back there are some specific medicines that are going to be available that will help make sure that your illness is not as severe and that you're less likely to die. could you take a minute and quickly list those, twor three of them are already approved, two or three like the antibody cocktails are very promising, and what would those things do? i mean like, remdesivir, if i've said that right, did i hear someone say that increase -- decreases by 32% the amount of

time to recovery. that's important specific information to someone. dr. collins: i totally agree with you that this is critical. it's a major part of operation warp speed. m glad to say janet woodcock is now the lead of warp speed, a very experienced scientist who knows how to get things done, it's a privilege to work with her. yes, remdesivir has been approved, does reduce hospitalization. senator alexander: if i'm a parent and my kid comes home sick, is that available to me to help make my hospital stay short her dr. collins: hempe is produced by gilead, the u.s. government has acquired large numbers of doses. it is intravenous so it's for people who are in the hospital and are pretty sick. senator alexander: what else would reassure me? dr. collins: there's a steroid

that has shown promise in a study in u.k., we worked with them all along, it showed a significant improvement in survival of those on ventilators and those not on ventilator bus oxygen. but that's not enough. we need to push forward all these other things quickly that look like they could have promise. the active partnership that i described, public-private partnership, looks hard to see. what would be the most important therapeutics to get prioritized because there were hundreds of ideas out there. then try to get those into clinical trials. there is a trial coming soon of other immunomodulators. things to damp down the overreaction of the immune system that seems to happen in people who are very sick, particularly those in i.c.u.'s there ast trial getting started soon on anti-coagulants, it's clear this vire does something that makes the blad overly clottable, it clots in the lungs and other places, that can be a

fatal outcome. we need to figure out how that works. there are immune systems, the antibody cocktail, the convalescent plasma, all those now being subjected to rigorous testing this summer as well in the united states. senator alexander: there's a possibility or a likelihood that some more of those will be available for parent, grandparents, teachers, administrators who are infected? dr. collins: we're going to push hard to get those trials to a point where you can draw a conclusion about the effectiveness by the end of summer, early fall. i think the antibody cocktails have a lot going for them because we know they worked for ebola and all kinds of reasons to think this is the kind of virus it should work for too. senator alexander: and you have several company making those in dr. collins: yes. senator alexander: and if they work and are safe you should be able to produce lots of those? dr. collins: that will be the

challenge, having warp speed involve and thinking about the manufacturing so we don't have a successful trial and have to wait to scale it up. barda is very enganged in that, as is n.i.h. as is the whole warp speed team. we want to be sure if we have something that works there's a lot of it out there senator alexander: thank you, mr. chairman. senator blunt: thank you, senator alexander. thanks to our witnesses. we've take an lot of your time today. it's been helpful to us. for people at h.h.s. who are here, who are following this hearing, i think we need more clarity in the next two weeks on specifically who is in charge of what, what are the deadlines, and what do you need to meet those deadlines and do the job that the country is counting on you to do and we're going to help you do that. but we need answers to those three questions. the record on -- >> may i comment on what you

just said? senator blunt: you can. >> it reminds me of admiral rickover who personally hired all the commanders of the navy nuclear subs from the 1950's and he said to them, you've got two jobs. one is your ship. and one is your reactor. and if anything happens to your reactor, your career is over. and he never had a problem with a reactor. because he put somebody on the flagpole. so i think that's what you just said. senator blunt: we need to know and we need to know in a hurry. we're -- we can't be help ffl you don't tell us how to help. and we need these questions answered. thank all of you. thank you for sticking with me. senator murray was with us right up until the end of this as well. the record will stay open for one week for additional questions. the subcommittee will stand in recess.

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>> this afternoon we'll bring you live coverage of house speaker nancy pelosi's end of the week news conference. she's expected to answer questions about democratic response to president trump's policies and what's ahead in congress after the house returns from its two-week fourth of july recess that briefing starts at 2:15 eastern. then at 3:30, live coverage as california senator kamala harris talks with "the washington post" about criminal justice and police reform. she's reportedly one of the candidates to be joe biden's vice-presidential pick. >> sunday night on q&a, physician and pulitzer prize winning author on the u.s. response to the covid-19 pandemic and the medical science being used to combat it. > i have not seen a level of collaborative spirit within the scientific community of this ilk or stature in my life. that's very encouraging news.

things have moved fast as they can possibly move. we will have hopefully by the end of this month two to three, maybe four potential drugs including antibodies that will attack the virus. these are still advanced phase study, i can't comment on whether they work or not and what settings they work on and we will also have about four or five or six new modalities to treat the inflammatory phase of the virus. >> watch sunday night at 8:00 eastern on c-span's q&a. >> c-span has unfiltered coverage of congress, the white house, the supreme court, and public policy events. you can watch all of c-span's public affairs programming on television, online, or listen on our free radio app. and be part of the national conversation through c-span's

daily washington journal program. or through our social media feed. c-span. created by america's cable information -- television company as a public service. and brought to you today by your television provider. >> the u.s. added 4.8 million jobs last month as workers laid off during the pandemic begin to go back to work, dropping the unemployment rate to just over 11%. however, the labor department says the unemployment rate remains historically high. over 20 million jobs were lost in the first two months of the andemic. president trump kicked off a briefing on today's unemployment numbers. the president didn't answer any questions but treasury secretary mnuchin did and he talked about what the administration wants as part of the next pandemic recovery package.