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Importance of the Biodefense Summit

Biodefense Summit Transcript

​Remarks by Secretary Alex Azar II, U.S. Department of Health and Human Services

​>> CICELY WATERS: Ladies and gentlemen, please welcome Dr. Robert Kadlec, the Assistant Secretary for preparedness and response within the U.S. Department of Health and Human Services.


>> ROBERT K​ADLEC: Good morning. Um, it is a pleasure to be here, and it is my honor and privilege to introduce, um, my Secretary, my boss. Alex Azar was sworn in as President Trump's Secretary of Health and Human Services in January 2018. His current tenure at HHS is a second tour of duty at the department, after serving his general council and then Deputy Secretary in the 2000s. He spent his career working in senior healthcare leadership roles in both public and private sectors. President Trump also appointed Secretary Azar to serve as the chair of the Biodefense Steering Committee, which leads the implementation of the national biodefense strategy. It is a pleasure and privilege to introduce to you the 24th Secretary of Health and Human Services, Alex Azar.


>> ALEX AZAR: Well, good morning, everyone. I hope everyone's well caffeinated.


>> ALEX AZAR: Thank you for joining us here today. I'm here to help kick off this summit, because as HHS Secretary, as Dr. Bob Kadlec mentioned, President Trump appointed me to oversee the implementation of our new national biodefense strategy, and that effort is going to benefit greatly from your input and efforts. From the start, the national strategy was designed to be a highly collaborative effort, engaging the public and all key stakeholders is absolutely vital to successful work on a complex issue like biodefense. I want to particularly thank the National Biodefense Science Board, the Federal Advisory Committee that advises HHS on biodefense, for recognizing the importance of outreach and for making recommendations about stakeholder engagement. Today's summit will allow the federal government to obtain valuable individual input from members of the public and the scientific community on important aspects of our shared work. So, first of all, why do we have a biodefense strategy that needs your input? The simple answer is that biologic threats of a manmade, accidental or naturally occurring nature are real, and they are growing. There are several factors driving these trends.

As the world grows more urbanized, interconnected, infectious threats can spread more rapidly and easily than ever before. We also face accidental and manmade threats. Today's rapid technological advances have great potential to improve human health, but they also create the opportunity for new kinds of threats, and for small scale actors or even individuals to make use of biological weapons. These trends aren't new, so our national strategy is the culmination of a long series of steps taken by HHS and the entire U.S. government to build up our biodefense capabilities. You're going to hear more of that from, that history from Dr. Kadlec in a moment, but I just wanted to give you a sense of the perspective that I've brought to my role at HHS and the personal interest that I have in biodefense. You know, over the last two decades, the growing complexity of biodefense threats have demanded the involvement of more and more of the biomedical and public health expertise we have at HHS, as well as more and more coordination across the government and with the private sector. It was back in the 90s, before I arrived at HHS, that my predecessor, Secretary Donna Shalala, declared HHS to be a National Security Agency, detailing a public health service commission core officer to the National Security Council for the first time. I think the recognition of the importance of HHS's role in biodefense and national defense grew during the years I was privileged to be at the Department in the previous Administration from 2001 to 2007.

I was confirmed in August 2001, one month before 9 11, when everything changed, but everything sort of progressed from what we had all been seeing in terms of chem bioradiological and nuclear defense programs. You know, the day of 9 11, we got to see the need of coordination, the need to think of ourselves as a genuine National Security Agency and a genuine part of that establishment. That can be as simple as the creation of the command center that we have, that keeps us linked across the government, provides a single portal of information and situational awareness, allows us to be tightly connected, where on 9 11, our connectivity with other agencies was on my personal cell phone, because the main systems had gone down, we had no phones. I'm sure there are a lot of people in this room who, on 9 11, here in DC, experienced the same and were in government agencies on that. You know, that day, Secretary Thompson declared what I think was the first Section 319 public health emergency. I think that was the first one, and back then, of course, that really tapped into access to funds that weren't funded, so there was some symbolism in that. We since wrote and passed various statutes that actually put meat behind Section 319, but I think it was important recognition of what we faced that day. I mean, we mobilized that day with the Red Cross, tragically, to try to get blood up to the World Trade Center, because we thought there would be survivors. That proved to not really be necessary. We very quickly suffered the anthrax attacks and had to face our first very real bioterrorism attack on this country.

Um, we had to come up with countermeasures, Cipro, we did procurements and development of an anthrax vaccine. We had to worry about smallpox. We had to vaccinate our troops, vaccinate our first responders, we had to secure the supplies of drive acts, see how we could maximize the supplies of remaining drive acts that we had here in the United States, and, of course, develop next generation smallpox vaccines. And then, you know, it goes from that to, sometimes, the almost comical. I remember waking up and seeing The New York Times one morning, and it was talking about monkey pox getting into the United States. How are they getting into the United States? Through the importation of giant Gambian rats, by collectors, and then how was it spreading? It was spreading by prairie dogs and people who trade and collect prairie dogs, and, so, we banned the importation and interstate sale of giant Gambian rats and prairie dogs. Just so you know, there is and remains a very active prairie dog lobby in the United States.


>> ALEX AZAR: I think it was probably the most death threats and hate mail I ever got.


>> ALEX AZAR: Um, we had SARS. I mean, I remember being out at Home Depot on a Sunday, and we had a ship coming into Seattle, and, of course, for us to quarantine, we have to have in an executive order a disease definition, and having to get up to, get an actual executive order up to Camp David to get President Bush to add SARS to the list of diseases for which we could quarantine so we could yellow flag a vessel that was out in the harbor in Seattle. Um, and, of course, the thing that people ask what keeps you most up at night in the biodefense world, pandemic flu, of course. I think everyone in this room probably shares that concern, and working with Secretary Leavitt, President Bush and the Congress to create the pandemic flu preparedness work that we did that really helped rejuvenate a domestic annual flu vaccine capability here in the United States revolutionized, we're not there yet, but revolutionized our capabilities and capacities around flu production in the U.S., to minimize shortages so we hopefully never go through what we did in 04 on the Chiron shortage, and then, um, now we've got capacity, but we still need to improve our speed of production of pan flu vaccine and our capacities. Then, of course, the Obama Administration, in 14 and 15, dealt with the Ebola crisis in West Africa, which, sadly, you know, came back on our watch in the DRC, but such advances, such advances have happened in just those years. Think about it, in the spring of 18, the Democratic Republic of Congo had, through PEPFAR and the global health security agenda, so advanced their public health capabilities, they had identified the outbreak, the first outbreak of Ebola. They came to the world committed transparently with information on that and brought the WHO and HHS and other international partners in, and now, as we're dealing with the current outbreak in the eastern DRC, a very difficult area, um, which to try to operate, we have tools.

The rather miraculous thing is just a couple years after 14, we have vaccines, we have experimental vaccines, we have experimental therapeutics, we're running clinical trials right now, multi clinical trials on therapeutics for Ebola there. Um, such change has happened. A lot of that is because of two really important innovations that we got started, which is Project Bioshield, and then BARDA, to enable the research and the development and the procurement of countermeasures for which we and the government would be uniquely the purchaser. We needed to be a stable partner to ensure that development, and it's really proven very valuable. 43 FDA approved countermeasures and products for CNBR and pan flu, most recently the first antiviral for smallpox approved and going into the strategic national stockpile. And, of course, um, essential to all of that was the creation of the assistant secretary for preparedness response. Dr. Bob Kadlec currently occupies that role, and I cannot tell you how delighted we are to have him, somewhat of his deep, deep expertise in this field, sitting in that chair. You know, all of these experiences, both what I've learned personally and what so many of the other dedicated professionals at HHS have seen, inform the work that we do on the biodefense strategy. These lessons of history led to the decision to place accountability in one place, the Secretary of HHS's chairman of a steering committee.

Now, this was a cooperative effort, with expertise from many domains, including the private sector. Many of you have been through the same journey that we have, but it's a cardinal rule of leadership that you have to have accountability, which means picking a leader, and that's a leadership lesson well understood by President Trump, who has a particular interest not just in our national security, but in preparedness for biodefense in particular. You know, this isn't a topic that crosses the minds of most Americans every day, thankfully. In order to keep it that way, we need to continuously improve our preparedness work, which is why the biodefense strategy is a blueprint for action. Since we officially launched the strategy at the White House back in September, we've begun implementing on a number of fronts. First, we established the biodefense coordination team, a group of leaders that is chaired by Dr. Bob Kadlec that began meeting regularly to begin implementation. We've been extremely pleased with the buy in of leadership across the federal government so far, both members of the coordination team, as well as my fellow cabinet secretaries. We also launched an internal request for information across the entire federal government to support the development of an overall biodefense assessment of our capabilities and capacities. Responses from the agencies are due at the end of May, and then we'll be analyzing this information to understand our current set of activities, where the gaps lie, and what our priorities need to be on filling them, but we need to know the lay of the land, not just inside the government, but also outside of it.

That's why we've engaged stakeholders, including many of you, to begin understanding your current activities and priorities, then identifying opportunities to improve and increase coordination. That's why we're here today. We're now at a point where the federal government is in particular need of your advice to inform our efforts. We want to come away from this meeting with individual perspectives from all stakeholders to inform our assessment of the biodefense enterprise and policy priorities. This is going to be not only the opportunity for public input, not the only opportunity for public input. We plan to engage the public further as we move forward, and many of you are going to play a critical role in the activities that fall under the strategy. So, thank you all for joining us here today at this important time for America's biodefense enterprise and the national strategy. I'm honored that HHS is helping to lead this work, and I hope you all are honored to play a crucial role in that as well. Thanks again for being here today. I look forward to years of continued partnership with all of you, and I'll turn things back now to Dr. Kadlec. Thank you very much.