Press Releases 2004

Remarks to the press, by Secretary of Health and Human Services Tommy Thompson

April 8, 2004

SECRETARY THOMPSON: Thank you, Mr. Kennedy. Namaste. I’m delighted to be here. I would like to start out and just explain why we’re here.

First off, this is a Presidential mission. The President has designated us to come here and to meet with as many people as possible and talk about health care issues.

We started out leaving on Saturday evening, on which we flew to Saudi Arabia. The reason we went to Saudi Arabia first was in order for me as Chairman of the Global Fund – I’m Chairman of the Global Fund as well as being Secretary of Health and Human Services in the United States – to meet with officials in Saudi Arabia in order to see if we could get the Saudis to contribute to the Global Fund.

Then went from there on to Afghanistan where my Ministry, Department, is building a hospital for women and children, a teaching hospital and clinic. This is something for women and children in Afghanistan as well as giving vaccine out to children in Afghanistan to eradicate polio.

From there we went on to Pakistan where we had an opportunity to meet with President Musharraf and other government officials. We met with President Karzai also in Afghanistan. In Pakistan we also went to several hospitals and clinics in which we also administered polio vaccine to children to prevent polio.

From there, last night we flew into Delhi and we this morning went to a clinic down in the slum areas of Delhi in order to administer polio vaccine and team up with some government officials as well as some medical officials. Since then we’ve been meeting with individuals dealing with AIDS, malaria, tuberculosis as well as eradication of polio.

I’m joined by some outstanding individuals from my Department as well as Jim Lacey who is President of Rotary International. He has been with us since the start. Rotary International as you know full well is doing everything they possibly can as an organization to eradicate polio. Of course we’re on the precipice of accomplishing that. India has a tremendous record. India is one of the last remaining six countries. Last year there were over 200 cases of polio, but there were only eight cases this year and it looks very promising. We’re cautiously optimistic that this year with all of our partners – I’m talking about government officials here in India, I’m talking about the Rotary International, I’m talking about the United States Government and my Department of Health and Human Services, as well as WHO and UNICEF. We have a great opportunity to eradicate polio.

This, of course, would be the only second disease in mankind’s knowledge that has been eradicated. Small pox was first and polio would be number two. We’re not there yet, and we are down to probably the last one thousand cases but they’re probably the most difficult to eradicate and so anything you can do in your capacity as individuals of the media to articulate that message would be extremely helpful in order to get all children vaccinated as soon as possible.

I’m joined also by Dr. Elias Zerhouni. Elias Zerhouni is the head of the National Institutes of Health which is part of the Department of Health and Human Services, but it also is probably the best research organization in the world. It has a tremendous amount of outstanding doctors and researchers and scientists that are collaborating with the wonderful doctors and researchers and scientists here in India. We have several collaborative programs going on all the way from vaccine development in HIV as well as to eradication of polio and also many other research items dealing with a lot of different topics.

India is the one country that has received more peer review grants than any other country in the world outside of the United States, so we have put a lot of dollars into research here in India. Because you have a tremendous capacity, a great knowledge base, and some outstanding researchers, scientists and doctors that are helping to collaborate with us in the United States to improve the quality of health of all people.

Then we have Dr. Julie Gerberding who is in charge of CDC, the Centers for Disease Control. That also is part of the Department of Health and Human Services. Julie has been to India once before this year and she has got many employees of her division over here in India working on many different subjects. One of her employees is working on the eradication and coordinating the eradication of polio with WHO here in country.

We have, I think we have six employees from the Department that are currently assigned to the Ambassador’s embassy here and working on many different topics and it just shows our tremendous interest in helping to improve the quality of health of the people of India.

We are very pleased to be here. We have had an opportunity to meet with the President who was an outstanding, passionate individual that gave us a lot of direction as to how we could be helpful. We also, of course, are very pleased with our wonderful ambassador, Ambassador Mulford, who had a lunch for us and invited in government officials as well as NGO and faith-based people with which we had an opportunity to discuss many issues. Then we had a roundtable discussion at our hotel in which we had people from various areas of the country and different groups talking about HIV/AIDS, tuberculosis and malaria.

In regards to the Global Fund which I’m the Chairman of, we have put in four different grants here in India in the last three years. We had grants one, two and three, and India has received grants in each one of those rounds, probably totaling $130 million over the next five years. Two of the four grants already have money that has come into India and is already being circulated. Two more grants are being – one more grant is just in the process of receiving their first tranche of money and the fourth one is going to be working on the agreement to be signed and that too will then allow for the money to flow into India.

The fourth round in grants are going to start in June of this year? India has applied for a very aggressive grant covering all three of the diseases – tuberculosis, malaria and HIV/AIDS, and I think they’re asking somewhere around $180 million over five years for fighting these three diseases.

You have a wonderful Minister of Health who has also just joined the Global Fund Board. Her first meeting was in February and we got a chance to meet with her then and also got a chance to meet with a little while ago talking about how we can work together as secondary minister as well as our various departments in order to improve our collaboration as well as find ways I which we can work closer in the future.

I thank you very much for being here. It’s an honor for me to appear in front of the press here in Delhi. So now I’ll open myself up for any questions you might have and then if you want to direct your questions to anybody from Jim Lacey from Rotary or from NIH or from CDC, please do so.

QUESTION: I’m with Associated Press.

Can you tell us what success you’ve had --

SECRETARY THOMPSON: I didn’t realize that David was here. I apologize.

Another outstanding individual of our delegation is an orthopedic surgeon, Dr. David Thornburg who is a representative of the Department of Defense. I’m very pleased to have the Department of Defense on this mission, and he has done well. I didn’t know you were here, David, I’m sorry. You weren’t at the last meeting so I didn’t introduce you, I didn’t look behind me. I apologize.

This is Dr. Julie Gerberding and this is Dr. Elias Zerhouni, and this is Jim Lacy. So --

QUESTION: Can you tell us what success you had in getting the Saudi Arabians to contribute to the fund and just how much money is needed to eradicate these last one thousand cases and why it is so difficult?

SECRETARY THOMPSON: I was cautiously optimistic. We had a chance to meet with some wonderful government officials. They were very encouraging and I think the possibilities of getting an enhanced donation from Saudi Arabia is very good. Saudi Arabia is currently giving about $10 million a year in this fight, and we asked them to increase their donation. They were pleased that we were there and they were encouraging. I now will continue my efforts to raise money, which I have been doing around the world, and hopefully we will be able to convince them and other Arab countries to join with us.

Because this is a fight that’s going to take all of us. It’s a worldwide fight. It’s a huge fight. If you stop and realize just the enormity of the numbers – 8,500 people die each and every day. That’s about, if you want to put it in a perspective so everybody can understand it, that’s 40 jumbo airliners crashing each and every day. Now if we knew that 40 jumbo airplanes were going to crash each day killing all the people on there, how long do you think the world community would stand still for that? That’s what’s happening every single day. People are dying from AIDS across this world.

The worst part is that 14,000 more are coming down with HIV/AIDS each and every day. So we are losing the battle and losing this war, and every one of us have got to get engaged in this war. That’s why I’m spending a lot of my time trying to raise the dollars in order to increase the resources.

We’ve gone from nothing in 30 months to raising $5.3 billion. We have given out over $300 million as we speak. We have committed over $2 billion, $2.5 billion of that $5.3 billion. We are in 121 countries. We have 224 projects going. This is within 30 months of starting this operation. I don’t know of any other startup business that’s ever been that successful. So I’m trying to convey to you and to the whole world community that we cannot afford to sit on the sidelines and watch this insidious virus continue to infect people and have so many people, our brothers and sisters around the world, die.

This of course is only AIDS. You also have malaria, tuberculosis, and so this is a huge fight and we need all of you to join in that fight.

Second, in regards to why the last thousand cases, that’s always the case. Any time you’re going to take on anything it’s always the last group that’s always the toughest. Whether you’re moving people from poverty to middle class, it’s the last group that’s always the hardest. Moving people from welfare to work, it’s always the last ones that are the hardest. They’re always the most difficult cases. If they were the easy cases you would have taken care of those cases first.

It’s poverty. A lot of people don’t understand that they have to be vaccinated. It’s the fact that some people live in far-away places that are hard to get to and be able to convince them. There are different ethnic groups that have some concerns about vaccine, different religious problems. All of these things come down to the last group is always the most difficult, in any kind of a program in order to get it, whether it be in education, whether it be in fighting disease, whether it be economic development. It’s always the last cases that are always the most difficult.

How much will it take? I don’t think that should be even a consideration. The eradication of polio is worth whatever it costs to accomplish it, and we are so close.

Can you imagine if we slack back and see polio start getting another foothold in other countries around the world? That’s going to cost a lot more than what it’s going to cost us to eradicate it once and for all. So whatever it costs, we have to find the money in order to do it.

QUESTION: Can you tell us about the key points of discussion of your discussion with President Musharraf and what is his response toward eradicating polio, because after India Pakistan is another big reservoir of polio virus still?

SECRETARY THOMPSON: You asked what President Musharraf?

QUESTION: Yes.

SECRETARY THOMPSON: I can’t hear you, I’m sorry.

QUESTION: You said that you had a discussion with President Musharraf. I think that what sort of response are you getting from President Musharraf in fight against polio in Pakistan?

SECRETARY THOMPSON: Thank you for the question. I was absolutely delighted with all three Presidents that we’ve had the opportunity to meet with and to discuss these issues.

President Karzai, with all the difficulties facing his young regime and the problems that he is having in Afghanistan, he was full-score behind what we’re doing. He is committed to trying to assist us with the meager amount of resources that he has. He’s going to talk about it and he wants to see what we can do as a nation, the United States, to assist him to eradicate polio.

President Musharraf was very knowledgeable not only about the eradication of polio but also about the infectious diseases such as malaria and tuberculosis and HIV/AIDS. He was very interested in what we were doing. He pledged his cooperation and wants to make sure that we eradicate polio first and move on to the other areas as soon as possible.

Your President, what a wonderful man. I told him, I said you are really a good person. We were all impressed by his humility, his intellect, but his passion to help individuals that need help. Low income people that he’s trying to move into the middle class and he’s set certain goals that I was very impressed by. He knew exactly what we were doing as far as eradication of polio and he’s very knowledgeable about it and he wished us well. He speaks about it and he’s going to do everything he possibly can to encourage the government to do more. He knows how important it is to get rid of it and he’s going to do a great deal.

So all three of them. I couldn’t be more pleased with our meetings with the Presidents. If all of our meetings were as good as we had with the Presidents it would have been just a stellar trip that we’ve been on.

QUESTION: As far as your participation in the polio vaccination for India and Pakistan, is it going to be only [inaudible] or technical and scientific programs as well?

SECRETARY THOMPSON: All of the above. All of the above plus the volunteers. We have Jay Winger who is here from the Department who is helping to coordinate the whole effort with WHO, with UNICEF, with your government leaders and our embassy. He’s just doing a great job. We have individuals here from USAID doing the same thing.

We also are contributing dollars to purchase the vaccine and will continue to do so. So there’s dollars involved, there’s also help from Rotary International. We want to see India be able to eradicate polio once and for all.

QUESTION: When do you expect to eradicate polio from India?

SECRETARY THOMPSON: By the end of this year.

QUESTION: Because India has reached, brought down incidence in 2001 but then we slipped back to 1,600 in 2002. So why are you so cautiously optimistic?

SECRETARY THOMPSON: Because last year went, 2002 it was over a thousand; 2003, I think, it was down around 260 some cases. This year at this point in time we only have eight cases.

I was listening to the individual experts, the people at the clinic we were at this morning, the government leaders, and all those individuals indicated to me that they are committed to eradicate polio by the end of this year. I don’t know, are there five different times this year that you’re going to vaccinate -- seven. Seven different times that there are going to be vaccination clinics set up throughout the country.

I was even more impressed by how the government and the NGOs and the people have set up ways in which they’re going to go to every household across India and knock on the door of the households, asking people if they have any children aged five or younger and if they’ve been vaccinated. Then there’s going to be follow-up to that. That is a tremendous undertaking. And they’ve got it set out, I told Dr. Gerberding, I wish they would have had that kind of a plan when I was running for public office. It was absolutely a fantastic way to reach everybody. That’s why I’m so cautiously optimistic, listening to the dedication of the people that are actually in the field and those individuals that are planning this effort. It’s absolutely amazing. I’m more optimistic today than I was at 6:00 o’clock this morning when we started, or 7:00 o’clock. I just am very impressed with what India’s doing. I didn’t have those positive feelings coming here. I was somewhat perplexed why we haven’t eradicated it before, and now I understand and I am just very pleased about the commitment of the government leaders and especially the health workers. They’re just doing a wonderful job and I think they should be complimented.

QUESTION: Can you elaborate a little bit about the grants you have made to India and what you will be making and what they will be for?

SECRETARY THOMPSON: We have made four grants. In the Global Fund we have Rounds 1, 2 and 3 already completed. All of these grants have to be peer reviewed. We peer review them with a group of experts worldwide, and they review them. Only about, I would say the norm is somewhere between 50 and 58 percent of the grants get through the peer review. We also have set up an independent peer review at NIH and the Department of Health and Human Services, just to review them so that they can give me expert analysis as to the grants that are being applied for. Once it gets through the peer review then it goes to the full board and then we grant approval or rejection.

India has been very good. Very few countries have been able to get grants in every one of the rounds. India got a first grant on TB in Round 1. I think it was a small grant. I can’t remember the total amount, but the total of the four grants is about $130 million. What was the first grant?

VOICE: $5.6 million.

SECRETARY THOMPSON: The first grant was $5.6 million. The second grant, India got two grants. They got one for HIV/AIDS and they got one for tuberculosis. What was the total amount?

VOICE: The total amount was, for two years, $18 million. It was two years and five years. The two year budget is about $60 million; the five years about $30 million.

SECRETARY THOMPSON: In the third round India got a fourth grant, and that was for fighting HIV/AIDS and that was --

VOICE: About $60 million.

SECRETARY THOMPSON: So totally, over five years, India’s going to receive $130 million out of those four grants. Now India has applied for an integrated grant in Round 4 which – it’s in the process of being peer reviewed right now. We’re going to meet in June to take into consideration what the peer review panel has decided and then we will vote on it, but India’s grant is for fighting all three of these. I think they’re asking for a grant of over $160, $180 million over five years. Hopefully India will qualify and hopefully India will get it.

QUESTION: I would like to know that the Global Fund is giving grants to various countries. Is there system of assessing whether the assistance is being properly utilized and how effective this fund has been in containing the diseases it is meant for.

SECRETARY THOMPSON: You’ve got to realize that it’s awfully early to tell. We’ve only been in existence 30 months. We had to raise the dollars, we had to set up the peer review mechanism, we had to hire a staff to operate the Global Fund, so there’s been a lot of preliminary work that had to be done before we could even get to the grant-making process. Once we got to the grant-making process India received the first grant.

Once you get through the grant-making process then you have to set up what we call a CCM, a country coordinating mechanism within the country. Then you have to set up a financial authority to review how the money is being spent. We have set up tremendous monitoring things to be able to see how effective these grants are. India has only received dollars out of two of the four grants so far. The third grant they’ll be receiving money very shortly. The fourth grant that India is going to receive, they haven’t received any money, they’re still going through what we call the contract negotiations period. India’s government is negotiating with the Global Fund as to the terms – the monitoring, the CCM, the financial authority and so on. So all of these things have got to take place.

So it’s not fair to say at this point in time that India’s got four grants and how well they’re doing. It’s still in the embryonic stages. We’ve set up monitoring programs so next year when you ask me that question and I’m back here I’ll be able to answer it and give you better details, but it’s just too early, it’s too early in the process to say that we’ve been effective.

I think we’re going to be very effective. I think the Global Fund has got an ambitious agenda evidenced by the fact that we’re in 120 countries, we’ve got 224 programs going. But it’s still too early to say how much we’re doing.

I can tell you that we’re losing the battle right now with the fact that 8,500 people die, but 14,000 are coming down with the disease each and every day. The numbers tell you we’re losing. But that also tells us how important this fight is and how absolutely important that you, the media, gets very much involved in this. Without your help – You’re going to be as important to winning this war as anybody else because what you can do is you can help instruct the people in India on prevention. First you’ve got to educate people about prevention and how this disease is transmitted. You’ve got a tremendous responsibility as media to explain that. Then of course it’s up to us to raise the dollars, get the program set up, and execute.

So all of us have got a role to play. Every single person can be involved in this program, whether it be just an individual student in college being able to go out and talk to other college students, or whether or not you’re a parent talking to your children about being careful and prevention. Any person has really some sort of a role to play in this war. You have a very vital role, and that is educating the public about it. You’re going to use your journalistic ability to criticize and to articulate, but you also have a responsibility as journalists, and I’m not going to lecture to you because you all know what you have to do, but you can do a tremendous job for society by educating people. So I’m calling upon you to get this information out and talk to people. You can do the same thing with your own individual lives.

So I thank you all. What is thank you, “Danivan”?

QUESTION: One more question?

SECRETARY THOMPSON: Sure, I’ll do one more question.

QUESTION: China has declared an HIV/AIDS epidemic in that country. Do you have any plans to visit China?

SECRETARY THOMPSON: Yes.

QUESTION: Do you have any plans for China?

SECRETARY THOMPSON: Sure. I’ve already visited China on the HIV/AIDS question, we were in China in October and we had a chance to meet with some government leaders about HIV/AIDS there.

China’s got a huge problem. China is finally recognizing their problem and is becoming quite passionate about doing something about it.

Thank you, you’ve been wonderful. Danivan and namaste. Thank you very much.