Thursday, March 28, 2002

Big press conference at DHHS for the announcement of the publication in NEJM of the dilution studies for smallpox vaccine. Also, in same issue of NEJM was my editorial calling for an open dialogue as to whether there should be pre-emptive vaccination of ”first responders” or even of the enitre population on a voluntary basis. D.A. Henderson is not particularly happy about my editorial since he continually has trouble admitting that a smallpox attack is a danger. Clearly this is related to the fact that he has devoted much of his professional life to trying to eliminate smallpox. Mar. 31 – April 6, 2002 – Went on a terrific trip to Africa with Sec. Thompson and a delegation listed below. We visited Mozambique, South Africa, Botswana, and Cote D’Ivoire. The trip was designated a Presidential Mission and so we received the royal treatment. Flew over on an Air Force jet and were received at each country with Secret Service protection and local military and police escourts via motorcades etc. Visited CDC and NIH funded facilities. Met with President Joaquim Chissano of Mozambique. Long conversation with South African Health Minister Manto Tshabalala-Msimang regarding reluctance of South African government to provide nevirapine to prevent mother to child transmission (MTCT). I disagree with her stance, but respect the difficult situation that she is in. She is driven by a need to decide things for herself since she was one of the original ANC members who were in exile during apartheid and she does not trust anyone but her own people. She, however, told me that President Tabo Mbeki respected me greatly and frequently speaks highly of me, During the Stay in South Africa the Supreme Court of SA ruled that the government must supply nevirapine to pregnant infected mothers and their newborns according to ACTG protocol 012. Met with President Festus Mogae of Botswana. He too had heard about me. Met with Prime Minister of Cote D’Ivoire. Representative people on the trip that I developed good friendships with in addition to Sec. Thompson and his staff of Bill Steiger, Terrell Halaska, Dave Boyer, Corina Gardner, Matt Bluhm and others were: Former Congressmen Ronald Dellums and Ray McGrath, Scott Evertz of the White House, Congresswomen Barbara Lee (D-CA) and EB Johnson (D-TX), Michael Miller of NSC, Anne Peterson of USAID, Bill Roper and others. April 25-30, 2002 – During the trip to South Africa, I spent about 1 ½ hours at dinner trying to convince her to help President Mbeki change his stance on treatment of HIVinfected people including pregnant women (see above). Of note, just this week the South African government has made a major change in their stance. They now allow treatment for rape victims and soon will start treating infected pregnant women. It is entirely conceivable that my discussions played some role in this turnaround.