15/11/2024 | Press release | Distributed by Public on 15/11/2024 21:09
WASHINGTON - The Select Subcommittee on the Coronavirus Pandemic held its final hearing titled "Preparing for the Next Pandemic: Lessons Learned and the Path Forward" to evaluate the most effective strategies for improving America's public health response during a future crisis and identify important lessons learned during the COVID-19 pandemic. Members pressed public health officials from the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the Food and Drug Administration (FDA) about their plans to reform systemic failures within each agency. The Select Subcommittee's effort to shed light on these failures, through a two-year investigation, was ultimately successful as each public health agency is now working to reform its deficiencies. All three government witnesses admitted that the failures at their agencies increased distrust in public health during the pandemic, and that they are working hard to rebuild the lost trust. Members also discussed the lack of transparency riddling America's bureaucracy and proposed reforms to improve government efficiency. Before the end of the 118th Congress, the Select Subcommittee will release a comprehensive report detailing its findings and propose recommendations for ensuring an improved public health response to a future pandemic.
Key Hearing Takeaways
Member Highlights
Select Subcommittee on the Coronavirus Pandemic Chairman Brad Wenstrup (R-Ohio), D.P.M, highlighted that reforming America's public health response will also help protect the economy during a future health crisis. Chairman Wenstrup questioned the Chief Medical Officer of the FDA about what can be done to limit shortages and strengthen supply chain resistance.
Chairman Wenstrup: "Dr. Marston, in your written testimony, you emphasize the need for greater transparency within the medical product supply chain. The supply chain issue is very important to me to help prevent and mitigate drugs shortages. The COVID-19 pandemic underscored just how fragile this supply chain is, as unprecedented demand led to severe shortages. Can you outline specific steps the FDA can take and maybe has started to take to strengthen supply chain resilience and prevent drug shortages during future public health crises?"
Dr. Marston: "…For the FDA in particular, there are some things that we can do to improve our ability to prevent and mitigate shortages. First, we really need to be able to know when there is a rise in demand that these companies can't keep up with. So currently they are required to tell us if a line goes down, then they can't keep up with supply. But if there's a spike in demand, for example, as we saw with the children's analgesics a couple of years ago, they don't need to tell us about that. So that sets us back in our ability to mitigate.
"Second, they don't need to specify their reliance on different manufacturers for active pharmaceutical ingredients. They don't need to put those things on their label. So, we have proposals that would address both of those and require that.
"And third, medical device manufacturers actually aren't required to tell us about any supply disruptions outside of a public health emergency. So, if a tornado takes out your factory, which unfortunately is a painfully real example, you're not required to tell the FDA. We might call you. We might see it in the news, but it's not a requirement. So that's, again, something that we want to address."
Committee on Oversight and Accountability Chairman James Comer (R-Ky.) revealed that Dr. Fauci's Senior Advisor - who lied to Congress- is still employed by the U.S. government. Chairman Comer pointed out that this is clearly inappropriate.
Chairman Comer: "Dr. Tabak, is Dr. David Morens still employed by the NIH?"
Dr. Tabak: "He is still an employee."
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Chairman Comer: "On the screen, in an email chain, shows an internal NIH email about a draft letter from Dr. Fauci to Senators Graham and Paul. Dr. Morens forwarded this, first to his Gmail, and then to Dr. Daszak. Does sharing that draft letter violate NIH policy?"
Dr. Tabak: "Yes, of course."
Chairman Comer: "The next email is the NIH informing Dr. Morens that the National Security Council would be leading the communications on the W.H.O. Origins report. Dr. Moran forwarded this first to his Gmail and then to Dr. Daszak. Does sharing this internal deliberation violate NIH policy?"
Dr. Tabak: "Yes, it does."
Chairman Comer: "The next email is Dr. Daszak soliciting Dr. Morens's help in responding to NIH. Dr. Morens responded with his edits to the letter. But let's not take Dr. Morens's word for it. The attachment includes comments and track changes done by Dr. Morens. Sir, does an NIH employee as editing a grantee's oversight response to NIH violate NIH policy."
Dr. Tabak: "It absolutely is inappropriate."
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Chairman Comer: "Dr. Morens was asked if he provided any advice to Dr. Daszak on how to respond to NIH oversight requests and he said no. As we discussed and you saw earlier, Dr. Morens personally edited a letter for Dr. Daszak that was directly related to NIH oversight of EcoHealth, the company at the center of the entire COVID pandemic. Did Dr. Morens lie to Congress again?"
Dr. Tabak: "Again, those types of action would be completely inappropriate."
Chairman Comer: "Yes, the answer is yes. The evidence is on the screen. There's evidence that Dr. Morens violated numerous NIH policies and lied to Congress multiple times. Dr. Tabak, would you fire Dr. Morens?"
Dr. Tabak: "As you know, we don't discuss specific personnel matters, but we are following all of our procedures to the letter."
Chairman Comer: "Well, this appears to be the perfect example of bureaucratic overreach."
Rep. Debbie Lesko (R-Ariz.) elicited an admission of guilt from the Director of the CDC, the Chief Medical Officer of the FDA, and the Deputy Director of NIH that each of their agencies played a role in decreasing Americans' trust in public health during the COVID-19 pandemic.
Rep. Lesko: "Americans have decreased trust, less trust in the federal health agencies after COVID. And I want to know from each of you if you or your agencies believe that you played a role in that. And if so, how are you going to change it?"
Dr. Tabak: "Well, since I have my microphone on, I'll start. Of course, this was a very fluid situation, as you of course appreciate from your work on this committee. And we understand that we have to do a much much better job of being more transparent, of doing better communication, of getting into communities, working with trusted partners in communities. You just can't so-called parachute in and expect people to benefit from your wisdom. You have to have a real conversation with them in a transparent manner."
Dr. Walke: "I would agree with Dr. Tabak. Trust is critical for a public health agency. The pandemic was moving quickly. The virus was changing rapidly. We were putting out a lot of guidance almost weekly and it became very difficult even to find the information that was needed on our CDC.gov website. We have made changes. We tried to be a lot more transparent. We've streamlined our website by about 60%. We've tried to move to make it more plain language so it's more accessible to the American public. So, we acknowledged that there were challenges here and we are responding to that."
Dr. Marston: "Yes, I would agree as well. I think one of the things that we've been working on is how to work in concert with individuals who are in other settings, clinical settings, the individuals right before us right now, people who also have the ear of the American people and trying to make sure that we're putting out information that is both high quality, up to our scientific standards, and digestible."
Rep. Michael Cloud (R-Texas) called out the NIH for hiding behind a wall of bureaucracy to avoid accountability for their mistakes, including its lackluster oversight of multi-million dollar grants.
Rep. Cloud: "Dr. Tabak, I wanted to ask you, one of the things that came up in much of our testimony, Dr. Fauci and Dr. Collins both indicated to this committee that even though their signatures appear on every grant, basically the process is that you have people researching the grants right? At a lower level, and basically they put it before a committee or a peer review committee. Then it receives a priority score. Then it goes to an advisory council and then it goes to, at the time, it was Dr. Fauci, for example, when we were talking about the NIH grants.
"Now, this is one of many cases. I've seen this in agency after agency after agency. These are supposed to be multiple levels of accountability. And what happens is, Dr. Fauci for example said well, yeah, my name's on it, but you know, I don't have time to read every grant. And that's kind of understandable. Well, then who is responsible for it? Well, it's this committee. Well, this committee votes on it and blocks grants to the tune of even sometimes 100 grants at the same time. They don't actually read it either.
"And so we end up having these supposed multiple layers of accountability that turn into multiple layers of plausible deniability. So, nobody ends up being held to account. And so, when we're talking about lessons learned, these are the kind of systemic things within agencies that I would like to hear - what are we doing to fix these things? What are we doing to make sure that we don't trample on people's civil rights again? What are we doing to make sure that we don't threaten the licenses of medical professionals who are experts in the field but might have a different view? These are the kinds of things that I'm wondering how are we going to make sure that the government stays in check so that we can begin to restore the trust of the American people?"
Rep. John Joyce (R-Pa.), M.D., confirmed that the Select Subcommittee's efforts to hold the NIH accountable for an inadequate grant process that allowed grantee, EcoHealth Alliance Inc., to avoid oversight were successful. NIH has implemented steps to increase transparency and accountability as a result of the work of the Select Subcommittee.
Rep. Joyce: "How is the NIH improving oversight of grant funding to ensure that failure seen, like with EcoHealth Alliance, would never happen again?"
Dr. Tabak: "We have restated the requirement that sub awardees, which is an example with the Wuhan Institute of Virology, are required to provide all data on it in a timely manner. We have made it clear to our staff that progress reports need to be reviewed in a timely manner and have put so-called red flags in our automated systems to ensure that a grant can't be renewed if there's an outstanding report that has not yet been reviewed…The timing for this is - when you are coming to the conclusion of over a year's period of funding, you are supposed to provide a progress report. I believe the window is two months. I would have to get back to you."
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Rep. Joyce: "I think it's clear that in the aftermath of our federal COVID 19 response, you need to do a lot of work. There's significant work to be done to repair the trust between the American people and our public health infrastructure. And in order to earn that trust, public health officials must learn from these large mistakes and it is my hope that the work of this subcommittee will help identify a path forward when responding to the next public health emergency."
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