Speaker 1: Today, we're glad to bring you a special episode of
Speaker 1: Why Am I telling You This. We'll be doing these
Speaker 1: episodes periodically to introduce you to some of the inspiring
Speaker 1: people in important ideas I've encountered throughout my career in
Speaker 1: public service and at the Clinton Foundation. On this episode,
Speaker 1: we're sharing a recent program hosted by the Foundation and
Speaker 1: the University of Arkansas Clinton School of Public Service, which
Speaker 1: focused on the research that took place at the National
Speaker 1: Institutes of Health when I was president, including developing antiretroviral
Speaker 1: treatments for HIV AIDS, laying the groundwork on vaccine research,
Speaker 1: both of which made it possible to develop COVID nineteen
Speaker 1: vaccines more quickly, and completing the mapping of the human
Speaker 1: genome at least the first draft. It was perhaps one
Speaker 1: of the most important and farthest reaching achievements of my
Speaker 1: eight years in office. I hope you'll find these conversations
Speaker 1: as fascinating as I did, and that you come away
Speaker 1: with a greater understanding why investing in science is one
Speaker 1: of the best things we can do to build a healthier, better,
Speaker 1: more equitable future for everyone. I want to thank all
Speaker 1: of you who are responsible for the Comparist Lecture series,
Speaker 1: especially Dean Comparis, do Comparis, Katherine and Trotter for endowing
Speaker 1: the series and their parents names. Frank Comparis was one
Speaker 1: of the most respected doctors in our native state. He
Speaker 1: and his wonderful wife Cooler, raised the great family and
Speaker 1: made the world a better place. So to the panelists,
Speaker 1: I can't thank you enough for doing this. Uh. Thank
Speaker 1: you to Donna Laila and I think still is the
Speaker 1: longest serving Secretary of Health and Human Services ever. She
Speaker 1: managed to fit that in between being president of Hunter
Speaker 1: called Ledge and Chancellor of the University of Wisconsin at Madison,
Speaker 1: and than her long tenure at the University of Miami,
Speaker 1: where she now teaches. And she did a stint as
Speaker 1: the most overqualified member of the United States House of Representatives.
Speaker 1: Thank you Harold Arms for all the work you did
Speaker 1: when I was president. Thank you Francis Collins for many things,
Speaker 1: but overseeing the international effort to sequence the human genome
Speaker 1: and in the process brokering of peace with Craig Vennor
Speaker 1: and the private sector effort to turn a race into
Speaker 1: a relay. Thank you Tony Fauci. I'm amazed you're still
Speaker 1: standing after all you've been through these last two years,
Speaker 1: and I was always grateful to you for your hard work,
Speaker 1: and never more grateful than to see you trying to
Speaker 1: talk common sense in the middle of nonsense. Thank you,
Speaker 1: John Gallen, thank you Gary Nabel, thank you Dr Wendy
Speaker 1: Chung and Charles Himy. I'm grateful to all of you.
Speaker 1: The n i H is a national treasure, and it
Speaker 1: had received even in the polarized times in which I governed,
Speaker 1: we had an astonishingly broad base of bipartisan support at
Speaker 1: the National Institute of Health. I came into office when
Speaker 1: we were entering the information age. The whole revolution in
Speaker 1: part made possible the sequencing of the human genome, which
Speaker 1: obviously required massive digital capabilities. There's always been attention in
Speaker 1: every budget season, and we saw it with Present Biden's
Speaker 1: recent budget, between the present and the future, always attention
Speaker 1: between what is too little and what is nowhere near
Speaker 1: enough to sleep comfortably at night. I'm very glad that
Speaker 1: we could double the budget of the NIH almost and
Speaker 1: more than up all the budget of the Human Genome Project.
Speaker 1: I think that it's clear that the work that was
Speaker 1: done helped to speed the development of antiretrovirals for HIV AIDS,
Speaker 1: did important work in vaccine research, and established the Vaccine Center,
Speaker 1: which I think hassendurability to develop the COVID vaccine, especially
Speaker 1: with the completion of mapping the human genome. I spent
Speaker 1: three billion dollars of the American taxpayers money on that,
Speaker 1: and we had the first rough draft in two thousand
Speaker 1: and I tell everybody that it's the best three billion
Speaker 1: dollars I ever spent in my life. We had a
Speaker 1: return on investment of something like three hundred four hundred
Speaker 1: to one already and an incalculable impact on the future
Speaker 1: prospects of life. Let me say one more thing before
Speaker 1: our panel starts. One of the reasons the nih accomplished
Speaker 1: as much as it did is that so many people
Speaker 1: with extraordinary talent and at a cation chose to work
Speaker 1: there and at the Department of Health and Human Services
Speaker 1: and in the White House, all pulling in the same direction.
Speaker 1: Most of them could have made more money doing something else,
Speaker 1: but none of them could make a bigger difference doing
Speaker 1: something else. So all of you are, by definition difference makers.
Speaker 1: We were talking before the program started about our friend
Speaker 1: Madeline Albright and the last conversation I had with her,
Speaker 1: I sort of began by asking about her health. Her
Speaker 1: voice was strong, her mind was clear. She said, Look,
Speaker 1: I'm not well, but I've got a good doctor and
Speaker 1: I'm doing what I'm supposed to do. And the leather
Speaker 1: worker it won't. Let's don't waste time on that. The
Speaker 1: only important thing is what kind of world are we
Speaker 1: going to leave to our grandchildren? And we proceeded to
Speaker 1: talk about that every day. Every step of progress you make,
Speaker 1: every blind alley you run into and then turn around
Speaker 1: and try something else, helps us in ways that are
Speaker 1: not always clear, to keep going forward and to keep
Speaker 1: proving that. In the end, the most important discovery of
Speaker 1: the Human Genome project is that all non age related
Speaker 1: differences we can see among human beings are rooted in
Speaker 1: less than half of one percent of our genome. And sadly,
Speaker 1: the world gets in trouble when we major in the
Speaker 1: minors and only talk about that half a percent. We
Speaker 1: spend nine and nine and a half or some of
Speaker 1: our time fixated on our differences, and when we're in
Speaker 1: a foul humor, we completely forget about the other nine
Speaker 1: and nine and a half. For some of us, that
Speaker 1: is the same by using your different abilities, by making
Speaker 1: your diversity of intellect, imagination and effort of virtue. Yeah,
Speaker 1: you reaffirm the fundamental sanctity of life in all of humanity.
Speaker 1: I'm very grateful and I can't wait to see what
Speaker 1: you have to say. Thank you very much, Thank you
Speaker 1: us the President for those remarks. As we transition to
Speaker 1: our first panel, let me introduce Secretary Donahalella, who before
Speaker 1: becoming Secretary of JHS, served as a chancellor of the
Speaker 1: University Wisconsin, one of the nation's top research institutions. Donna,
Speaker 1: thank you very much, Kevin UH, and thank you, Mr President.
Speaker 1: I've always believed that the President's most important legacy was
Speaker 1: his commitment to science, to the NIH in particular. There
Speaker 1: will be lots of references, and he made one of
Speaker 1: them to bipartisan efforts UH to successfully double almost double
Speaker 1: the NIH budget, which unleashed golden age of biomedical research.
Speaker 1: But for me, it was not just the doubling, but
Speaker 1: what the leadership did with that money. Um. First, second, Um,
Speaker 1: it was really the leadership we recruited and those we retained,
Speaker 1: and the impact of of training grants on preparing a
Speaker 1: new generation of of scientists. Today, we're going to hear
Speaker 1: from some of those leaders, and I'll introduce the four
Speaker 1: for my panel, starting with Dr Harold Varmus. Dr Varmus,
Speaker 1: of course, won the Nobel Prize with his colleague Mike
Speaker 1: Bishop in nineteen eighty nine, the Nobel Prize in Physiology
Speaker 1: or Medicine. He was director of the n i H
Speaker 1: from to nine nine, and he came back to lead
Speaker 1: the n c I from two thousand and ten to
Speaker 1: two thousand and fifteen. Dr Tony Fauci, Director of the
Speaker 1: National Institute of Elogy and Infectious Diseases and now the
Speaker 1: Chief Medical adviser as well to President Biden and of
Speaker 1: course our leader during the Clinton administration in an extraordinary
Speaker 1: effort UM against AIDS. Dr John Gallen, director of the
Speaker 1: NIH Clinical Center. Actually from to two thousand and seventeen
Speaker 1: twenty two years, John Gallen led the criticals UH the
Speaker 1: very critical Clinical Center UM named for for Dale bumpers Um.
Speaker 1: Currently he's the chief Scientific Officer for the Clinical Center
Speaker 1: and Associate Director for Clinical Research at NIH. And Dr
Speaker 1: Gary Nable Um, who was recruited to build a vaccine
Speaker 1: research program for the country, and I really made a
Speaker 1: mistake that's named after. The Vexie Research Center is named
Speaker 1: Actor uh Dale bumper Um. He was the founding director
Speaker 1: of the Vaccine Research Center at ni AI D and
Speaker 1: uh pioneered a renaissance in vaccine development and will hear
Speaker 1: from Gary about how that was the underpinning for the
Speaker 1: vaccines of the future. He's currently at Modex Therapeutics as
Speaker 1: the President and Chief Executive Officer, uh Dr Varmus. This
Speaker 1: is all yours, Thank you very much. The NIH has
Speaker 1: been in existence for over a century. It's a federation
Speaker 1: of today seven institutes and centers, each of which m
Speaker 1: received their direct appropriations. The budget for the NIH today
Speaker 1: is about forty three billion. When the Clinton administration started
Speaker 1: it was a little under eleven billion, increased steadily and
Speaker 1: then initiated a five year doubling process. Then h is
Speaker 1: a health related science agency. Doesn't do any direct healthcare.
Speaker 1: It provides basic and clinical research opportunities, training, and infrastructure
Speaker 1: to the nation's medical research establishment. About ten percent of
Speaker 1: the research that is done by the NIH is done
Speaker 1: by government scientists, mainly on the campus in Bethesda. The
Speaker 1: rest done through grants and contracts to institutions and medical
Speaker 1: schools and universities UH in all states and some abroad
Speaker 1: UH and these grants and contracts are issued importantly through
Speaker 1: competitive peer review. Like all agencies, NIH has annual appropriation.
Speaker 1: But it's important to note that the NIH does its
Speaker 1: research through multi year grants and contracts and works on
Speaker 1: very long term problems, which means that support from the
Speaker 1: administration to keep its budget strong is incredibly important. We've
Speaker 1: had support of the NIH from both sides of the
Speaker 1: aisle for many years, and in general we have a
Speaker 1: good working relationship with both the executive and these legislative branches. UM.
Speaker 1: There are two ways in which the executive branch, especially
Speaker 1: the White House, provides comfort and support to the ni
Speaker 1: H during an administration. First is the support for that
Speaker 1: long term, ongoing work that supports the biggest medical research
Speaker 1: enterprise in the world. And you're gonna hear about how
Speaker 1: things came to fruition during the Clinton administration and the
Speaker 1: treatment of HIV and AIDS UH and, but there are
Speaker 1: many other examples that we could have been illustrating on
Speaker 1: in advances in cancer treatments and the improved outcomes of
Speaker 1: cardiovascular disease and stroke, and and many other things. But
Speaker 1: they're also shorter term needs, health crises, construction projects, starts
Speaker 1: to new programs, expansions of others like the Genome Project.
Speaker 1: Will talk about in some detail in a moment. From
Speaker 1: my perspective as the annied director during most of the
Speaker 1: Clinton administration and as a scientist who's dependent on ni
Speaker 1: H all the time from my own work, I look
Speaker 1: back on the Clinton years as the golden years and
Speaker 1: medical research for many reasons. First, we had the enthusiasm
Speaker 1: of not just the president, but the President's family. Indeed,
Speaker 1: the first member of the family to come visit us
Speaker 1: was was was the first lady who came to the
Speaker 1: NIH for a day long tutorial about genetic research and virology.
Speaker 1: Uh and she then uh brought the President out for
Speaker 1: his Saturday tutorial just after giving a radio address about
Speaker 1: the Family Leave Act. Uh and uh he heard about
Speaker 1: research going on in AIDS and genomics and cancer research,
Speaker 1: and that persuaded the first daughter to turn up and
Speaker 1: spend several days working in one of the lab run
Speaker 1: by one of our outstanding female scientists. We still have
Speaker 1: vials that are labeled C C one, C C two,
Speaker 1: C C three for mutants of a bacterial proteas that
Speaker 1: she isolated. UM. The second reason is that the strength
Speaker 1: of the budget proposals. The President said to me many times,
Speaker 1: I'm not I'm not proposing everything I want you to have,
Speaker 1: but I know the Congress is gonna double your increase
Speaker 1: even even when Republicans are in charge. And uh. He
Speaker 1: followed that prescription for many years and helped us start
Speaker 1: the five year doublings had the effects that Secretary she
Speaker 1: Leila just mentioned. A third aspect of his support was
Speaker 1: the quality and attitude of our partners in the US
Speaker 1: government during during the administration that I've served in. Other
Speaker 1: members of the panel who haven't been introduced to you
Speaker 1: will illustrate some of the things that remained incredibly important
Speaker 1: to the dire scientific enterprise. The first is how long
Speaker 1: term science pays off. And you're gonna hear from Tony
Speaker 1: Faucci about UM, who has been director of the Allergy
Speaker 1: and Infectious Disease Institute for almost forty years, about how
Speaker 1: long term investments in the studies of infectious agents, including
Speaker 1: HIV have led led to culminations of those efforts during
Speaker 1: the Clinton years, with our ability to prevent transmission of
Speaker 1: HIV from mothers to infants, the development of protease inhibitors,
Speaker 1: and development of highly effective therapies against AIDS. When the
Speaker 1: clint administration began the the program that was run by
Speaker 1: government scientists and Bethesda was under some criticism and a
Speaker 1: report from outside scientists arguing that one thing we needed
Speaker 1: to do was revitalized clinical research at the clinical center
Speaker 1: in the n I t intramural program led to recommendation
Speaker 1: that was given due UM scrutiny by Office of Office
Speaker 1: and the Office of Management and Budget UH and UM
Speaker 1: UH and he'll tell us about the planning of the
Speaker 1: new clinical research center named from Mark Hatfield UM and
Speaker 1: the new the many new things that have been done there.
Speaker 1: And then you'll hear from Gary Nabel about how he
Speaker 1: managed as the first director of the Vaccine Research Center,
Speaker 1: which is a direct outcome of President Clinton's involvement in
Speaker 1: a research UH. The then head of the Office of
Speaker 1: of of a Research, Bill Paul unfortunately deceased a couple
Speaker 1: of years ago. UH led to UM proposal we put
Speaker 1: together a vaccine research center on campus, and one day
Speaker 1: the President and Al Gore had me and Tony Faucci
Speaker 1: come down and chat with him about what needed to
Speaker 1: be done in AIDS research, and he immediately bought onto
Speaker 1: this idea of building a vaccine research center and made
Speaker 1: that part of an address he gave shortly thereafter Morgan State,
Speaker 1: and that persuaded Congress to proceed with the investment that,
Speaker 1: as you'll hear, is paid off in many ways. So
Speaker 1: let's turn this over now to members of other members
Speaker 1: of the panel, starting with Professor Fauci. I just went
Speaker 1: through my mind the other day, um, almost on a
Speaker 1: year by year basis, the extraordinary advances that we experience,
Speaker 1: literally from the day you set foot into the White House.
Speaker 1: You remember, one of the first things that you did
Speaker 1: was to establish the White House Office of National Aids
Speaker 1: Policy or a NAP, which actually is still today exerting
Speaker 1: an important function. We never had that before you came
Speaker 1: into the White House. And then though, it was also
Speaker 1: at a time when the toll of morbidity mortality was
Speaker 1: accelerating in the country and by nine four AIDS became
Speaker 1: the leading cause of death of all Americans age four.
Speaker 1: But then things started to turn around with regard to therapy.
Speaker 1: You'll remember the famous A C T G O seven
Speaker 1: six results. The first time that we showed that you
Speaker 1: could actually interfere with the transmission of HIV from a
Speaker 1: pregnant mother to the baby. That has to be one
Speaker 1: of the true hallmarks of iconic studies done at the
Speaker 1: n H under your leadership as president the years that
Speaker 1: really was so exciting, all eight of them, But there
Speaker 1: was a cluster of a few in the middle that,
Speaker 1: from my standpoint, was transforming from and that's when we
Speaker 1: went from one and then two and then three drugs
Speaker 1: in combination, culminated by the first time of the use
Speaker 1: of protease inhibitors, which was the third drug in the
Speaker 1: three drug combination. What happened then was something that I
Speaker 1: have to tell you without hyperbole. Every time I reflect
Speaker 1: back on that, I still get little bits of goose
Speaker 1: bumps because I had been taking care of persons with
Speaker 1: HIV for those years, from right up until the time
Speaker 1: when that combination proved to be completely transforming and turning
Speaker 1: around the lives of persons with HIV and the summer
Speaker 1: Vancouver International AIDS Conference, those results were presented and it
Speaker 1: shook the world in a very positive way because from
Speaker 1: that time onward, the idea of hospices was a thing
Speaker 1: of the past. For persons with HIV. I have a
Speaker 1: photograph that I show at many meetings of Harold and
Speaker 1: and you and I and Vice President Gore and Bill
Speaker 1: Paul in the Oval office. I was presenting to you
Speaker 1: a schematic of a brand new UM discovery of a
Speaker 1: co receptor called c c R five for HIV. You've
Speaker 1: got very wonky because you really wanted to know the
Speaker 1: details of what that receptor was. But at the end
Speaker 1: of the scientific discussion you brought up with Harold had mentioned,
Speaker 1: you said, by the way, Tony, it's December, the three UM.
Speaker 1: It's we had HIV since and the virus was discovered
Speaker 1: in eighty four. Why don't we have a vaccine? And
Speaker 1: that's when we got into the discussion of the possibility
Speaker 1: of having a vaccine research Senate, and you said you
Speaker 1: would do something about it. I thought you were just
Speaker 1: trying to be nice to us, But to our great surprise,
Speaker 1: in May, you announced at a commencement address at Morgan
Speaker 1: State that you actually were going to support the building
Speaker 1: of a vaccine research center at ni H. But the
Speaker 1: years went on and things actually got better and better.
Speaker 1: One of the things you did do that led to
Speaker 1: the success in a subsequent administration of the pep FOP program.
Speaker 1: But even as you were president, you issued an executive
Speaker 1: order to assist developing countries in importing and producing generic
Speaker 1: HIV treatments so that they could have available to them
Speaker 1: treatments that were costing tens of thousands of dollars here
Speaker 1: and importantly, when you left the presidency, through the Clinton Foundation,
Speaker 1: you continued that pushing to have the availability of drugs
Speaker 1: to people in the lower middle income countries. So it
Speaker 1: was an extoy, very run and I'm so proud to
Speaker 1: have been a part of it with you. We'll be
Speaker 1: right back. The NIH Clinical Center opened in n Since
Speaker 1: it's opening, incredible teams of basic and clinical scientists in
Speaker 1: close partnership with very courageous patients, often in the scariest
Speaker 1: moments in their lives, resulted in an outstanding history of
Speaker 1: accomplishment improving health care for the nation and the world.
Speaker 1: A few examples of early accomplishments at the Clinical Center
Speaker 1: include chemotherapy for cancer, cure for childhood leukemia, lithium for depression,
Speaker 1: fluoride to prevent teeth decay, identification of high cholesterol as
Speaker 1: a risk factor for heart disease, first three treatments of
Speaker 1: AIDS and the discover if hepatitis viruses B and C
Speaker 1: that caused cirrhosis and liver cancer that eventually led to
Speaker 1: a vaccine for hepatitis B and tools to protect the
Speaker 1: blood supply from and to treat hepatitis C. Dr Barup
Speaker 1: Bloomberg received the Nobel Prize in nineteen seventies six for
Speaker 1: discovery of hepatitis B, and Dr Harvey Alter from the
Speaker 1: clinical center, in partnership with doctors Michael Houghton and Charles Rice,
Speaker 1: shared the Nobel Prize in for co discovery of hepatitis C.
Speaker 1: Forty years after the clinical center opened, the hospital infrastructure
Speaker 1: was barely able to sustain modern clinical care and science,
Speaker 1: and the clinical center came under scrutiny. In a report
Speaker 1: on the NIH Intramural Program to the NIH, Director Harold Varmes,
Speaker 1: by committee co chaired by doctor's Gail Castle and Paul
Speaker 1: marks Wreck commended for the first time a new clinical
Speaker 1: center be reconstructed as promptly as possible. The same year,
Speaker 1: Vice President Gore's Reinventing Government to initiatives said that the
Speaker 1: clinical center should be critically reviewed and re engineered to
Speaker 1: improve its effectiveness and efficiency. In response to these recommendations,
Speaker 1: the Department of Health and Human Services Secretary Donna Shoela
Speaker 1: convene a team coordinated by Dr Helen Smitz to conduct
Speaker 1: a review. The review reiterated the earlier recommendations to build
Speaker 1: a new clinical center. As a result, with the support
Speaker 1: of the Clinton administration and the Congress, plans to construct
Speaker 1: a new clinical center were initiated. Key events in moving
Speaker 1: the process forward included President Clinton visiting the clinical center
Speaker 1: in August. On September, Congress approved funding of the new hospital,
Speaker 1: to be named the Marco Hatfield Clinical Research Center. Construction
Speaker 1: began in January nine and was completed in August two
Speaker 1: thousand and four, and on September twenty two, two thousand
Speaker 1: and four, at a ribbon cutting ceremony, a patient speaker,
Speaker 1: the late Susan Butler, called the clinical center the House
Speaker 1: of Hope, highlighting what the clinical center means to patients
Speaker 1: and to the public. The opening of the new Marco
Speaker 1: Hatfield Clinical Research Center enabled the continuation of great accomplishments
Speaker 1: that continued to improve the health of the nation. These
Speaker 1: include cell based immunotherapy for cancer, new treatments for kidney cancer,
Speaker 1: a new drug for depression ketamine, first in human studies
Speaker 1: with the Ebola and cove and vaccines. Discovery of a
Speaker 1: new category of diseases, auto inflammatory diseases and new drugs
Speaker 1: to treat them. Gene therapy for several rare diseases, including
Speaker 1: sickle cell disease, and creation of the Undiagnosed Diseases Program,
Speaker 1: where patients from across the nation with unexplained medical problems
Speaker 1: are brought to the Clinical Center for evaluation and advice
Speaker 1: for treatment. In two thousand and eleven, the Clinical Center
Speaker 1: received the Mary Woodward Laska Bloomberg Award for Public Service
Speaker 1: for serving since its inception as a model research hospital,
Speaker 1: providing innovative therapy and high quality patient care, treating rare
Speaker 1: and severe diseases, and producing outstanding physicians scientists whose collective
Speaker 1: work has set a standard of excellence in biomedical research.
Speaker 1: John thanks very much for that really terrific summary of
Speaker 1: not of not just the clinical Center itself, but espressing
Speaker 1: the importance of clinical research. It gets more important every
Speaker 1: day is basic science produces more products that need to
Speaker 1: be properly tested and evaluated. In the context of what
Speaker 1: is the world's largest research hospital in the world. UM,
Speaker 1: we're gonna turn now to Gary Nable to say more
Speaker 1: about a topic that has already been introduced by a
Speaker 1: few of us that nambly the Vaccine Research Center. Gary. Welcome, Thanks, Harold.
Speaker 1: President Clinton. Is really an honor and a pleasure to
Speaker 1: join you today along with the powerhouse team that you
Speaker 1: would put together at the time that I came to
Speaker 1: NI Secretary of Lela Harold, Tony John, It's great to
Speaker 1: be reconnected on this occasion. You know, when we think
Speaker 1: back now to the age crisis, as Tony outlined, UH,
Speaker 1: as our memory these UH fade, we we sometimes forget
Speaker 1: the unimaginable toll that that crisis took on human life.
Speaker 1: Not only the toll on human life, but the quality
Speaker 1: of life for victims and families, as well as the
Speaker 1: profound effects economically and politically throughout the world. More than
Speaker 1: thirty nine million people have died in the epidemic so far,
Speaker 1: more than five times the numbers that we've faced with
Speaker 1: COVID so far, and despite the gravity of the global
Speaker 1: health threat and significant investments in the science at the time.
Speaker 1: By the late nineties, despite the pronouncement from Margaret Heckler
Speaker 1: and the Reagan administration that we have a vaccine in
Speaker 1: a few months. Back in the early eighties, the vaccine
Speaker 1: remained elusive, and yet it remained the best way to
Speaker 1: prevent and contain the epidemic. Now, the reason for it,
Speaker 1: obviously is the biology of HIV. This as an insidious
Speaker 1: virus and it posed an unprecedented scientific challenge for vaccine development.
Speaker 1: And the reason for that is because it had such
Speaker 1: enormous genetic diversity, and it also had the ability to
Speaker 1: camouflage many of its important viral entry proteins. There are
Speaker 1: more variants of HIV and a single person infected with
Speaker 1: the virus then there is in the entire planet and
Speaker 1: the whole population of the world during a single year
Speaker 1: of an epidemic like COVID or flu. So compared to
Speaker 1: licensed vaccines where there may be three to ten components
Speaker 1: that much as at most, this complexity poses a really
Speaker 1: daunting challenge, one that thwarted the best and the brightest
Speaker 1: of scientists working in individual labs around the world. So
Speaker 1: it was really in this context that Harold and Tony
Speaker 1: and Bill Paul, with support from Secretary Shilela, approached you
Speaker 1: uh and and where you all decided that the best
Speaker 1: thing to do is to develop a dedicated vaccine research
Speaker 1: center to be built in NIH to overcome the scientific, technical,
Speaker 1: and early development challenges facing HIV, UH and other emerging
Speaker 1: global health threats. The room where it happened was the
Speaker 1: Oval Office of the White House, and I think it's
Speaker 1: important to note that this group that met there really
Speaker 1: served as a brain trust that not only started the process,
Speaker 1: but importantly remained involved and nurtured its growth. The Vaccine
Speaker 1: Research Center was an innovative model for the support of
Speaker 1: scientific research in three ways. First, it provided a physical place,
Speaker 1: a physical laboratory whereby you could bring the best and
Speaker 1: the brightest scientists together in one research center UH and
Speaker 1: where they could work in a multidisciplinary way to approach
Speaker 1: the problem because vaccine development is is highly complex and
Speaker 1: involves many different UH types of approaches. Secondly, it was
Speaker 1: it was a mission driven research organization. We came to
Speaker 1: work each day knowing that a day saved and bringing
Speaker 1: a vaccine to the world saved six thousand lines. Those
Speaker 1: efforts extended not only to HIV, but also as we
Speaker 1: worked at the NIH to other emerging health threats. The
Speaker 1: first stars at break Avian, flew Ebola, Chicken, Gunja, Zeka
Speaker 1: and now covid UH. And finally, it was a place
Speaker 1: where we could actually make clinical products and conduct human trials.
Speaker 1: And so it allowed us to operate independent of the
Speaker 1: constraints by the vaccine industry and undertaking vaccine development. And
Speaker 1: it's important to recognize that in large part many of
Speaker 1: these vaccines are not developed because there's a a failure
Speaker 1: of the private markets to address global health challenges. So
Speaker 1: it's an important model for public private partnerships. The center
Speaker 1: has succeeded in a number of ways. More than a
Speaker 1: hundred clinical trials have been performed, Connections to industry have
Speaker 1: been made to make new vaccines accessible to the public.
Speaker 1: Perhaps the most tangible recent success has been its catalytic
Speaker 1: role in accelerating the development of the covid MR and
Speaker 1: a vaccine. The VRC worked quickly internally and with industry
Speaker 1: to advance prototypes and to identify structure based mutations that
Speaker 1: frees the virus in a form, freezes the virus in
Speaker 1: a form that optimizes vaccine protection and gives us some
Speaker 1: of that protection that we're now seeing across diver restraints.
Speaker 1: And finally, at least from my perspective, the Vaccine Research
Speaker 1: Center is a gift that keeps on giving. The VRC
Speaker 1: has multiple productive collaborations with academic and biotech UH and
Speaker 1: pharma labs. There's now a diaspora of VRC scientists who
Speaker 1: have taken the training that they've received there in the
Speaker 1: spirit of the institution, to new places where their work
Speaker 1: contributes to the preservation of continued preservation of global health. UH.
Speaker 1: COVID vaccines have likely saved tens, if not hundreds of
Speaker 1: millions of lives, and the VRC contributed in a foundational
Speaker 1: way to its development. While progress continues to this day
Speaker 1: on HIV, BOLO, chicking, GUNYAH, and universal flu For me personally,
Speaker 1: it was an unparalleled and special opportunity to show how
Speaker 1: science and data can impact human well being and save lives.
Speaker 1: To President Clinton, Secretary Lela Harold Tony, your leadership and
Speaker 1: wisdom has achieved significant goals, and I'm confident there's more
Speaker 1: to come, so stay tuned. The work continues, and finally,
Speaker 1: I very much appreciate the opportunity to help build the
Speaker 1: center and to serve. Given the pressure everybody was under,
Speaker 1: you could have just made the vaccine center very narrowly
Speaker 1: focused on HIV AIDS, but it seems to me that
Speaker 1: the decision to make it a vaccine center to cover
Speaker 1: more than just AIDS was absolutely critical for the future.
Speaker 1: That is really an important issue. It became very clear
Speaker 1: to me and to Gary who is the director at
Speaker 1: the time, that the talent that we had accumulated in
Speaker 1: the senior people and then their junior colleagues and acolytes
Speaker 1: was such that although we put a full blown effort
Speaker 1: on HIV, particularly some of the things that Gary mentioned,
Speaker 1: the structural biology capability, the idea of of structure based
Speaker 1: imaagen design, it became very apparent to us Donna, that
Speaker 1: that was applicable to r s V, that was applicable
Speaker 1: to any of a number of viruses. That we did
Speaker 1: not want to constrain ourselves just to studying HIV, so
Speaker 1: we went into flu. You know, we did coronaviruses with
Speaker 1: the first saws Kovie one and then Mayors and then
Speaker 1: the particular interest that Bonnie Graham had in respiratory since
Speaker 1: sechel virus, which was his love before he even came there,
Speaker 1: actually ultimately partnered with Peter Kwang to develop the image
Speaker 1: design that led to the coronaviruses. So it was just
Speaker 1: a beautiful symphony of people who were playing together, and
Speaker 1: it became very clear that it would go well beyond HIV,
Speaker 1: which it has. I'm not gonna make one footnote to
Speaker 1: that comment. At Tony UM back in the very first
Speaker 1: days of the Clinton administration, when things were not going
Speaker 1: very well in in the development of treatments and protections
Speaker 1: against AIDS, we had commissioned an outside group headed by
Speaker 1: a distinguished virologist, Arnie Levine, to evaluate the AIDS program,
Speaker 1: and one of the recommendations was that that the the
Speaker 1: development of immunology as a as a as a discipline
Speaker 1: was not being sufficiently applied yet to the study of
Speaker 1: HIV and U and then Bill Paul, who had been
Speaker 1: director of the Office of AIDS Research, noted that we
Speaker 1: had tremendous strength and immunology ranging from people like you
Speaker 1: donate to many others on campus who could make a
Speaker 1: contribution to development of of UH vaccine research. And people
Speaker 1: on the campus began to gather and the next thing
Speaker 1: we knew, we had a proposal for a vaccine WIS Center.
Speaker 1: And I'm very grateful to the President for saying this
Speaker 1: is not just going to be an HIV center. It
Speaker 1: was going to be a center for for vaccine production
Speaker 1: and it's proven to be incredibly valuable. Along the lines
Speaker 1: that you said, many people think that that ni H
Speaker 1: is organized into silos, and it seems to be the
Speaker 1: vaccine research center, the clinical center of two examples where
Speaker 1: the entire um community of NIH came together. John, you
Speaker 1: would not have been successful if everybody hadn't bought in
Speaker 1: absolutely all the seventeen centers and institutes that the intrameral
Speaker 1: program used the hospital and they all interact very closely.
Speaker 1: That's great. I think President Clinton wanted to make a
Speaker 1: command here. Mr President, this was fascinating hearing this from
Speaker 1: your perspective. I wanted to, uh say to me, you
Speaker 1: might have ace that if we want to continue this,
Speaker 1: we have to give get broad based support, and I'll
Speaker 1: give you both within the Congress and in the larger country.
Speaker 1: In the Congress. Herald, I've always given you credit for this.
Speaker 1: I don't know if you deserve it, but if you
Speaker 1: don't give it somebody else. But you know, we got
Speaker 1: waxed in the ninety four presidential election because I tried
Speaker 1: and failed to get healthcare reform, allowing the history of
Speaker 1: it to be rewritten. And because I tried and succeeded
Speaker 1: in getting the assault weapons ban, the ten lad ammunition
Speaker 1: clip limit, and and the Brady Bill passed. But I
Speaker 1: talked to new Gearbridge one day and he had a
Speaker 1: hundred members of his new majority who didn't didn't have
Speaker 1: a passport, and we're proud of it. And thought, government,
Speaker 1: would you know, mess up a two car parade? And
Speaker 1: the purpose us to have less of it? And Uh,
Speaker 1: I knew he was interested in science because he had
Speaker 1: given me a copy of E. O. Wilson's book on ants.
Speaker 1: So I said the new well, we gotta we gotta
Speaker 1: get these people on the research band wagon. You need
Speaker 1: to take him to m I N I H. But
Speaker 1: when they got there, these people who thought the government
Speaker 1: was some sort of amorphous evil blob. Whoever was responsible
Speaker 1: for the tour of these freshman congressmen took started them
Speaker 1: in a hospital bed, and they lay in a bed
Speaker 1: and looked at the films, UH saying what all the
Speaker 1: ni H was doing on the TV in the hospital room.
Speaker 1: And it was an elemental political observation, which is that
Speaker 1: everyone wants to go to heaven this morning, but nobody
Speaker 1: wants to die. We all would live as long as
Speaker 1: we can. And it was really and all of a sudden,
Speaker 1: we had no problems getting the Republicans to vote for
Speaker 1: the NAG budget. We had a couple of years where
Speaker 1: the Christian evangelical community leaders basically were involved in mainstream politics,
Speaker 1: talking to everybody. UH. I brought them in in two
Speaker 1: thousand on the Millennial Debt Relief initiative, and was had
Speaker 1: worked with a couple of them who were friends of mine,
Speaker 1: and they all supported relieving the debt of the world's
Speaker 1: poorest countries if they put the savings in the health
Speaker 1: care or education or development. And the President Bush later
Speaker 1: institutionalized this, but they weren't quite ready on age yet,
Speaker 1: you know, they weren't quite fast. All we just got
Speaker 1: to talk about profession and accidence and nothing else. But
Speaker 1: by the time he got to the point where he
Speaker 1: had the votes in Congress because of their support to
Speaker 1: pass the pep far program, which I loved. You know,
Speaker 1: we we tripled overseas aids UH assistance when I was president,
Speaker 1: and we were giving on what the world was giving,
Speaker 1: but it was peanuts nothing. And so after he did that,
Speaker 1: I want to give him credit for something else that
Speaker 1: a lot of people don't know. Uh. In the beginning,
Speaker 1: they were only working I think in seven or eight
Speaker 1: countries because they were requiring pep far to purchase for
Speaker 1: these countries UH medicine that big farmer was making, and
Speaker 1: they'd give him a discount, but it was like a
Speaker 1: hundred and fifty uh D dollars a year, which was
Speaker 1: less than a ten thousand or so we were playing
Speaker 1: in Harlem, but way more than a hundred and fifty
Speaker 1: or so. We were already down to with the products
Speaker 1: the prices we had negotiated through the Clinton Health Access initiative.
Speaker 1: So I was flying with the President Bush to the
Speaker 1: Pope's funeral and flying home, and he said, talk to
Speaker 1: me about what you're doing on AIDS, and so I did,
Speaker 1: and I said, you know, you ought not to make
Speaker 1: these countries by generic drugs, but you ought to give
Speaker 1: them the option to take the money you give them
Speaker 1: and spend it on generics that they want. And he said, well,
Speaker 1: I'm told that they're not as effective. I said, I
Speaker 1: know they tell you that, and I know they're important
Speaker 1: to you politically, but it's not true. I said, what
Speaker 1: if I were to submit to the f d A
Speaker 1: every single drug we put in any human body in
Speaker 1: any country for review and approval if they get approved
Speaker 1: with you okay, the money, he said, it sounds like
Speaker 1: a fair deal to me. It was just the two
Speaker 1: of us talking. He didn't have no lobby, has had
Speaker 1: a chance of talking about of it. He just aired
Speaker 1: about where the poor people were going to live or die,
Speaker 1: and I could tell he really cared. And uh so
Speaker 1: we submitted twenty two, as I remember, twenty two different products,
Speaker 1: and nineteen were immediately approved by the FDA. And he
Speaker 1: didn't slow walking, he didn't do any He played it
Speaker 1: totally straight. They just reviewed them and approved them, and
Speaker 1: all of a sudden, PET four was in more than
Speaker 1: twice as many countries, treating a hugely greater number because
Speaker 1: he did that, and he had the support of the
Speaker 1: Christian evangelical community. So that's a good Both those examples
Speaker 1: show you why we need to keep working to build
Speaker 1: broad based support for the work of the nih UH
Speaker 1: and our common humanity can sometimes be found when we're
Speaker 1: sick or someone we love has something wrong with them,
Speaker 1: and even when it's not available anywhere else. So and
Speaker 1: thank you and Harold, I've always giving you credit for
Speaker 1: putting those congressmen in the hospital. Man More after this,
Speaker 1: we're going to continue the conversation meant very much in
Speaker 1: the same vein of talking about how UM science proceeds,
Speaker 1: how it works, how presidential support really helps, especially when
Speaker 1: it comes to getting increased allocations of funds for an
Speaker 1: important project and getting the the confirmation of that significance
Speaker 1: by having the president himself speak out on the importance
Speaker 1: of genetics. And indeed we've just heard uh, just a
Speaker 1: few moments ago UM President Clinton reminiscing about the importance
Speaker 1: of learning how much of our generic genetic heritage is
Speaker 1: held in common among people who UH seem to thrive
Speaker 1: on on strife, as opposed to recognizing the pot nine
Speaker 1: percent some identity in one genome one genome to the next.
Speaker 1: Before we launch into this more detailed discussion of the
Speaker 1: human genome project, I want to issue was very brief
Speaker 1: reminder that genomeics, like everything else, is built on prior
Speaker 1: work and work of the NIH and other organizations around
Speaker 1: the world for twenty or thirty even forty years to
Speaker 1: develop the tools of molecular biology and genetics. Was fundamental
Speaker 1: to being able to put ourselves in the position of
Speaker 1: imagining UH, the sequencing of a complete genome, and indeed
Speaker 1: even the idea of doing a complete analysis of the
Speaker 1: genome was dependent upon the development of technologies that that
Speaker 1: many people around the world we're working on having a
Speaker 1: specific proposal, initially from a revered cancer searcher We're not
Speaker 1: on tobacco and Nobel Prize winner who made the what
Speaker 1: seemed initially to be an outrageous proposal that we do
Speaker 1: something as as outrageous as UH, looking at every nucleotide
Speaker 1: of the three billion pairs of nucleotides in the human
Speaker 1: genome um. And then the vetting by the National Academy
Speaker 1: of Sciences, first steps being taken by the Department of
Speaker 1: Energy at Los Alamos, the establishment of an office in
Speaker 1: an i H in a prior administration, then the recruitment
Speaker 1: by Donna show L and Bernardine Healy, my predecessor as
Speaker 1: director of n i H of Francis Collins, from whom
Speaker 1: you'll hear just a moment and just a moment. UH.
Speaker 1: That all set the stage for this remarkable acceleration of
Speaker 1: work on the genome project that that went on over
Speaker 1: the next several years, leading to the culmination of the
Speaker 1: work in the around around the year two thousand UH.
Speaker 1: And you're gonna hear from three people about the importance
Speaker 1: of all this. First from Francis himself, who was the
Speaker 1: prime leader of the program during the Clinton years as
Speaker 1: director of the Human Genome Resurgence Institute UH. And then
Speaker 1: and how he worked with other agencies the top Armament
Speaker 1: of Energy, for example, and international partners including the Welcome
Speaker 1: Trust and and the UK and many others and in
Speaker 1: a large number of countries who participated in this remarkable
Speaker 1: global effort. And then you're gonna hear about applications of
Speaker 1: the Human Genome Project from two UH individuals who were
Speaker 1: not engaged directly in the Clinton administration, but in some
Speaker 1: sense have through their work fulfilled the the ambitions of
Speaker 1: the Clinton administration in his effort to accelerate the Human
Speaker 1: Genome Project. First from Wendy Chung, who's the director of
Speaker 1: Clinical Genetics at Columbia UH, talking about how the Genome
Speaker 1: Project has influenced her attends to diagnose UH, particularly inborn
Speaker 1: diseases that involve changes in our genes, and how those
Speaker 1: patients are cared for. And then you'll hear from Charles Rotimi,
Speaker 1: who is currently the director of the trans NIDE Center
Speaker 1: for Research on Genomics and Genomic Health, Genomics and global
Speaker 1: health through the use of genomics and international work in
Speaker 1: that in that regard, So Francis, if you would spend
Speaker 1: some minutes telling us about the experience you had in
Speaker 1: the Clinton administration accelerating the genome project, then we'll turn
Speaker 1: it over to the other two speakers. Well, i'd be
Speaker 1: glad to and thank you Harold, Mr President Secretary Shlela
Speaker 1: Dear colleagues and friends. It is a privilege to be
Speaker 1: part of this event with people I admire so much. Yeah,
Speaker 1: I'm walking back the memory lane here to the fall
Speaker 1: of I had been hired by Bernardine Healy to come
Speaker 1: and lead the human Genome project at a time where,
Speaker 1: let's be clear, it was a little uncertain about whether
Speaker 1: this was gonna work, and a fair percentage of the
Speaker 1: scientific community was not at all supportive, thinking that this
Speaker 1: was just going to be a boondoggle. And then there
Speaker 1: was an election and people began to say to me,
Speaker 1: did you realize that you were hired by the previous
Speaker 1: administration and maybe you ought to be a little careful
Speaker 1: about whether you really have a job. Well, I need
Speaker 1: not have worried, because I got a call I don't
Speaker 1: know if it was the day after the election or
Speaker 1: the day after that from Donna Chola saying, never fear,
Speaker 1: we really believe in the Clinton administration about this project.
Speaker 1: I'm going to be your secretary and I will make
Speaker 1: sure that this project gets the attention it deserves. So
Speaker 1: I decided that was right and gave up my professorship
Speaker 1: in Michigan and moved into the old nurses Dorm on
Speaker 1: the NIH campus. We're together with a very plentiful abundance
Speaker 1: of cockroaches. I began to learn how the government actually operates,
Speaker 1: and was happily joined a few months later by Harold,
Speaker 1: who lived in another part, met down the hall in
Speaker 1: the old nurses Dorm with Connie, his spouse. The good
Speaker 1: part of that was we did a lot of strategizing
Speaker 1: at night over red wine about what exactly could be
Speaker 1: done here as we began to bring molecular biology and
Speaker 1: genomics forward at the NIH in a way that showed
Speaker 1: such promise, and we knew we had wonderful leadership with Donna,
Speaker 1: and we've learned just how enthusiastic the President was about
Speaker 1: genomics when he visited US on a Saturday and had
Speaker 1: the experience of hearing his questions, showing him how to
Speaker 1: dissect a human chromosome, and recognizing that we had a
Speaker 1: dream team to support NIH and to support the genome project.
Speaker 1: And that was good because, of course, the general project
Speaker 1: began with a budget that was essentially zero before it
Speaker 1: got started, and it had to ramp up, and it
Speaker 1: had to ramp up faster than the rest of NIH
Speaker 1: or it couldn't possibly do its job inventing all these
Speaker 1: technologies and also figuring out how to actually do sequencing
Speaker 1: at scale. Something like a thousand base pairs a second
Speaker 1: was what we had to get to, and when we
Speaker 1: started out, we were lucky to do with thousand base
Speaker 1: pairs in a day. It began to pick up speed.
Speaker 1: UH Secretary Slela decided in seven that the National Center
Speaker 1: for Human Genome Research could be upgraded to an institute
Speaker 1: as it now is today. Thank you Donna for that.
Speaker 1: And it was international from the start, and that was
Speaker 1: a big part of what it made possible to go
Speaker 1: at this pace with partners in six countries and twenty labs,
Speaker 1: all agreeing to work at the same set of guidelines
Speaker 1: and standards for excellence and accuracy of the data, and
Speaker 1: a very important decision made about that time that this
Speaker 1: data ought to be in the public domain. This not
Speaker 1: this should not be something as our shared inheritance that
Speaker 1: anybody owned, and so we began putting that sequence into
Speaker 1: the public domain every twenty four hours. President Clinton strongly
Speaker 1: agreed with that. There were other entities that were claiming
Speaker 1: bits and pieces of the genome and trying to file
Speaker 1: intellectual property and sometimes getting it on those and so um.
Speaker 1: In the spring of two thousand, President Clinton and Tony
Speaker 1: Blair put out a statement saying it would be a
Speaker 1: good thing for the genome sequence that belongs to all
Speaker 1: of us to be accessible to everybody. Well, Joe low
Speaker 1: Lockhart in his press briefing that morning, didn't quite get
Speaker 1: it right, and I think he said something like, well,
Speaker 1: Jane Pattons aren't going to be allowed anymore. And the
Speaker 1: stock market crashed, which was a little embarrassing. But fortunately
Speaker 1: it all got cleared up fairly quickly, and it was
Speaker 1: a deep dip that was then retrieved and brought back
Speaker 1: into the better place. Although I think some people in
Speaker 1: biotechnology were a little shaken up by it. Well about
Speaker 1: that time, we had this race that the President was
Speaker 1: referring to with a private sector effort called Salera led
Speaker 1: by Craig Ventor. It was getting a bit unseemly both
Speaker 1: the public project in the private project. We're making progress.
Speaker 1: Um I asked Ari Petrinos, who was running the Department
Speaker 1: of Energies effort in genomics, to convene Craig and me
Speaker 1: for pizza and his basement. And many essays and articles
Speaker 1: have been written about that pizza party, and there was
Speaker 1: more than one and the result of that a memorable day,
Speaker 1: Mr Presidents June two thousand, Eastroom of the White House,
Speaker 1: with the scientific community and the world kind of gathered
Speaker 1: to see what this was as we announced a not
Speaker 1: complete yet but a very good draft about nine of
Speaker 1: the Genome. It was the milestone that many people have
Speaker 1: been waiting for. Mr President. You referred to the map
Speaker 1: that Meriwether Lewis had presented to Thomas Jefferson in that
Speaker 1: same room. Well, that was pretty interesting as a parallel,
Speaker 1: and I went back and read your remarks. You called
Speaker 1: the genome the most important, most wondrous map ever produced.
Speaker 1: By humankind, and it was the language in which God
Speaker 1: aided life. And you emphasized how all humans, regardless of race, yes,
Speaker 1: are more than the same. And we all knew that
Speaker 1: you were quite attached to that, having noted how you
Speaker 1: had lectured the Serbs and the Croats and Kosovo that
Speaker 1: they really shouldn't be fighting with each other because their
Speaker 1: genomes were so similar. I'm never quite sure how that
Speaker 1: played out, but I thought it was a wonderful way
Speaker 1: to put forward some science at a difficult time. And
Speaker 1: that was such a moment. And we got to the
Speaker 1: end of the speeches and you closed with this ad
Speaker 1: lib and for some reason, they're just stuck in my mind,
Speaker 1: so I thought I would read it again. You said,
Speaker 1: when we get this all worked out, and we're all
Speaker 1: living to be a hundred and fifty, young people will
Speaker 1: still fall in love. Old people will still fight about
Speaker 1: things that should have been resolved fifty years earlier. We
Speaker 1: will on occasion do stupid things, and we will all
Speaker 1: see the unbelievable capacity of humanity to be noble. This
Speaker 1: is a great day. It was a great day, Mr President.
Speaker 1: We crossed into New Territory that day, but just before finishing,
Speaker 1: I'd say, there's another day that I'll remember. About six
Speaker 1: months later, there was a farewell in the Indian Treaty
Speaker 1: Room for the President and the First Lady. Interestingly, right
Speaker 1: now my office in the E. E E O B is
Speaker 1: right down the hall from the Indian Treaty Room. As
Speaker 1: I'm now serving as the acting Science Advisor to President Biden.
Speaker 1: I got an invitation to this farewell to the President,
Speaker 1: the First Lady and from Chris Jennings, and I thought
Speaker 1: I have to bring something, and the timing was just right.
Speaker 1: I brought the first CD that contained the human genome
Speaker 1: sequence on something you could hold in your hand, and
Speaker 1: I made a brief presentation. We were finishing the Nature
Speaker 1: paper that described this, which would have gotten published about
Speaker 1: a month later. And in that paper, which I had
Speaker 1: a lot of time devoted to trying to say something
Speaker 1: that was maybe even a little poetic, it ended with T. S.
Speaker 1: Elliott's famous words from Little Getting, we shall not cease
Speaker 1: from exploration, and the end of all of our exploring
Speaker 1: will be to where will be, to arrive where we started.
Speaker 1: And then the First Lady finished the quote for me
Speaker 1: and know the place for the first time. Yes, we
Speaker 1: know the place. It's a textbook of medicine, it's a
Speaker 1: parts list, and it's a record of our history. Genomics
Speaker 1: has expanded beyond anyone's dreams and expectations since then. The
Speaker 1: Human Genome Project took thirteen years and three billion dollars.
Speaker 1: Now your genome can be sequenced in a day for
Speaker 1: less than a thousand. Applications to cancer, birth defects, drug discovery,
Speaker 1: gene therapy, infectious disease including COVID have massively extended our
Speaker 1: reach in science and medicine, and there is much more
Speaker 1: to come. And for that, I turned to the next
Speaker 1: two speakers, beginning with Dr Wendy Joe, thank you. I'm
Speaker 1: so privileged to be here prisoning Clinton. UM. As I
Speaker 1: was listening to speakers today, I would say I'm actually
Speaker 1: a product of much of what they spoke about. I
Speaker 1: actually began my career scientifically as a student at the
Speaker 1: NIH Clinical Center and in I h S. When was
Speaker 1: inspired to become a genome scientist. I started out my
Speaker 1: training literally the year the Human Genome projects started. And
Speaker 1: realize this, Dr Collins said, if worst putting that much
Speaker 1: money into this, there's going to be amazing things that
Speaker 1: we're going to be able to do, and was able
Speaker 1: to start dreaming about the day when we would be
Speaker 1: able to actually sequence our genome within a day. Just
Speaker 1: to give you a sense of where we are as
Speaker 1: I look back of those twenty thousand genes that we
Speaker 1: now know of, there are remarkable seven thousand of those
Speaker 1: that we can now associate with a very specific human disease.
Speaker 1: And in fact, these conditions are quite common. Individually, many
Speaker 1: of them are rare, I'll grant you that, but collectively,
Speaker 1: if we look at many of these men Delian conditions,
Speaker 1: ten percent of us actually have or will have manifestations
Speaker 1: of these conditions. And I is still a practicing physicians
Speaker 1: see a lot of these patients that are at risk,
Speaker 1: for instance, for hereditary breast or a varying cancer. But
Speaker 1: they're able now today to be able to walk a
Speaker 1: different path than their mothers walked, or for those at
Speaker 1: risk for calling cancer, to walk a different path than
Speaker 1: their fathers have walked. They're able to see that there
Speaker 1: are at risk and they're able to do something about it.
Speaker 1: They're able to take that into their hands and not
Speaker 1: let that be their destiny. They're able to really rewrite
Speaker 1: by seeing what's ahead, and to be able to take
Speaker 1: very conscious and deliberate actions, sometimes very brave, but to
Speaker 1: be able to lead a different life and to be
Speaker 1: lead able to lead a healthier life. They really they're inspiring.
Speaker 1: They are incredible in terms of what they personally do
Speaker 1: with this information. But there's so much more that's yet
Speaker 1: to come. It's been remarkable for me to be able
Speaker 1: to see that technologically we can read out those three
Speaker 1: billion base pairers. We can do it for less than
Speaker 1: a thousand dollars, but we had to overcome other hurdles.
Speaker 1: Sometimes this has been referenced, even legal hurdles to be
Speaker 1: able to take down gene patents, to be able to
Speaker 1: have the ability to know that information content, and to
Speaker 1: be able to use that to take care of ourselves
Speaker 1: as we've done and I did it just yesterday and
Speaker 1: the Neonatal UH intensive care unit our hospital. We can
Speaker 1: take babies, for instance, who are critically ill and be
Speaker 1: able to read out their genome just in some cases
Speaker 1: hours to days, and be able to make critically life
Speaker 1: threatening decisions about how to save their lives. In some cases,
Speaker 1: some cases where we'll need to be able to do
Speaker 1: an emergent transplant of an organ, to be able to
Speaker 1: take care of a body part for them that is
Speaker 1: failing them in some cases, to be able to give
Speaker 1: them medicines that are now tailor made for their particular
Speaker 1: cystic fibrosis mutation, or as you'll be hearing in terms
Speaker 1: of gene therapy, to do some remarkable things that we're
Speaker 1: just beginning to think about for certain types of immuno
Speaker 1: deficiencies or certain types of hematological conditions like sickle cell.
Speaker 1: I'll tell you one story that really has been made
Speaker 1: a big impression on me in terms of what is
Speaker 1: yet to come for us. When I started medical school,
Speaker 1: the most common genetic cause of death for children less
Speaker 1: than two years of age was a tragic condition called
Speaker 1: spinal muscular atrophy. And I'm using intentionally the past tense.
Speaker 1: Used to be the most common genetic cause of death.
Speaker 1: It was heart wrenching for me to see these children,
Speaker 1: because many of them with the most severe form of
Speaker 1: the disease wouldn't live to see their first birthday because
Speaker 1: they were so profoundly weak, so profoundly weak that they
Speaker 1: could not breathe, They could not be able to inspire,
Speaker 1: to be able to take a breath. With time, though,
Speaker 1: and with a lot of this very foundational work that
Speaker 1: came from the Human Genome Project, from the science that
Speaker 1: came with it, we've learned that there are in fact
Speaker 1: not just one gene, but also a backup copy of
Speaker 1: that gene called survival motor neuron, and being able to
Speaker 1: use the technology to co opt that second gene, we've
Speaker 1: been able to think about creative ways to be able
Speaker 1: to tweak it, to be able to up regulate it,
Speaker 1: to be able to use it, to be able to
Speaker 1: compensate for the deficiency that those children have when they're born.
Speaker 1: One of the remarkable things that we've done with that
Speaker 1: is to actually, in tandem a developed methods of being
Speaker 1: able to identify those children as newborns. So at this
Speaker 1: point we can now actually from my heel prick, be
Speaker 1: able to identify those newborns who are going to be
Speaker 1: at risk for spinal muscular atrophy, a progressive degenerative disease
Speaker 1: that otherwise would have taken their life, and now be
Speaker 1: able to use either gene therapy or one of three
Speaker 1: FDA approved medications that is now life saving for them.
Speaker 1: So that as we've been able to do that and
Speaker 1: for this condition, which is an equal opportunity condition that
Speaker 1: affects all different individuals from all different parts of the world,
Speaker 1: now to have a completely different outcome for them, hopefully
Speaker 1: to be able to give them long, full and healthy
Speaker 1: lives that particular scenario. To be able to go from
Speaker 1: knowing that condition, diagnosing it newborns coming up with treatment
Speaker 1: we did in record time, really just a matter of
Speaker 1: four years. We were able to compress that with the diagnosis,
Speaker 1: rapid diagnosis and getting those treatments, those three treatments to
Speaker 1: now be approved, and I'm convinced that these are things
Speaker 1: that we can do over and over again with the
Speaker 1: foundation of this technology and with the industry that's been
Speaker 1: developed to be able to use this important to me,
Speaker 1: and I'll end with this is just as this comes forward.
Speaker 1: What we did with spinal muscular atrophy was so important
Speaker 1: to me from an equity point of view that, as
Speaker 1: I alluded to, we were able to take a drop
Speaker 1: of blood from a newborn and be able to understand
Speaker 1: what conditions they would be at risk for. From a
Speaker 1: public health point of view, where we could do this
Speaker 1: for every single baby and it mattered not where they
Speaker 1: were born, who their parents were every single baby would
Speaker 1: get the same access and does get the same access
Speaker 1: to this phenomenal care that we can provide them, and
Speaker 1: that I think is going to be one of the
Speaker 1: things in terms of the future of what the Human
Speaker 1: Genome Project will have produced, allowing everych I want to
Speaker 1: have an equal healthy start to life by using that
Speaker 1: information to be able to keep them safe and keep
Speaker 1: them healthy. It's been remarkable to be with you today.
Speaker 1: I'm honored. We'll be right back. Thank you very much.
Speaker 1: It's really an honor and a privilege to be being
Speaker 1: a member of this panel and to be invited by
Speaker 1: the present Claton's Foundation. I want to stop by saying
Speaker 1: today's my birthday and I couldn't. I can't think of
Speaker 1: any other way able to celebrate it with President Clinton
Speaker 1: and this wonderful lest Steam panel. So again I am
Speaker 1: in celebrating mood and I think my parents who give
Speaker 1: birth to men Injuria, US some sixty five years ago
Speaker 1: and I just qualified for medicare uh you know it's
Speaker 1: that will be extremely proud to see me on this panel.
Speaker 1: My comments today really will be to emphasize how we
Speaker 1: can continue to ensure that the gains of the human
Speaker 1: genome is indeed accrue to all human populations around the world.
Speaker 1: I am it was a great honor when I was
Speaker 1: invited by Franciscollins and Orders to participate in a spinoff,
Speaker 1: the very first spinoff of the sequence of human genome
Speaker 1: and that's the International Have My Project WISH. I was
Speaker 1: indeed very important because apart from knowing the addresses of
Speaker 1: the four combination of letters that make up our genome,
Speaker 1: we needed to know how these vary between individuals, between
Speaker 1: families and also you know, between ancestry populations around the world.
Speaker 1: And scientists realize that it is only by knowing these
Speaker 1: differences and similarities that will be able to really fully
Speaker 1: understand how the signatures of the environment that our ancestors
Speaker 1: live shaped our genome and how that varies, and how
Speaker 1: their influences disease and human health around the world. So
Speaker 1: the engagement of African population in the hap MATH study,
Speaker 1: especially firstly the europa community in Abiden, Nigeria, was truly
Speaker 1: the first major effort to engage African communities in the
Speaker 1: in the human genome and how we can indeed bring
Speaker 1: our global populations to bear on this wonderful success stories
Speaker 1: that was indeed funded under the Clinton administration. They have
Speaker 1: my project, you know, also was again, like I said,
Speaker 1: my first opportunity to be out of this major initiative.
Speaker 1: But what you have not show to us. And I
Speaker 1: just emphasize the point that President Clinting made earlier in
Speaker 1: his comment, and that is when we look out the
Speaker 1: diversity and and the magnitude and scope of EMA genetic variations,
Speaker 1: we we come to the to the conclusion that Africa
Speaker 1: populations has the highest diversity in the world, and that
Speaker 1: is not a coincident. That is based on our evolutionary history.
Speaker 1: African populations, our human based in general, have lived the
Speaker 1: longest on the African continent and therefore had had their
Speaker 1: genome have had more time to vary within that environment.
Speaker 1: And the point I'm making here is that there are
Speaker 1: aspects of our genome that we can only study by
Speaker 1: looking at African people. So I want to say that
Speaker 1: studying African populations and other global populations is a social
Speaker 1: justice issue, but more importantly it's a scientific imperative. We
Speaker 1: cannot truly appreciate this coupe of human variation which are
Speaker 1: going to the roots and the credle of humanity. And
Speaker 1: this is why I say sometimes that beneath all of
Speaker 1: our skins, we are indeed Africans. If we treat our
Speaker 1: history fire enough, most of us, or if not all
Speaker 1: of us, we end up somewhere on that geographical location
Speaker 1: called Africa today. So it's critically important that we engage
Speaker 1: the African community. It will beneto Africa, but it would
Speaker 1: benefit the world even more so. This is why under
Speaker 1: the umbrella of the African Society of Human Generics U
Speaker 1: and working with the Francis Collins and other African scientists,
Speaker 1: we were able to establish the what we call History Africa,
Speaker 1: Human Editary and Health in Africa that has brought over
Speaker 1: two hundred million dollars to change the participation of African
Speaker 1: scientists and African population in human genetics. This was funded
Speaker 1: by the end I AGE with Francis Collins as a
Speaker 1: director and also the welcome Trost Foundation, uh you know
Speaker 1: in the UK. Now, this initiative was unique in the
Speaker 1: sense that he actually enabled African scientists to fully participate
Speaker 1: by giving them the money directly to African institutions and
Speaker 1: to African investigators, and it has led to the creation
Speaker 1: of Pan African laboratories. You know about repository Islam by
Speaker 1: informatics HOBS. That is changing the way African scientists are
Speaker 1: participating and informing uh you know the Human engine Our
Speaker 1: project and its success to this as it continue to be.
Speaker 1: We are not in a position where we can cure
Speaker 1: this is like sickle cell us engine editing, so that
Speaker 1: is rebarkable. African countries are also using the gamest of
Speaker 1: Human General Project to inform a cential drug list in
Speaker 1: all the way to HIV in places like Bosowana and
Speaker 1: understanding genetic variation in terms of drug metabolizing for something
Speaker 1: like coding in Ethiopia. So you can see the gainst
Speaker 1: the beginning to accrue. But what is important here is
Speaker 1: creating the opportunity for African scientists to be a part
Speaker 1: of this wonderful initiative and to ensure that tomorrow's medicine
Speaker 1: will indeed be available to all humanity. We are indeed
Speaker 1: all come from the same place and we need to
Speaker 1: share is that there are diversities. Non illusion, but we
Speaker 1: should not use it to re emphasize all prejudice. Thank
Speaker 1: you for inviting me really glad to be a part
Speaker 1: of this effort. Charles thank you very much for those
Speaker 1: interesting remarks. UM. President Clinton began our discussion of genomics
Speaker 1: at the start of the session by emphasizing how much
Speaker 1: of the genome is held in common and how what
Speaker 1: we're learning from genomics can be a way of trying
Speaker 1: to bring the world together and make it a safer place.
Speaker 1: I think we're learning to that the diversity that you
Speaker 1: refer to and the pathogenicity of certain UH variations in
Speaker 1: the genome can be the source of disease. As Wendy
Speaker 1: pointed out, UH presents a challenge for all of us
Speaker 1: to be sure that the fruits of our research are
Speaker 1: widely shared in Africa and Asia, South America, everywhere in
Speaker 1: the world. And in a few minutes we have remaining
Speaker 1: before we wrap this up, I'd be curious to hear
Speaker 1: from the any of the three of you about ways
Speaker 1: you see that that our existing institutions and scientists can
Speaker 1: have more of an effect on providing open access to
Speaker 1: the fruits of genomics. I know that my own work
Speaker 1: for the World Health Organization of the last several months
Speaker 1: that there is a receptivity to the idea of of
Speaker 1: sharing genomic technologies even in the poorest countries and to
Speaker 1: be sure that, as has been illustrated during this pandemic,
Speaker 1: that the technologies that have been developed UH in response
Speaker 1: to and partly in response to the pandemic are influential
Speaker 1: and in saving lives. Well, I'll just quickly respond, I think, Harold,
Speaker 1: you're right that we have a great opportunity here and
Speaker 1: with projects Charles mentioned Age three, Africa has a start
Speaker 1: on this where the goal really is to enhance research
Speaker 1: capacity in a sustainable way in low and middle income countries.
Speaker 1: That is the best possible way to place the kind
Speaker 1: of capabilities in the hands of those who will need
Speaker 1: them in their own countries, and also perhaps to stem
Speaker 1: the brain drain which otherwise has been a really serious
Speaker 1: issue for losing the talent that you want to have maintained.
Speaker 1: And I'm excited to see how that is taking shape
Speaker 1: in Sub Saharan Africa. Although we've got a long way
Speaker 1: to go. We need to come up with even better
Speaker 1: ways to provide some kind of a partnership with industry,
Speaker 1: with NIH and the Welcome Trust and other philanthropy organizations.
Speaker 1: But we need to get countries in Africa to recognize
Speaker 1: that this is time for them to invest as well.
Speaker 1: We need to go from what I would call donorship
Speaker 1: to ownership, where a ministers of finance recognize that one
Speaker 1: of the best things they can do for their economy,
Speaker 1: for their people is to put some money into research
Speaker 1: and development because it will pay off over and over again.
Speaker 1: And we're kind of making that case and starting to
Speaker 1: get I think, some receptivity, but that's what it's going
Speaker 1: to do. Yeah, I agree entirely with that, and the
Speaker 1: World Health Organization is going to be participating in that
Speaker 1: as well. And I think in many ways fulfilling the
Speaker 1: kind of ambitions that President Clinton and many others have
Speaker 1: had since the inception of the Genome Project, that this
Speaker 1: is something that can help unite humanity and as opposed
Speaker 1: to tearing it apart. And um, we are approaching the
Speaker 1: end of our session here and I did want to
Speaker 1: reflect just for a moment on the incredible privilege has
Speaker 1: been for many of us to serve in the Clinton
Speaker 1: administration when things did move ahead so swiftly and at
Speaker 1: the n i H, not just in in elucidating genomes,
Speaker 1: but in improving UH, the UH our understanding of how
Speaker 1: the human body and many other organizations work and how
Speaker 1: the studies of of biological systems from many perspectives can
Speaker 1: lead to improvements and our understanding of disease and our
Speaker 1: efforts to create new therapies for diseases like AIDS and
Speaker 1: cancer and cardiovascular disease and many others. And I think
Speaker 1: it's used will for all of us to acknowledge our
Speaker 1: appreciation for the respect that the president in that era,
Speaker 1: um President Bill Clinton, had on the country's appreciation of
Speaker 1: science and uh the efforts that the scientists are making
Speaker 1: to improve human welfare. Why am I telling you? This
Speaker 1: is a production of our Heart Radio, the Clinton Foundation
Speaker 1: and at Will Medium. Our executive producers are Craigmanascian and
Speaker 1: Will Molnadi. Our production team includes Jamison Katsufas, Tom Galton,
Speaker 1: Sara Horowitz, and Jake Young, with production support from Liz
Speaker 1: Raftoree and Josh Farnham. Original music by Wat White. Special
Speaker 1: thanks to John Sykes, John Davidson on hell Orina, Corey Ganstley,
Speaker 1: Kevin thurm Oscar Flores, and all our dedicated staff and
Speaker 1: partners at the Clinton Foundation. Hi. I'm Stephanie Street, exa
Speaker 1: keive director of the Clinton Foundation, where we work every
Speaker 1: single day to advance President Clinton's commitment to public service
Speaker 1: and improve lives across the country and around the world.
Speaker 1: President Clinton often reminds us that we're all in this together,
Speaker 1: that we rise or fall together. That's why in the
Speaker 1: face of crisis, we enter the call we act. At
Speaker 1: the Clinton Presidential Center, we've been proud to work together
Speaker 1: with partners to serve hundreds of thousands of meals to
Speaker 1: those struggling, to put food on the table, to get books,
Speaker 1: early learning and educational resources into the hands of parents, families,
Speaker 1: and educators who are navigating the realities of remote learning
Speaker 1: and need it most. And the Center continues to serve
Speaker 1: as an educational and cultural institution focused on cultivating the
Speaker 1: next generation of leaders to make our future brighter than ever.
Speaker 1: Learn more about this work and see how you can
Speaker 1: get involved visit www dot Clinton Foundation dot org. Slash
Speaker 1: Podcast two