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Ebola in West Africa: a Global Challenge and Public Health Threat

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Ebola in West Africa: a Global Challenge and Public Health Threat S. HRG. 113–869 EBOLA IN WEST AFRICA: A GLOBAL CHALLENGE AND PUBLIC HEALTH THREAT JOINT HEARING BEFORE THE COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS UNITED STATES SENATE AND THE SUBCOMMITTEE ON LABOR, HEALTH AND HUMAN SERVICES, EDUCATION AND RELATED AGENCIES OF THE COMMITTEE ON APPROPRIATIONS UNITED STATES SENATE ONE HUNDRED THIRTEENTH CONGRESS SECOND SESSION ON EXAMINING EBOLA IN WEST AFRICA, FOCUSING ON A GLOBAL CHALLENGE AND PUBLIC HEALTH THREAT SEPTEMBER 16, 2014 Printed for the use of the Committee on Health, Education, Labor, and Pensions ( Available via the World Wide Web: http://www.gpo.gov/fdsys/ U.S. GOVERNMENT PUBLISHING OFFICE 24–456 PDF WASHINGTON : 2017 For sale by the Superintendent of Documents, U.S. Government Publishing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 VerDate Sep 11 2014 00:30 Aug 17, 2017 Jkt 000000 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 S:\DOCS\24456.TXT DENISE LIFEBOOK092 with DISTILLER COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS TOM HARKIN, Iowa, Chairman BARBARA A. MIKULSKI, Maryland LAMAR ALEXANDER, Tennessee PATTY MURRAY, Washington MICHAEL B. ENZI, Wyoming BERNARD SANDERS (I), Vermont RICHARD BURR, North Carolina ROBERT P. CASEY, JR., Pennsylvania JOHNNY ISAKSON, Georgia KAY R. HAGAN, North Carolina RAND PAUL, Kentucky AL FRANKEN, Minnesota ORRIN G. HATCH, Utah MICHAEL F. BENNET, Colorado PAT ROBERTS, Kansas SHELDON WHITEHOUSE, Rhode Island LISA MURKOWSKI, Alaska TAMMY BALDWIN, Wisconsin MARK KIRK, Illinois CHRISTOPHER S. MURPHY, Connecticut TIM SCOTT, South Carolina ELIZABETH WARREN, Massachusetts DEREK MILLER, Staff Director LAUREN MCFERRAN, Deputy Staff Director and Chief Counsel DAVID P. CLEARY, Republican Staff Director (II) VerDate Sep 11 2014 00:30 Aug 17, 2017 Jkt 000000 PO 00000 Frm 00002 Fmt 5904 Sfmt 5904 S:\DOCS\24456.TXT DENISE LIFEBOOK092 with DISTILLER COMMITTEE ON APPROPRIATIONS BARBARA A. MIKULSKI, Maryland, Chairman PATRICK J. LEAHY, Vermont RICHARD C. SHELBY, Alabama TOM HARKIN, Iowa THAD COCHRAN, Mississippi PATTY MURRAY, Washington MITCH MCCONNELL, Kentucky DIANE FEINSTEIN, California LAMAR ALEXANDER, Tennessee RICHARD J. DURBIN, Illinois SUSAN COLLINS, Maine TIM JOHNSON, South Dakota LISA MURKOWSKI, Alaska MARY L. LANDRIEU, Louisiana LINDSEY GRAHAM, South Carolina JACK REED, Rhode Island MARK KIRK, Illinois MARK L. PRYOR, Arkansas DANIEL COATS, Indiana JON TESTER, Montana ROY BLUNT, Missouri TOM UDALL, New Mexico JERRY MORAN, Kansas JEANNE SHAHEEN, New Hampshire JOHN HOEVEN, North Dakota JEFF MERKLEY, Oregon MIKE JOHANNS, Nebraska MARK BEGICH, Alaska JOHN BOOZMAN, Arkansas CHRISTOPHER A. COONS, Delaware CHARLES E. KIEFFER, Staff Director WILLIAM D. DUHNKE III, Minority Staff Director SUBCOMMITTEE ON LABOR, HEALTH AND HUMAN SERVICES, EDUCATION, AND RELATED AGENCIES TOM HARKIN, Iowa, Chairman PATTY MURRAY, Washington JERRY MORAN, Kansas, Ranking MARY L. LANDRIEU, Louisiana THAD COCHRAN, Mississippi RICHARD J. DURBIN, Illinois RICHARD C. SHELBY, Alabama JACK REED, Rhode Island LAMAR ALEXANDER, Tennessee MARK L. PRYOR, Arkansas LINDSEY GRAHAM, South Carolina BARBARA A. MIKULSKI, Maryland MARK KIRK, Illinois JON TESTER, Montana MIKE JOHANNS, Nebraska JEANNE SHAHEEN, New Hampshire JOHN BOOZMAN, Arkansas JEFF MERKLEY, Oregon Professional Staff ADRIENNE HALLETT MARK LAISCH LISA BERNHARDT MICHAEL GENTILE ROBIN JULIANO KELLY BROWN LAURA A. FRIEDEL (Minority) JENNIFER CASTAGNA (Minority) CHOL PAK (Minority) M.V. YOUNG (Minority) Administrative Support TERI CURTIN (III) VerDate Sep 11 2014 00:30 Aug 17, 2017 Jkt 000000 PO 00000 Frm 00003 Fmt 5904 Sfmt 5904 S:\DOCS\24456.TXT DENISE LIFEBOOK092 with DISTILLER CONTENTS STATEMENTS TUESDAY, SEPTEMBER 16, 2014 Page COMMITTEE MEMBERS Harkin, Hon. Tom, Chairman, Committee on Health, Education, Labor, and Pensions, opening statement ............................................................................... 1 Alexander, Hon. Lamar, a U.S. Senator from the State of Tennessee, opening statement .............................................................................................................. 3 Moran, Hon. Jerry, a U.S. Senator from the State of Kansas, opening state- ment ...................................................................................................................... 4 Reed, Hon. Jack, a U.S. Senator from the State of Rhode Island ....................... 32 Burr, Hon. Richard, a U.S. Senator from the State of North Carolina ............... 34 Murray, Hon. Patty, a U.S. Senator from the State of Washington ................... 36 Isakson, Hon. Johnny, a U.S. Senator from the State of Georgia ....................... 38 Casey, Hon. Robert P., Jr., a U.S. Senator from the State of Pennsylvania ...... 40 Boozman, Hon. John, a U.S. Senator from the State of Arkansas ...................... 42 Bennet, Hon. Michael F., a U.S. Senator from the State of Colorado ................. 43 Whitehouse, Hon. Sheldon, a U.S. Senator from the State of Rhode Island ...... 46 Durbin, Hon. Richard J., a U.S. Senator from the State of Illinois .................... 47 Mikulski, Hon. Barbara A., a U.S. Senator from the State of Maryland, opening statement ................................................................................................ 49 WITNESSES—PANEL I Bell, Beth P., M.D., MPH, Director, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA ........................................................................................................... 5 Prepared statement .......................................................................................... 7 Fauci, Anthony S., Director, National Institute of Allergy and Infectious Dis- eases, National Institutes of Health, Bethesda, MD ......................................... 11 Prepared statement .......................................................................................... 13 Robinson, Robin A., Ph.D., Director, Biomedical Advanced Research and De- velopment Authority, Deputy Assistant Secretary for Preparedness & Re- sponse, U.S. Department of Health and Human Services, Washington, DC .. 23 Prepared statement .......................................................................................... 25 WITNESSES—PANEL II Brantly, Kent, M.D., Former Medical Director, Samaritan’s Purse Ebola Care Center in Monrovia, Liberia, Ebola Survivor, Fort Worth, TX ........................ 52 Prepared statement .......................................................................................... 55 Charles, Ishmael Alfred, Program Manager, Sierra Leone Healey Inter- national Relief Foundation, Freetown, Sierra Leone ........................................ 59 Prepared statement .......................................................................................... 61 (IV) VerDate Sep 11 2014 00:30 Aug 17, 2017 Jkt 000000 PO 00000 Frm 00004 Fmt 5904 Sfmt 5904 S:\DOCS\24456.TXT DENISE LIFEBOOK092 with DISTILLER ADDITIONAL MATERIAL Statements, articles, publications, letters, etc.: Response by Beth P. Bell, M.D., MPH to questions of: Senator Casey ............................................................................................ 70 Senator Bennet .......................................................................................... 71 Senator Whitehouse .................................................................................. 72 Senator Shaheen ....................................................................................... 74 Senator Baldwin ........................................................................................ 76 Senator Warren ......................................................................................... 77 Senator Alexander ..................................................................................... 80 Senators Alexander and Burr .................................................................. 83 Senator Moran ........................................................................................... 84 Senator Cochran ........................................................................................ 86 Senator Shelby ........................................................................................... 87 Senator Burr .............................................................................................. 88 Senator Kirk .............................................................................................. 91 Senator Enzi .............................................................................................. 92 Response by Anthony S. Fauci, M.D., and Robin A. Robinson, Ph.D., to questions of: .............................................................................................. Senator Casey ............................................................................................ 94 Senator Bennet .......................................................................................... 95 Senator Whitehouse .................................................................................. 96 Senator Baldwin ........................................................................................ 97 Senator Warren ......................................................................................... 98 Senator Alexander ..................................................................................... 99 Senator Moran ..........................................................................................
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