Niera tanden and senator joe manchin on Health Policy issues facing the u. S. They spoke at politicos 2024 Health Care Summit in washington, d. C. Hello, everybody. Beyonce is for me. I need that in order to be excited in the morning. I heard that earlier. They know, they know. As kevin just said, i work and write the politico playbook and am excited to kick off our Health Care Summit and am joined by President Biden from hamden. Thanks for having me. You h fun . It will be a blast. Your portfolio is expansive, domestic policy. Well try to stick in e an easy topic and everybody agrees on everything, very good. I want to start with probably the most important topic of today,osis empick. Today, o its not time to its time to go further and give medicare the power to negotiate lower prices for 500 different drugs over the nexthe government to negotiate lower costs on popular weight loss drugs like ozempic . People want to know. I am people. Thank for you that question. The Inflation Reduction Act asks c. M. S. To do a expenditure drugs and drugs that have been on the market and specified in the law that drugs have been on the markef years a. Decides what drugs to negotiate. Thats a decision that they make. They definitely are focused on expensive drugs for seniors that that were negotiating for the first time, c. M. S. Is negotiating and totally happening but all 10 Drug Companies that have been in the first lot, these drugs cover blood clots, blood cancer, diabetes, drugs seniors really rely on. And were excited for the fact that we are well on the way to seeing those 10 lower drugs by september of this year. And in the coming years, we want to see more drugs. I cant tell you whether ozempic or wegovy. But i will say what the president was doing in the state of the union was announcing a policy to all major drugs that are real cost drivers, thats 50 drugs a year, 500. That builds on medicare and farreaching consequences. The president talked about cracking down on price gouging and capping insulin at 35 for americans. A question that comes to mind is how can he keep those promises with Congress Working the way it does or does not . Well, thats a great question. So i will say, for a long time i thought there was no way that any president would get the power to negotiateru prices. I have been working in Health Policy for maybe a decade or three. And ive been on a series of campaigns and worked at a think tank. Weve all talked for years about giving power to medicare to negotiate drug prices like the v. A. Of defense. And perhaps, because the power of the industry, no president was able to deliver until joe biden. He got that power to negotiate. Now, it is contentious. The republicans did vote against the Inflation Reduction Act. They have wanted but i would sas incredibly popular and myhat ife president wins a second term that we expect in politico, agea Going Forward because there is strong interest. One of the things that the president on rope lines and Events People really understand what drug prices mean for them, 35 insulin and get drug prices down. I feel optimistic we can create a Democratic Congress might help. Im not here for politics. But u know, there is uniformity in the party to really make this a priority. We can focus attention to the public on an issue. There were support for the president s agenda just going by public polling. And that is an important point. At important moment for state of the union. The other moments and i imagine and its not for me but i imagine what advertising is about as well and you saw that again an important part of the president s first ad was on this issue as well. We all have to do the work getting the message out. In an election year, there vehin focus their attention. And i would say health care is a place where the stakes are relatively high. As a person who works to protect the aft against republican ef it, today, i would say millions more people have benefited from the aft. 21 million more people as when joe biden were in the health care exchanges. Many more have health care. And you are talking about million, 40 million americans in total if the effort to repeal it comes back again. Move to opioids. You announced a challenge to increase training on and access lifesiesk opioid overdoses. You have invested billions and billions in this in opioids and protecting people from them. What is the money tied to this effort. We have significa funding in the budget and we also had a dramatic increase in funding over the last several years into opioid response. What this effort this morning was about is what is the privatepublic partnership opioa specific way. We are proud of the fact that the f. D. A. Approved overthe counter medication that does save lives. But the real question is to get that ma locksin in the hands of people. And this access to narcan can save lives. Todays announcement was an announcement with the private sector activity will be, a range of companies have announced efforts to make it available but does not take away from the investments we have made in states and want states to use their resources resources to make mel objectionin. This is something going on for years and people are understanding it. Curious what the federal governments rule in fighting this crisis . I think excellent question. We have multiple roles. One from a medication side, making access medication a much easier is importa. And treatment. Er is significant demand for treatment that is not being met in every corner. And that is for samhsa. But agency that deals with providing treatment dollars to localities. But also the savings in their dollars, their grant dollars to do ts as well. This is a challenge, which is a lot of dollars best way to program these dollars to make them most effective. I spoke last week in rural survivors and innovation at the state level but maximizing that impact. I want to move to i. V. F. Access and the president wants to codify roe v. Wade. And he has agreed to a filibuster reform on abortion. One of our speakers, joe manchin and sinema are both leaving. Are you hopeful that he would be do this filibuster and codify roe v. Wade in the next administration . I think this is one of the central debates this fall. I think the president has made reproductive freedom that first issue of his issue layout. That was no and made freedoms and rights agenda for the next year and reproductive freedom and access to abortion is a central pillar of that. I think that the president and even in the discussion of i. V. F. , what is happening with i. V. F. Is women who are desperate to have children are now a crazy chaotic system even after the actions of last week are concerned about their ability to do that. Cornsr women and front and center and my hope is weill see the last couple of years as almost unexpected majority that comes e rights around it and you will have a congress and a senate that a full majority that respects wants to restore roe and one of the first actions we can take. When i talk to women in the reproductive space, they say there is a frustration with democrats who work in the Biden Administration not working on it earlier. I think there was a complacency within the Democratic Party that roe was possibly on the chopping block. That■5 changed. 2008, 2009, we did not have a prochoice vote majority in the senate. I totally understand that concern and as someone who was thinking of those issues at the time, we didnt have that. Lets have the fight. And ben nelson of nebraska, way back, those who want to go way back. You know, i have been privileged to talk to the president of this issue this as a central element of dignity for women and one of the few times in our historyhe really taken a right that people have enjoyed and taken it back. So i think this is athat and i appreciate the frustration that people have, but i will say for those of us who were on the front lines arguing about this and did say things like hey, if you repeal rmp oe, you wouldthre allowed to say that . We are. We have been what is at stake is the ability of women to control their own future and that is what is at stake. And last week speaker johnson sang radical things. And well see a contrast this entire year. When you talk to people who are here in the abortion advocacy space, one thing i heardbout dobbs and shoutout to my colleagues. I hear thankfulness for and then doing and the thankfulness for the president s action and there is a little bit of frustration with President Biden and the thing i often here is they have an Uneasy Alliance and want him to him doing more. And in the state of the union, the prepared remarks had abortie the state of the union, the word abortion wasnt in there. Why did he has an issue with saying the word abortion. A few weeks ago at a rally in virginia, he attended abortion. Who is fighting for you. And the president has been fighting on this issue. He is making it a central element in his state of the union. Without saying the word. Reproductive freedoms. It is about abortion. And fundamentally i think about reproductive freedom and women. My take on this is he is taking every actione can do in this space. We are fighting aggressively and Crystal Clear that this will be a central component of th agenda Going Forward and the contrast. He has been clear of where he stands and what he is fighting for and how he sees reproductive freedom and abortion and the other side is not just about taking restricting a right but pulling us back decades whe women didnt have the full opportunities that they have today. They want to hear him say the word often . Vice president harris said it. Do you feel his actions dont i would say to me, actions speak louder than words and important to think about the actions and words do matter. But here, thetalked about abortd reproductive freedom. But fundamentally the issue is whose side the political leaders on, are they on your side and fighting through the issues you care about or on the side of taking away your freedoms. And right now, the moderate position on the other side is a nationwide ban. One form of a nationwide ban versus one form of a the president is in the trenches every day and that is what matters. Hanext steps from the administration not just concrete steps and making promises, what can over the next eight months . Im going to be real with everybody. You. It is hard to take a right, a constitutional right and rip i e action. He has done a lot we have tried to do a right now, the department is legitimating a way■ women who need access to Emergency Care can get it even if it includes when thr life ans abortion. There are fights all around on these issues and fighting as strongly as can. But feel like you have gone through all the executive actions. The door is open. Other exece actions, we would love to hear about them. The truth is be hers 100 honest, we have to restore roe, when the people speak, political and my hope is that well see as strong a majority come out and stand behind roe and we will have a congress that responds to that. Its on■÷ the cusp of it if we t a majority in the senate and majority in the house. This is a big order of business for the president. San Francisco Mayor had mandatory testing for welfare and im curious what the white house stance is on those kinds of things . I think you will have to ask h. H. S. If there are any federal funds there. That is a significant question. We dont have any rules that prohibit that kind and my initial take it is important for us to reduce poverty our country. We have a couple of minutes here and bounce over to the possible menthol cigarette ban. This has been bouncing around. And seems like we might have an answer later on this month. When i talk to want to know what is the holdup . Its in the process, a big rule. And i cant talk about it but it is■ rule. It is one that takes time to get through. What is the president s stand on the president s ban . I cannot discuss it. Last question. When i talk to voters and get on the road, they president and i know you are not political and they say we are going to finish the job and he laid it out at the state of the union, we give you four more years, what are the things we arent talking about that are impacting Peoples Health all the time that thisn would focus on . That is a great question. People are entitled to know what a president will do for them. It means ensuring that were helping drugs seniors. We have a 2,000 cap and the president talked about that for Prescription Drug costs so every american would have the security that drugs of control. And covering millions more people and access to care and de challenges like longterm care that families face. We are doing with the most personal decisions, health care is different from Energy Policy or financial policy because people can locate their most personal decisions, but this is a president who gets it and he understands how important protecting Peoples Health care and expanding health care for people and people dont feel the need that they have to take one pill instead of■wo or skip a day because they cant afford it. They understand and lowering drug costs costs and the security of the Health Care System available to all americans is a top priority. I could do this all day. And thank you so much for the conversation. Thank you for the questions. [applause] he offered me moonshine that we cant have this early in the morning. Senator man church announced earlier he would not run for president and not run for reelection and last year in the senate and politics would you say . Really . You opposed her. And we had comfort think shed person and wish her well. I thought it was the wrong fit for the wrong job when body had that type of who buyin. And o. M. B. Is Important Office and i was re supportive than against someone. Its one thing the people here are against knowing what theyre for. Im not going to be against anything if i think someone is better prepared or would do a better job. You get along with her . N proper. She is kind to my wife who was in a car accident and she got a chance to talk to her. These things arent personal. She was asked about one of your critical issues, the filibuster it might be changed for abortion rights. Sounded like President Biden talked about consideringhat in the future. Greatest mistake we are making is the filibuster in the senate and gives us certainty at all tay weave a cans of keeping a piece of legislation or keeping a change in legislation that might have a chance to survive. Ifou are concerned about the house and what goes on in the house right now, you do that to the senate, and that will be on steroids. What you are seeing in the house will be on steroids. 51vote threshold. The whole purpose of who we are as a country, imagine the founding fathers, 13 colonies and Continental Congress someone had to say pennsylvania, massachusetts a virginia, guess what we have a bicameral and peoples house and the upper d you are going to have two representatives. Can you someone in massachusetts saying you mean rhode island and delaware is going to have the same voice and same power that i have. And my state is carrying this country . Yes. What is the best way to get roe v. Wade you are not going to eliminate everything. Roe v. Wade was law for 50 years, it wasnt pro ky choice or prolife enough. Which dn put it to threaten people. So murkowski, susan and myself we want to codify. When you first came to the senate, did you have that same belief . I have always been there. I have been considered prolife. But increst, rape and a womens choice, two daughters and six granddaughters, i am totally outnumbered. One thing we will be talkingg prices. A lot of americans dont know the actions that you and President Biden helped to lower drug prices as part of the Inflation Reduction Act. What do you hear on the ground from west veepians. If we were serious about lowering drug prices with the buying power we have as a government, it should go through the v. A. And we dont. And there is a reason that we dont. And thats a shame because we had a hard time getting the buying power of the medicare to buy down and drug price negotiations. And by the time at the end of the day we had limited amount of drugs. Just letcan do it, medicare and medicaid should go through the v. A. Should the administration what they have done and what they plan to do . Sure. At the end of the day, i can tell you what i would like to see happen. Going in with certain thoughts. But never walked away from anything that i thoughtoint a tn though i wanted to clear up x, y, z. Those who watch sports, we are going to see a touchdown every play. You want to see a home run . Not the way the game is played. You want a basket every time you shoot, not the way we play. We have not accepted the challenge of the sports. And progress we make, did you my good friend came into our Bipartisan Group and we had as many on the electoral count act and 10ds and 10rs and hit c in and had a different venue and he said thats not going to work. And we negotiated back and forth, he said im for it. And im for it. Every time. Thats not what you hear from most politicians. Right now, we are fighting these things on the front the br crisis which is absolutely the greatest crisis we face as a nation today. The border. We have millions of people coming here we dont know who they are and what their intentions and that is dangerous and have to be shut down. My republican friends and i agreed we shouldnt be doing aid and talking about aid unless we do the same importance at the border, security of our own country. And had a build on a and everybody seemed to be for it. On monday, President Trump said not a good bill and they just misrepresented the bill. James lankford, the most conservative and character value personal to a deal. The 5,000 thing was misrepresented 5,000 people a day. Thats all you can adjudicate. And put that in there because he thought biden would liberate it again. His team took it and used it against him. Stupid, crazy. And that was the enemy of the good. How do you rate at this moment given that the Biden Administration that the president did support that do you rate that better . I think the president should have declared a National Emergency and secured the border. I think he has to. Its his responsibility. I have said this and i told the your policy. You have done it for humane reasons after the pandemic. And he never thought we would get overrun that way. ■u i get it. This is unbelievable. Since 1999, one Million People have died from overdose, 70 of the last three, four years. We have 106,000 in 2021 was the last reports tt had. 70,000 has died because of illegal fentanyl. A Million People, thats more than the spanishamerican war, world war i, world war ii, korean war, vietnam war, a Million People have been killed in america and we have done nothing. And they go into mexico. Are nof person not to cast blame, is the washingtons fault . F. D. A. Is bringing more products. I tried to pass everything. Why are you bringing so much opioids on the market . And targeted my state ■j west virginia. And people were getting injured and they have a lot of aches and pains and this drug was put on the market and it was sold to them and the doctors prescribed it and became a tremendous epidemic in my state and hasnt stopped. Making the Drug Companies pay into a fund to help victims of fentanyl. No different than tobacco and other the things that we felt were harmful for our society. Nothing is deadly as what isyouk our government would start limiting it. One of our manufacturers and pharmaceutical and new, opioid. Keeps getting worse and the doctors, my brother is a doctor, john, how much schooling have you had, how much have you been trained on dispensing . Now out of eight, 10 years of education, he said about two weeks. ■no no nothing required. And then you said on that. Dont you think they should at least pay for the Treatment Centers that we nee than the crs that we have to protect women. Cant we do something women. The bill that i introduced and continue to introduce it and it says if you are going to produce this product and think part of y per milley gram. That would give us 2 billion ao centers in every community in every state and in. You saw how the house of representatives moved on this tick tock bill. Have no clue. I guess the lobbying is so great. The lobbying is so great. The other side has to be your enemy. Any way or shape or form is defeated. The Business Model and you are going to giv me more money. It is a great Business Model. And consider ourselves center left, center right and all the decisions have been made and how you run your life and your businesses are successful. And you see success from the extremes. But there is no one that is homeless or helpless. Where do you put President Biden that spectrum. Good person. I have known. He has been pushed so far left, and i have been raising hell since day one. This is not how you are going to get reelected. Come back here. He has the administration and staff that pushed him so far left. I said to him. When is the last time you spoke to him. We speak. You described former President Trump as a threat to democracy deem. I love my country to support a vote for donald trump. Why not endorse joe■ biden. We have plenty of time. What will it take to get there . For me to be vocal and boys trust is goin to be until i see some movement to have a chance that you just identified. You dont ever stop or think about stopping legal immigration. You must control illegal immigration. Thats all. And im afraid throwing the bab. Citizen. T take it to be hard to why is it so difficult . Thats the pathway to least resistance. I feel a failure of that bill motivated senator sinema to not to run again. She is a young person and ve bright an very well together and thats what we need. Who could you hope■h succeed her, gallego or lake . I dont know. In my private life be involved, we have americans together. And trying to attract cdived ins and put the country before the party and basically commit themselves to term limits. It is time to have term limits. Year and senate two six years. You are going to support i dont care what they are. Put our country, are you doing it for Public Service and not self service. I think justice quote is in the race. Do you want jim justice to win . I think he would represent the state. The person i want to see iselle yot, former mayor of wheeling. Topnotch. Hes a democrat. And independent as they come. Good man, understands it. And can work with sides. Wouldnt miss a beat. Part of the news you not running for president , larry hogan is running for the senate in maryland. Are you going to support him . Im glad larry is involved. I will be helpful. We got into it on fentanyl little bitf everything. Private advice. Hold the f. D. A. Responsible. And just overwhelm our markets. We never had this growing up. You have to be in■c the hospita. Thanks. [applause] h good afternoon everyone, im the executive director of politico q. I am happy to talk with the Principal Deputy commissioner at the■ f. D. A. Briefly a quick note, we are politicos Regulatory Research division. But we focus on regulatory policy and intelligence. So given this discussion, future of health care, who inteu the number two at the f. D. A. At a time when they are reviewing gene therapist and reforming the agencies. Dr. , maybe to start off, you are in your role and been there a month and a half and after a fi. My question is what is your vision, what do you want to accomplish . Thank you. Great to be way to replace dr. I have been at f. D. A. For a year and a half. And i was chief scientist at f. D. A. First and as i started to work as scientist, i got involved in the processes and organized ourselves and science and research and talk about the fact that we do science at f. D. A. And i belt a lot of relationships there and got understanding of■ the agency to take on this role. And it has been great. F. D. A. In general and wonderful place to work i have been leading institutions and work with the f. D. A. Are amongst the most hard working and dedicated. And all encompassing and the level of opportunity that we have is really different than you find in other settings. As deputy commissioner, how we enhance collaboration and continue to find ways to partner and to do their best work and thinking about science, too and access to the best science and science is the foundation of our Decision Making. I think im well positioned for this role. I want to dig into transformation. Well know because you are leading these is involved in two majorverhaulingd division on one side and office of regulatory affairs, the group that does inspections and investigations on the other, what is the vision there, what are you trying to accomplish with all of those changes . I think optimizing our resources that we are able to move things forward and have streamline processes. One of that is humanized food program and brought on depy commissioner kim joins and a lot of expertise and food safety and weeadership to strengthen our leadership around schools. It creates an opportunity for our laboratory, our work around food in the right testing space or in moreng and development of methods to Work Together to be under one umbrellas. A unified way is helping us to bed effective and efficient. Their focus in investigations and inspections and proposed reorganization by proposing this organization that would be the office of investigation and inspections to utilize that expertise that they have that is so central to the mission of the agency. But there are a lot of things that are happening around the agency, processes around laboratories and make those moral effective and thinking about how they align and interact and Work Together and strengthening, our chief medical officer came in the same time as me, building her unit and building an office of chief medical officer. And exciting and touches many corners of the agencies and this proposal will increase and enhance the way we Work Together. One of the concerns i have heard raised by industry as you are preparing to modernize the moving thousands of staff around. There was a recent hearing on capitol hill talking about th f. D. A. s spption and balance those reforms and moving around staff while maintaining that continuity of service, the inve f. D. A. s needs to do on a daily basis . The one thing that has come about is the way we work and doing things like inspections and as part of that, we are having increased interaction around the agency how do we streamline and what kind of components and training opportunities. So its something that is central to this process and i think we will see a strengthening of our ability to perform our functions through this proposal. I think many of us in the audience are familiar with the f. D. A. S Advisory Council when products from moderna and pfiz. You are advising the committee process. What is the rational . Are you not getting the best advice . We have the advisory staff that falls into the chief contid interest. But we dont always evaluate our processes and doing it■ through proposals and we are doing in lots of things, how do we ensure we are doing things the most effective and meaningful way. And it is so important for us to get the most up to date and access to the knowledge. We have world leading scientists inside f. D. A. But we want to talk to folks understand that have perspective that talk to us about things in a certain way or introduce to a certain topic. So the external operations are important for us. We want to make sure we are doin well. I am looking at internal logistics and ensure that we have the experts we need and ths so it is seamless and make an enya experience and understanding that they are people with many things. But thinking about when we Call AdvisoryCommittee Meetings and we have been doing this work for a while and the efforts are ongoing and how can we call■z tm around broader scientific topics . We talk about those type of things but they could give us input and thinking about leveraging that more as well. In late 2022, Congress Passed a law which contained a ton of provisions but very important one that i know you have be on n plans and the f. D. A. Would be given the power to require that pharmaceutical and medical Device Companies to make sure wider range of ethnicities. What are the f. D. A. s per dont work as well across certain populations . I think these are things that want to know. We want to know if there is variability between the range of products that we at. The more in our Clinical Trials informs the population that the product will be targeting and get a better understaha totality of what the potential responses could be in the populations. Humans are similar than different. There are could be differences in the way a drug or medicine is processed in our bodies. I studied that in my life. One way to make sure we understand that is ensuring we have diversity in our Clinical Trials. We are looking at things how toe use digital technologies, telehealth and things that are accessible to people and not just Race Ethnicity but geographic regions, and age, how products may intrl act with pele span and products that older adults may not be included in Clinical Trials and something we may be interested in as well and looking at gender and sex. That is very important. Ill say with people in interest in this, our center of drugs provid and see demographics of people that were in the snapshot and something we do for the public to see and very informative and we are trying to move forward this whole effort. One of the frequent topics of congress how do we make the development of the drugs faster. No, i want my drug more slowly. How do you balance that need for speed in regulatory reviews and having diversity action plans well, let these trials larger that account for these factors and both of them are nobells to make sure that things are moving forward and people are getting access to these products that are useful quickly. So the strategies that i talked about are ways we can do it. Digital health. Thinking about the are conducteg trials to the communities and where are the places they are being conducted and comnitieskl where you may be able to engage in an effective way. So i dont think that Clinical Trials versus something we should think of we are going to halt the process now. We have strategies and understand a lot and there are a lot of to leverage modernization, science and technology to ensure clinical trial. Congress asked f. D. A. To start and making effective some of these policies. F. D. A. s missed that deadline by four, five months. What is the holdup and when can we expect it to be published . Something we are working on internally. We have over the past few years ensuring industry to give thinking around this. And Minority Health and opportunities to learn from f. D. A. And understand how we are thinking around this process. There is a lot and discussion around it. Congress is as well and something that came out in 2022 legislation was a provision called the f. D. A. Modernization act 2. 0 focused on the topic and you know animal testing and that law called upon the f. D. A. To remove certain requirements that phrma companies test their products in animals providerhe w process. What is your reaction to that . Do you think that is a noble goal or is needing to work through . Our requirement is that sponsors, entitiedeveloping these products that they use approaches that that they show the safety of the products goinl forward. So what this clarifies, you are mentioning that alternative methods could be used for that process and we are interested in and alternative methods these nonanimalbased approaches and it could be other approaches we do internal work and research on chip and understanding how they can be used in certain instances and what is going on. A. I. Based approaches. The science is not at a place to replace animal testing. If you want to understand where a product distributes in the body preclinically, you need an organism to do that work. We cant have chips tom understand where a product might go, for instance. There is utility for animals in research. We can reduce, refine and replace and we are committed to that. And partnering externally to encourage innovation in this joe manchit opioids and talking about him, he wasnt the most complimentary on the f. D. A. On the topic of opioids and talk about what the f. D. A. Views as Going Forward on this topic of opioids. We are a agency. We have committed group of tens of thousands of mostly Civil Servants who are really dedicated to ensuring we are advancing our publichealth mission. And science piece is really key. Again. Not only are we receiving information from external parties but doing our expand are the understanding. We are scientists. We care aboutverage our sciencen our Decision Making to make the best decisions that we can. What do you think is the greatest piece of potential that transform the f. D. A. , and second, do you feel like the f. D. A. Has not only the expertise but also the capacity to handle Artificial Intelligence reviews right now . Theres a lot there. So we do see Artificial Intelligence already coming through in applications and we are handling that and we have expertise and even have people doing original research in the area of Artificial Intelligence and machine learning. But i do think certainly as this continues to grow, we probably do need to grow expertise and work force around that and is something well be looking at. I think theres lots of opportunity, one, curation of data and trying to think about how we predict outcomes, whether its clinically or preclinically. A lot of the data we have there as a sign of community and collected different ways, a. I. , one thing that can be used to is securing the data and making it accessible so we can leverage it. Preclinically, weve been using it to predict algorithms. And it could be a message to use a. I. Or utilize a. I. To leverage as far as reducing animal testing, for instance, or a place in certain instances. You had a line for me, rat models. I think weve had it happen clinically and theres po Clinical Trials and lots to do this and i want to make sure were not reinforcing biases and Clinical Trials not having been diverse and preclinical studdies have not been diverse historically. What we know about far as the pretesting has been done in male animals and means theres a lot left out as far as how to make predictions. We want to make using a. I. Tools were not reinforcing any of the biases based on historic data thats as diverse as we want it■d. I. Coulp us predict that. Do we need a diversity plan for animal models, too . We have a few seconds left, maybe a lightning question for you. Ive heard dr. Robert, the f. D. A. Commissioner, say hes not interested in serving an additional term under a future president or a second Biden Administration. Do you see yourself as s that rr bumpus. Hes a reason im here and im a Civil Servant and here to serve in my capacity and i love being deputy and its a wonderful opportunit do you see yourself being acting commissioner if he steps down as well . Im Principal Deputy commissioner and i love it, thank the time we have. I want to thank the doctor for being with us today and now id like to welcome to stage politico Vice President for client partnerships, heidi summer. Up next, white house counselor to former president donald trump, Kellyanne Conway and Samantha Power on Health Policies in the u. S. And spoke at politico Health Care Summit in washington, d. C. Good afternoon, everyone, im ryan, the coauthor of playbook and the host of politicos playbook deep dive