The measures the respective agencies are taking to combat the spread of monkeypox. Other topics discussed in the hearing into the Monkeypox Vaccine, and the opioid crisis. Esses include doctor rochelle walensky, director of the cdc. Nih director anthony fauci, and fda commissioner doctor robert kayla. Live coverage on cspan three. Good morning. The Senate Education and Labor Committee will come to order. Today, we are having a hearing on the federal response to the monkeypox outbreak as we work to stop the spread of this virus. I will have an opening statement, followed by senator burr, and then we will introduce our witnesses. Before we start, i do want to take a moment to congratulate one of our witnesses, dr. Fauci. On announcing his upcoming retirement. Dr. Fauci, you have served through multiple decades and president s and Public Health threats, and worked to save countless lives. I hope you know that you have the thanks of a grateful nation for your Incredible Service to this country. So thank you. Thank you for being here today. After the witnesses gave their testimony, senators will each have five minutes for a round of questions, and while we are unable to have this hearing fully open to the public or media for inperson attendance, live video is available on our committee website. If anyone is in need of accommodations, including closed captioning, please reach out to the committee or the office of accessibility services. According to the center for Disease Control and prevention, the u. S. Now has over 21,000 confirmed cases of monkeypox, more than anyone else in the world. And my home state of washington has over 500 cases. Ive heard from families who are rightly concerned about how bad it is has gotten, and Public Health officials, including back in Washington State, who are frustrated by running into issues we should be prepared for buy now. Thats why i have continued to push the Biden Administration about my concerns with the pump response and urged quick action on testing, on treatment, on action, on vaccines, and unclear guidance to the public. There are Health Care Providers it is reassuring to see that we are making a progress on testing, capacity, and it has increased to 1000 . And fda just approved faster track additional testing. On vaccines, spart a is helping to send out a new vaccine in michigan. Hhs is it working to expand the number of Distribution Sites in the state, and the administrations advice for splitting doses has greatly stretched our vaccine supply. On average, the administration has started working with states to make Vaccines Available at an advanced for many people from the Lgbtq Community. And perhaps most importantly, the rate of new cases is going down. That is all encouraging news, but let me be clear, we must remain vigilant in our response. And the promising improvements do not excuse the issues i have been hearing about from communities, from state health officials, and advocates from the very start of this outbreak. Patients have spoken out about how hard it is to get tested, some even waited days despite having clear symptoms. Providers have had to jump through hoops together patients treatment and i am constantly talking, to Public Health officials in my state who have told me that communications with states could have been far clearer and faster, and how the accessing vaccines has delayed responses. I know states have especially struggled with the decision to forgo the system we typically used to distribute vaccines, the one we are already using for covid vaccines. When it comes to Vaccine Distribution, some shipments have been sent to the wrong state, and even spoiled after storage room temperature. Theres been issues with vaccine supply, like with thousands of vaccine doses were delayed because the fda had yet to inspect where they were coming from. Or when the Biden Administration is an opportunity at a Crucial Point in this outbreak. And again, we are seeing an outbreak in some communities. Advocates in the Lgbtq Community have faced the vast majority of cases have made clear they feel they are being overlooked. We need to keep focusing on outrage and getting to those who are most at need and most at risk. That includes communities of color, who we know do not have equitable access to vaccines. This is especially important as data suggests the black and latino communities are disproportionately burdened by this outbreak we have to do better. We have to be applying what we learned from the Covid Response and applying it to of course, there is an enormous difference between this and the covid pandemic, which is thanks to decades of investment, we already had test and treatments and vaccines ready to go before this crisis began. That should serve as a reminder to all of us about the immense value of investing in Public Health preparedness. But its also why theyre stumbles and getting these tools deployed were especially frustrating, and inexcusable. To learn from this, we need to be clear eyed about where we were wrong. Not just by the challenge we face for the past several months, but that we have faced for decades of challenges that, to be frank, have been for many champions, not just this one. They were not replaced and expired over the course of the decade. I know i joined my Ranking Members and members of the this committee when i say weve got to do better. Not just on covid, not just on monkeypox, but on Public Health threats period. Because we know there will be more. Just last week, new york declared an emergency due to polio. He had another Public Health risk. We need to watch closely. So i want to hear from our Witnesses Today about not just what they are doing right now to improve our response to the monkeypox outbreak, and fast, but also how we can fix this in the long term and make sure the stumbles of the past couple months never happen again. I want to know what you and the administration are doing to make sure we have enough tests and treatments and vaccines for this outbreak, and get them where they need to go, while also maintaining an adequate stock of supplies for any smallpox threat. What you are doing to improve outreach to the Lgbtq Community, address disproportionate harm to black and latino communities, fight stigma and misinformation, and rising inequities weve seen no response so far. How will we make the most of new research to develop promising vaccines with therapeutics, and make them more quickly available while continuing the covid Gold Standard of safety and effectiveness. And are we getting schools and colleges everything they need to stay open and keep students in schools and communities safe . I am glad a cdc has provided guidance for k to 12 schools, and fortunately the science tells us elementary and secondary school kids are not at higher risk. And cdc has also released research for colleges, which is critically students returning to campus in the full. We need to make sure colleges and universities are equipped to prevent outbreaks for students living into dorms. I realize youve got your work cut out for you in all of this, especially with covid still raging. But there is no reason for us to fall behind. So i am going to keep pushing in here, because families back in Washington State, and across the country are counting on all of you to get it right. That is also why i am going to keep pushing my colleagues here in congress about the need for funding to support all of this work. I know im not the only one here with concerns about the monkeypox response, but we cant just say this isnt working without providing the funding to end this outbreak and build a Public Health system americans deserve. So i will continue to work with colleagues on both sides of the aisle and push to deliver the resources that will help get families the testing, treatment, and vaccines they need. Im interested in hearing from the witnesses on what the needs are to invest in our monkeypox response. Its also important to me we continue to keep our eyes on the horizon when it comes to future outbreaks and pandemics and build a stronger Public Health network for whatever threat comes next. As the saying goes, an ounce of prevention is worth a pound of cure. And that starts with building a worldclass Public Health system, rather than one that legs behind our peers. Our communities deserve to be as safe as anyone in the world, which is why senator burr and i are continuing to work to pass our prevent the pandemic act. Our Bipartisan Legislation implemented the lessons from our Covid Response, and improves our policies and processes on issues like strengthening supply chain, improving management of our national stockpile, modernizing data systems, and other items which would address many of the challenges we face with monkeypox. A strong Public Health system also requires strong investment. Our Public Health system is underfunded before covid struck, and it has been overwhelmed ever since. We have to end the cycle of crisis and complacency by making the same investments that allow us to build and maintain a robust Public Health infrastructure at all levels. I will keep pushing for all of these steps, because we should all know by now just how much is at stake. I can tell you that families in seattle know, parents in spoken no, workers in olympia no. People across Washington State and across the country know. Covid was never going to be the last Public Health crisis we face. And neither is monkeypox. The question is not whether there will be a new threat, it is when it will strike and whether we will be ready. The truth is the monkeypox response so far has not been encouraging. But there are some signs of progress and there are clear steps we can and should take to improve. I dont want to hear today about the steps we will be taking, i do want to see action, and i will be watching closely. I hope we can Work Together to build on the progress and in this crisis to and make the kind of improvement we need to put our Public Health security on solid footing once and for all. Thank you very much, and i will turn over to senator burr for closing remarks. Thank you, madam chair, and good morning. I am glad we are finally here, having a hearing on the monkeypox outbreak. It is hitting our nation. Monkeypox is now a Public Health emergency. It didnt have to become one. I think the one promising thing that can be said this morning is the infection rate has slowed. That may be the only thing, since the first transmission was reported in the uk and europe. Ive been pressing the administration for a strategy and a plan. After almost three years, since the covid pandemic, you think the Public Health agency is responsible for our preparedness and response would be prepared for anything, particularly a threat like monkeypox, which weve known about for decades, and for which we have vaccines and treatments. Doctor fauci talked to this committee before about monkeypox. Its almost the definition case of what our sister agencies should be prepared to tackle. The virus spread through physical contact, the virus spreads when an infected person as an obvious sign of infection. Its not like covid, which was a newly emerged virus that spread asymptomatic infection. But by any measure, in fact by every measure, the response from the Biden Administration a monkeypox crisis has been a catastrophic failure. He repeated each of the mistakes from the early days of the Covid Response, and the cultural arrogance from Public Health officials who are supposed to be the forefront of our response lead this country down again. Since the covid pandemic started, the response during both the trump and Biden Administrations, i think we are being sick of plus having to hold you accountable for systematic errors. But it seems nothing has changed. We cant blame the last administration on this one. The first confirmed monkeypox case, 2022, was may 7th in united kingdom. The first case of monkeypox in this outbreak was reported in the u. S. On may 18th. We had warning. We had warning that this was coming, we should have been prepared to manage it when it arrived. Lets review. We failed testing. Although we eventually may Testing Available through the response network, these tests were too hard to access. It took weeks before doctors were able to get parents and their patients tested without first consulting there is also a significant delay in engaging the private sector on the outbreak. They waited until june 27th to engage the private sector. Still active after that company develop diagnostic tests that could help address some of the slow turnaround. They were left waiting months, without delay. We failed on vaccines. An enhanced strategy to offer vaccines to at risk individuals in known contact was announced june 28th. This was already after some local jurisdictions have taken it upon themselves to use the vaccine in this manner, and a whole month after the uk joint committee on vaccines and immunization met to discuss a similar strategy for their citizens. Why do we continue to be meanwhile, decisions about Vaccine Administration seem to have been made seemingly on the fly. Even when the fda issued an emergency authorization last month, allowing vaccines to be administered through durable injections. There were no Public Meetings of the fta cdc experts to discuss relevant questions on the minds of impacted americans, and inform these decisions. No professionals patients were scared that they were being experimented on. To make matters worse, they had no time to prepare for the change in Vaccine Administration. After the fda made its decision, they made the assumption every vial would yield five doses. We know this has not been the case in every state, resulting in some vaccines vaccinating fewer, not more at risk people. We failed to have a plan. Monkeypox outbreaks have been occurring in nigeria and other places with increasing frequency. It was identified as a threat under our and a threat for which we had countermeasures in our stockpile. I might also add that our earliest purchase of the nordic vaccine was in 2017. But it seems there was no real plan on how to respond to the information and research we needed to understand this outbreak. Only after both i and the chair sent separate letters asking for a plan, did the office of science and Technology Blog about their research priorities. The priorities were vague, it was not clear what Research Activities hhs was undertaking in response. These have allowed the disease to spread. 31 cases and may quickly turn to 650 cases in june. More than 6000 cases in july, and more than 12,000 cases in august. And near 22,000 since september. It should have been obvious to all of us, but the timing of these early cases coupled with the evidence would create a perfect storm for a large outbreak. Monkeypox is a virus that largely transmits through skin to skin contact, most easily it frequently between sexual partners. What do room just before pride celebrations across the country. And after two years of lockdown and social distance, agency should been screaming from the rooftops about how they suspected monkeypox was spread. Instead, we remain silent. People got sick, and paid for that silence. But consenting adults need to be told what Behavioral Changes they should consider to avoid getting a preventable disease like monkeypox. You failed at a time when communities were most at risk. Disease control and prevention preparedness and response is a literally in the name of two of your agencies. Yet you did none of that. It was no surprise to me that these administrations, that the coordinate shows why this committee passed the freedom act. The secretary of hhs has been totally lax, and when hes been involved only seems to make matters worse. But new ad hoc groups within the government are addressing the problem. We need a consistent and coherent government wide response to be effective. That could only be led by the white house. I hope that in the coming weeks, we will be able to get that legislation over the finish line, and i will be spending my remaining weeks in United States senate doing everything i can to help the white house set up the new office with a Lasting Mission and clearer judgment. I will spend the next several years conducting thorough examination of each of the agencies, flooding each and every one of those that we have seen now in response to the accountability of you have the authority. Its a question of you have been giving astonishing amounts of money. Its a question of leadership. Its a question of focus, its a question of squashing the typical bureaucratic roadblocks and ineptitude. We n