Those are some of the things that the Contingency Fund is about. It is a fund we have submitted for because we want to make sure there is a block that the funding will not be used only as needed, but we want to plan for things we cant exactly predict right now. Youve asked for some money for fda for vaccines. Would you speed it up, bring more people into the process, are there steps in an emergency situation like this that there is a way to go through them more quickly or go around them to get to the end product quicker . Yes, sir. We have seen that in process right now. The Congress Gave us emergency use authorization that would allow us to approve diagnostics quickly. Weve used that authorization six times. Fda has used it six times. We approved from start to finish in 36 hours. One of those diagnostics. With regard to other emergency authorities that fda has, we have approved drugs. What happens is when a drug is not approved, if a clinician asks fda for approval for that individual to receive the drug, every patient thats been treated in the United States has received a drug. Cant speak to the specifics because of hipaa, but each one has received a drug. Those have been approved. One was approved in one hour. So right now fda is on a path and there are over 300 people who have been working on these efforts. Because it cuts across therapeutics, diagnostics, vaccines. The team is working across all of those issues to make sure that we are moving as fast as we possibly can across all of those categories to support, and approve. Were supporting the efforts and hundreds of questions have come in from commercial entities. And thats great because a number of commercial entities are out there and they want to help us find the solutions to ebola. Most of those questions are legitimate. It is about speeding their efforts. Some of those things, as you know, there are people who are saying things work that dont. Fda needs to watch for that, too, in this important time. Thats what the funding is for. It is about that speed and moving things through quickly. One last question on that topic. For anybody who would know the answer, is there anything we need do or were doing in this bill to be sure that ebola is clearly defined as one of the things that you can use those accelerated processes for . We have not had the authorities that you all have given, as i mentioned have been in a way that we can use them. When weve needed to, we can add to definitions. So far we have not. I will take your question and make sure though with the fda that it is answered for all categories. Every there are a number of categories and we need to make sure. So far we have not had any issues and thank you all for the authorities that you have given us. I think you hear that we are using them and using them quickly as we can. But thank you for raising it. If we are, we can come back. Chairman, while everybody else is making a comment, id like to thank you for your really talented and great leadership of this committee. Thank you for all youve done. Thank you. Were now going to turn to senator koontz but ill ask senator shaheen to call the superintendent and ask that the air conditioning be turned off. I asked 45 minutes ago. I would be delighted to do that, madam chair. I have tried to get him to turn down the air conditioning in this building before. Now because this Committee Really doesnt want to waste energy, either that of the members or of the taxpayer paying for air conditioning that is unneeded, unnecessary, and unwanted. Okay . Well, better to have heated discussion than wasted money. Senator koontz. Thank you, chair mccullsky. Ill join senator blunt and thank you for your tremendous leadership in this committee. To the many witnesses who have testified today i want to thank you for the vigorous discussion of the administrations Emergency Funding request to deal with this Global PublicHealth Crisis and remind all of us that the Ebola Outbreak in west africa has been characterized as among the most severe Public Health emergencies weve faced in modern times. Chairman, i emphatically agree with your characterization that our First Priority is to protect american lives and that the single best way for us to protect american lives is to engage vigorously in the work and the fight against ebola on the ground, in west africa. This Emergency Fundsing request provides support for every facet of whats needed to keep americans safe, first but strengthening and bolstering our readiness here in the United States but principally but ensuring that we contain ebola in liberia, in sierra leone, in guinea, and preventing its spread to neighboring countries. I want to take a moment to share that i recently had my third recent conversation with president Sirleaf Johnson who i visited several times in liberia in previous years and who wanted me to make a point of thanking the American People for our generosity and our engagement, but urged us not to let off now because just because there is some hopeful news doesnt mean that weve turned the corner on this and in the region it still remains a very, very dangerous and difficult time. I visited with delawareans of liberian heritage who have lost their entire family to this disease and we need to redouble our efforts. I also want to acknowledge the remarkable sacrifice, the dedication of our uniformed servicemen and women, of the thousands of volunteer Health Professionals and missionaries on the front line of the work against ebola. Americans who go abroad should not be stigmatized when they return, should be honored and supported in their commitment and service and should have confidence that they can return from their service and be supported when they do so. Let me turn to the Global Health security agenda, if i might. A piece of this emergency request is for the Global Health security agenda within ideas in the cdc and nid designed to strengthen the whole Health Security systems of a ring of countries around guinea and sierra leone and liberia. Dr. Frieden or deputy secretary higginbotham, if you wanted to speak to how many total nations will you target with this funding request, what will you do to increase their capacity, and why is this essential to ensuring that americans are safe from ebola and that this outbreak, this epidemic, is effectively contained. Our focus stro strengthen the systems that will find problems when they first emerge, respond effectively and prevent them where it ever possible. And the goal there, if we just think of what could have happened in rural guinea if there had been a Monitoring System or Surveillance System that found the initial cluster, that responded to it promptly, we would see a very different outcome today. In fact, over the past 24 to 48 hours weve been dealing urgently with a situation in mali which is a real illustration of this. As part of our response to the west african outbreak, cdc had already sent teams to each of the surrounding countries to ensure that they went through a clear checklist of the things that were needed. Laboratory systems. Surveillance systems. Isolation capacity. Emergency response capacity. Contact tracing and Public Health and series of other things that were needed. The team was actually in mali when the 2yearold child came from guinea there. Sadly, died in mali. But the team helped organize a response of tracing more than 100 people. Over the past day or two weve learned of a new situation which is of great concern where an individual died probably from ebola in the funeral services, family members were infected. In the care of that individual before he died and other individuals, Health Care Workers, were probably infected. Were now facing a cluster in mali. The challenge is to make sure that that cluster ends as the nigerian cluster did with making mali ebola free again. But whether or not that happens is entirely dependent on the ability to have those systems in place, in advance, to find problems before they get out of hand, to respond effectively. Thats what the Global Health security aspect of this emergency request is essential for. Its about understanding that their vulnerability is our v vulnerabili vulnerability. What we do to find problems there and stop them is up to us. The difference in outcomes in nigeria versus the other three countries is the difference in having a had a robust Public Health infrastructure that made it possible to do the Contact Tracing and do the immediate response. Part of this is a legacy of pet far. How will cdc and usaid coordinate to make sure these investments are made wisely and effectively and that we strengthen the whole regions Public Health infrastructure. Thank you, senator. We were hand in glove, aid with cdc. Cdc is essential for setting the policy for bringing the technical and medical expertise forward. We work very closely with them in implementing these approaches, these policies. Weve been jointly conducting workshops for the 12 countries in the region, for example, around the issues that dr. Frieden just outlined. Were also looking forward to the fact that you have increased population pressures in areas that were previously forested. So the possibility of increased jumps of diseases from animals to humans is something that is very much a part of looking forward to how to get ahead of these kinds of outbreaks in the future. I appreciate that. My last question will be this senator, your time lass expired. Thank you, madam chair. I dont mean to be bruvg squo anyone but weve now been here an hour and a half and we have ten more senators to go. Senator coates, im going to be a little bit more strict now. Madam chairman, its good to see that you havent lost your touch. Well, we have to vote, so yes, understand. Ill try to be brief here. First of all, thank you for calling the hearing. I think theres so much misinformation, disinformation and misperceptions and a lot of nervousness out there among the public. Weve all had to address that and i think this hearing gives us a better clarity in terms of where we are, where weve been and where were going. So i think all that is helpful. I commend teeveryone sitting at the table there. Remember when secretary johnson called me weeks ago saying this is going to be a governmentwide effort. This is a crisis deserving of full response, all hands on deck, and lot of those hands are sitting here at the table. And there has been some positive news here in terms of some steps that have been taken despite some early struggles and couple of bumbles that made all of us nervous. I think weve clarified some of that. I think all of that is positive but i do have some questions about how were continuing to go forward. Point number one, as secretary burwell said, weve got to fight this battle at the source. And i understand that. But some countries, and others, have said look, if youre going to fight it at the source, you need to have it contained at the source. And while the military has set one set of standards in terms of anyone who has been at the source relative to what they need to do when they return, that standard stands in contrast too what our current standard is relative to people coming back, and of course, the screening is important. Secretary johnson talked about that, so forth. So i have couple questions here relative to all that. Is canada and australian and these countries that have basically said look, if were going to fight it at the source, were going to close our borders to anybody coming from the source, thats the best way to keep our country free of that. That may or may not be the right thing to do, necessary thing to do. But nevertheless, it certainly assured their public that, yeah, okay, theyre fighting it at the source. Then when you add that together with what the military has done, supported by the secretary of defense, relative to anybody going to the source i was with general williams over at Africa Command in italy in Early September and then noticed at that point they were not going to send any soldiers in there. The president made a decision, they did send people in and theyre sending people in. But general williams came home and immediately the team that he was with, which i think was about a dozen or so, quarantined themselves. And so what are we to tell people back at home about, well, the militarys taking these steps. The rest of the public is taking these steps. And so i guess i would like some response to that and then i do have, if i have time, a question for secretary johnson. Maybe one person can speak for the group. Yes, if i may. Thank you, sir. As you mentioned, secretary hagel approved the 21day controlled Monitoring Program at the request of the Service Chiefs and the chairman of the joint chiefs of staff. The military is a unique entity and because of the scope and the scale of the number of people that we have. The region, it seemed like a prudent course of action. Ill defer to my colleague over at joint staff who can tell you about the formulation of that recommendation. Senator, thank you for the question. As secretary said, weve got the youngest and largest population of personnel responding to this crisis. As the chairman said on 30 october, weve got a unique role and responsibility for the u. S. Military personnel due to the scale of the deployment and the responsibility to the health of our Service Personnel and to their families. We decided to take this more conservative approach. It is not because we know something more than everybody else. It is just this is the way we chose to redeploy our personnel. But the question from the public, to me, and my question is okay. I mean people say are kind of gratified to hear that. Our soldiers are doing everything they can to protect themselves not to be a carrier back and not to have this spread through it. And we appreciate that the military is taking those stands. On the other hand, were saying well health workers, they dont rise to the level of having the same standards applied. Or all those who are courageously putting themselves in harms way who are not wearing the uniform, there is a different standard there. Who wants to respond to that . I guess before let my colleagues respond, i would like to point out this was not a med kay based decision. This was operational decision made by the chairman based on the recommendation. But it kind of makes common sense, doesnt it . If you have just been over in an infested area, you could potentially be the carrier, why not take the extra conservative step to go under quarantine so we know for sure someones not out bowling with a fever . Let me jump in here. Whos jumping . Im jumping. Coat senator coates who also chairs the Homeland Security or is the Ranking Member on Homeland Security, raises a question that is lynnly asked. Why the military has one standard, and the civilians have another. Though his time is expired, because this is a question that is continually raised nationally, im going to ask you, miss burwell, to answer or call upon the scientific expert to clarify that. Then well move on. So the distinction and i think my colleague from the department of defense spoke, that this was not based on the science. This was based on the management of the force and the forces desires. As we work through this, thats something we want to respect for anyone and everyone. With regard to the civilian parts of the Defense Department, they are under the same guidance that we are using and that cdc has issued. I think whats important is that we make decisions based on the risk and the science, and thats what the standards are about. I also think it is important that we respect those that are serving and that those that are there and what they actually ask and want to do. Theres the question of the science and the standard that we need to set to protect the nation. But theres also the desire of those that have taken the steps to serve. I think thats a part of what my colleague was reflecting in terms of what the force was requesting of the joint chiefs. I think we will want to hear that, too. When theres the return, as people come back, there are people that will make choices. We need to do the steps that we believe are science based to protect the nation. If there are those who have a desire or a wish to do other, or more, thats something that they should do. But the decisions and what we have been put in place are based on risk levels and the science related to that. I dont know if dr. Fauci or dr. Frieden, you want to add. If i can just make a couple of points. In ebola, there is no carrier state. So you cannot make other people ill unless you yourself are ill. From everything that weve seen of how the virus operates, til date. At cdc itself, weve already had more than 100 of our top disease detectives and Public Health specialists go to fight the outbreak, and then come back to cdc. They come back into active work at cdc so that they can be productive in the response and protecting plerns in oth ining ways. But our active Monitoring Program is to ensure that every person that comes back is monitored, their temperature is taken every day, because the key is that wherever you are, quarantine or your own home or workplace, as soon as you develop any symptoms whatsoever, even if they dont turn out to be ebola, you immediately get assessed and isolated. Thats how we can protect americans most effectively in terms of people coming back themselves. Thank you very much, dr. Frieden. But to dr. Fauci, i think did you have something to add . Because as i understand the statement is the 21day monitoring is mandatory. The 21 the residential approach of the military is precautionary. And they