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	U.S. Department of Health and Human Services

REMARKS BY:	TOMMY G. THOMPSON, SECRETARY OF HEALTH AND HUMAN SERVICES
PLACE:	Mayo Clinic's "National Conference on Medicine and the Media", Rochester, Minnesota
DATE:	September 20, 2002

Thank you so very much, Dr. (Hugh) Smith (Chair of the Mayo Board of Governors) for those very kind words and for your dedicated, compassionate work on behalf of Mayo and its many patients.

Mayo is a national treasure and a world leader in medicine and health. I love coming here, as every time I do I'm impressed by the caliber of the physicians, nurses and staff and by Mayo's aggressive and innovative approach to medical research and treatment.

Mayo has played a significant role in advising me at HHS. Dr. Tom McDonald, a distinguished ear, nose and throat specialist and surgeon, has been a trusted advisor since early in my tenure as Secretary. And as a fellow Irishman, Tom is one of my favorite people.

Dr. Doug Wood, a nationally respected cardiologist here at Mayo, is chairman of my Advisory Committee on Regulatory Reform, and has done such a wonderful job in that capacity as we've begun to truly transform the health care regulatory system.

And I'm so very grateful for the leadership of Dr. Michael B. Wood as President and CEO of Mayo … and I know that Dr. Denis Cortese, who has been a dynamic leader of Mayo's Jacksonville facility, will do a wonderful job as his successor.

Since its founding so many years ago, Mayo has been a national and global leader in the art and science of medicine. Some of the world's most significant medical breakthroughs have been made here at the Rochester campus.

To name just a few: It was in 1915 that Mayo began the world's first formal graduate training program for physicians. It was in 1934 that Dr. Edward Kendall isolated cortisone. It was in 1990 that Mayo researchers helped identify the source of illness in individuals taking a health supplement called L-tryptophan.

So it's always a pleasure for me to brag about Mayo as I travel the world and meet with my colleagues from other nations.

I always enjoy coming to Minnesota because this great state is essentially a suburb of my home state of Wisconsin. In our states, we have a lot of things in common - great football, wonderful out-of-doors recreation and some very interesting place names. Names in Minnesota like Bemidji ... Waseca … and Owatonna. In Wisconsin, there's Kewaskum … Wauwautosa … and Wonewoc.

I'm reminded of the story of the tourist who went to one of our towns, a place called Ashwaubenon. He saw the signs for the town but just couldn't figure out how to say it.

So, the tourist went to a local restaurant and kind of sheepishly asked the guy behind the counter, "Hey, I just can't figure out the name of this place. Can you tell me how to pronounce it?"

The counter guy looked at the tourist for a minute and then said, very slowly, "Dairy Queen."

Well, you've come to a place about which there's no confusion. The Mayo Clinic is known throughout the country as one of our vital national resources.

All of our national resources were stretched thin last year when we were attacked on September 11 and then when the anthrax mailings brought our first bioterrorism attack.

Since then, our Department of Health and Human Services has worked tirelessly to build our bioterrorism preparedness and public health care system.

If there are any beneficial results from the attacks last year, one is that we are now strengthening what is already the best public health system in the world. We are getting stronger every day.

That's in contrast to where we were one year ago. We have to admit that all of our departments - local, state and federal - were not devoting the resources necessary to make us ready for a public health emergency, including a biological attack.

Even as Governor, I fell into the same trap concerning public health. When you're weighing the costs of public schools, the University of Wisconsin system, prisons and direct health care services like Medicaid, improving the public health system was something that would get put off until the next budget.

But now that's changing, very much for the better. The nation's focus - at all levels of government - is on building the public health infrastructure. And that's going to help not just in our bioterrorism preparedness, but also in our abilities to deal with other health care matters, such a flu outbreaks, West Nile virus, or other health emergencies.

Beyond the public health system, we're building our bioterrorism capabilities in the federal government as well. Bioterrorism has been a priority for me from the time of my nomination. The very first briefing related to HHS that I received was on bioterrorism, and it took place while I was still Governor of Wisconsin.

Among the first steps I took upon coming to Washington was raising the profile and importance of bioterrorism at HHS. In fact, I had a tough time getting reporters interested in bioterrorism during the first months of my tenure.

In the spring and summer of 2001, I testified twice before congressional committees on bioterrorism. At both hearings there were more than a dozen reporters who swarmed me after the testimony. But all they wanted to talk about was stem cells. Not one word was written, nor one question asked, about bioterrorism.

Now, I can't go past any reporter without at least one question on bioterrorism.

We've transformed HHS into an agency that makes bioterrorism preparedness as essential a function as the multitude of other major health and social service matters we manage - and that's been a dramatic culture change, particularly for some of our agencies.

The CIA briefs me every day. I'm part of the Homeland Security Council. I'm constantly in touch with members of Congress … leading scientists and researchers … and, as my staff will tell you, I'm relentless in finding out where we stand and how we can improve.

One of our greatest accomplishments has been creating the program and infrastructure to provide states with $1.1 billion to strengthen state and local public health infrastructure. That is the largest one-time investment in our nation's public health system. Ever.

Just three weeks after the President signed the bill authorizing this money, HHS built and implemented the bioterrorism grant program and sent 20 percent of the money to states, asking them to develop their plans by April 15.

The states sent us their plans quickly - and they were solid, well-designed plans. We reviewed and approved them rapidly … and now the money is in the hands of public health officials in the areas where it can do the most good.

Put simply, we're constructing a cohesive public health system for all of America. The plans have been laid. The architecture has been framed. And now the construction has begun and is well underway.

A few months ago, we got more help when the President signed the Public Health Security and Bioterrorism bill, which was drafted by my department. This bill authorizes $4.3 billion for bioterrorism preparedness in the next fiscal year. That's a 45 percent increase over the current fiscal year and authorizes the biggest one-time investment in bioterrorism preparedness ever.

We are also continuing to invest in the development of new drugs, vaccines, and diagnostic procedures. In the next fiscal year, we're calling for no less than $250 million in anthrax vaccine procurement … a total of $612 million this year and next for purchase of smallpox vaccine … $103 million over a two-year period for the FDA to review vaccine developments and other critical safety issues … and nearly $1 billion for the National Pharmaceutical Stockpile over a two-year period.

We have purchased enough antibiotics to treat up to 20 million people exposed to anthrax. And we have, on hand, enough smallpox vaccine for 160 million Americans … and by December, we should have an additional 72 million doses from Acambis. Every American is going to be covered in the very near future.

Currently, we are working on a plan regarding smallpox vaccination. This is a very complicated matter and there is no final decision yet. But I want to commit to you today - the scientific community and the journalists - that when a decision is made, we will reach out and articulate it clearly and quickly.

We also continue to understand and address the concerns of the scientific community regarding the vaccine as we work toward a decision. And we're keeping our other partners at the table as well, with ongoing lines of communication with the public health community, the medical community and state and local governments.

The biomedical research enterprise of this nation is one of our greatest assets in the war against terrorism, and the President's request for the National Institutes of Health is $1.75 billion for these research activities.

Since September 11, and at my strong urging and that of my department, we are paying increased attention to the safety of our food supply, 80 percent of which is regulated by the FDA … even though only 20 percent of the funding goes to the FDA, the rest going to the Department of Agriculture.

Let me tell you, my biggest surprise when I started as Secretary was to learn that we only had 125 food inspectors for 175 points of entry. We were inspecting only one percent of the foodstuffs coming into the United States. I was shocked and concerned to learn that - the prospect of a pathogen making its way into our food and beverage supply was significant.

So, we persuaded Congress of the need to beef-up our food inspection efforts, and they responded with the resources to hire 832 new employees authorized this year - all of whom are now on board and working. By the end of this year, FDA will be able to conduct 24,000 on-site import inspections, nearly double the total in 2001 and four times more than in 2000. That capacity will continue to increase, doubling again to 48,000 next year. That's a dramatically larger sample and much more of a safeguard for every American.

In addition, as many of you know, we had 50 tons of medical supplies and vaccines in New York City within about seven hours of the terrorist attacks. It was one of our "Push Packages." And now, the number of 50-ton "Push Packs" - which are in strategic and secure locations nationwide - has been increased from 8 to 12, ready to reach any part of the U.S. within 12 hours.

CDC's Epi-X, which is short for the "Epidemic Information Exchange," is also being strengthened. Epi-X is a secure, Web-based network for information sharing among 1,200 designated federal, state and local public health officers, so that any unusual disease symptoms or patterns can be spotted quickly. CDC also plans to station an epidemiological officer in each state … and eventually, I want one in every major metropolitan area in the country.

I've also committed additional funding to help 25 more U.S. cities prepare for a rapid, coordinated medical response to large-scale public emergencies. We've issued contracts for development of additional Metropolitan Medical Response Systems, or MMRS.

The contracts will enable cities to coordinate emergency first responders, public health systems and hospitals to better respond to the needs of their citizens in times of crisis. With 97 cities already aided by HHS under the MMRS program, the contracts bring the total number of cities in the system to 122.

CDC's Laboratory Response Network will be further expanded to provide additional capacity. This network links state and local public health labs with advanced diagnostic capacity. Currently there are 108 labs in the network, with 24 more to be added next year.

During the anthrax attacks of 2001, these labs performed more than 125,000 tests. That's a tremendous record, but we're expanding the CDC's capacity even more. CDC's own resources are also being upgraded and expanded, including its Rapid Response and Advance Technology Lab.

So this is what we've done in the past year to build and strengthen our ability to respond to a terrorist attack.

But we also learned a great deal from the bioterrorism events of last fall, particularly in our dealings with the media and our public health partners - in other words, those of you here today.

One of the great lessons we learned from anthrax was our need to build and strengthen our communication system. Our communication infrastructure wasn't strong enough for the type of mass communication we needed to do in an emergency -- whether communicating with the medical community or the media.

At the same time, imagine trying to reach over 50 states and several large cities, plus over 6,000 local health departments - simultaneously. That's a daunting and highly complex task.

But our health Alert Network, or HAN, is designed to do just that. Through HAN we can reach every public health professional almost simultaneously. HAN is a high-speed, secure Internet connection for local health officials and first responder agencies, providing access to CDC's prevention recommendations, practice guidelines, surveillance, and laboratory and disease data. We're working on a comparable system for clinicians.

HAN today reaches all 50 states and over one million first-responders. And it's getting even better coordinated and sophisticated.

We're also improving ways we can educate the medical community quickly in an emergency. We're developing methods for quickly and efficiently disseminating information to diverse groups who need the same knowledge but for perhaps different reasons. And we want to make sure our lines of communication with the media are strong - for benefit of the American people.

In a profound sense, that's why we're meeting here this evening. I wanted to fill you in on where we stand in our preparedness efforts because you are the men and women that will transmit the first information to the public.

We in the government can issue all the reports, news alerts, studies and what-have-you anyone could ever want, but unless they're disseminated to ordinary Americans in a way that's clear, accurate and accessible, our best efforts amount to lengthy academic exercises relevant to only a very few. That means we need the media to have clear, accurate and accessible information, as well as our public health partners.

So I will always be candid with you - as those who know me well can attest. My instincts are to tell you what I know and what is happening. In fact, if you look back at some of the criticism I took last fall, it came about because I was too candid in telling the media what was taking place in our investigation that first day. I was too open with what our scientists were relaying to me and what they were doing. Of course, I never thought I'd have reporters criticizing me for being too open with the facts.

Particularly regarding the media, we're responding to the communication concerns you expressed during the anthrax crisis. We're committed and better equipped to get you the information you need as quickly as we can.

Throughout the Department, we've made it clear that reporters must get a prompt return of their calls - even if it's just to acknowledge the call and let you know we're working on your question.

I can't guarantee we're going to have everything you want when you want it, but if we have confirmed information we're going to get it out right away. And if we don't know something yet, we're going to tell you we don't have an answer yet.

And we're upgrading our technological capabilities to better loop the media in and meet its communication needs in a crisis. This includes linking CDC into our auditorium from its home in Atlanta, so we can do broadcast-quality news conferences that include the CDC director and her experts.

So we're strengthening our communication capabilities, as well.

I compliment the media on the overall job it did last fall. It provided the American people with up-to-the-minute information about often confusing data.

But to strengthen the lines of communication between the media and HHS, there are some issues I'd like to raise so there's a better understanding between us.

First, we want to make sure the media understands how a public health crisis progresses. When you're dealing with the spread of a disease - particularly one in which we have very little scientific knowledge like anthrax - the science and the decision-making is going to evolve as we learn more about the disease.

That doesn't make what was done initially in a health crisis wrong. Nor does it make it inaccurate. But as our scientists learn more, they're going to adjust their decisions and treatments based on the latest information and facts.

In fact, I think the CDC deserves a tremendous amount of credit for how quickly it learned and adjusted on the fly regarding anthrax. The CDC saved many, many lives because of its quick study and adaptability. Remember, we had very little scientific data on anthrax and how it acts.

Let me put this concern in journalistic terms. When you cover a story that is evolving, or doing an investigative piece where you're digging up ongoing details, the facts of your story will change over time. That doesn't mean the story you wrote on Day 1 is wrong if there's new, more informed data in your story 10 days later. Obviously, the newspaper doesn't issue a correction of the original story - people understand that information progresses.

Science progresses the same way. As Dr. Jeff Koplan, formerly the head of the CDC, said so well, in any public health crisis, you always wish you knew on Day One what you know on Day 20.

Science evolves. And our actions will evolve with the science. We need the media to understand that so they can put things in the proper perspective for the public.

To help enhance the understanding of science by reporters, we're going to pursue more educational opportunities for journalists to sit down with our scientists and experts and get briefed on topics they're likely to cover.

NIH and CDC have been providing fellowships to journalists for some time, but I want to make sure we have more frequent briefings for as many journalists as we can. The goal of these briefings won't be to generate stories, necessarily, but to give reporters more knowledge and background on a subject.

It is my hope that this will help reporters as they go about their jobs.

And I'll toss out one observation for the editors in our audience - it might be helpful to all involved if science writers cover public health crises whenever possible. They have a better understanding of the issues and are better able to adapt to what's going on. And they're better wired into the scientific community, including our experts at HHS.

This is actually a concern raised to us by some frustrated science reporters. And I must say that the problems I did see in stories and newscasts on anthrax came from reporters who weren't science writers. They might have been political reporters, for example. It's just an observation I throw out there for editors to consider.

Next, I would caution journalists to be careful about the quality of their sources. This proved particularly frustrating to our scientists and experts at HHS.

Everyone acknowledged how little scientific information we had about anthrax in this country prior to the attacks. Yet it was amazing to me the proliferation of "anthrax experts" after October 4. It seemed that everyone who sat behind a desk at a university was an anthrax expert.

We even had one commonly quoted expert admit in a public discussion that his level of understanding about anthrax was based on what he was reading in the newspapers. He had no independent insight, experience or information regarding these cases.

So I encourage you all to vet your sources well. Make sure they do indeed know what's going on, that they've been involved in research and that they don't have some axe to grind or book to sell.

One more piece of insight on the danger of uninformed sources. The Washington Post recently used the opinion of one senior official from the American Public Health Association to grade the Department's bioterrorism efforts. That one individual gave us a bad grade. Well, what the Post didn't know and this person obviously failed to tell them, is that APHA had just put out its own report card on HHS' efforts. And APHA gave us all Bs and B+s. So his opinion was way out of tune to his own organization.

Finally, and this is directed to everyone in the room, including those who are not journalists, please be sure to contact HHS when you need information. Come to the source. We're eager to work with you. There's no reason that you have to rely on second-hand information.

We're committed to being as effective as we can in getting you answers to your questions as quickly as we can. If we can't answer you're question, we'll tell you. While we may not always be perfect in our communication efforts, perfection is certainly the standard we are striving to meet.

Well, again, thank you all for the work you do to get the information that's urgently needed out to the American people when they need it. I value our great free press. And although sometimes you don't always give me the coverage I want (which I just can't understand), you serve a noble purpose - advancing human freedom and representative democracy.

The great American patriot Fisher Ames, a colleague of Alexander Hamilton and one of the most brilliant of the Founders, understood the importance of press freedom very well. In his words, and I quote, "We are, heart and soul, friends to the freedom of the press … there would be no liberty without it."

That was true in 1807 when Fisher Ames wrote it. And it's true today. I thank each and every one of you for your role in sustaining the liberties we all cherish.

Thank you again, and I look forward to your questions.