That congress agreed to do this and now we didnt leave any residual forces in iraq and its become a mess and now theyre going to say we can go back and do the war because well, it was under the other agreement. But that went away when they pulled everybody out so why wont they do at least a vote on syria and say, yes or no, you should go in or you shouldnt go in . I mean, because we get these residual forces from the other countrieses which is great and i do believe they do need to be we do need to protect our country and stop this big massacres but i find it disingenuous that they talk out of both sides of their mouth and they wont let congress say what their real thoughts are. Host okay. We have to leave it there. This conversation will continue on the washington journal but today were going to switch gears. Were going to go to the National Institute of health coming here. Talking to director Francis Collins and later joined by Patricia Grady of the National Institute for Nursing Research. Well get to that right after this break. Price, whatever you do, do not take cspan 3 off. Its a very educational show. I listen to it mostly every day. And im finding out more and more about my government. And also, books and history. Please do not take it off the air. Caller why is cspan favoring republicans over democrat caller katrina. Republican call in and demonize the president and not get cut off but democrat Say Something about republicans, they are cut off. Cspan is not fair. Continue to let us know what you think. Call us, email us or send us a tweet. Join the cspan conversation. Like us on facebook. Follow us on twitter. Washington journal continues. Host this morning here at the washington journal we are going over to the National Institute of health in the Washington Area to talk to the institute and director about what this National Institute of health does. Research facilities and as well as news that has been made about ebola and what they are doing over there to fight that and bio terror and lab security. Joining us is dr. Francis collins, the director of the nih. I want to begin with breaking news yesterday. Cnn tweeted this out saying if there are no additional interventions, the ebola death toll could rise. This according to the cdc. Dr. Collins, what is the role of nih in fighting ebola . Guest good morning. Yes, nih is deeply engaged in thest to try to turn back a frightening outbreak of ebola in west africa and yesterday, tom freeden did make this projection that if nothing happens, we could look at more than a million cases of ebola over the next few months. A frightening number. But we want to make sure everything is dont to keep that from happening. What is our role . Largest supporter of research in the world including research on Infectious Diseases led by the best known Infectious Disease expert in the world, tony fauche. Partly the development of vaccines and developments of new treatments for people infected. Vaccines moving forward at unprecedented rate and this is an effort we started 13 years ago anticipating there might be a need for a vaccine because ebola has been around since 1976. Albeit small outbreaks. This is the 5th generation ebola vaccine. Looks very good in the animal models. You dont know until you try it out in human patients whether it will be safe or work. We did start three weeks ago what is called a phase one trial of this vaccine. 20 individuals have now been injected with that. They are volunteers here at the nih Clinical Center. So far, all is going well. No red flags to indicate there is a problem with the vaccine but it will take a couple of months to see whether or not those individuals mount an immune response that you would think would be protective against acquiring the disease. Once we have the data, we need to move quickly to get this into what you call a phase two trial in west africa in individuals that are at risk. All of that is very complicated in a circumstance where in liberia and sierra leone and guinea, a great deal of stress as you can imagine on the Health Care Systems but were determined to figure out a way. Host what is the time line . Guest november before we have the evidence about whether the vaccine is looking promise in this phase one trial. If it looks good, shortly after that, meetings are going on today and every day exactly about how to do the design, we would try to then set up this more extensive trial in west africa that would determine whether the vaccine is actually effective or not. Theres a second vaccine we also played a role in, developed in canada. That is also getting tested sort of parallel and we have partners in england in the Welcome Trust tufting one of our vaccines in a different population, all hands on deck here. Everybody is trying to do Everything Possible to speed up a process desperately needed. You said this is unprecedented. So, describe what it has been like to ramp up this Vaccine Research and effort. Guest well, weve been working hard on this for 13 years. We didnt know when this outbreak might happen but many were fearful it would. Nobody anticipated it would be as bad as it is where the disease spread into the cities making it difficult to follow. Frankly, if nih had been in a better position as far as Research Support over the last 10 years, we would be further along. This is a consequence that were not in a position to already have this vaccine ready to distribute. But we pulled out all the stops. Colleagues at fda have been hep full speeding up the process of approval but i wish we were a little further along. I promise you that working with cdc and other partners, were trying to make this our highest priority. Peoples lives are at risk. Host did you get more money. Congress voted for a continuing resolution that funds the government. Extra money in there to fight ebola. Guest for c tv and organization trying to speed up the therapeutic development. Let me say a word of that. Vaccines are preventive but for people already infected, vaccines will not help so there you need a treatment. People have heard about zmapp. Cocktail of antibiotics shown in animal model to be protective against dying from this disease. We want to be able to see how that works. A total of seven people have received zmapp as part of a come passionate use effort inclusion the two individuals we first heard about that were air lifted to emory hospital in georgia. We dont know with seven individuals whether this work in humans or not. The problem is those were the only seven does thats existed. Nobody expected a big push so barta is pushing forward with dollars from the cr, a scaleup of thattest. For technical reasons, that is not trivial. Acts are developed in a tobacco leaf program. And that doesnt necessarily turn into something where you just turn the crank and have lots of it. It is taking a while to do that scaleup. Two or three other therapeutics are promising but none in human trials. We have a big push there as well. As far as nih, we did not receive additional dollars in the continuing resolution. That goes through to december 11th. Clearlily, whatever happens after that, we hope norad additional dollars because this is going to cost a lot of money. Host all right. Were talking about ebola with the director Francis Collins. Join us for that conversation. The nih funding for 2013 is about 30 billion, 29. 2 billion. And the 2015 request from the white house is 30. 4 billion. Founded in 1887. Located in bethesda, maryland in sprawling campus. 37 separate institutes and centers. Worlds largest hospital dedicated to clinical research. A little over 23,000 unique patience in 2013. Your questions, your comments for the director of nih. Get your thoughts in a minute. William is up first. Vicksburg, michigan. Democrat, thanks for hanging on the line. Go ahead. Caller actually im from mississippi. Host sorry about that. Go ahead. Caller first of all, thank you to cspan for allowing me to comment on this subject. First of all, first of all, i shouldnt say this but im a free mason and i dont want you guys to lie about health and thing like this because one thing about it is i love to help other people. Its one of the things that i love to do. If you guys are funded for this ebola operation, then you can put forth the most earth to it and i understand that what youre saying and everything but if you reach out to the other cities, countries, states and ask them for funding, if they wont give you funding, ask the other people will they fund you to help the ebola. Because first is the country of America Needs to survive and if anything happens to america, then i believe the whole world is just out of hand. Host dr. Collins, are you preparing for Ebola Outbreak in the United States . Guest i think the chance is low. On the other hand, it would not be shocking if someone with ebola got off a plane at some point in the next few months in the United States because this is such a large outbreak in west africa though efforts are being made to do screening at airports, that is possible but our Public Health system is excellent and such an individual would be rapidly identified, isolated, we would make sure that kind of quarantining took place. I think the chances therefore that you would have a widespread outbreak in this country are low. A testimony to the Public Health system that has been built up over many decades to make it possible for me to say that. The caller is also suggesting that we do need to lean on other countries and i agree with that. The World Health Organization is a major convener of all of those countries trying to help. Lots of ngos involved and particularly to Doctors Without Borders carrying a great deal of the load in the early parts of this outbreak. Weve all got to work together. Greet that, you mentioned the statistics about nih. Also important for callers to know most of our money is not spent in bethesda. Goes out in grants. 85 to our best and finest universities and research institutions. When you hear about a break through that happened at stanford or the university of chicago or the university of mississippi or wherever, its very likely if its by a medical research, it was funded by nih. Host lets go back to the situation with ebola in the news that was broken yesterday, the wall street journal has these numbers, 1. 4 million. Cdc worst case easy mat by mid january. 2,811 the latest death toll. This 1. 4 million is if nothing were to happen and doesnt take into calculation what the president announced recently with more money and sending soldiers, sending the u. S. Military down to liberia. Well, exactly. That projection, we have many miami doing this kind of modeling and they come up with somewhat different answers but it does look quite frightening when youre on a exponential curve which is what is happening now in liberia, then over time, you can see numbers very fast into this kind of category of over a million but we want to stop that. So the president s announcement which i was heartened by and involved lots of input from different parts of the government including nih was to make a bold step here to try to put in place efforts to stop this outbreak in going further including asking the department of defense to set up in rapid fashion here 1700 beds in liberia so those individuals who aren infected or thought potentially to have been exposed can get the kind of treatment and isolation they decurvee serve but that wont be enough. We also have to have a plan actively pursued about how do you handle individuals who are potentially exposed outside of these treatment units because we wont have enough space for all of them to come in. Lots of work being done on that. Obviously the countries where this is all happening, liberia, sierra leone, guinea, with the leaders increasingly effective in engaging with communities, this has to be a full bore effort on the part of efficient everybody involved. The u. S. Of course has an i want worldwide in trying not just to be sol injuries to the world but doctors to the world. I think were pulling out all the stops to do what we can. Larry in alexandria, independent call you are. Yes. Caller good morning. I want to thank you first for putting himself in harms way in dealing with these issues because we have some things out there that i know they just havent yet spoke of but what noters me is it is taking so long for them to get a handle on potential answers to questions like they said, theyve had since 1976. Is there any way to cut down, anything we can do to cut down the time lag in fighting these . We have to analyze them after so many deaths before we get the idea that maybe this is important . Guest very sobering question. One we all struggle with. No one anticipated when the first case of ebola appeared in new guinea in march of this year that there was the potential for this kind of explosive outbreak and for the first couple of months looked like it was under control and then by the summer things started to happen that were alarming. It is very challenging given the already difficult circumstances in these west africa countries as far as Public Health systems which are in many cases quite rude men try to mount effective effort. That made this difficult. The fact that the outbreak han in the cities has made this much harder than previous since 1976 mostly in rural a areas, more easily contained. It was sort of the perfect storm. I share the callers sense of urgency and frustration about how hard it has been to get on the ground every resource we think is needed but im heartened by the steps taken in the last couple of weeks especially by the u. S. Government. We do need more partners on the International Stage and im hoping more of them will step up to the plate as well. This is an International WorldwidePublic Health emergency. No one should hang back if they have resources to contribute. Host i want to introduce another topic, dr. Collins. That is security at labs. Its a story in the news recently with lab agencies, not just your own but cdc and others, heres u. S. A. Today yesterday. What has nih done since reports have come out about mice being infected with the ebola. What has nih done . Guest were taking this very seriously greta, an issue we really need to attend to maintain public trust. Important to point out that though there have been surprise discoveries of agents around for a long time, decades in some instances that have been lost track of, no individuals were hurt as a result of it. No risk to the public. At the same time, recognizing that it is possible for things to slip through after many years of people coming and going from an institution like nih or cdc. We are in the midst of doing a thorough sweep of every freezer, refrigerator, shelf, drawer, to make sure that everything is where it should be and were well along with that and by the end of this month will have a full reporting of what we have found here at nih and likewise, we have asked all our granting institutions, most of the people in the u. S. That do medical research to do the same. A Good Opportunity to take a full inventory. Again, i will not want anyone to be alarmed that there is a serious risk to Public Health as a result of this, but it is prudent for us to be sure our house is in order and thats what were doing. Host is there enough money for the nih and laboratories at universities, enough money separated out for security . Guest i think so. We will put in place today a new sort of recommendation that will be announced later on today about how they should Pay Attention to biosecurity issues in relation to research that might potentially be used for nefarious purposes by those that have malintent about what they want to do with certain types of research, dual use research of concern. Universities are struggling now. Nih is struggling. Frankly in answer to your question, maybe i should point out that nih and all granting institutions have lost about 25 of our purchasing power for research over the last 10 years. Putting a stress on the system and a lot of great science that wed like to do is slowed down or stopped as a result of this ten year decline. Its rather ironic when america has led the world in Biomedical Research for about 50 years that we are now slipping in that regard when other countries are coming up fast. That is bad for the potential here of medical sad vanses, bad for our economy. Im hoping that over the course of time and very soon, in fact, Decision Makers in the congress will figure out a way to turn this corner and bring us back into a stable support for this remarkable engine of discovery, Biomedical Research in the United States. Host who has oversight over the University Labs . Is it the federal government . Guest yes. Every one of our granting institutions as part of the contract they sign on with us in order to receive taxpayer money to do research have certain obligations they have to follow and institutional biosafety committees that oversee this issue of biosafety in place for a long time. Those are activity involved in this Current Business of looking for any evidence that their are agents in places that shouldnt be. They are strongly in a place i think which ought to provide a lot of confidence that these institutions are very much taking care of the issue. Host we go do michael, North Carolina, independent caller. Good morning. Caller hi. How are you today . Good morning. Go ahead. Caller dr. Collins, with all the good help we do around the world, thats what america is about, when a