The hearing is just under three hours. Committee on health, education, labor and pensions, and the appropriations subcommittee on labor, health, human services, appropriations will come to order. In march of this year, Public Health officials reported an outbreak of ebola virus in guinea. Unlike past Ebola Outbreaks that it have been efficiently and effect if there stopped, this outbreak has spread in ways that are potentially catastrophic for the world. Due to the gravity of the situation, the danger poses not only to the affected region but also to our country, i have taken the unusual step of calling together this joint hearing of both the authorizing committee i chair and the appropriations subcommittee which funds it, which i also chair. We have come togetherred to to learn what can so we can Work Together over the coming weeks to stop this daysly plague. The extent of this epidemic is tragic and grows more serious with each passing day. The death toll is already far greater than all other previous Ebola Outbreaks combined. The World Health Organization estimates 20,000 people may become infected by dem if current control efforts north strengthened and we know the mortality rate is close to 40 to 50 percent. We have other estimates that are much higher. And of course, the constant concern that thats virus spreads it can also start to mutate and become even more deadly. Or have other means of transmission other than through badly fluids. Ebola is just an example. Others include avian flu. Me rs, and Health Threats easily crisscross the planet. Thats why i worked hard to strengthen, all of us on both completeeyes, to strickennening investments in Public Health preparedness and responsibility capabilities at home. Last year the bipartisan pandemic and all hazards preparedness reauthorization act was signed into law. That came through this committee and, of course i see senator bur r here, who led a lot of effort on that. On his side, senator alexander, senator casey, all worked very hard on this bill. It strengthens cdcs response capables and ensuring the Biomedical Advance ResearchDevelopment Committee has the authority it need to spout the attempt of critical dreams and vaccines. The Appropriations Committee has worked together for years to curtail fundings at cdc to set up a network of Disease Detection nevers across the globe. We now have ten, including three in africa. We need one in every country africa. It is these centers that are now deploying trained epidemiologists and other staff to help in areas and well have more discussion on that when we get to our witnesses with the cdc. I hope and expect that in the exday for two the senate will vote in favor of the 88 million we are trying to secure. This is a crucial investment that will enable 100cdc scientists to continue working inest africa. It will keep the zmap and vaccine candidates moving quickly through Clinical Trial us but its just a first step. I hate to say this but ebola will not be conquered in at the ten weeks of the continuing resolution. When we come back to negotiate the fiscal year 2015 appropriations bill the fight to contain ebola must continue be an urgent priority. The subcommittee passed a senate labor hhs bill that includes a new 40 million Global Health security initiative. You must carefully consider the size and goals of this initiative in light of the Ebola Outbreak, while maintaining our commitment to cdr staff in the field. As this crisis illustrates, we must stop chases diseases after the fact. And Start BuildingPublic Health systems around the globe, capable of detecting and stopping diseases before they cross borders. Last year, with the help of senator mr. An, we were able to start a new Global Initiative called the national Public Health institute to do just that. This Program Needs to be expanded, in light of this epidemic. With these big challenges ahead of us, todays hearing is absolutely critical. We have a distinguished group here to educate us and advise us. Ask i will now turn to senator alexander and senator moran. Before before that i request the record be kept open for ten days. I recognize senator alex anywhere. Thank you, mr. Chairman, and thanks the birdie coming here today. We must take the dangerous deadly threat of ebola as seriously as we take isis. Let me say that again. We must take the dangerous, deadly threat of the ebola epidemic as seriously as we take isis. I think i have a reputation as a senator who is not given to overstatement. The spread of this disease deserves a more urgent response from our country other countries around the world than its now getting. This is one over most explosive, deadly epidemics in modern time if we do not do what we know how to do to control it. It will require a huge and immediate response. Theres no known cure. Theres no vaccine. Half of those who get sick, die. Each sick person, accord together center for diseases control could infect 20 or more others, including caregivers, friends and family. Samantha powers, the u. N. Ambassador, said to me earlier this week, she is trying to get other countries to view this with the same urgency that we do. This is an instance she said when we should be running toward the burning flames with our fireproof suits on. A doctor who has contracted ebola and has recovered and is here to talk about it. It is the like of flu italy spread by bodily fluids of did through burial practices are carrying for someone who was sick but only one airplane ride away from a person exposed to ebola getting on the plane in the United States than once they arrive. But human tragedy in africa it affects the United States and dr. Brantly will testify as the ebola patient and is graduates from the university in like Many Americans go on a Mission Trips around the world to help people. Level support the administration request that senator hart did talk about with Biomedical Research advance treatment and there is a request to address 500 million of reprogramming so why should our military be involved . They have to. There is no way for doctors and nurses and Health Care Workers to do it. I am pleased double sides of the aisle to recognize the severity of this epidemic. And to learn about the severity and what we must do control it. I will endorse started. We must take that deadly and dangerous threats as seriously as we take isis. Senator thank you i appreciate your leadership from the senator of tennessee it is interesting to see what is taking place in africa but we have the ability to make a significant difference in the outcome of what is occurring. Sometimes we dont know what to do and while i realize we have not discover of skiers and treatments we do well will save peoples lives and the spread of ebola around the globe so the encouraging fein is from the United States senate. And so i appreciate the Leadership Today we need to declare war on ebola it is real but something with that campaign we have the ability to change peoples lives did diminish the number of people that is effective the future it is a Global Response to provide necessary of leadership that the war was one. Thank you chairman. We have a distinguished panel and now we will move ahead with the statements. First director of the National Center for the emerging e factious diseases that cdc. Dr. Bell is responsible for the efforts to respond to a of a broad range of emerging and established threats and to help lead the response to the Ebola Outbreak in west africa. Serving in multiple leadership roles including during the response of the 2001 anthrax attacks and h1n1 influenza epidemic. Dr. Brantly deposition held since the team 84 providing outstanding leadership. Receiving a portfolio of applied research to improve our understanding of Infectious Diseases to apply this knowledge with prevention and treatment they and strategy. Serving as one of the key advisers to the white house and d. H. Us on the initiative to you pollster prepared this is against the emerging Infectious Disease threats. I will extend the committees will come to a director of the Biomedical Advanced Research authority and about office of the assistant secretary preparedness response that vhs. Dr. Robinson is responsible for France Development and acquisition of innovative medical countermeasures including vaccines and diagnostic tools to protect against manmade and naturally occurring Health Threats. Played a key will to ensure the Ongoing Research and development of experimental ebola treatments. I would just ask consent all statements be made a part of the record and dr. Bell give us a summary for the we will have a lot of questions so i just set up we would appreciate it. Good afternoon chairman market. Ranking members and members of that committee. I a director of the National Center for Infectious Diseases at the cdc and i appreciate the opportunity to be here today to discuss the current epidemic of ebola in west africa that shows of a tragic way that need to strengthen Global Health security and i have been asked to send sincere regrets to the doctor to not be here in person but also your continuing support to will be able us to build this sustain a capacity to respond to Health Threats like ebola. This epidemic is ferocious and spreading exponentially. The first is recognized and west africa of the biggest and most complex ever documented as of last week it surpassed 4400 pripet cases including 2300 documented deaths although we believe there is considerable under reporting and expect the actual numbers would be two or three times higher. We have now seen cases imported into nigeria and senegal and other countries are at risk as the outbreak grows there is the urgent need to help border countries to help prepare for cases now in st. The detection of response capabilities and africa. This includes the collapse of the Underlying Health care system with the inability to treat malaria has led as non healthful impacts such as economic instability. These are intensifying and not only signally growing humanitarian crisis but also impact on the ability to respond to the ebola epidemic itself. There is a window of opportunity to control the spread of this disease but it is closing. If we do not act now we could be dealing with it for years to come affecting larger areas of africa is currently an epidemic the worst outbreak in history, but we have tools to stop it and accelerated global the spots is urgently needed. It is important to note we do not view ebola as a significant Public Health threat to the United States the best way to protect the u. S. Is stop the outbreak in west africa but is possible that infected traveler could derided the u. S. And if it occurs your confident our Public Health systems can prevent any outbreak here to recognize the authorities in investments provided by your committee have put us in this strong position. Many challenges remain since there is no fair pure vaccine shown to be saved and effective. We need to strengthen the Global Response which requires close collaboration with the who and additional assistance from International Partners and a strong and coordinated government response. Cdc has over 100 staff currently and hundreds of additional staff are supporting the effort in atlanta. We will continue to work with our partners elsewhere to focus on the five pillars of response. Establishing effect the Emergency Operation centers. Rapidly ramping up isolation facilities. Helping to promote safe burial practices. Strengthening Infection Control and other elements of the Health Care System and improving communication of the disease and how we can be contained. Controlling the outbreak will be costly requiring sustained effort by the u. S. And world community. With hhs the administration recent proposed congress provide 30 million for a response during that continuing resolution period a and Counter Measures in the president indicated a logistics and capabilities of the military would be engaged and we work across United States government to assess the full range of resources to change the trajectory of the epidemic. Working with our partners we have been able to stop every outbreak and were determined about this one. It will take meticulous work and we cannot take shortcuts. As cdc director has noted fighting ebola is like a fire if you leave behind one case and the epidemic could reignite. This tragedy highlights the need for stronger Public Health systems around the world and there is a worldwide agreement on the importance of Global Health security but the ebola epidemic demonstrates there are much more to be done and legal liability could have widespread impact if not stopped at the source. As you are aware that fyi 15 president budget includes an increase of 45 million to strengthen the fundamental health around the globe. If there currently battling to leaven their early outbreak would not have grown to what we are facing today. Stopping the outbreak where they occur is the most effective and least expensive way to protect peoples health. I and many of you have traveled to africa to see our work and we come away with an appreciation of the challenges that people face. These may be or not more evident than the current epidemic each day i was impersonal, the contact with people in the field to have a desired need to put real faces on the tragedy that cannot simply be reduced to numbers or fax but these also reinforce the role that cdc and partners play with the intensified global focus to make a difference. Think you for the opportunity to appear before you to make cdc were, the epidemic and the Health Threats possible. Thank you very much mr. Chairman ranking members and members of the committee i appreciate the opportunity to speak to you about the role of the National Institute of Infectious Diseases and research addressing the ebola virus disease. I have some handouts with the visuals. The involvement of nih and ebola dates back to the tragic events of 9 11 2001 followed closely by those anthrax the tax through the mail to the senators as well as members of the press because this led to a broad smaltite agency in denver of by a defense against threats not only deliver it but unexpected naturally each emerging threats. As you can see on the righthand side there was a Research Agenda of category agents they are listed there and anthrax, botulism, and on the bottom you can see as a category called those fever viruses which are ebola. The reason why they were so important and deadly and in need of Counter Measures is as you named in those introductory remarks they have a high degree of lethality. Unfortunately this mostly supportive without specific antiviral drugs directed against the microbes in question and as we know, a a vaccine for any is not available at present. The tea levin fibrous given the name of the appearance one has when they look at it , the countermeasure research and Development Program is ongoing and has been but before i even mentioned that underscore something that dr. Bell said. Right now today the best way to contain this epidemic is by intensifying intensive control capability to isolate and identify and protect the Health Care Workers with personal equipment. But to be prepared we need countermeasures. What we do is basic Clinical Research but provide the resources to get to that end game that is better diagnostic and therapeutic and vaccine. That Product Development pipeline for developing that concept tooling preclinical studies which i will mention. We partner with our colleagues who are involved in the advanced development to hand the baton over to industry for commercial manufacturing with the ultimate regulation and approval by the u. S. Fda among other agencies if you will hear from dr. Robin since shortly. Let me have those promising therapeutics. You have heard of a combination of artificial the produced antibuddies against ebola virus and has been shown to be promising in the animal model and as you will hear it was given for the first time to humans is very important to reenter stand how well it works and if it is safe and what it looks like it could be beneficial but we dont know that. It is our job to prove it to have their readily available. But among those interventions one of those drugs with the