[background noises] [background noises] [background noises] [background noises] [background noises] [background noises] good morning. The Senate Education and labor and pensions given it 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 thisr virus. I will have an Opening Statement followed by senator and then we will introduce our witnesses. For restart, i want to take a moment to congratulate one of our witnesses, dr. Fauci on announcing its upcoming retirement. Dr. Fauci, you have served through multiple decades and president s. And Public Health threats and work to save countless lives. I hope you know you have the thanks of a grateful nation for your Incredible Service to this country, so thank you and thank you for being here today. So, after the witnesses give their testimony centers which have five minutes for round of questions. While we are able to have this hearing fully open to the public and media for inperson attendance my video is available on oures Committee Website help. Senate. Gov. If anyone is in need of accommodations including close captioning, please reach out to the committee or the office of congressional accessibility services. According to the senators entrance centers for Disease Control and prevention the u. S. Now has over 21000 confirmed cases of monkeypox. More than anyone else in the world. My home state of washington has over 500 cases. I have heard from families who are rightly concerned about how bad this is gotten in a Public Health officials including a back in state who are frustrated to see the response run into issues we should be prepared for by now for that is why i continued to push the bite administration about my concerns with the monkeypox response and urge quick action on testing, on treatment, on vaccine and unclear guidance to the public to our Healthcare Providers and state Public Health officials. It is reassuring to say we are making progress on testing. Capacity is increased thousand fda just approved a faster track for additional tests. On vaccines, bert is helping stand up a new vaccine sites in michigan. Hhs is working to expand the number of Distribution Sites in the states the Administration Advice for splitting doses has greatly stretched over a vaccine supply. On outreach, the ministration started working with states to make Vaccines Available at events with many people from Lgbtq Community in attendance. Perhaps most importantly, the rate of new cases is going dow. Now that its all encouraging news. But let me be clear, we must remain vigilant in our response. These promising improvements do not excuse the issues ive beenn 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 to get their patients treatment. And i am cussing talk to Public Health officials in my state who have told me how communication with state could have been far clearer and faster. How the challengesns in accessig text and maxine have delayed their response by no states have especially struggled with the federal governments decision to forgote 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 states. Even spoiled after storage at the wrong temperature. Di there been issues with vaccine supply as well. Like when thousands of vaccine doses were delayed because fd had yet to inspect the new plants theyre coming from. When the bite administration missed an opportunity to procure vaccines at a Crucial Point in this outbreak. And again we are seeing in equities worse in this outbreak for some communities. Advocates and Lgbtq Community vast majority of cases have made clear they feel theyre being overlooked or in some instances stigmatized. We need to keep focusing and improving on outreach. Getting information and resources like vaccines to those who are most in need and most at risk. That must include committees of color who we know do not have equitable access to vaccines. This is especially important as early data suggests a black ando latino communities are disproportionately burdened by this outbreak. We have to do better. We need to be applying what we learn from the Covid Response in providing the resources communities have made cleari need. Of course there is an enormous difference between this and the covid pandemic, which is, thanks to decades of Smallpox Research we are, treatment and vaccine ready to go before this crisis began trade that should serve as a reminder to all of us about the immense value of investing in Public Health preparedness. But it is also why the stumbles and these tools deployed were specially frustrating and inexcusable. To learn from this, we need to be clear eyed about what went wrong. Not just the challenges we face and left several months, butbl that we have faced for decades. Challenges that to be frank spent many administration, not just this one. For example we had over 20 million vials of smallpox vaccines and our National Stockpile but they were not replaced as they expired over the course of a decade. My Ranking Member and members of this committee when i say weve got to do better. Not just on covid, not just on monkeypox but Public Healthen threats. Because we know there will be more. Just last week nork declared an emergency due to polio at another Public Health risk we need to watch closely. I would tear from our Witnesses Today not just what theyre doing right now to improve our response to the monkeypox outbreak 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 knowth you and the administration are doing to make sure we have enough tests, treatments and vaccines for this outbreak and get them where they need to go. Also s maintaining an adequate stock of supplies for any smallpox threats. What you are doing to improve outreach to the Lgbtq Community, address disproportionate harm to black and latino communities. Fight stigma and misinformation write the inequities weve seen in our response so far. How are we making the most of the noose researched about promising vaccines and therapeutics . Make them more quickly availablh while continuing to uphold the Gold Standard of safety and effectiveness. Are weakening schools and colleges everything they need to stay open and keep students in School Committee safe questar complied cdc has provided guidance for k12 schools. Fortune the science tells us Elementary Secondary School kid are not at high risk. Cdc is also released resources for colleges which is critical students returning to campus this fall. We need to make sure colleges and universities are equipped to prevent potential outbreaks of students movede into dorms and live in close quarters with each other. I really should got your work cut outed for you and all this especially with covid still raging. There is no reason for us to fall behind. Im going to keep pushing you here because families back in Washington State and across the country are counting on all of you to get it right. That is also am going to keep pushing my colleagues here in congress about the need for funding to support all this work. I know im not the only one here with concerns about the monkeypox response. We cannot just say this isnt working without providing the funding to end this outbreak and build the Public Health system it. Icans deserve ill continue to work with our colleagues on both sides of the out push to deliver the resources that will help get families the testing, treatment and vaccine they need. Im interested in hearing from the witnesses about the needs are when it comes investing her monkey pumpp response. Its important we continue give her eyes on the horizon when it comes to future outbreaks in build a stronger Public Health system. The saying goes an ounce of prevention is worth a pound ofbr cure. That starts with building a worldclass publicst health sysm rather than one that lags behind our peers. Our communities deserve to be as safe as anyone in the world which is why senator and i are contingent to work to pass our prevent packed. Implements the lessons from her Covid Response and improves our policies and processes on issues like strengthening supply chain, improving management or National Stockpile. Modernizing data system many challenges we face with monkeypox. Strong Public Health system also requires strong investment. Because her Public Health system was underfunded before covid struck it is been overwhelmed ever since. We have to end the cycle ofck crisis and complacency by making sustained investments that allow us to build and maintain a Robust Health infrastructure at all levels. How could pushing for all the steps we should all know by now just how much is at stake. I can play families in seattle know, appearance in spokane, nurses know, workers in olympia know people cross Washington State and across the country now. W. Covid was never going to be the last Public Health crisis we face i neither was monkeypox for the question is not whetherer there will be a new threat, it is when it will strike on weatherby will be ready. The truth is the monkey pox response so far as not been encouraging. There are clear signs of progress there are clear steps that we can and should take to improve. I dont to just hear about the steps she will be taking a doing to tc action. Ill be watching close of how we build together to end this crisis and make the kind ofs improvements we need to help security on solid footing onceel and for all. I think youve a much all turned over for his openingng remarks. Exit thank you men and german good morning. I am glad we are finally here, having an outbreak on monkeypox outbreak. As it hits our nation but monkeypox is now a Public Health emergency. It did not 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 theg only thing sine inmate when the first transmission was reported in the uk and europe ive been pressing the administration for strategy and upland. After almost three years of the coed pandemic you the Public Health agencies responsible for preparedness and response to be prepared for anything particularly a threatt like monkeypox which we have known about for decades. And for which we have vaccines and treatments. Dr. Fauci talked to this committee before but monkeypox. Its almost a definitional case of what cdc and their sister agencies should be prepared to tackle. A virus that spreads through physical contact, a virus that spreads when an infected person has an obvious sign of infection. This is not like cold lid though stay tuned newly emergent virus that spread asymptomatic infection. But by any measure in fact by every measure the response and the bite administration a monkeypox crisis has been a catastrophic failure. He repeated each of the mistakes of the early days of Covid Response. The cultural arrogance from Public Health officials who are supposed to be the forefront of our response let this country down again. E since he covid pandemic started this committee has held 13 hearings on the response during both the trump and the biting ministration. I would think you be sick to be called to the carpet on us having to hold you accountable for systematic failures. But it seems as if nothing has changed. You cannot blame the last administration on this failure. The first confirmed monkeypox case in 2022 was inmate seventh in the United Kingdom. The first case of monkeypox in this outbreak was reported in the u. S. On may 18. We had a warning. We had morning this was coming but we should have been prepared to manage what came when it arrived. Lets review. We failedth testing. Although he eventually made Testing Available through Laboratory Response networks, these tests were too hard to access. It took weeks before doctors were able to get their patients tested without have to First ConsultPublic Health officials. There is alsowe significant dely in conducting with outbreak would wait until june 22 to announce engagement with the private sector. Still, after that Companies Interested in developing thison known diagnostic tests that could help address some of the slow turnaround times ande improve access had been left waiting months for samples needed to develop those tests. Without delay upon delay we failed on vaccines. Enhance strategy to at risk individuals and known contacts was announced june 28. On a full month after the uk joint committee on vaccines and immunizations met to discuss a similar strategy with their citizens. Why do we continue to be behind . Meanwhile decisions about vaccine a ministration in f the u. S. Seem to have been made seemingly onthefly. Even fda administered authorization last month allowing vaccines to be administered objections there were no Public Meetings at the fda, cdc outside experts to discuss relevant questions on the minds of impactedin americas and inform these decisions. Health professionals were confused aboutng the initial pot patients scared they were being experimented on. To make matters worse the states had no time to prepare for this change in Vaccine Administration right after fda made its decision, as to reduce statein Vaccine Allocation under the assumption every vile would yield fiveve doses. Yet you know this is not been the case in every state resulted in some vaccinating fewer, not more at risk people. Failed at having a plan. Monkeypox outbreaks have been occurring in nigeria and other places with increasing frequency. It was identified a threat under our threat matrix and the threat for which we had countermeasures in our stockpile. I might also add our earliest purchase of the vaccine in bulk was in 2017. N the policy but the priorities were varied its not clear what Research Activities hhs isk actually undertaken in response. These failures have allowed thei disease just bradford anyone cases made quickly quickly turned a 650 cases in june. More than 6000 cases in july at more than 12000 cases in august. Near 22000 so far in september. Should have been obvious to all of us the timing of the early cases coupled with evidence of cases were not linked would create a perfect storm for a large outbreak. Monkeypox is a virus that largely transmits their skin to skin contact. Most easily regally transmitted between sexual partners. Monkeypox arrived just before the pride celebrations across the country. Locked in thes of social distancing, your agency should been screaming from the rooftops about what you knew or suspected how monkeypox would spread. Instead we remain silent. People got sick because of that silence. This is not rocket science. Th consenting adults need to be told what Behavioral Changes s they should consider to avoid getting a preventable disease like monkeypox. You failed at a time when the communities most at risk needed you. Disease control and prevention and response is literally in the name of two of your agencies. Yet, you did none of that. There was no surprise to me the administration after months ofo floundering appointed a new czar at the white house to coordinate the response. Shows why this committee passed the prevent act to create a Mission Control but secretary of hhs is been totally absent. When he has been involved ithe only seems it makes matters worse. But no ad hoc groups within government are exactly the problem. We need a consistent coherent governmentwide response to be effective for that can only be led by the white house. I hope in the coming weeks we will be able to get that legislation over the finish line i will commit to spending my remaining weeks in the United States i senate doing everythini can to help the white house set up the new office with a Lasting Mission and clear agenda. If i were not retiring its in the neck servers conducting a thorough examination of each of your agencies highlighting each and everyone of the systematic and bureaucratic failures that we have seen it now and response, after response and demand accountability for the American People. D there is a question of authority. You have the authority its a question mike i