Secretary Donna E. Shalala, Dr. Harold Varmus, Dr. Francis Collins, Dr. Anthony S. Fauci & More: How to Invest in a Healthier Future

In existence for over a century, the National Institutes of Health (NIH) is arguably one of the most important agencies of the federal government. Its work is so critical that it often enjoys rare and widespread bipartisan support. In this special bonus episode, President Clinton and nationally recognized experts share first-person accounts and unique perspectives of how the Clinton administration’s unprecedented investment in research and science at NIH led to some of the most impactful scientific breakthroughs in the last century – including developing antiretroviral treatments for HIV/AIDS, accelerating research which ultimately made it possible to develop COVID-19 vaccines, and the sequencing of the human genome.

This episode features talks by:

• President Bill Clinton, 42nd President of the United States, Founder and Board Chair, Clinton Foundation 
• Dr. Donna E. Shalala, Secretary of Health and Human Services in the Clinton Administration
• Dr. Anthony S. Fauci, Director of the National Institute of Allergy and Infectious Diseases at the NIH
• Dr. John I. Gallin, NIH Associate Director for Clinical Research who served as the inaugural chief scientific officer of the NIH Clinical Center
• Dr. Gary Nabel, President & CEO of ModeX Therapeutics and the first director of the NIH Dale and Betty Bumpers Vaccine Research Center
• Dr. Harold Varmus, the Lewis Thomas University Professor of Medicine at Meyer Cancer Center of Weill Cornell Medicine, former Director of NIH, and Nobel Prize winning scientist
• Dr. Wendy Chung, Director of Clinical Genetics at Columbia University
• Dr. Francis Collins, longstanding former NIH Director and Director of the National Human Genome Research Institute
• Dr. Charles Rotimi, Director of the Trans-NIH Center for Research on Genomics and Global Health

This podcast was adapted from an event held in partnership with the Clinton Presidential Center and the University of Arkansas Clinton School of Public Service as part of the Kumpuris Distinguished Lecture Series. To learn more, visit www.clintonpresidentialcenter.org. 

See omnystudio.com/listener for privacy information.

Episode Transcript

Speaker 1 (00:05):
Today, we're glad to bring you a special episode of
Why Am I telling You This. We'll be doing these
episodes periodically to introduce you to some of the inspiring
people in important ideas I've encountered throughout my career in
public service and at the Clinton Foundation. On this episode,
we're sharing a recent program hosted by the Foundation and

(00:25):
the University of Arkansas Clinton School of Public Service, which
focused on the research that took place at the National
Institutes of Health when I was president, including developing antiretroviral
treatments for HIV AIDS, laying the groundwork on vaccine research,
both of which made it possible to develop COVID nineteen
vaccines more quickly, and completing the mapping of the human

(00:47):
genome at least the first draft. It was perhaps one
of the most important and farthest reaching achievements of my
eight years in office. I hope you'll find these conversations
as fascinating as I did, and that you come away
with a greater understanding why investing in science is one
of the best things we can do to build a healthier, better,

(01:09):
more equitable future for everyone. I want to thank all
of you who are responsible for the Comparist Lecture series,
especially Dean Comparis, do Comparis, Katherine and Trotter for endowing
the series and their parents names. Frank Comparis was one

(01:32):
of the most respected doctors in our native state. He
and his wonderful wife Cooler, raised the great family and
made the world a better place. So to the panelists,
I can't thank you enough for doing this. Uh. Thank
you to Donna Laila and I think still is the
longest serving Secretary of Health and Human Services ever. She

(01:56):
managed to fit that in between being president of Hunter
called Ledge and Chancellor of the University of Wisconsin at Madison,
and than her long tenure at the University of Miami,
where she now teaches. And she did a stint as
the most overqualified member of the United States House of Representatives.
Thank you Harold Arms for all the work you did

(02:16):
when I was president. Thank you Francis Collins for many things,
but overseeing the international effort to sequence the human genome
and in the process brokering of peace with Craig Vennor
and the private sector effort to turn a race into
a relay. Thank you Tony Fauci. I'm amazed you're still

(02:40):
standing after all you've been through these last two years,
and I was always grateful to you for your hard work,
and never more grateful than to see you trying to
talk common sense in the middle of nonsense. Thank you,
John Gallen, thank you Gary Nabel, thank you Dr Wendy
Chung and Charles Himy. I'm grateful to all of you.

(03:04):
The n i H is a national treasure, and it
had received even in the polarized times in which I governed,
we had an astonishingly broad base of bipartisan support at
the National Institute of Health. I came into office when
we were entering the information age. The whole revolution in

(03:24):
part made possible the sequencing of the human genome, which
obviously required massive digital capabilities. There's always been attention in
every budget season, and we saw it with Present Biden's
recent budget, between the present and the future, always attention

(03:45):
between what is too little and what is nowhere near
enough to sleep comfortably at night. I'm very glad that
we could double the budget of the NIH almost and
more than up all the budget of the Human Genome Project.
I think that it's clear that the work that was

(04:07):
done helped to speed the development of antiretrovirals for HIV AIDS,
did important work in vaccine research, and established the Vaccine Center,
which I think hassendurability to develop the COVID vaccine, especially
with the completion of mapping the human genome. I spent
three billion dollars of the American taxpayers money on that,

(04:29):
and we had the first rough draft in two thousand
and I tell everybody that it's the best three billion
dollars I ever spent in my life. We had a
return on investment of something like three hundred four hundred
to one already and an incalculable impact on the future
prospects of life. Let me say one more thing before

(04:50):
our panel starts. One of the reasons the nih accomplished
as much as it did is that so many people
with extraordinary talent and at a cation chose to work
there and at the Department of Health and Human Services
and in the White House, all pulling in the same direction.
Most of them could have made more money doing something else,

(05:12):
but none of them could make a bigger difference doing
something else. So all of you are, by definition difference makers.
We were talking before the program started about our friend
Madeline Albright and the last conversation I had with her,

(05:35):
I sort of began by asking about her health. Her
voice was strong, her mind was clear. She said, Look,
I'm not well, but I've got a good doctor and
I'm doing what I'm supposed to do. And the leather
worker it won't. Let's don't waste time on that. The
only important thing is what kind of world are we
going to leave to our grandchildren? And we proceeded to

(05:55):
talk about that every day. Every step of progress you make,
every blind alley you run into and then turn around
and try something else, helps us in ways that are
not always clear, to keep going forward and to keep
proving that. In the end, the most important discovery of

(06:17):
the Human Genome project is that all non age related
differences we can see among human beings are rooted in
less than half of one percent of our genome. And sadly,
the world gets in trouble when we major in the
minors and only talk about that half a percent. We
spend nine and nine and a half or some of
our time fixated on our differences, and when we're in

(06:41):
a foul humor, we completely forget about the other nine
and nine and a half. For some of us, that
is the same by using your different abilities, by making
your diversity of intellect, imagination and effort of virtue. Yeah,

(07:01):
you reaffirm the fundamental sanctity of life in all of humanity.
I'm very grateful and I can't wait to see what
you have to say. Thank you very much, Thank you
us the President for those remarks. As we transition to
our first panel, let me introduce Secretary Donahalella, who before

(07:22):
becoming Secretary of JHS, served as a chancellor of the
University Wisconsin, one of the nation's top research institutions. Donna,
thank you very much, Kevin UH, and thank you, Mr President.
I've always believed that the President's most important legacy was

(07:43):
his commitment to science, to the NIH in particular. There
will be lots of references, and he made one of
them to bipartisan efforts UH to successfully double almost double
the NIH budget, which unleashed golden age of biomedical research.
But for me, it was not just the doubling, but

(08:04):
what the leadership did with that money. Um. First, second, Um,
it was really the leadership we recruited and those we retained,
and the impact of of training grants on preparing a
new generation of of scientists. Today, we're going to hear

(08:26):
from some of those leaders, and I'll introduce the four
for my panel, starting with Dr Harold Varmus. Dr Varmus,
of course, won the Nobel Prize with his colleague Mike
Bishop in nineteen eighty nine, the Nobel Prize in Physiology
or Medicine. He was director of the n i H
from to nine nine, and he came back to lead

(08:49):
the n c I from two thousand and ten to
two thousand and fifteen. Dr Tony Fauci, Director of the
National Institute of Elogy and Infectious Diseases and now the
Chief Medical adviser as well to President Biden and of
course our leader during the Clinton administration in an extraordinary

(09:09):
effort UM against AIDS. Dr John Gallen, director of the
NIH Clinical Center. Actually from to two thousand and seventeen
twenty two years, John Gallen led the criticals UH the
very critical Clinical Center UM named for for Dale bumpers Um.

(09:36):
Currently he's the chief Scientific Officer for the Clinical Center
and Associate Director for Clinical Research at NIH. And Dr
Gary Nable Um, who was recruited to build a vaccine
research program for the country, and I really made a
mistake that's named after. The Vexie Research Center is named

(09:57):
Actor uh Dale bumper Um. He was the founding director
of the Vaccine Research Center at ni AI D and
uh pioneered a renaissance in vaccine development and will hear
from Gary about how that was the underpinning for the
vaccines of the future. He's currently at Modex Therapeutics as

(10:22):
the President and Chief Executive Officer, uh Dr Varmus. This
is all yours, Thank you very much. The NIH has
been in existence for over a century. It's a federation
of today seven institutes and centers, each of which m

(10:42):
received their direct appropriations. The budget for the NIH today
is about forty three billion. When the Clinton administration started
it was a little under eleven billion, increased steadily and
then initiated a five year doubling process. Then h is
a health related science agency. Doesn't do any direct healthcare.

(11:06):
It provides basic and clinical research opportunities, training, and infrastructure
to the nation's medical research establishment. About ten percent of
the research that is done by the NIH is done
by government scientists, mainly on the campus in Bethesda. The
rest done through grants and contracts to institutions and medical

(11:27):
schools and universities UH in all states and some abroad
UH and these grants and contracts are issued importantly through
competitive peer review. Like all agencies, NIH has annual appropriation.
But it's important to note that the NIH does its
research through multi year grants and contracts and works on

(11:50):
very long term problems, which means that support from the
administration to keep its budget strong is incredibly important. We've
had support of the NIH from both sides of the
aisle for many years, and in general we have a
good working relationship with both the executive and these legislative branches. UM.

(12:10):
There are two ways in which the executive branch, especially
the White House, provides comfort and support to the ni
H during an administration. First is the support for that
long term, ongoing work that supports the biggest medical research
enterprise in the world. And you're gonna hear about how
things came to fruition during the Clinton administration and the

(12:34):
treatment of HIV and AIDS UH and, but there are
many other examples that we could have been illustrating on
in advances in cancer treatments and the improved outcomes of
cardiovascular disease and stroke, and and many other things. But
they're also shorter term needs, health crises, construction projects, starts

(12:55):
to new programs, expansions of others like the Genome Project.
Will talk about in some detail in a moment. From
my perspective as the annied director during most of the
Clinton administration and as a scientist who's dependent on ni
H all the time from my own work, I look
back on the Clinton years as the golden years and
medical research for many reasons. First, we had the enthusiasm

(13:20):
of not just the president, but the President's family. Indeed,
the first member of the family to come visit us
was was was the first lady who came to the
NIH for a day long tutorial about genetic research and virology.
Uh and she then uh brought the President out for
his Saturday tutorial just after giving a radio address about

(13:41):
the Family Leave Act. Uh and uh he heard about
research going on in AIDS and genomics and cancer research,
and that persuaded the first daughter to turn up and
spend several days working in one of the lab run
by one of our outstanding female scientists. We still have
vials that are labeled C C one, C C two,

(14:02):
C C three for mutants of a bacterial proteas that
she isolated. UM. The second reason is that the strength
of the budget proposals. The President said to me many times,
I'm not I'm not proposing everything I want you to have,
but I know the Congress is gonna double your increase

(14:23):
even even when Republicans are in charge. And uh. He
followed that prescription for many years and helped us start
the five year doublings had the effects that Secretary she
Leila just mentioned. A third aspect of his support was
the quality and attitude of our partners in the US

(14:43):
government during during the administration that I've served in. Other
members of the panel who haven't been introduced to you
will illustrate some of the things that remained incredibly important
to the dire scientific enterprise. The first is how long
term science pays off. And you're gonna hear from Tony
Faucci about UM, who has been director of the Allergy

(15:06):
and Infectious Disease Institute for almost forty years, about how
long term investments in the studies of infectious agents, including
HIV have led led to culminations of those efforts during
the Clinton years, with our ability to prevent transmission of
HIV from mothers to infants, the development of protease inhibitors,

(15:30):
and development of highly effective therapies against AIDS. When the
clint administration began the the program that was run by
government scientists and Bethesda was under some criticism and a
report from outside scientists arguing that one thing we needed
to do was revitalized clinical research at the clinical center

(15:53):
in the n I t intramural program led to recommendation
that was given due UM scrutiny by Office of Office
and the Office of Management and Budget UH and UM
UH and he'll tell us about the planning of the
new clinical research center named from Mark Hatfield UM and

(16:13):
the new the many new things that have been done there.
And then you'll hear from Gary Nabel about how he
managed as the first director of the Vaccine Research Center,
which is a direct outcome of President Clinton's involvement in
a research UH. The then head of the Office of
of of a Research, Bill Paul unfortunately deceased a couple

(16:37):
of years ago. UH led to UM proposal we put
together a vaccine research center on campus, and one day
the President and Al Gore had me and Tony Faucci
come down and chat with him about what needed to
be done in AIDS research, and he immediately bought onto
this idea of building a vaccine research center and made

(16:57):
that part of an address he gave shortly thereafter Morgan State,
and that persuaded Congress to proceed with the investment that,
as you'll hear, is paid off in many ways. So
let's turn this over now to members of other members
of the panel, starting with Professor Fauci. I just went

(17:19):
through my mind the other day, um, almost on a
year by year basis, the extraordinary advances that we experience,
literally from the day you set foot into the White House.
You remember, one of the first things that you did
was to establish the White House Office of National Aids
Policy or a NAP, which actually is still today exerting

(17:45):
an important function. We never had that before you came
into the White House. And then though, it was also
at a time when the toll of morbidity mortality was
accelerating in the country and by nine four AIDS became
the leading cause of death of all Americans age four.

(18:08):
But then things started to turn around with regard to therapy.
You'll remember the famous A C T G O seven
six results. The first time that we showed that you
could actually interfere with the transmission of HIV from a
pregnant mother to the baby. That has to be one
of the true hallmarks of iconic studies done at the

(18:31):
n H under your leadership as president the years that
really was so exciting, all eight of them, But there
was a cluster of a few in the middle that,
from my standpoint, was transforming from and that's when we
went from one and then two and then three drugs

(18:54):
in combination, culminated by the first time of the use
of protease inhibitors, which was the third drug in the
three drug combination. What happened then was something that I
have to tell you without hyperbole. Every time I reflect
back on that, I still get little bits of goose

(19:15):
bumps because I had been taking care of persons with
HIV for those years, from right up until the time
when that combination proved to be completely transforming and turning
around the lives of persons with HIV and the summer

(19:38):
Vancouver International AIDS Conference, those results were presented and it
shook the world in a very positive way because from
that time onward, the idea of hospices was a thing
of the past. For persons with HIV. I have a
photograph that I show at many meetings of Harold and

(20:01):
and you and I and Vice President Gore and Bill
Paul in the Oval office. I was presenting to you
a schematic of a brand new UM discovery of a
co receptor called c c R five for HIV. You've
got very wonky because you really wanted to know the

(20:23):
details of what that receptor was. But at the end
of the scientific discussion you brought up with Harold had mentioned,
you said, by the way, Tony, it's December, the three UM.
It's we had HIV since and the virus was discovered
in eighty four. Why don't we have a vaccine? And

(20:47):
that's when we got into the discussion of the possibility
of having a vaccine research Senate, and you said you
would do something about it. I thought you were just
trying to be nice to us, But to our great surprise,
in May, you announced at a commencement address at Morgan

(21:07):
State that you actually were going to support the building
of a vaccine research center at ni H. But the
years went on and things actually got better and better.
One of the things you did do that led to
the success in a subsequent administration of the pep FOP program.

(21:28):
But even as you were president, you issued an executive
order to assist developing countries in importing and producing generic
HIV treatments so that they could have available to them
treatments that were costing tens of thousands of dollars here
and importantly, when you left the presidency, through the Clinton Foundation,

(21:51):
you continued that pushing to have the availability of drugs
to people in the lower middle income countries. So it
was an extoy, very run and I'm so proud to
have been a part of it with you. We'll be
right back. The NIH Clinical Center opened in n Since

(22:20):
it's opening, incredible teams of basic and clinical scientists in
close partnership with very courageous patients, often in the scariest
moments in their lives, resulted in an outstanding history of
accomplishment improving health care for the nation and the world.
A few examples of early accomplishments at the Clinical Center

(22:42):
include chemotherapy for cancer, cure for childhood leukemia, lithium for depression,
fluoride to prevent teeth decay, identification of high cholesterol as
a risk factor for heart disease, first three treatments of
AIDS and the discover if hepatitis viruses B and C

(23:02):
that caused cirrhosis and liver cancer that eventually led to
a vaccine for hepatitis B and tools to protect the
blood supply from and to treat hepatitis C. Dr Barup
Bloomberg received the Nobel Prize in nineteen seventies six for
discovery of hepatitis B, and Dr Harvey Alter from the

(23:23):
clinical center, in partnership with doctors Michael Houghton and Charles Rice,
shared the Nobel Prize in for co discovery of hepatitis C.
Forty years after the clinical center opened, the hospital infrastructure
was barely able to sustain modern clinical care and science,

(23:44):
and the clinical center came under scrutiny. In a report
on the NIH Intramural Program to the NIH, Director Harold Varmes,
by committee co chaired by doctor's Gail Castle and Paul
marks Wreck commended for the first time a new clinical
center be reconstructed as promptly as possible. The same year,

(24:08):
Vice President Gore's Reinventing Government to initiatives said that the
clinical center should be critically reviewed and re engineered to
improve its effectiveness and efficiency. In response to these recommendations,
the Department of Health and Human Services Secretary Donna Shoela
convene a team coordinated by Dr Helen Smitz to conduct

(24:33):
a review. The review reiterated the earlier recommendations to build
a new clinical center. As a result, with the support
of the Clinton administration and the Congress, plans to construct
a new clinical center were initiated. Key events in moving
the process forward included President Clinton visiting the clinical center

(24:58):
in August. On September, Congress approved funding of the new hospital,
to be named the Marco Hatfield Clinical Research Center. Construction
began in January nine and was completed in August two
thousand and four, and on September twenty two, two thousand

(25:21):
and four, at a ribbon cutting ceremony, a patient speaker,
the late Susan Butler, called the clinical center the House
of Hope, highlighting what the clinical center means to patients
and to the public. The opening of the new Marco
Hatfield Clinical Research Center enabled the continuation of great accomplishments

(25:43):
that continued to improve the health of the nation. These
include cell based immunotherapy for cancer, new treatments for kidney cancer,
a new drug for depression ketamine, first in human studies
with the Ebola and cove and vaccines. Discovery of a
new category of diseases, auto inflammatory diseases and new drugs

(26:07):
to treat them. Gene therapy for several rare diseases, including
sickle cell disease, and creation of the Undiagnosed Diseases Program,
where patients from across the nation with unexplained medical problems
are brought to the Clinical Center for evaluation and advice
for treatment. In two thousand and eleven, the Clinical Center

(26:32):
received the Mary Woodward Laska Bloomberg Award for Public Service
for serving since its inception as a model research hospital,
providing innovative therapy and high quality patient care, treating rare
and severe diseases, and producing outstanding physicians scientists whose collective

(26:53):
work has set a standard of excellence in biomedical research.
John thanks very much for that really terrific summary of
not of not just the clinical Center itself, but espressing
the importance of clinical research. It gets more important every
day is basic science produces more products that need to

(27:13):
be properly tested and evaluated. In the context of what
is the world's largest research hospital in the world. UM,
we're gonna turn now to Gary Nable to say more
about a topic that has already been introduced by a
few of us that nambly the Vaccine Research Center. Gary. Welcome, Thanks, Harold.

(27:35):
President Clinton. Is really an honor and a pleasure to
join you today along with the powerhouse team that you
would put together at the time that I came to
NI Secretary of Lela Harold, Tony John, It's great to
be reconnected on this occasion. You know, when we think
back now to the age crisis, as Tony outlined, UH,

(27:59):
as our memory these UH fade, we we sometimes forget
the unimaginable toll that that crisis took on human life.
Not only the toll on human life, but the quality
of life for victims and families, as well as the
profound effects economically and politically throughout the world. More than

(28:20):
thirty nine million people have died in the epidemic so far,
more than five times the numbers that we've faced with
COVID so far, and despite the gravity of the global
health threat and significant investments in the science at the time.
By the late nineties, despite the pronouncement from Margaret Heckler

(28:42):
and the Reagan administration that we have a vaccine in
a few months. Back in the early eighties, the vaccine
remained elusive, and yet it remained the best way to
prevent and contain the epidemic. Now, the reason for it,
obviously is the biology of HIV. This as an insidious
virus and it posed an unprecedented scientific challenge for vaccine development.

(29:07):
And the reason for that is because it had such
enormous genetic diversity, and it also had the ability to
camouflage many of its important viral entry proteins. There are
more variants of HIV and a single person infected with
the virus then there is in the entire planet and

(29:27):
the whole population of the world during a single year
of an epidemic like COVID or flu. So compared to
licensed vaccines where there may be three to ten components
that much as at most, this complexity poses a really
daunting challenge, one that thwarted the best and the brightest

(29:50):
of scientists working in individual labs around the world. So
it was really in this context that Harold and Tony
and Bill Paul, with support from Secretary Shilela, approached you
uh and and where you all decided that the best
thing to do is to develop a dedicated vaccine research

(30:10):
center to be built in NIH to overcome the scientific, technical,
and early development challenges facing HIV, UH and other emerging
global health threats. The room where it happened was the
Oval Office of the White House, and I think it's
important to note that this group that met there really

(30:33):
served as a brain trust that not only started the process,
but importantly remained involved and nurtured its growth. The Vaccine
Research Center was an innovative model for the support of
scientific research in three ways. First, it provided a physical place,
a physical laboratory whereby you could bring the best and

(30:56):
the brightest scientists together in one research center UH and
where they could work in a multidisciplinary way to approach
the problem because vaccine development is is highly complex and
involves many different UH types of approaches. Secondly, it was
it was a mission driven research organization. We came to

(31:20):
work each day knowing that a day saved and bringing
a vaccine to the world saved six thousand lines. Those
efforts extended not only to HIV, but also as we
worked at the NIH to other emerging health threats. The
first stars at break Avian, flew Ebola, Chicken, Gunja, Zeka

(31:41):
and now covid UH. And finally, it was a place
where we could actually make clinical products and conduct human trials.
And so it allowed us to operate independent of the
constraints by the vaccine industry and undertaking vaccine development. And
it's important to recognize that in large part many of

(32:03):
these vaccines are not developed because there's a a failure
of the private markets to address global health challenges. So
it's an important model for public private partnerships. The center
has succeeded in a number of ways. More than a
hundred clinical trials have been performed, Connections to industry have

(32:25):
been made to make new vaccines accessible to the public.
Perhaps the most tangible recent success has been its catalytic
role in accelerating the development of the covid MR and
a vaccine. The VRC worked quickly internally and with industry
to advance prototypes and to identify structure based mutations that

(32:47):
frees the virus in a form, freezes the virus in
a form that optimizes vaccine protection and gives us some
of that protection that we're now seeing across diver restraints.
And finally, at least from my perspective, the Vaccine Research
Center is a gift that keeps on giving. The VRC

(33:07):
has multiple productive collaborations with academic and biotech UH and
pharma labs. There's now a diaspora of VRC scientists who
have taken the training that they've received there in the
spirit of the institution, to new places where their work
contributes to the preservation of continued preservation of global health. UH.

(33:30):
COVID vaccines have likely saved tens, if not hundreds of
millions of lives, and the VRC contributed in a foundational
way to its development. While progress continues to this day
on HIV, BOLO, chicking, GUNYAH, and universal flu For me personally,
it was an unparalleled and special opportunity to show how

(33:51):
science and data can impact human well being and save lives.
To President Clinton, Secretary Lela Harold Tony, your leadership and
wisdom has achieved significant goals, and I'm confident there's more
to come, so stay tuned. The work continues, and finally,
I very much appreciate the opportunity to help build the

(34:13):
center and to serve. Given the pressure everybody was under,
you could have just made the vaccine center very narrowly
focused on HIV AIDS, but it seems to me that
the decision to make it a vaccine center to cover
more than just AIDS was absolutely critical for the future.

(34:37):
That is really an important issue. It became very clear
to me and to Gary who is the director at
the time, that the talent that we had accumulated in
the senior people and then their junior colleagues and acolytes
was such that although we put a full blown effort

(34:58):
on HIV, particularly some of the things that Gary mentioned,
the structural biology capability, the idea of of structure based
imaagen design, it became very apparent to us Donna, that
that was applicable to r s V, that was applicable
to any of a number of viruses. That we did

(35:21):
not want to constrain ourselves just to studying HIV, so
we went into flu. You know, we did coronaviruses with
the first saws Kovie one and then Mayors and then
the particular interest that Bonnie Graham had in respiratory since
sechel virus, which was his love before he even came there,

(35:43):
actually ultimately partnered with Peter Kwang to develop the image
design that led to the coronaviruses. So it was just
a beautiful symphony of people who were playing together, and
it became very clear that it would go well beyond HIV,
which it has. I'm not gonna make one footnote to

(36:03):
that comment. At Tony UM back in the very first
days of the Clinton administration, when things were not going
very well in in the development of treatments and protections
against AIDS, we had commissioned an outside group headed by
a distinguished virologist, Arnie Levine, to evaluate the AIDS program,
and one of the recommendations was that that the the

(36:27):
development of immunology as a as a as a discipline
was not being sufficiently applied yet to the study of
HIV and U and then Bill Paul, who had been
director of the Office of AIDS Research, noted that we
had tremendous strength and immunology ranging from people like you
donate to many others on campus who could make a

(36:48):
contribution to development of of UH vaccine research. And people
on the campus began to gather and the next thing
we knew, we had a proposal for a vaccine WIS Center.
And I'm very grateful to the President for saying this
is not just going to be an HIV center. It
was going to be a center for for vaccine production
and it's proven to be incredibly valuable. Along the lines

(37:10):
that you said, many people think that that ni H
is organized into silos, and it seems to be the
vaccine research center, the clinical center of two examples where
the entire um community of NIH came together. John, you
would not have been successful if everybody hadn't bought in

(37:31):
absolutely all the seventeen centers and institutes that the intrameral
program used the hospital and they all interact very closely.
That's great. I think President Clinton wanted to make a
command here. Mr President, this was fascinating hearing this from

(37:52):
your perspective. I wanted to, uh say to me, you
might have ace that if we want to continue this,
we have to give get broad based support, and I'll
give you both within the Congress and in the larger country.

(38:13):
In the Congress. Herald, I've always given you credit for this.
I don't know if you deserve it, but if you
don't give it somebody else. But you know, we got
waxed in the ninety four presidential election because I tried
and failed to get healthcare reform, allowing the history of
it to be rewritten. And because I tried and succeeded
in getting the assault weapons ban, the ten lad ammunition

(38:36):
clip limit, and and the Brady Bill passed. But I
talked to new Gearbridge one day and he had a
hundred members of his new majority who didn't didn't have
a passport, and we're proud of it. And thought, government,

(38:56):
would you know, mess up a two car parade? And
the purpose us to have less of it? And Uh,
I knew he was interested in science because he had
given me a copy of E. O. Wilson's book on ants.
So I said the new well, we gotta we gotta
get these people on the research band wagon. You need

(39:17):
to take him to m I N I H. But
when they got there, these people who thought the government
was some sort of amorphous evil blob. Whoever was responsible
for the tour of these freshman congressmen took started them
in a hospital bed, and they lay in a bed

(39:37):
and looked at the films, UH saying what all the
ni H was doing on the TV in the hospital room.
And it was an elemental political observation, which is that
everyone wants to go to heaven this morning, but nobody
wants to die. We all would live as long as
we can. And it was really and all of a sudden,

(40:01):
we had no problems getting the Republicans to vote for
the NAG budget. We had a couple of years where
the Christian evangelical community leaders basically were involved in mainstream politics,
talking to everybody. UH. I brought them in in two

(40:22):
thousand on the Millennial Debt Relief initiative, and was had
worked with a couple of them who were friends of mine,
and they all supported relieving the debt of the world's
poorest countries if they put the savings in the health
care or education or development. And the President Bush later

(40:44):
institutionalized this, but they weren't quite ready on age yet,
you know, they weren't quite fast. All we just got
to talk about profession and accidence and nothing else. But
by the time he got to the point where he
had the votes in Congress because of their support to

(41:04):
pass the pep far program, which I loved. You know,
we we tripled overseas aids UH assistance when I was president,
and we were giving on what the world was giving,
but it was peanuts nothing. And so after he did that,
I want to give him credit for something else that
a lot of people don't know. Uh. In the beginning,

(41:27):
they were only working I think in seven or eight
countries because they were requiring pep far to purchase for
these countries UH medicine that big farmer was making, and
they'd give him a discount, but it was like a
hundred and fifty uh D dollars a year, which was

(41:48):
less than a ten thousand or so we were playing
in Harlem, but way more than a hundred and fifty
or so. We were already down to with the products
the prices we had negotiated through the Clinton Health Access initiative.
So I was flying with the President Bush to the

(42:08):
Pope's funeral and flying home, and he said, talk to
me about what you're doing on AIDS, and so I did,
and I said, you know, you ought not to make
these countries by generic drugs, but you ought to give
them the option to take the money you give them
and spend it on generics that they want. And he said, well,
I'm told that they're not as effective. I said, I

(42:31):
know they tell you that, and I know they're important
to you politically, but it's not true. I said, what
if I were to submit to the f d A
every single drug we put in any human body in
any country for review and approval if they get approved
with you okay, the money, he said, it sounds like

(42:52):
a fair deal to me. It was just the two
of us talking. He didn't have no lobby, has had
a chance of talking about of it. He just aired
about where the poor people were going to live or die,
and I could tell he really cared. And uh so
we submitted twenty two, as I remember, twenty two different products,

(43:13):
and nineteen were immediately approved by the FDA. And he
didn't slow walking, he didn't do any He played it
totally straight. They just reviewed them and approved them, and
all of a sudden, PET four was in more than
twice as many countries, treating a hugely greater number because
he did that, and he had the support of the

(43:34):
Christian evangelical community. So that's a good Both those examples
show you why we need to keep working to build
broad based support for the work of the nih UH
and our common humanity can sometimes be found when we're
sick or someone we love has something wrong with them,

(43:57):
and even when it's not available anywhere else. So and
thank you and Harold, I've always giving you credit for
putting those congressmen in the hospital. Man More after this,

(44:21):
we're going to continue the conversation meant very much in
the same vein of talking about how UM science proceeds,
how it works, how presidential support really helps, especially when
it comes to getting increased allocations of funds for an
important project and getting the the confirmation of that significance

(44:44):
by having the president himself speak out on the importance
of genetics. And indeed we've just heard uh, just a
few moments ago UM President Clinton reminiscing about the importance
of learning how much of our generic genetic heritage is
held in common among people who UH seem to thrive

(45:04):
on on strife, as opposed to recognizing the pot nine
percent some identity in one genome one genome to the next.
Before we launch into this more detailed discussion of the
human genome project, I want to issue was very brief
reminder that genomeics, like everything else, is built on prior
work and work of the NIH and other organizations around

(45:27):
the world for twenty or thirty even forty years to
develop the tools of molecular biology and genetics. Was fundamental
to being able to put ourselves in the position of
imagining UH, the sequencing of a complete genome, and indeed
even the idea of doing a complete analysis of the
genome was dependent upon the development of technologies that that

(45:53):
many people around the world we're working on having a
specific proposal, initially from a revered cancer searcher We're not
on tobacco and Nobel Prize winner who made the what
seemed initially to be an outrageous proposal that we do
something as as outrageous as UH, looking at every nucleotide
of the three billion pairs of nucleotides in the human

(46:16):
genome um. And then the vetting by the National Academy
of Sciences, first steps being taken by the Department of
Energy at Los Alamos, the establishment of an office in
an i H in a prior administration, then the recruitment
by Donna show L and Bernardine Healy, my predecessor as
director of n i H of Francis Collins, from whom

(46:37):
you'll hear just a moment and just a moment. UH.
That all set the stage for this remarkable acceleration of
work on the genome project that that went on over
the next several years, leading to the culmination of the
work in the around around the year two thousand UH.
And you're gonna hear from three people about the importance

(46:58):
of all this. First from Francis himself, who was the
prime leader of the program during the Clinton years as
director of the Human Genome Resurgence Institute UH. And then
and how he worked with other agencies the top Armament
of Energy, for example, and international partners including the Welcome

(47:20):
Trust and and the UK and many others and in
a large number of countries who participated in this remarkable
global effort. And then you're gonna hear about applications of
the Human Genome Project from two UH individuals who were
not engaged directly in the Clinton administration, but in some

(47:42):
sense have through their work fulfilled the the ambitions of
the Clinton administration in his effort to accelerate the Human
Genome Project. First from Wendy Chung, who's the director of
Clinical Genetics at Columbia UH, talking about how the Genome
Project has influenced her attends to diagnose UH, particularly inborn

(48:05):
diseases that involve changes in our genes, and how those
patients are cared for. And then you'll hear from Charles Rotimi,
who is currently the director of the trans NIDE Center
for Research on Genomics and Genomic Health, Genomics and global
health through the use of genomics and international work in
that in that regard, So Francis, if you would spend

(48:29):
some minutes telling us about the experience you had in
the Clinton administration accelerating the genome project, then we'll turn
it over to the other two speakers. Well, i'd be
glad to and thank you Harold, Mr President Secretary Shlela
Dear colleagues and friends. It is a privilege to be
part of this event with people I admire so much. Yeah,

(48:49):
I'm walking back the memory lane here to the fall
of I had been hired by Bernardine Healy to come
and lead the human Genome project at a time where,
let's be clear, it was a little uncertain about whether
this was gonna work, and a fair percentage of the
scientific community was not at all supportive, thinking that this
was just going to be a boondoggle. And then there

(49:10):
was an election and people began to say to me,
did you realize that you were hired by the previous
administration and maybe you ought to be a little careful
about whether you really have a job. Well, I need
not have worried, because I got a call I don't
know if it was the day after the election or
the day after that from Donna Chola saying, never fear,
we really believe in the Clinton administration about this project.

(49:32):
I'm going to be your secretary and I will make
sure that this project gets the attention it deserves. So
I decided that was right and gave up my professorship
in Michigan and moved into the old nurses Dorm on
the NIH campus. We're together with a very plentiful abundance
of cockroaches. I began to learn how the government actually operates,

(49:55):
and was happily joined a few months later by Harold,
who lived in another part, met down the hall in
the old nurses Dorm with Connie, his spouse. The good
part of that was we did a lot of strategizing
at night over red wine about what exactly could be
done here as we began to bring molecular biology and
genomics forward at the NIH in a way that showed

(50:16):
such promise, and we knew we had wonderful leadership with Donna,
and we've learned just how enthusiastic the President was about
genomics when he visited US on a Saturday and had
the experience of hearing his questions, showing him how to
dissect a human chromosome, and recognizing that we had a

(50:36):
dream team to support NIH and to support the genome project.
And that was good because, of course, the general project
began with a budget that was essentially zero before it
got started, and it had to ramp up, and it
had to ramp up faster than the rest of NIH
or it couldn't possibly do its job inventing all these
technologies and also figuring out how to actually do sequencing

(50:58):
at scale. Something like a thousand base pairs a second
was what we had to get to, and when we
started out, we were lucky to do with thousand base
pairs in a day. It began to pick up speed.
UH Secretary Slela decided in seven that the National Center
for Human Genome Research could be upgraded to an institute

(51:19):
as it now is today. Thank you Donna for that.
And it was international from the start, and that was
a big part of what it made possible to go
at this pace with partners in six countries and twenty labs,
all agreeing to work at the same set of guidelines
and standards for excellence and accuracy of the data, and

(51:39):
a very important decision made about that time that this
data ought to be in the public domain. This not
this should not be something as our shared inheritance that
anybody owned, and so we began putting that sequence into
the public domain every twenty four hours. President Clinton strongly
agreed with that. There were other entities that were claiming

(52:00):
bits and pieces of the genome and trying to file
intellectual property and sometimes getting it on those and so um.
In the spring of two thousand, President Clinton and Tony
Blair put out a statement saying it would be a
good thing for the genome sequence that belongs to all
of us to be accessible to everybody. Well, Joe low

(52:20):
Lockhart in his press briefing that morning, didn't quite get
it right, and I think he said something like, well,
Jane Pattons aren't going to be allowed anymore. And the
stock market crashed, which was a little embarrassing. But fortunately
it all got cleared up fairly quickly, and it was
a deep dip that was then retrieved and brought back

(52:41):
into the better place. Although I think some people in
biotechnology were a little shaken up by it. Well about
that time, we had this race that the President was
referring to with a private sector effort called Salera led
by Craig Ventor. It was getting a bit unseemly both
the public project in the private project. We're making progress.

(53:02):
Um I asked Ari Petrinos, who was running the Department
of Energies effort in genomics, to convene Craig and me
for pizza and his basement. And many essays and articles
have been written about that pizza party, and there was
more than one and the result of that a memorable day,
Mr Presidents June two thousand, Eastroom of the White House,

(53:24):
with the scientific community and the world kind of gathered
to see what this was as we announced a not
complete yet but a very good draft about nine of
the Genome. It was the milestone that many people have
been waiting for. Mr President. You referred to the map
that Meriwether Lewis had presented to Thomas Jefferson in that

(53:45):
same room. Well, that was pretty interesting as a parallel,
and I went back and read your remarks. You called
the genome the most important, most wondrous map ever produced.
By humankind, and it was the language in which God
aided life. And you emphasized how all humans, regardless of race, yes,
are more than the same. And we all knew that

(54:08):
you were quite attached to that, having noted how you
had lectured the Serbs and the Croats and Kosovo that
they really shouldn't be fighting with each other because their
genomes were so similar. I'm never quite sure how that
played out, but I thought it was a wonderful way
to put forward some science at a difficult time. And
that was such a moment. And we got to the
end of the speeches and you closed with this ad

(54:31):
lib and for some reason, they're just stuck in my mind,
so I thought I would read it again. You said,
when we get this all worked out, and we're all
living to be a hundred and fifty, young people will
still fall in love. Old people will still fight about
things that should have been resolved fifty years earlier. We
will on occasion do stupid things, and we will all
see the unbelievable capacity of humanity to be noble. This

(54:55):
is a great day. It was a great day, Mr President.
We crossed into New Territory that day, but just before finishing,
I'd say, there's another day that I'll remember. About six
months later, there was a farewell in the Indian Treaty
Room for the President and the First Lady. Interestingly, right
now my office in the E. E E O B is

(55:17):
right down the hall from the Indian Treaty Room. As
I'm now serving as the acting Science Advisor to President Biden.
I got an invitation to this farewell to the President,
the First Lady and from Chris Jennings, and I thought
I have to bring something, and the timing was just right.
I brought the first CD that contained the human genome
sequence on something you could hold in your hand, and

(55:38):
I made a brief presentation. We were finishing the Nature
paper that described this, which would have gotten published about
a month later. And in that paper, which I had
a lot of time devoted to trying to say something
that was maybe even a little poetic, it ended with T. S.
Elliott's famous words from Little Getting, we shall not cease

(56:01):
from exploration, and the end of all of our exploring
will be to where will be, to arrive where we started.
And then the First Lady finished the quote for me
and know the place for the first time. Yes, we
know the place. It's a textbook of medicine, it's a
parts list, and it's a record of our history. Genomics

(56:23):
has expanded beyond anyone's dreams and expectations since then. The
Human Genome Project took thirteen years and three billion dollars.
Now your genome can be sequenced in a day for
less than a thousand. Applications to cancer, birth defects, drug discovery,
gene therapy, infectious disease including COVID have massively extended our
reach in science and medicine, and there is much more

(56:46):
to come. And for that, I turned to the next
two speakers, beginning with Dr Wendy Joe, thank you. I'm
so privileged to be here prisoning Clinton. UM. As I
was listening to speakers today, I would say I'm actually
a product of much of what they spoke about. I
actually began my career scientifically as a student at the
NIH Clinical Center and in I h S. When was

(57:08):
inspired to become a genome scientist. I started out my
training literally the year the Human Genome projects started. And
realize this, Dr Collins said, if worst putting that much
money into this, there's going to be amazing things that
we're going to be able to do, and was able
to start dreaming about the day when we would be
able to actually sequence our genome within a day. Just

(57:28):
to give you a sense of where we are as
I look back of those twenty thousand genes that we
now know of, there are remarkable seven thousand of those
that we can now associate with a very specific human disease.
And in fact, these conditions are quite common. Individually, many
of them are rare, I'll grant you that, but collectively,
if we look at many of these men Delian conditions,

(57:49):
ten percent of us actually have or will have manifestations
of these conditions. And I is still a practicing physicians
see a lot of these patients that are at risk,
for instance, for hereditary breast or a varying cancer. But
they're able now today to be able to walk a
different path than their mothers walked, or for those at
risk for calling cancer, to walk a different path than

(58:10):
their fathers have walked. They're able to see that there
are at risk and they're able to do something about it.
They're able to take that into their hands and not
let that be their destiny. They're able to really rewrite
by seeing what's ahead, and to be able to take
very conscious and deliberate actions, sometimes very brave, but to
be able to lead a different life and to be

(58:32):
lead able to lead a healthier life. They really they're inspiring.
They are incredible in terms of what they personally do
with this information. But there's so much more that's yet
to come. It's been remarkable for me to be able
to see that technologically we can read out those three
billion base pairers. We can do it for less than
a thousand dollars, but we had to overcome other hurdles.

(58:54):
Sometimes this has been referenced, even legal hurdles to be
able to take down gene patents, to be able to
have the ability to know that information content, and to
be able to use that to take care of ourselves
as we've done and I did it just yesterday and
the Neonatal UH intensive care unit our hospital. We can
take babies, for instance, who are critically ill and be

(59:15):
able to read out their genome just in some cases
hours to days, and be able to make critically life
threatening decisions about how to save their lives. In some cases,
some cases where we'll need to be able to do
an emergent transplant of an organ, to be able to
take care of a body part for them that is
failing them in some cases, to be able to give
them medicines that are now tailor made for their particular

(59:38):
cystic fibrosis mutation, or as you'll be hearing in terms
of gene therapy, to do some remarkable things that we're
just beginning to think about for certain types of immuno
deficiencies or certain types of hematological conditions like sickle cell.
I'll tell you one story that really has been made
a big impression on me in terms of what is
yet to come for us. When I started medical school,

(01:00:01):
the most common genetic cause of death for children less
than two years of age was a tragic condition called
spinal muscular atrophy. And I'm using intentionally the past tense.
Used to be the most common genetic cause of death.
It was heart wrenching for me to see these children,
because many of them with the most severe form of
the disease wouldn't live to see their first birthday because

(01:00:21):
they were so profoundly weak, so profoundly weak that they
could not breathe, They could not be able to inspire,
to be able to take a breath. With time, though,
and with a lot of this very foundational work that
came from the Human Genome Project, from the science that
came with it, we've learned that there are in fact
not just one gene, but also a backup copy of
that gene called survival motor neuron, and being able to

(01:00:45):
use the technology to co opt that second gene, we've
been able to think about creative ways to be able
to tweak it, to be able to up regulate it,
to be able to use it, to be able to
compensate for the deficiency that those children have when they're born.
One of the remarkable things that we've done with that
is to actually, in tandem a developed methods of being

(01:01:08):
able to identify those children as newborns. So at this
point we can now actually from my heel prick, be
able to identify those newborns who are going to be
at risk for spinal muscular atrophy, a progressive degenerative disease
that otherwise would have taken their life, and now be
able to use either gene therapy or one of three
FDA approved medications that is now life saving for them.

(01:01:32):
So that as we've been able to do that and
for this condition, which is an equal opportunity condition that
affects all different individuals from all different parts of the world,
now to have a completely different outcome for them, hopefully
to be able to give them long, full and healthy
lives that particular scenario. To be able to go from
knowing that condition, diagnosing it newborns coming up with treatment

(01:01:56):
we did in record time, really just a matter of
four years. We were able to compress that with the diagnosis,
rapid diagnosis and getting those treatments, those three treatments to
now be approved, and I'm convinced that these are things
that we can do over and over again with the
foundation of this technology and with the industry that's been
developed to be able to use this important to me,

(01:02:19):
and I'll end with this is just as this comes forward.
What we did with spinal muscular atrophy was so important
to me from an equity point of view that, as
I alluded to, we were able to take a drop
of blood from a newborn and be able to understand
what conditions they would be at risk for. From a
public health point of view, where we could do this

(01:02:39):
for every single baby and it mattered not where they
were born, who their parents were every single baby would
get the same access and does get the same access
to this phenomenal care that we can provide them, and
that I think is going to be one of the
things in terms of the future of what the Human
Genome Project will have produced, allowing everych I want to

(01:03:00):
have an equal healthy start to life by using that
information to be able to keep them safe and keep
them healthy. It's been remarkable to be with you today.
I'm honored. We'll be right back. Thank you very much.

(01:03:25):
It's really an honor and a privilege to be being
a member of this panel and to be invited by
the present Claton's Foundation. I want to stop by saying
today's my birthday and I couldn't. I can't think of
any other way able to celebrate it with President Clinton
and this wonderful lest Steam panel. So again I am

(01:03:48):
in celebrating mood and I think my parents who give
birth to men Injuria, US some sixty five years ago
and I just qualified for medicare uh you know it's
that will be extremely proud to see me on this panel.
My comments today really will be to emphasize how we

(01:04:12):
can continue to ensure that the gains of the human
genome is indeed accrue to all human populations around the world.
I am it was a great honor when I was
invited by Franciscollins and Orders to participate in a spinoff,

(01:04:34):
the very first spinoff of the sequence of human genome
and that's the International Have My Project WISH. I was
indeed very important because apart from knowing the addresses of
the four combination of letters that make up our genome,
we needed to know how these vary between individuals, between

(01:04:57):
families and also you know, between ancestry populations around the world.
And scientists realize that it is only by knowing these
differences and similarities that will be able to really fully
understand how the signatures of the environment that our ancestors
live shaped our genome and how that varies, and how

(01:05:19):
their influences disease and human health around the world. So
the engagement of African population in the hap MATH study,
especially firstly the europa community in Abiden, Nigeria, was truly
the first major effort to engage African communities in the

(01:05:39):
in the human genome and how we can indeed bring
our global populations to bear on this wonderful success stories
that was indeed funded under the Clinton administration. They have
my project, you know, also was again, like I said,
my first opportunity to be out of this major initiative.

(01:06:02):
But what you have not show to us. And I
just emphasize the point that President Clinting made earlier in
his comment, and that is when we look out the
diversity and and the magnitude and scope of EMA genetic variations,
we we come to the to the conclusion that Africa

(01:06:25):
populations has the highest diversity in the world, and that
is not a coincident. That is based on our evolutionary history.
African populations, our human based in general, have lived the
longest on the African continent and therefore had had their
genome have had more time to vary within that environment.

(01:06:49):
And the point I'm making here is that there are
aspects of our genome that we can only study by
looking at African people. So I want to say that
studying African populations and other global populations is a social
justice issue, but more importantly it's a scientific imperative. We

(01:07:13):
cannot truly appreciate this coupe of human variation which are
going to the roots and the credle of humanity. And
this is why I say sometimes that beneath all of
our skins, we are indeed Africans. If we treat our
history fire enough, most of us, or if not all
of us, we end up somewhere on that geographical location

(01:07:36):
called Africa today. So it's critically important that we engage
the African community. It will beneto Africa, but it would
benefit the world even more so. This is why under
the umbrella of the African Society of Human Generics U
and working with the Francis Collins and other African scientists,

(01:07:58):
we were able to establish the what we call History Africa,
Human Editary and Health in Africa that has brought over
two hundred million dollars to change the participation of African
scientists and African population in human genetics. This was funded

(01:08:20):
by the end I AGE with Francis Collins as a
director and also the welcome Trost Foundation, uh you know
in the UK. Now, this initiative was unique in the
sense that he actually enabled African scientists to fully participate
by giving them the money directly to African institutions and

(01:08:42):
to African investigators, and it has led to the creation
of Pan African laboratories. You know about repository Islam by
informatics HOBS. That is changing the way African scientists are
participating and informing uh you know the Human engine Our
project and its success to this as it continue to be.

(01:09:03):
We are not in a position where we can cure
this is like sickle cell us engine editing, so that
is rebarkable. African countries are also using the gamest of
Human General Project to inform a cential drug list in
all the way to HIV in places like Bosowana and
understanding genetic variation in terms of drug metabolizing for something

(01:09:25):
like coding in Ethiopia. So you can see the gainst
the beginning to accrue. But what is important here is
creating the opportunity for African scientists to be a part
of this wonderful initiative and to ensure that tomorrow's medicine
will indeed be available to all humanity. We are indeed

(01:09:47):
all come from the same place and we need to
share is that there are diversities. Non illusion, but we
should not use it to re emphasize all prejudice. Thank
you for inviting me really glad to be a part
of this effort. Charles thank you very much for those
interesting remarks. UM. President Clinton began our discussion of genomics

(01:10:10):
at the start of the session by emphasizing how much
of the genome is held in common and how what
we're learning from genomics can be a way of trying
to bring the world together and make it a safer place.
I think we're learning to that the diversity that you
refer to and the pathogenicity of certain UH variations in

(01:10:33):
the genome can be the source of disease. As Wendy
pointed out, UH presents a challenge for all of us
to be sure that the fruits of our research are
widely shared in Africa and Asia, South America, everywhere in
the world. And in a few minutes we have remaining
before we wrap this up, I'd be curious to hear

(01:10:54):
from the any of the three of you about ways
you see that that our existing institutions and scientists can
have more of an effect on providing open access to
the fruits of genomics. I know that my own work
for the World Health Organization of the last several months
that there is a receptivity to the idea of of

(01:11:17):
sharing genomic technologies even in the poorest countries and to
be sure that, as has been illustrated during this pandemic,
that the technologies that have been developed UH in response
to and partly in response to the pandemic are influential
and in saving lives. Well, I'll just quickly respond, I think, Harold,

(01:11:38):
you're right that we have a great opportunity here and
with projects Charles mentioned Age three, Africa has a start
on this where the goal really is to enhance research
capacity in a sustainable way in low and middle income countries.
That is the best possible way to place the kind
of capabilities in the hands of those who will need

(01:12:00):
them in their own countries, and also perhaps to stem
the brain drain which otherwise has been a really serious
issue for losing the talent that you want to have maintained.
And I'm excited to see how that is taking shape
in Sub Saharan Africa. Although we've got a long way
to go. We need to come up with even better
ways to provide some kind of a partnership with industry,

(01:12:22):
with NIH and the Welcome Trust and other philanthropy organizations.
But we need to get countries in Africa to recognize
that this is time for them to invest as well.
We need to go from what I would call donorship
to ownership, where a ministers of finance recognize that one
of the best things they can do for their economy,
for their people is to put some money into research

(01:12:44):
and development because it will pay off over and over again.
And we're kind of making that case and starting to
get I think, some receptivity, but that's what it's going
to do. Yeah, I agree entirely with that, and the
World Health Organization is going to be participating in that
as well. And I think in many ways fulfilling the
kind of ambitions that President Clinton and many others have

(01:13:04):
had since the inception of the Genome Project, that this
is something that can help unite humanity and as opposed
to tearing it apart. And um, we are approaching the
end of our session here and I did want to
reflect just for a moment on the incredible privilege has
been for many of us to serve in the Clinton
administration when things did move ahead so swiftly and at

(01:13:28):
the n i H, not just in in elucidating genomes,
but in improving UH, the UH our understanding of how
the human body and many other organizations work and how
the studies of of biological systems from many perspectives can
lead to improvements and our understanding of disease and our

(01:13:49):
efforts to create new therapies for diseases like AIDS and
cancer and cardiovascular disease and many others. And I think
it's used will for all of us to acknowledge our
appreciation for the respect that the president in that era,
um President Bill Clinton, had on the country's appreciation of

(01:14:13):
science and uh the efforts that the scientists are making
to improve human welfare. Why am I telling you? This
is a production of our Heart Radio, the Clinton Foundation
and at Will Medium. Our executive producers are Craigmanascian and
Will Molnadi. Our production team includes Jamison Katsufas, Tom Galton,

(01:14:34):
Sara Horowitz, and Jake Young, with production support from Liz
Raftoree and Josh Farnham. Original music by Wat White. Special
thanks to John Sykes, John Davidson on hell Orina, Corey Ganstley,
Kevin thurm Oscar Flores, and all our dedicated staff and
partners at the Clinton Foundation. Hi. I'm Stephanie Street, exa

(01:15:00):
keive director of the Clinton Foundation, where we work every
single day to advance President Clinton's commitment to public service
and improve lives across the country and around the world.
President Clinton often reminds us that we're all in this together,
that we rise or fall together. That's why in the
face of crisis, we enter the call we act. At

(01:15:21):
the Clinton Presidential Center, we've been proud to work together
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(01:15:42):
as an educational and cultural institution focused on cultivating the
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Learn more about this work and see how you can
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Podcast two