[House Hearing, 118 Congress]
[From the U.S. Government Publishing Office]






                    PREPARING FOR THE NEXT PANDEMIC: 
                  LESSONS LEARNED AND THE PATH FORWARD

=======================================================================

                                HEARING

                               BEFORE THE

            SELECT SUBCOMMITTEE ON THE CORONAVIRUS PANDEMIC

                                 OF THE

               COMMITTEE ON OVERSIGHT AND ACCOUNTABILITY

                     U.S. HOUSE OF REPRESENTATIVES

                    ONE HUNDRED EIGHTEENTH CONGRESS

                             SECOND SESSION

                               __________

                           NOVEMBER 14, 2024

                               __________

                           Serial No. 118-136

                               __________

  Printed for the use of the Committee on Oversight and Accountability






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               COMMITTEE ON OVERSIGHT AND ACCOUNTABILITY

                    JAMES COMER, Kentucky, Chairman

Jim Jordan, Ohio                     Jamie Raskin, Maryland, Ranking 
Mike Turner, Ohio                        Minority Member
Paul Gosar, Arizona                  Eleanor Holmes Norton, District of 
Virginia Foxx, North Carolina            Columbia
Glenn Grothman, Wisconsin            Stephen F. Lynch, Massachusetts
Michael Cloud, Texas                 Gerald E. Connolly, Virginia
Gary Palmer, Alabama                 Raja Krishnamoorthi, Illinois
Clay Higgins, Louisiana              Ro Khanna, California
Pete Sessions, Texas                 Kweisi Mfume, Maryland
Andy Biggs, Arizona                  Alexandria Ocasio-Cortez, New York
Nancy Mace, South Carolina           Katie Porter, California
Jake LaTurner, Kansas                Cori Bush, Missouri
Pat Fallon, Texas                    Shontel Brown, Ohio
Byron Donalds, Florida               Melanie Stansbury, New Mexico
Scott Perry, Pennsylvania            Robert Garcia, California
William Timmons, South Carolina      Maxwell Frost, Florida
Tim Burchett, Tennessee              Summer Lee, Pennsylvania
Marjorie Taylor Greene, Georgia      Greg Casar, Texas
Lisa McClain, Michigan               Jasmine Crockett, Texas
Lauren Boebert, Colorado             Dan Goldman, New York
Russell Fry, South Carolina          Jared Moskowitz, Florida
Anna Paulina Luna, Florida           Rashida Tlaib, Michigan
Nick Langworthy, New York            Ayanna Pressley, Massachusetts
Eric Burlison, Missouri
Mike Waltz, Florida

                                 ------                                
                       Mark Marin, Staff Director
             Mitchell Benzine, Subcommittee Staff Director
                        Marie Policastro, Clerk

                      Contact Number: 202-225-5074

                Miles Lichtman, Minority Staff Director
                      Contact Number: 202-225-5051
                                 ------                                

            Select Subcommittee On The Coronavirus Pandemic

                     Brad Wenstrup, Ohio, Chairman
Nicole Malliotakis, New York         Raul Ruiz, California, Ranking 
Mariannette Miller-Meeks, Iowa           Minority Member
Debbie Lesko, Arizona                Debbie Dingell, Michigan
Michael Cloud, Texas                 Kweisi Mfume, Maryland
John Joyce, Pennsylvania             Deborah Ross, North Carolina
Marjorie Taylor Greene, Georgia      Robert Garcia, California
Ronny Jackson, Texas                 Ami Bera, California
Rich Mccormick, Georgia              Jill Tokuda, Hawaii


























                         C  O  N  T  E  N  T  S

                              ----------                              
                                                                   Page

Hearing held on November 14, 2024................................     1

                               Witnesses

                              ----------                              

Lawrence Tabak, D.D.S, Ph.D., Principal Deputy Director, National 
  Institutes of Health
Oral Statement...................................................     4

Henry Walke, M.D., M.P.H., Director of the Office of Readiness 
  and Response, Centers for Disease Control & Prevention
Oral Statement...................................................     6

Hilary Marston, M.D., M.P.H., Chief Medical Officer, U.S. Food & 
  Drug Administration
Oral Statement...................................................     8

Written opening statements and the written statements of the 
  witnesses are available on the U.S. House of Representatives 
  Document Repository at: docs.house.gov.

                           Index of Documents

                              ----------                              

  * Questions for the Record to: Dr. Marston; submitted by Rep. 
  Cloud.

  * Questions for the Record to: Dr. Tabak; submitted by Rep. 
  Cloud.

  * Questions for the Record to: Dr. Walke; submitted by Rep. 
  Cloud.

  * Questions for the Record to: Dr. Walke; submitted by Rep. 
  Miller-Meeks.

Documents are available at: docs.house.gov.

 
                    PREPARING FOR THE NEXT PANDEMIC:  
                  LESSONS LEARNED AND THE PATH FORWARD

                              ----------                              


                      Thursday, November 14, 2024

                     U.S. House of Representatives

               Committee on Oversight and Accountability

            Select Subcommittee on the Coronavirus Pandemic

                                                   Washington, D.C.

    The Subcommittee met, pursuant to notice, at 11:30 a.m., in 
room 2154, Rayburn House Office Building, Hon. Brad R. Wenstrup 
(Chairman of the Subcommittee) presiding.
    Present: Representatives Wenstrup, Miller-Meeks, Lesko, 
Cloud, Joyce, Greene, McCormick, Ruiz, Dingell, Mfume, Ross, 
Garcia, Bera, and Tokuda.
    Dr. Wenstrup. Good morning. The Select Subcommittee on the 
Coronavirus Pandemic will come to order.
    I want to welcome everyone here today.
    Without objection, the Chair may declare a recess at any 
time.
    I now recognize myself for the purpose of making an opening 
statement.
    I would like to thank the witnesses for their testimony at 
the Select Subcommittee's final hearing.
    The COVID-19 pandemic stands as one of the most devastating 
crises in our Nation's history. It claimed the lives of 
millions of Americans, disrupted livelihoods, and took a 
profound physical, emotional, and economic toll on families and 
communities across the country.
    Sadly, this likely will not be the last pandemic. There 
will be others that test our Nation's preparedness and 
resiliency in the future. So, we're here today to look at the 
lessons learned from the COVID-19 pandemic in order to prepare 
for and hopefully prevent the next one.
    In the last 2 years, the Select Subcommittee has sent 118 
investigative letters, conducted 38 transcribed interviews, 
held 25 hearings, and reviewed nearly 1 million pages of 
documents. The work of the Select Subcommittee revealed serious 
flaws in the government's response to the pandemic, 
underscoring the need for reforms.
    We saw inconsistent, contradictory guidance from the CDC 
that sowed confusion and diminished trust. Students were out of 
the classroom and told to attend school remotely even when the 
science had started to clearly demonstrate it was safe for them 
to be back in the classroom.
    We saw Americans pressured to receive a vaccine they were 
assured that would make them a dead-end for the virus and 
prevent reinfection and transmission--something that was known 
to be false based on vaccine trials.
    And at the NIH, there was a glaring lack of oversight over 
Federal grants that posed risk to public health and national 
security, and millions in taxpayer dollars funded risky gain-
of-function research in China. We found nefarious behavior by 
several federally funded actors--actions that betray the trust 
of the American citizens.
    We must learn from these errors, take the lessons to heart, 
and make fundamental changes. We must establish clearly defined 
roles, with an overarching structure that empowers agencies to 
act swiftly and effectively in mitigating the spread of novel 
viruses, as an example.
    It is essential for institutions such as NIAID and CDC to 
execute their assigned missions, functions, and tasks and not 
stray out of their respective lanes. For example, NIAID is 
entrusted with vaccine development, while the CDC is tasked 
with controlling and containing the spread of diseases. 
Throughout the pandemic, NIAID encroached into CDC's lane by 
advising on matters pertaining to containing the spread, 
creating confusion among the American people.
    Poor decisions made by Federal agencies shattered trust in 
our public-health institutions and left Americans questioning 
the very leadership that was supposed to protect them.
    Decisions made out of lack of knowledge and data is one 
thing, but poor decisions must be corrected. To be successful 
in the next pandemic, our Federal public-health institutions 
must be accountable to the people again. To be successful, our 
health organizations must do what they are supposed to do--
protect Americans. Stronger oversight, better accountability, 
and improved structure within our agencies are essential.
    Congress must consider a dedicated authority to oversee 
agency practices, ensuring that agencies act solely within 
their areas of statutory responsibilities and subject-matter 
expertise and insisting that public-health decisions are 
transparent, consistent, and credible.
    Let today's hearing be a step toward lasting reforms that 
will protect future generations from similar crises. I want to 
thank you, and I look forward to a strong on-topic discussion 
today.
    I would now like to recognize Ranking Member Ruiz for the 
purpose of making an opening statement.
    Dr. Ruiz. Thank you, Mr. Chairman.
    When COVID-19 hit our shores in the early months of 2020, 
our Nation began one of the most challenging chapters in its 
history. We entered a period marked by uncertainty, fear, and a 
staggering loss of life.
    And in those initial months, we, as Members of Congress and 
as a Nation, overcame our differences and came together to 
protect and provide relief through the Families First 
Coronavirus Response Act and the CARES Act for the American 
people in the face of this novel threat.
    Since that time, thanks to the life-saving impact of 
vaccines and the tireless work of our Nation's scientists and 
public-health officials, we have turned the page on the darkest 
days of the COVID-19 pandemic.
    But during that same period, we have also seen an 
unsettling rise in mistrust for our Nation's public-health 
officials and misinformation and disinformation about the very 
interventions that saved us.
    As we began the 118th Congress, we had a rare opportunity 
to take a serious, constructive look at these problems and 
develop forward-looking solutions to safeguard Americans from 
current and future threats. And when I became Ranking Member, I 
stood ready to work with any Member on either side of the aisle 
who would join me in this objective.
    But instead of taking steps forward to prevent and prepare 
our Nation for future pandemics, this Select Subcommittee has 
spent 2 years fanning the flames of people's mistrust in public 
health and taking advantage of their fears. And under the 
Republicans' leadership, the Select Subcommittee pursued 
vendettas against our Nation's scientists and public-health 
officials for partisan gain.
    But whether it was allegations that Dr. Fauci caused and 
covered up the origins of the COVID-19 pandemic or that our 
Nation's public-health officials sought to keep schools and 
businesses closed, more than half a million pages of documents, 
more than 30 transcribed interviews, and nearly two dozen 
hearings failed to turn up evidence to substantiate these 
extreme and baseless claims.
    And while the Select Subcommittee's probes did reveal 
discrete issues of misconduct that must be taken seriously, 
including by Dr. Peter Daszak and Dr. David Morens, we must ask 
ourselves whether our efforts over the past 2 years have 
fulfilled the objective of constructively improving our 
Nation's ability to prevent and prepare for the future 
pandemics on the issues that matter most and that would have 
the most significant impact in those future pandemics.
    Look, since day one, I have said that the Select 
Subcommittee's mission must be collaborating to develop the 
forward-looking solutions that leave our Nation better prepared 
for future novel viruses.
    I have wanted to examine how we close pathways for novel 
viruses to emerge, be they in nature or in a lab; or to focus 
on how we can strengthen our schools so that they can be better 
prepared to maintain safe, in-person learning during future 
pandemics; to look at how we can build on progress in 
strengthening infection prevention and control in nursing homes 
to keep our seniors safe and save lives; to explore how we can 
lay the groundwork for the rapid development of future vaccines 
and therapeutics for novel viruses when they inevitably emerge.
    And we could've done all these important things, things 
that have a high impact, significant ability to curb the deaths 
of the next pandemic or possibly even prevent them--and I've 
asked for more over the past 2 years--but we didn't. We didn't.
    And while we haven't yet come together to tackle these 
serious challenges--challenges facing Republicans and Democrats 
alike--I have always looked for opportunities to do so.
    So, as we begin today's hearing, I want to acknowledge that 
I welcome its focus, that I wish that we spent more time 
pursuing this subject with more experts, and I hope that we can 
commit to a forward-looking discussion about the road ahead. 
Because, even after 2 years, I still believe that there is a 
lot more to do, and it's not too late to come together and do 
the work of saving future lives.
    Thank you, and I yield back.
    Dr. Wenstrup. Our witnesses today are:
    Dr. Lawrence Tabak. Dr. Tabak is the Principal Deputy 
Director of the National Institutes of Health and served as 
Acting Director of the NIH from December 2021 to November 2023.
    Dr. Henry Walke. Dr. Walke is the Director of the Office of 
Readiness and Response at the Centers for Disease Control and 
Prevention.
    Dr. Hilary Marston. Dr. Marston is the Chief Medical 
Officer at the U.S. Food and Drug Administration and was a 
senior advisor on the White House COVID-19 Response Team.
    Pursuant to Committee on Oversight and Accountability rule 
9(g), the witnesses will please stand and raise their right 
hands.
    Do you solemnly swear or affirm that the testimony that you 
are about to give is the truth, the whole truth, and nothing 
but the truth, so help you God?
    Thank you.
    Let the record show that the witnesses all answered in the 
affirmative.
    The Select Subcommittee certainly appreciates you all for 
being here today, and we look forward to your testimony.
    Let me remind the witnesses that we have read your written 
statements and they will appear in full in the hearing record. 
Please limit your oral statements to 5 minutes.
    As a reminder, please press the button on the microphone in 
front of you so that it is on and the Members can hear you. 
When you begin to speak, the light in front of you will turn 
green. After 4 minutes, the light will turn yellow. When the 
red light comes on, your 5 minutes has expired and we would ask 
that you please wrap up.
    I now recognize Dr. Tabak to give an opening statement.

                STATEMENT OF LAWRENCE TABAK, DDS, PH.D.

                       PRINCIPAL DEPUTY DIRECTOR

                     NATIONAL INSTITUTES OF HEALTH

    Dr. Tabak. Thank you, Chairman Wenstrup, Ranking Member 
Ruiz, and distinguished Members of the Subcommittee.
    I appreciate the opportunity to be here today to discuss 
the critical role NIH plays in supporting research necessary 
for preventing infectious-disease outbreaks and preparing for 
the next public-health threat. We are here today because of our 
shared belief that taking stock of the lessons learned during 
the recent pandemic needs to happen sooner rather than later.
    While far too many lives were lost, we are proud of the 
research communities and brave research volunteers who 
participated in NIH-supported research that delivered a 
vaccine, diagnostic tests for home use, and a treatment, all in 
under a year--three remarkable feats.
    It is fair to say that many thousands of additional people 
would've died were it not for the public's investment in NIH-
supported research. But more work is needed to prepare for 
future threats, and it is essential to leverage what we've 
learned from the COVID-19 pandemic.
    To maximize our readiness for future pandemics, NIH must 
better coordinate its key assets, such as research and trial 
networks, as well as standardize platforms to rapidly evaluate 
the efficacy of diagnostic tests.
    To ensure that we can evaluate the broadest range of 
potential interventions, meaningful collaboration across the 
USG, industry, academia, and the public must be forged now. 
Plans must be put into place to assess potential interventions 
for their value to all communities of our Nation.
    It is not currently feasible to characterize and develop 
countermeasures for all circulating viruses around the globe. 
Therefore, the NIH, led by the National Institute of Allergy 
and Infectious Diseases, has developed a pandemic preparedness 
plan that prioritizes development of medical countermeasures 
for representative viruses from each of nine virus families.
    The knowledge gained will not only provide ready potential 
prevention and treatment strategies for the many different 
viral variants that could emerge but also the framework for a 
rapid research and product-development response to other 
viruses within each family in the event of an outbreak.
    In addition, by standardizing reagents, models, and data 
outputs, NIH's coordinated research networks would be able to 
more easily share results and collaborate quickly to enhance 
research efforts.
    We must also continue to invest in the development of 
methods for detecting transmission of virus that can be 
deployed in communities equitably and rapidly across the 
country. NIH is now applying the so-called RADx approach to 
address a range of health problems, including technologies to 
reduce the spread of HIV, and developing emergency diagnostics 
for emerging threats such as avian flu and then the seasonal 
flu.
    Finally, NIH knows that we cannot tackle emerging 
infectious diseases on our own, and we are working in 
partnerships with others to tackle emerging threats across the 
globe.
    One example is Marburg virus disease, a severe and often 
fatal illness in humans clinically very similar to Ebola virus 
disease. Currently, there are no FDA-approved therapeutics or 
vaccines available. In September of this year, Rwanda reported 
cases around their country.
    NIH is working with HHS counterparts and international 
partners to support research through the ongoing outbreak. 
NIAID has supported research on candidate therapeutics and 
vaccines for the disease and has helped make these candidates 
available in Rwanda to enable patient treatment and vaccination 
of contacts and healthcare workers.
    NIH remains committed to supporting these efforts and more 
to advance pandemic preparedness and enhance the international 
research capacity to respond to infectious disease.
    Continued success in NIH pandemic preparedness and 
biodefense efforts is contingent upon sustained congressional 
support. The President's budget request includes $20 billion in 
mandatory funding for the Public Health and Social Services 
Fund, of which $2.69 billion will support NIH's work.
    We appreciate your attention and support for these efforts. 
NIH will continue to meet the public-health emergency needs by 
advancing high-priority research of these threats.
    I thank you for your attention and welcome your questions.
    Dr. Wenstrup. Thank you, Doctor.
    I now recognize Dr. Walke.
    And if I mispronounced your name earlier, I apologize.
    Dr. Walke. That's OK.
    Dr. Wenstrup. Dr. Walke, you can give an opening statement, 
please.

                  STATEMENT OF HENRY WALKE, M.D., MPH

            DIRECTOR OF THE OFFICE OF READINESS AND RESPONSE

               CENTERS FOR DISEASE CONTROL AND PREVENTION

    Dr. Walke. Thank you. Chairman Wenstrup, Ranking Member 
Ruiz, and distinguished Members of the Subcommittee, it's an 
honor to be here today.
    I'm Henry Walke, the Director of CDC's Office of Readiness 
and Response, and I'm here today to discuss how CDC is working 
every day to protect our health security and save lives by 
putting science into action to help people and communities 
prevent, detect, and respond to health threats at home and 
abroad.
    We're seeing more infectious-disease threats than ever 
before, including emerging pathogens like avian influenza; 
viral hemorrhagic fevers like Ebola and Marburg; mpox; and 
Oropouche a new illness linked with birth defects.
    At the same time, many of the leading causes of death and 
the largest drivers of healthcare costs for Americans are 
noninfectious diseases such as heart disease, stroke, overdose, 
and suicide. CDC works in coordination with state and local 
health departments around the country to provide communities 
with effective strategies to combat all of these threats. With 
about 80 percent of our domestic funds going directly to state 
and local partners, we dedicate ourselves to partnering with 
communities to protect Americans.
    We are also in over 60 countries around the world, 
increasing laboratory capacity and building work force 
expertise so we can identify and stop pathogens at their 
source, protecting Americans at home. The relationships CDC 
builds in other countries means the first call ministries of 
health make when a health threat arises is often to CDC. It's a 
matter of national security that we maintain our world-class 
expertise to be the first to respond.
    The COVID-19 response showed a number of important 
successes, but it also exposed challenges and gaps that need to 
be filled. CDC, in conjunction with outside stakeholders, 
conducted an extensive review of our processes and 
organizational structure to document lessons learned and 
identify corrective actions. As this Committee has heard 
before, the report identified a number of areas for 
improvement, including streamlining communication, sharing data 
faster, and promoting partnerships.
    CDC has implemented over 160 key actions to drive 
accountability. These changes are seen every day in how CDC 
operates.
    Starting last respiratory season, CDC now has a public 
dashboard displaying COVID-19, flu, and RSV information all in 
one place.
    CDC recently made the first-of-its-kind awards with five 
private-sector clinical laboratory companies that provide a 
warm base of support for rapid and efficient distribution of 
diagnostics.
    And we're getting data out faster with the launch of the 
1CDP data platform that leverages data reported to CDC from 
thousands of sources to programs across the entire agency and 
shares it back in an action-oriented format for Federal, state, 
and local partners.
    I'm proud of the work we have done, but I have been at CDC 
long enough now to know that we can't do it alone. One of the 
core themes identified in moving forward with an effort to 
improve and modernize the agency was that CDC needed to bolster 
our core capabilities of data analytics, laboratory capacity, 
public-health work force, and domestic and global readiness and 
response.
    Strengthening these core functions would allow CDC to be 
nimble enough to address any health challenge, but we need the 
necessary funding and authority from Congress if we want to 
make the type of lasting change needed to respond to the next 
pandemic--or, better yet, to prevent it.
    Unfortunately, public-health funding is boosted when there 
is a crisis, but much of that funding is allowed to lapse 
during peacetime. We've seen this with H1N1, Ebola, Zika, and 
now COVID-19.
    These resources let us create incredible tools that can be 
used in an emergency but also support situational awareness for 
other pathogens--for example, our national wastewater system 
that gives us an early look at how diseases are progressing; or 
the RREDI platform that supports a response-ready agency to use 
data to make decisions near-real-time; or our Center for 
Forecasting Outbreak Analytics that can now show us when and 
where an emerging threat may go, helping communities best 
target limited resources; and, more broadly, continuing to 
modernize our public-health data capabilities.
    Without increased and sustained resources, these 
capabilities, which were all largely built with one-time 
emergency funds, are at risk of going away. Without authorities 
that let us surge and sustain our work force for the next 
emerging threat, we'll be back where we started before COVID.
    The CDC works every day to achieve our mission of 
protecting your communities from health threats. But we can't 
be the national-security asset Americans deserve without 
bipartisan support. I look forward to speaking with you today 
on the ways that we can enhance our collaboration to protect 
health and improve lives.
    And I'm happy to answer your questions.
    Dr. Wenstrup. Thank you.
    I now recognize Dr. Marston to give an opening statement.

                 STATEMENT OF HILARY MARSTON, M.D., MPH

                         CHIEF MEDICAL OFFICER

                   U.S. FOOD AND DRUG ADMINISTRATION

    Dr. Marston. Thank you so much.
    Chair Wenstrup, Ranking Member Ruiz, and Members of the 
Subcommittee, thank you for the opportunity to discuss the 
FDA's pandemic preparedness efforts.
    Recent events, whether the COVID-19 pandemic, the presence 
of highly pathogenic avian influenza in dairy cattle, or the 
emergency-induced supply chain disruptions that we're seeing 
with Hurricanes Helene and Milton, have all underscored the 
need to continue to optimize our Nation's preparedness and 
response capabilities.
    We know the profound impact that public-health emergencies 
and our ability to respond to them have on American lives. This 
can range from how global supply chains affect access to foods 
and medical products to the value and importance of vaccines, 
therapeutics, and diagnostics to address those public-health 
threats, reduce suffering, and ultimately save lives.
    The additional authorities and funding requested in the 
Fiscal Year 2025 President's budget are necessary to address 
future public-health threats effectively.
    Specifically for FDA, our public-health preparedness 
priorities are: one, providing greater transparency into supply 
chains; two, fostering medical countermeasure development; and 
three, ensuring operational readiness and surge capacity within 
the agency.
    So, first, supply chains. We need greater transparency into 
supply chains to help ensure access to critical medical 
products. Supply chains are subject to a range of market forces 
that are well beyond FDA's scope. For example, generic drugs, 
particularly generic sterile injectables, are most vulnerable 
to shortage. We know this. But that's due to market dynamics, 
including competition, investment needs, and uncertain demand--
all dynamics beyond the FDA's scope.
    FDA has worked within its current authorities to find ways 
to prevent and mitigate medical product shortages. Since the 
COVID-19 pandemic, we've worked with manufacturers to 
successfully mitigate or prevent 586 drug, biologic, and 
medical-device shortages. We rely on notifications from 
manufacturers to help prevent supply disruptions, and we've 
identified changes that could help the agency better mitigate 
or prevent shortages.
    Specifically, FDA seeks authorities to require FDA 
notification when there's increased demand for a product; 
require manufacturers to report sources of active 
pharmaceutical ingredients and the extent of manufacturer 
reliance on them; require labeling to include the original 
manufacturer and supply chain information; and require 
manufacturers to notify FDA about interruptions or 
discontinuances in medical-device manufacturing outside of 
public-health emergencies.
    Second, the COVID-19 pandemic underscored the importance of 
fostering medical countermeasure development as a preparedness 
measure.
    Throughout the COVID-19 response, FDA's scientists and 
employees worked around the clock trying to provide guidance to 
manufacturers and researchers, minimizing the time between 
clinical development, manufacturing, scale-up, and regulatory 
review. This is how FDA was able to help make critical medical 
countermeasures, especially COVID-19 vaccines, available as 
quickly as possible based on our stringent scientific and 
regulatory standards.
    We're leveraging the lessons learned from the COVID-19 
response in our everyday reviews, including reviews of platform 
technologies and improving communications with manufacturers.
    Third, ensuring operational readiness and surge capacity is 
critical in emergencies.
    During the COVID-19 pandemic, we saw FDA staff pulled away 
from other work to focus on pandemic work for 3 years, leading 
to backlogs and fatigue. Creating a specialized program to 
defend against emerging pathogens and other threats would leave 
the FDA best positioned to respond to future emergencies and 
focus experienced staff to work quickly on medical 
countermeasure development.
    Critical investments are also needed to increase FDA's 
inspectorate work force capacity to conduct oversight of those 
products.
    The key lessons learned and proposals I'll discuss today 
will bridge key gaps to enable a robust and timely response to 
future emergencies. They'll help enhance early detection; 
provide safe, effective, and accessible medical products; and 
maintain health system capacity.
    We look forward to continuing to work with Congress to 
improve public-health preparedness. Thank you for the 
opportunity to testify. I look forward to your questions.
    Dr. Wenstrup. Thank you.
    I now recognize myself for questions, but I do want to take 
a moment to thank you all again for being here.
    And I would tell you, I appreciate your constructive 
reforms that you talk about, actions that have been taken since 
the pandemic response, the idea of solutions, and honest self-
reflection that we all need to undergo if we are going to do 
better in the future. And I do hope that there can be robust 
work with Congress and the agencies and our Federal Government 
to do better.
    One of the things that we wanted to look at is the grant 
process. And we looked into that, and there seem to be, from 
Dr. Fauci's testimony, several flaws that I think we can 
correct. And we can correct them together for sure, improving 
the process. But part of that process is holding those that get 
grants accountable for their own responsibilities.
    So, Dr. Tabak, this past May, HHS immediately suspended and 
proposed debarment for both EcoHealth and Dr. Daszak. And, just 
following up, our understanding is that this process remains 
ongoing at this time?
    Dr. Tabak. That's correct.
    Dr. Wenstrup. And does NIH still support the debarment of 
EcoHealth and Dr. Daszak?
    Dr. Tabak. We do. And we have provided all necessary 
documents to the Department.
    Dr. Wenstrup. Thank you.
    At the time HHS announced the suspension, EcoHealth had 
three active grants with NIH. These grants had moneys already 
outlaid and obligated.
    Does the suspension stop future funding on these grants 
even if the money has already been obligated but not outlaid?
    Dr. Tabak. If the activity occurred before the suspension, 
we are, by law, obligated to reimburse them on a case-by-case 
basis. Any activities after the suspension are not 
reimbursable.
    Dr. Wenstrup. Did NIH make any efforts to claw back 
already-outlaid funds, or just realized you couldn't?
    Dr. Tabak. This has not occurred. This is--going forward 
from the suspension, they are not allowed to get additional 
funds.
    Dr. Wenstrup. OK. Thank you.
    One final question for you. Dr. Daszak has routinely said 
that the regulations did not require that he provide NIH with 
lab notebooks from the Wuhan Institute of Virology. Last year, 
NIH put out a new rule regarding this issue.
    So, just to clarify, when NIH asked for these lab 
notebooks, was Dr. Daszak required to produce them?
    Dr. Tabak. He was indeed.
    Dr. Wenstrup. Thank you.
    Dr. Walke, the Select Subcommittee went to Southeast Asia, 
Cambodia and Laos in particular, some of us, to get firsthand 
experience on how we work with these countries to protect the 
United States. And, quite frankly, I find it, as we discussed 
yesterday, a good form of diplomacy for the United States. But 
while we were there, we had meetings with CDC employees that 
were in-country.
    Now, you worked in global health. Do you think having U.S. 
Government personnel in countries to try to prevent pandemics 
from reaching our shores has a large return on investment? And, 
briefly, why?
    Dr. Walke. Thank you for the question.
    Absolutely. CDC has over 60 country offices spread around 
the world. We have CDC staff embedded in ministries of health 
to work on surveillance or data collection, laboratory 
capability, and trying to help improve their work force.
    So, when there is a cluster of illness anywhere in the 
world, our staff can work closely with ministries of health to 
detect that outbreak and then to try to rapidly control the 
outbreak at its source so that it actually maintains--that 
outbreak is maintained actually within the country or the 
region and never makes it to the U.S.
    So, it's a national-security asset to have these global 
health relationships.
    Dr. Wenstrup. Yes, I appreciate that. And I got to see that 
firsthand and receive praise to the United States for our 
efforts in that area. And it does reduce the potential for a 
pandemic to reach our shores, or an epidemic.
    The CDC issued hundreds of guidelines during the pandemic. 
The Federal and state governments took these guidelines a step 
further and imposed mandates. We had mask mandates, vaccine 
mandates, vaccine passports. These types of mandates blocked 
individuals from seeking personalized medical advice from their 
doctors very often.
    Do you think in future pandemics ensuring the sanctity of 
the doctor-patient relationship is vital?
    Your microphone, please.
    Dr. Walke. Thank you. Thanks again for the question.
    The COVID vaccine saves millions of lives. Related to the 
need for continued vaccine--I'm sorry, sir. I forgot your 
question. I apologize.
    Dr. Wenstrup. I said, do you think in a future pandemic 
ensuring the sanctity of the doctor-patient relationship is 
vital?
    Dr. Walke. I----
    Dr. Wenstrup. I think that, with mandates, we eliminated 
too much of the discussion that a patient can have with their 
doctor to talk about--yes, the vaccine saved millions of lives; 
I'm convinced of that. But there were things it couldn't do. 
And patients wanted to know that.
    So, I just wanted your take on maintaining that doctor-
patient relationship.
    Dr. Walke. Yes. No medical intervention, including 
vaccines, is risk-free, so it's very important for the patient 
or the person receiving that medical intervention, a vaccine 
for example, to have that strong relationship with their 
provider so they have the medical advice that they need. Some 
of these patients, for example, have underlying diseases or may 
have some complication related to the medical intervention.
    So, CDC makes recommendations for the population, for large 
communities--for communities at large, but maintaining that 
relationship between the provider and the patient helps 
interpret those recommendations for the individual.
    Dr. Wenstrup. Thank you, Doctor.
    Dr. Marston, in your written testimony, you emphasize the 
need for greater transparency within the medical-product supply 
chain--the supply chain issue is very important to me--to help 
prevent and mitigate drug shortages. The COVID-19 pandemic 
underscored just how fragile the supply chain is, as 
unprecedented demand led to severe shortages.
    Can you outline specific steps the FDA can take and maybe 
has started to take to strengthen supply chain resilience and 
prevent drug shortages during future public-health crises?
    Dr. Marston. Well, first, I want to say I appreciate the 
question, because these shortages are incredibly painful for 
communities across the country. They are not a new problem, but 
they certainly were laid bare during the COVID-19 pandemic.
    Also, it's important to recognize what's causing these 
shortages. And the primary causes of the shortages, the long-
term causes, are these weaknesses in the markets, right?
    These generic sterile injectables in particular, not 
everybody can make them. They need to be sterile; that's an 
important thing. You know this as a physician. They can't be 
made everywhere. And they require additional upkeep of those 
lines, additional care, the ability to have buffer stocks. All 
of these things cost money, and unfortunately the profit 
margins are very razor-thin.
    That is quite clearly beyond the mission of the FDA, but it 
is something where we are often trying to work on the fallout 
from those issues. So, one of the things that we've been doing 
is trying to partner across government for solutions that can 
address those market-based issues.
    But for the FDA in particular, there are some things that 
we can do to improve our ability to provide and mitigate 
shortages.
    First, we really need to be able to know when there is a 
rise in demand that these companies can't keep up with. So, 
currently, they are required to tell us if a line goes down and 
they can't keep up with supply. But if there's a spike in 
demand, for example, as we saw with the children's analgesics a 
couple of years ago, they don't need to tell us about that. So 
that sets us back in our ability to mitigate.
    Second, they don't need to specify their reliance on 
different manufacturers for active pharmaceutical ingredients. 
They don't need to put those things on their label. So, we have 
proposals that would address both of those and require that.
    And, third, medical-device manufacturers actually aren't 
required to tell us about any supply disruptions outside of a 
public-health emergency. So, if a tornado takes out your 
factory, which unfortunately is a painfully real example, 
you're not required to tell the FDA. We might call you, we 
might see it in the news, but it's not a requirement. So 
that's, again, something that we want to address.
    Dr. Wenstrup. Well, I don't know if you had previously read 
my next question, but it sounds like it. Because an idea we 
have had is to stand up a manufacturing reserve corps, in 
essence, to have trusted companies with capabilities ready to 
make things like masks, hand sanitizer, gowns, or vaccines, all 
that in place.
    So how can the FDA improve its coordination with 
manufacturers and healthcare providers to anticipate and meet 
surges in demand? And how can Congress help with that as well?
    Dr. Marston. So, maintaining those open lines of 
communication is one of our lessons learned from the pandemic, 
that, early and often, those communications are really what's 
needed to make us most effective.
    In terms of manufacturers, our small-but-mighty drug-
shortages staff is in close touch with manufacturers of some of 
these critical medical products, understanding their 
capabilities to make these products and be able to respond 
particularly for critical medical products should a supply 
disruption occur.
    As I mentioned, generic sterile injectables, particularly 
drugs like penicillin, these are things that are difficult to 
make, right? Not everybody can make them. So, it would be 
important to make sure that those manufacturers are qualified 
and have good processes in place, don't have an issue with 
cross-contamination, for example, which could end up in quite a 
bit of damage.
    Dr. Wenstrup. Thank you.
    I now recognize the Ranking Member, Dr. Ruiz from 
California, for 5 minutes of questions--or as you see fit.
    Dr. Ruiz. Thank you.
    As the Select Subcommittee gathers today, our Nation faces 
a pivotal moment when it comes to the future of pandemic 
prevention and preparedness.
    Thanks to the tireless work of the agencies and the 
individuals in those agencies sitting before us over the past 4 
years, our Nation overcame the darkest days of the COVID-19 
pandemic and has taken meaningful strides to strengthen our 
public-health infrastructure going forward.
    But the possibility of a future pandemic remains very real. 
Even today, we are facing emerging viruses like H5N1 which will 
continue to require investments of time and resources to 
contain. So, we must keep our foot on the gas even if it might 
be tempting to let up.
    Dr. Walke, let me begin with you. I understand an essential 
component of fortifying CDC's readiness for future outbreaks is 
providing the agency with expanded authority for robust public-
health data collection.
    Why is this reform so important? And what other reforms 
should Congress consider going forward to ensure your agency is 
best positioned to respond to emerging viruses?
    Dr. Walke. Thank you for the question.
    Early in the pandemic, as the virus was changing--first we 
had the wild type, then Alpha, Beta, Delta, and then Omicron--
we had difficulty trying to understand where transmission was 
happening. It was difficult to integrate our laboratory data 
with our hospital data with our case-based information in a way 
that we could actually create dashboards and make quick 
decisions on what to do. Some of our jurisdictions were even 
faxing information in around case reports.
    With sustained investment from Congress, we made incredible 
progress in pulling together that information and creating 
those systems so we could create that interoperability between 
all those various systems. But in order to keep going forward, 
we're going to need sustained investment in our data platforms.
    We have a large number of jurisdictions now who, still, 
healthcare providers are entering information in manually, 
actually, to report case reports. We've made incredible strides 
in electronic case reporting, moving from 187 healthcare 
facilities before COVID now to over 45,000 healthcare 
facilities who are able to quickly give us information around 
case reports. So, we need to continue that investment and 
actually improve it.
    We need authorities, though, as well. Early in the 
pandemic, early in an outbreak, before an emergency, a public-
health emergency is declared, we have to collect information 
very quickly to understand what's happening, as in COVID, and 
we need those policy changes to enable us to collect the 
information that's needed to make decisions.
    As well, that's a core capability related to data, but I'll 
stop there.
    Dr. Ruiz. Thank you.
    Dr. Marston, one of the great success stories of the 
pandemic was the effective and efficient manner in which 
scientists and the FDA brought a safe and effective COVID-19 
vaccine to the market and distributed throughout our Nation.
    What lessons did FDA identify from its work on the COVID-19 
vaccine? And how can Congress help to ensure these best 
practices remain in place for emerging public-health threats 
going forward?
    Dr. Marston. Thanks so much for that question and for your 
kind words about the work of the professionals at the FDA. 
Couldn't agree more with you. I joined the FDA in 2022, so I 
was an observer of that work. But, really, a tremendous effort.
    A couple of lessons that we learned.
    No. 1, continued transparency. We have made sure that our 
advisory committees are airing the data that they're seeing, 
that we're putting out summaries of our views, of our own 
analysis of the data that's provided by manufacturers. We do 
our own analysis, right? We don't just take things that are 
given to us. Our professionals look into the data themselves.
    Second, we have certainly learned a lesson and we have 
taken this lesson across the FDA for various medical 
countermeasures: the importance of telescoping to industry what 
our expectations are going to be, what sort of information that 
they're going to need to provide to us. So, we do that in the 
form of guidance, and we've done it in vaccines several times, 
therapeutics, and diagnostics.
    Third is this issue of surge capacity. Our folks are 
incredibly dedicated, and they worked around the clock. As I 
mentioned, that's led to backlogs, it's led to fatigue. If we 
had a cadre of folks who were experts in medical 
countermeasures, during, quote/unquote, ``peacetime'' they 
could work on those preparedness medical countermeasure 
development issues and during a response could jump into 
action. That would be tremendously helpful for the 
organization.
    Dr. Ruiz. Thank you.
    Let me conclude with you, Dr. Tabak. While the Select 
Subcommittee's efforts did not ultimately shed light on the 
origins of the novel coronavirus, they did underscore the 
importance of addressing pathways for potential pandemics both 
in nature and in labs.
    How can we balance the need for continued essential 
research to identify and get ahead of future viruses with the 
imperative that research take place safely and in a manner that 
is transparent to American taxpayers?
    Dr. Tabak. Well, as you point out, we do need to take the 
appropriate steps to ensure that any research of this type is 
done in a safe and efficient manner, but I think we do need to 
continue the long-term investment in basic discovery. Because 
without the fundamental knowledge of, for example, the 
different viral families for which we have less information, we 
would be working blind should one of those escape to be a new 
emergent pathogen.
    We also have to continue to build on the infrastructure 
that we have in place to ensure that we are ready for the next 
pandemic. And that includes things like, you know, pathogen 
surveillance and genomic sequencing and informatics and 
structural biology so that we have better understanding of what 
potential targets might be.
    And then, finally, we have to maintain a flexible domestic 
and global clinical-trial network infrastructure so that we can 
rapidly deploy potential countermeasures and test them for 
their efficacy.
    Dr. Ruiz. And what would the ramifications be of cutting 
funding to NIH for this and other essential research as a knee-
jerk reaction to the possibility that the novel coronavirus 
emerged from a lab incident?
    Dr. Tabak. The need for basic discovery is essential. We 
need to understand who the pathogens are. We need to understand 
how the pathogens transmit. We need to understand what their 
mechanisms of action are; what type of disease, what type of 
pathology they cause. And we need to support the key 
infrastructure that is essential going forward if we are to 
successfully defeat any emergent pathogen.
    Dr. Ruiz. OK.
    And I'm pretty confident that our own labs could attain 
that level of security. The question is, how do we work with 
adversarial countries to ensure that they're not--that they're 
up to code and they're transparent?
    Dr. Tabak. As you know, international collaboration and 
research is essential. And the pandemic underscored that. But, 
unfortunately, when there are instances of noncooperation, we 
have to, you know, call that out and hopefully work, you know, 
through both diplomatic and other channels to try and bring 
those organizations into, you know, a more favorable 
compliance.
    Dr. Ruiz. Thank you.
    Dr. Walke, you mentioned earlier that having investments in 
personnel in other countries is very important to be able to 
monitor any emerging virus.
    In your opinion, do we have--have we mapped the high-risk 
animal-to-human potential transmission locations? Are we in the 
right places?
    Dr. Walke. Thank you for the question.
    Related to emerging threats, there's a lot of work being 
done, both within CDC and public-health agencies, as well as 
the academic world, around where the next emerging threat might 
be. There's a number of issues here related to deforestation, 
for example, and population movements. But we do have staff 
actually in most of these areas--for example, in South America 
or in Africa--where we're seeing some of these emerging 
threats.
    We also place our staff where there's a large burden of 
disease--for example, HIV or malaria or tuberculosis. So, 
there's a number of different criteria when we make decisions 
about where to put our staff.
    But, as you have said, it's incredibly important to 
actually have that face-to-face people on the ground working 
side-by-side with ministries of health, because when something 
happens actually, they then work with our staff and ask for 
technical assistance and we're actually able to have that 
partnership.
    Dr. Ruiz. In what other ways, in addition to technical 
assistance, are we building the host countries' capacity to 
identify any emerging viruses and to better respond to those 
emerging viruses, to contain it there?
    Dr. Walke. In a similar way that we're trying to build 
capacity in this country in data and analytics and laboratory 
capacity, that trained public-health work force. And for global 
response, we do similar things, actually, in other countries.
    We embed within the laboratories and try to make sure that 
they have the validated assays available. We work with their 
data systems to make sure they can connect with each other. We 
actually train their field epidemiologists so that they know 
how to go out and collect the information to understand the 
transmission of these----
    Dr. Ruiz. OK.
    Dr. Walke [continuing]. Of these pathogens.
    Dr. Ruiz. Well, I really appreciate all of you--thank you--
all of you individually for your tireless work for our 
government, for the American people. Thank you for your work 
during the pandemic, and thank you for being here.
    I yield back.
    Dr. Wenstrup. I now recognize the Chairman of the Full 
Committee, Mr. Comer from Kentucky.
    Mr. Comer. Thank you.
    Dr. Tabak, is Dr. David Morens still employed by the NIH?
    Dr. Tabak. He is still an employee.
    Mr. Comer. When you testified this summer, I asked you a 
series of questions about some of Dr. Morens' actions. The 
first was if the NIH FOIA Office teaches employees how to avoid 
FOIA. You said, and I quote, ``I certainly hope not.''
    Are you aware one of your former FOIA officers invoked the 
Fifth Amendment when asked about this issue?
    Dr. Tabak. I have learned that in the lay press, yes.
    Mr. Comer. I then asked if Dr. Morens' deleting emails and 
using his personal email to hide his relationship with 
EcoHealth was consistent with NIH policy, and you said no.
    Do you stand by that?
    Dr. Tabak. Absolutely.
    Mr. Comer. I then asked if Dr. Morens' sharing internal NIH 
deliberations or helping EcoHealth craft responses was 
consistent with NIH policy. You said, quote, ``If those actions 
occurred, they would not be consistent.''
    Do you stand by that?
    Dr. Tabak. Yes, sir, I do.
    Mr. Comer. If I show you proof of those actions, will you 
take more employment action against Dr. Morens?
    Dr. Tabak. Sir, we are taking the actions necessary in all 
cases----
    Mr. Comer. OK.
    On the screen, in an email chain, it shows an internal NIH 
email about a draft letter from Dr. Fauci to Senators Graham 
and Paul. Dr. Morens forwarded this first to his Gmail and then 
to Dr. Daszak.
    Does sharing that draft letter violate NIH policy?
    Dr. Tabak. Yes, of course.
    Mr. Comer. The next email is the NIH informing Dr. Morens 
that the National Security Council will be leading the 
communications on the WHO origins report. Dr. Morens forwarded 
this first to his Gmail and then to Dr. Daszak.
    Does sharing this internal deliberation violate NIH policy?
    Dr. Tabak. Yes, it does.
    Mr. Comer. The next email is Dr. Daszak soliciting Dr. 
Morens' help in responding to NIH. Dr. Morens responded with 
his edits to the letter.
    But let's not take Dr. Morens' word for it. The attachment 
includes comments and track-changes done by Dr. Morens.
    Sir, does an NIH employee editing a grantee's oversight 
response to NIH violate NIH policy?
    Dr. Tabak. It absolutely is inappropriate.
    Mr. Comer. Have you read Dr. Morens' transcript of his 
interview before the Select Subcommittee?
    Dr. Tabak. I have not.
    Mr. Comer. Well, I'd like to share you with a few examples 
of his testimony.
    Dr. Morens was asked if he ever deleted an official record 
from his NIH account, and he answered, ``No.''
    On January 21, 2022, Dr. Morens wrote, and I quote, ``Twice 
in the past, including a month or so ago, I deleted everything 
with EHA people from my entire Outlook,'' end quote.
    Then, on August 1, 2022, Dr. Morens wrote, and I quote, 
``Hopefully no problems with the emails that came to me at my 
NIH address. I deleted them quickly,'' end quote.
    Did Dr. Morens lie to Congress?
    Dr. Tabak. Sir, I don't know if he successfully deleted the 
emails or not. If he's a Capstone employee, he would not be 
able to delete the emails. It goes out of his----
    Mr. Comer. Well, he thought he deleted them.
    Dr. Tabak. Well, he may have that thought that, but if he's 
a Capstone employee----
    Mr. Comer. So----
    Dr. Tabak [continuing]. It would remain in the record.
    Mr. Comer [continuing]. It looks to me like he lied to 
Congress. And that's a felony.
    Dr. Tabak. Well, again, I----
    Mr. Comer. Dr. Morens was asked if he provided any advice 
to Dr. Daszak on how to respond to NIH oversight requests, and 
he said, ``No.''
    As we discussed and you saw earlier, Dr. Morens personally 
edited a letter for Dr. Daszak that was directly related to NIH 
oversight of EcoHealth, the company at the center of the entire 
COVID pandemic.
    Did Dr. Morens lie to Congress?
    Dr. Tabak. Again, those types of actions would be 
completely inappropriate.
    Mr. Comer. ``Yes.'' The answer is ``yes.'' The evidence is 
on the screen.
    There's evidence that Dr. Morens violated numerous NIH 
policies and lied to Congress multiple times. Dr. Tabak, will 
you fire Dr. Morens?
    Dr. Tabak. As you know, we don't discuss specific personnel 
matters, but we are following all of our procedures to the 
letter.
    Mr. Comer. Well, this appears to me the perfect example of 
bureaucratic overreach, the type of bureaucratic overreach I 
think the American people sent a loud message to Washington 
that they're fed up with. And they want the bureaucracies 
dismantled.
    And one thing where I think we have bipartisan agreement is 
that there were a lot of mistakes made during the COVID 
pandemic. That's what the purpose of this Select Committee is 
for, and I think this Committee has been very effective in 
getting the truth to the American people.
    I look forward to working with the incoming Trump 
administration to get rid of waste, fraud, abuse, and 
mismanagement in the government and get rid of Federal 
employees that stand in the way of trying to bring transparency 
and efficiency to the Federal Government.
    Thank you, Chairman Wenstrup. Thank you for the great work 
you've done on this Select Committee.
    And I yield back.
    Dr. Wenstrup. Thank you.
    I now recognize Dr. Bera from California.
    Dr. Bera. Thank you, Mr. Chairman.
    You know, the title of this is ``Lessons Learned and the 
Path Forward.'' And there were a lot of lessons learned, and 
there's a lot that we should be thinking about.
    And this is an area that I've spent my six terms in 
Congress thinking about, pre-pandemic. You know, my staff 
would, early on, often wonder, like, why are you spending so 
much time thinking about this? I'd say, ``Go watch 'Contagion.' 
'' And then, unfortunately, you know, we lived it. That wasn't 
the hope.
    You know, post-Ebola, we put in some things in place, you 
know, in terms of having someone who was in charge of pandemic 
preparedness at the NSC looking around, programs like the 
PREDICT program that, you know, would be out there. And I 
visited those folks in Sierra Leone to see what we were doing 
to try to have early warning systems and do disease 
surveillance.
    A lot of that was dismantled in the first Trump 
Administration, and we sounded the alarms that it would make us 
vulnerable. I'm glad that we've put some of that back.
    You know, early in the winter of 2020, we sounded the 
alarms when we saw what was going on. We had the first hearing 
in Congress about this novel coronavirus and understood it was 
something different.
    We've now spent the better part of 4 years talking about 
COVID origins. I don't think we will ever get to the bottom of 
that, because the evidence was probably destroyed. And, you 
know, it was unfortunate we weren't able to get to the hot zone 
immediately in early 2020.
    I would urge us, as Congress and the country, to just 
accept both as plausible theories, so we can--you know, if it 
is a lab leak, let's actually raise lab standards. Let's have 
the ability--if folks are doing gain-of-function research and 
other research that is absolutely necessary for preparedness, 
let's make sure they're adhering to the highest of lab 
standards.
    We also know that viruses occur naturally and there are 
naturally occurring pathogens. We should do everything we can 
to, you know, try to prepare for that, and I think it's time 
for us to move on.
    You know, we have to better understand, with a novel virus 
and a pandemic and a very fluid situation where new information 
was coming in, how we get that information, how do we 
communicate it to the public. Because what we knew in March 
2020 was very different than what we knew in October 2020.
    And, again, in a fluid situation where people are scared, 
we should spend time thinking about how we allow the scientists 
to be the scientists, how we allow the politicians to be the 
politicians, but not have the politicians try to be the 
scientists and the scientists try to be the politicians. How do 
we work together to communicate that, again, to a scared 
public.
    You know, Dr. Marston, you talked about the critical 
vulnerabilities in our supply chain. Those clearly were 
exposed. We, as Congress, should do everything we can, with the 
rest of the world, to address those critical shortages, think 
about what that looks like, and, you know, fairly quickly, 
where it makes sense, on APIs, on protective equipment, et 
cetera, you know, make sure we've got adequate stockpiles but 
we've also got the reserve capacity to flex up very quickly.
    Early on, I was involved in lots of conversations that 
talked about various strategies of--you know, we knew older 
patients were more vulnerable. You know, perhaps this did not 
seem to be impacting younger folks as quickly as possible, 
given the devastation we were seeing in New York. We made broad 
decisions which I think made sense at that juncture, but as we 
gained more information, we should've fed that back into 
strategies.
    You know, I totally understand why in the spring of 2020 we 
closed schools. Was that the right decision in the fall of 
2020? You know, we've got a perfect ability to--different 
states did different things. We should go back and learn from 
that and feed that into the future so, if we're faced with the 
same dilemma, we have that information.
    I still have plenty of questions about why, as this virus 
evolved--you know, it came up through the East Coast, through 
Italy, into New York, devastated New York. We had the first 
naturally occurring case at my home institution, UC Davis, but 
it didn't rip through California. You know, I would've expected 
to see really bad results in Japan--densely populated area, 
they're a little bit more open, an older population. Why did 
the virus impact different countries differently? It didn't rip 
through India, which, you know, we were incredibly worried 
about.
    I would hope that we, in an objective way, as a scientific 
community, taking politics out of this, could go back and try 
to understand the epidemiology. Was it that Japanese culture is 
a mask-wearing culture, et cetera.
    So, you know, there are plenty of questions that still 
remain outstanding. If we could allow the scientists and the 
academics to address those things, I would hope that we, as 
Congress, could fund those studies, understand it, not to 
prosecute anyone or anything else but to actually better 
prepare ourselves as a country and the world.
    You know, our public-health systems I knew had atrophied. 
We had very bad disease surveillance systems. Obviously, we've 
stood up wastewater surveillance and other measures. We could 
do better, though, to protect our public.
    And it is not just naturally occurring pathogens. The 
Chairman and I sit on the Intelligence Committee and we talk 
about, you know, the vulnerabilities of bad actors, of bio 
threats, et cetera. We ought to, as a Congress, in a 
nonpartisan way, learn from the past but better prepare 
ourselves for the future.
    There were real successes as well. You know, I never 
would've expected that we would get a vaccine--several vaccines 
that were safe and efficacious within 12 months. We did it. 
Some of that was because of prior investments in research at 
the NIH and elsewhere. Can we get that from 12 months to 3 
months?
    Can we--the FDA successfully streamlined processes to get 
biotherapeutics to market. What are lessons learned there? Can 
we take some of those and actually use them to develop those 
therapeutics and countermeasures fairly quickly?
    I'm out of time. I can go on and on. But I would hope, as 
we look forward, we actually do a real, objective analysis 
without trying to point--we got things right, and we got things 
wrong. Let's actually learn from that, and let's better prepare 
for the future.
    Thank you, Mr. Chairman.
    Dr. Wenstrup. You know, I thank you, Dr. Bera. I'm going to 
have to take a second to comment on your comment. Because I 
agree with you tremendously. Yes, part of what we are doing 
here--we had to look back. We can't look forward if we don't 
look back and see how we can do things better. And I think you 
just gave a very constructive approach to what can be done in 
the future. And that's greatly appreciated. And I want people 
to hear that.
    This Committee is doing a lot of things. Sometimes there's 
things people don't like, and sometimes there's things people 
do like. But, nonetheless, it's, what are we doing going 
forward?
    And so, this has been an after-action review. Lessons 
learned. And that's how you create the path forward. And I 
think you touched on many of those things. And I thank you for 
taking your time today to reflect on that.
    I now recognize Dr. Miller-Meeks from Iowa for 5 minutes of 
questions.
    Dr. Miller-Meeks. Well, thank you very much, Chairman 
Wenstrup.
    And thank you to witnesses for testifying before the Select 
Subcommittee today.
    And I am going to dovetail a little bit on what my 
colleagues just said.
    Today being the last scheduled hearing for the Select 
Subcommittee, this is my fourth year on this Select 
Subcommittee. I would like to take a moment to thank Dr. 
Wenstrup and his staff for their incredible leadership 
throughout this Congress on investigating and evaluating the 
Federal Government's response to the COVID-19 pandemic.
    Under his direction, we have held key agencies and 
witnesses accountable for their actions made during the 
pandemic, fulfilling the Oversight and Accountability 
Committee's mission to provide a check and balance on the role 
and power of Washington, and a voice to the people it serves.
    I'm really proud of the work that we have done, and I look 
forward to another productive hearing. And, most importantly, 
the majority of us on this Committee understood that our 
mission was, in fact, to prepare for the next pandemic. And so, 
what has been brought up by Dr. Wenstrup and Dr. Bera is 
precisely that. I spent 24 years in the military, as well as a 
practicing nurse, doctor, former director of the Iowa 
Department of Public Health. And, if we don't look back on what 
we did and do an after-action report, we don't know how to 
buildupon what has gone before, what our errors were.
    Dr. Walke, you are the director of the Office of the 
Readiness and Response at the CDC where you support the 
agency's effort to improve performance for public health 
emergencies. And, as you likely know, as I just stated, I was 
the director of the Department of Public Health, and I was a 
practicing physician prior--before, after, and then prior to 
coming to Congress.
    And I thank Dr. Bera for his comments about origins. Yes, 
we spent a lot of time on origins. But, even in 2020 as a 
freshman Congressperson when the media and social media was 
trying to portray this as a witch hunt, and it was useless, my 
comments in 2021 are the same as they are today. It was 
necessary to investigate origins because that's how we prepare 
for the next pandemic.
    We need to discuss immediate disclosure, which the Chinese 
Community Party did not do and are required to do under 
international law. We need to discuss lab safety, what type of 
laboratory research occurs and what lab environments, and that 
it's in the correct lab environment. And, No. 3, we need to 
discuss the ethics of certain types of research, i.e., gain-of-
function research. So that's why those were important issues.
    And, you know, my next question is going along this line on 
how people were treated who engaged in conversations, not 
conformity of thought. During the COVID-19 pandemic, I 
administered vaccines to Iowans in all 24 counties in my 
district but never supported any sort of vaccine mandate or 
vaccine passport. And that's because I'm a physician first.
    I was and still am critical of the CDC's messaging 
surrounding vaccines during the pandemic, largely because it 
inserted itself between the doctor-patient relationship, and it 
discouraged patients from asking questions. It downplayed and, 
in fact, refuted that there was infection-acquired immunity and 
herd immunity. People were labeled as antivaxxers, radicals, 
and called other demeaning terms simply for questioning whether 
novel vaccines that had not been FDA approved were right for 
them; or if they needed to be vaccinated if they'd already had 
proven disease and immunity; or if, because of their age--and 
we saw two of the expert--vaccine experts at the FDA resign 
over the FDA's position.
    So, as a result, we have seen increased rate of vaccine 
hesitancy, which could have a detrimental impact on public 
health, especially as we're entering flu season. In most of my 
district, for example, rates of vaccine hesitancy are already 
at 15 percent. And, as a state senator in 2019 and 2020, I can 
tell you there were numerous bills entered and discussed about 
prohibiting vaccines.
    So, do you believe that the CDC's, I'll call it forceful, 
to be diplomatic, guidance on COVID-19 vaccines, and lack of 
detailed information on possible adverse outcomes, like when 
they downplayed that there was myocarditis in young men, that 
it's contributed to the increasing rates of vaccine hesitancy?
    Dr. Walke. Thank you for the question. COVID vaccines have 
really undergone the most rigorous safety monitoring of any 
vaccine in history. And there are----
    Dr. Miller-Meeks. I'm sorry. Please don't do that. Please 
don't do that. I'm asking you, how is the CDC going to overcome 
increasing vaccine hesitancy? And talking to people about the 
most rigorous scientific protocol for COVID-19 vaccines is not 
going to end that hesitancy. They have people they talk to in 
their community. They have young people who have myocarditis. 
We have people who were kicked out of the military because they 
declined to get a vaccine when they didn't need it. I even was 
advised, even though I had strong antibodies, to get the 
booster. And I'm a physician and asking the physician, ``Why in 
the world would you recommend this when you just tested my 
antibodies?'' The purpose of vaccines is to confer immunity.
    So, what is the CDC doing on vaccine hesitancy? Have you 
worked with outside stakeholders and providers? And how are you 
going to meaningfully reduce vaccine hesitancy?
    Dr. Walke. We are working with a number of different 
external groups to try to improve trust and try to overcome 
vaccine hesitancy.
    Vaccines are incredibly effective and the best defense. We 
also believe that CDC makes recommendations for the general 
public. But that relationship between the provider and the 
patient is incredibly important to interpret that 
recommendation from a public health agency----
    Dr. Miller-Meeks. I would wholeheartedly agree, which is 
what the CDC should have done and how they should have messaged 
during the vaccine, to leave that between the doctor and 
patient.
    With that, I yield back. Thank you.
    Dr. Wenstrup. I now recognize Mr. Mfume from Maryland for 5 
minutes of questions.
    Mr. Mfume. Thank you very much, Mr. Chairman. I want to 
thank you and the Ranking Member for leading us through these 
last 2 years of this Subcommittee. And I think it's fair to say 
that Members on both sides of the aisle have had an opportunity 
to express themselves but also an opportunity to listen to and, 
at different points, appreciate the positions of other Members 
of this Committee that may not be in line with ours.
    I want to thank, in particular, the Ranking Member for 
leading us toward a minority report, which as we know submitted 
and carried the best thinking, the thoughts, and the position 
of those of us on this side of the aisle. And just both of you 
for the way you have worked together and the example that you 
have put forward.
    I always talk about real time when I get a chance to speak 
here on this Committee. Because COVID was real time. And there 
was no playbook. There were no real guidelines. And we learned, 
and we made mistakes in real time.
    The one thing that I do want to preface of my remarks is 
that we must never, ever, ever forget the millions of people 
who died here and all over this globe as a result of this 
pandemic. We don't talk about them that much as we get further 
and further away. But we cannot do an autopsy of what we went 
through without mentioning the fact that so many lives, so many 
families were and still are affected by this.
    So, we have a special calling, I think, to find in a 
bipartisan way those things that will help us in future years 
as we look back on this. And it is important, in many respects, 
since we are no longer in real time of a disease, that we do 
that autopsy, do it the right way, and make sure that this 
Congress, at least, leaves behind at the conclusion of the 
Select Subcommittee, a path and a way forward, and a number of 
suggestions and other things that will help us well into the 
future.
    Now, I think it's, for me at least, always important to 
make sure that there is a public record established, and 
sometimes it means through redundancy.
    So, I want to speak directly to you, Dr. Walke, Dr. Tabak, 
maybe Dr. Marston, and be a little redundant here. But 
redundancy is important because, if, in fact, in your positions 
and if, in fact, with the expertise that you bear, that you say 
what you said prior to this meeting over the last several 
years, but that you say it one more time.
    So, Dr. Marston, Dr. Walke, give me, please, what you 
believe is the way that we can, in this Nation, persuade the 
public that approved vaccines are safe and effective while 
taking into considerations the things that come up after the 
issuance of those vaccines that call attention to special 
groups or special circumstance that then ought to be rolled 
into how we move forward. Either or both of you if you could.
    Dr. Walke. Thank you for the question. Related to mistrust 
around vaccines, a Federal agency like CDC can make 
recommendations for vaccines and through--and with our other 
agencies create the scientific base so that they are the best 
defense against hospitalizations and death.
    But I remember when I was in the emergency operation center 
in 2000 watching the deaths climb. And then, when vaccines 
became available, I saw the rates go down. And it was 
tremendous. It was magnificent. But then the distrust and the 
miscommunication around vaccines started, and we saw those 
death rates plateau.
    A Federal agency can only do so much. It requires 
healthcare providers. And that relationship, it requires 
communities, leaders in the communities, and various different 
types of leaders actually to trust in leaders----
    Mr. Mfume. Well, let me interrupt you here. I'm also trying 
to get to what happens when there are new developments after 
the issuance of a vaccine? The gentlewoman from Iowa spoke 
about enlargement of the heart syndrome and how that was 
believed to be affecting certain groups. When those types of 
information come forward, how do you evolve then your 
presentation of the evidence or of the vaccine? Because, if 
not, there's going to be continue to be a great deal of 
mistrust.
    Dr. Walke. I'll start. Again, we have these adverse events, 
surveillance systems in place to detect any adverse event. And 
then we have other systems in place to try to see if there is a 
cause, if myocarditis was related or not. And, once we have 
that type of information, we try to push that out in various 
ways, including the scientific publications but also through, 
again, various state and local leaders to try to engage with 
their communities.
    Mr. Mfume. Is that what we did?
    Dr. Walke. That is what--we had a multiprong approach to 
try to communicate the risk related to vaccines. But, again, I 
think we have a--there is a number of different communities in 
our country, and we need to do better, I believe, at trying to 
reach those communities to talk to them about what are some of 
the issues they have with vaccine.
    Mr. Mfume. Dr. Tabak----
    Dr. Wenstrup. If we can, your time has expired, but I do 
want to let Dr. Marston reply as well. I think it was a very 
important question that you asked, and I would like to give you 
opportunity to reply.
    Dr. Marston. Thank you, Mr. Chairman, I would be glad to. 
So, the truth of the matter is that we worked quite closely 
with the CDC on these matters. And the most important lesson, I 
think, that we have learned is to show our work and explain our 
work.
    For example, when we see a safety signal in something like 
VAERS, we're going to look in our multiple systems to see if 
that actually is something that is plausibly related to the 
vaccine. Where then, we then have multiple cases, taking those 
analyses and put them into the published literature, we also 
present them at advisory committees.
    I think one of the things that we are also looking at is 
that that's not good enough, right? So that reaches a certain 
group of people. The people who are regularly reading the 
medical literature, for example. We need to take it a step 
further, right, and communicate those things on multiple levels 
so that they're easy to understand.
    So, one of the things that we've been doing is working with 
the clinician community, trying to make sure that they're armed 
digestible information that they can then relate at their 
patients. Because, you know, people might not be listening to 
the Federal Government, the public health agencies. I hope that 
they will. But we also want to make sure that we're meeting 
people where they are. And, if that's with their local 
clinician with their physician, with their nurse, we want to 
give those people the info they need.
    Mr. Mfume. Thank you. Thank you for the extra time, Mr. 
Chairman.
    Dr. Wenstrup. I now recognize Mrs. Lesko from Arizona for 5 
minutes of questions.
    Mrs. Lesko. Thank you, Mr. Chairman. Before I ask 
questions, I want to say thank you to the Chairman Wenstrup. 
Both he and I are ending our careers in Congress, and so I 
really appreciate all the work that you've done. I think this 
has been a very important Committee, and thank you for inviting 
me on it.
    I also want to thank the other Members, including the 
Ranking Member, Dr. Ruiz. It's been an honor serving with all 
of you.
    Now, I'm going to get to my question.
    Dr. Tabak, I want to followup on what Chairman Comer asked 
about and Dr. Morens. It does appear to me from previous 
testimony and questions that our staff--that he violated rules, 
whether that's FOIAs. He was trying to get around FOIAs. It 
appears that he was trying to help EcoAlliance, EcoHealth 
Alliance I should say. And why can't you fire him? I don't 
understand why it hasn't happened already.
    Dr. Tabak. We are following our process.
    Mrs. Lesko. What is the process? How long does it take to 
fire somebody?
    Dr. Tabak. We follow our process.
    Mrs. Lesko. What is the process?
    Dr. Tabak. The individual is accorded the opportunity to be 
present their side of the facts.
    Mrs. Lesko. Right.
    Dr. Tabak. An individual is then charged with making a 
decision as to what should occur. Again, this is hypothetical, 
of course, in terms of--I can't discuss any specific case.
    Once that decision is provided to the individual staff 
member, he or she is allowed to appeal that decision, and then 
that goes to a second official for a final adjudication. So, 
we're following our process, and that's what we're doing.
    Mrs. Lesko. Has this process been started?
    Dr. Tabak. I'm not allowed to discuss any specifics of the 
process. Over----
    Mrs. Lesko. Well, I hope you understand, sir, why, you 
know, myself and the American public just don't--they think 
this is not a good policy because.
    For instance, in a regular company or business, if somebody 
violated the rules, you just get fired. Right? And so that's 
why I think some of the actions that are being taken with the 
next Administration are probably happening because the American 
public just don't understand why somebody who seems to have 
clearly violated things, you know, the answer is just, ``We're 
following the process.''
    But my next question is actually for all of you in the 
little over 2 minutes I have. The Americans have decreased 
trust, less trust in the Federal health agencies after COVID. 
And I want to know from each of you if you or your agencies 
believe that you played a role in that, and if so how are you 
going to change it?
    Dr. Tabak. Well, since I have my mic on, I'll start. Of 
course, this was a very fluid situation, as you, of course, 
appreciate from your work on this Committee. And we understand 
that we have to do a much, much better job of being more 
transparent, of doing better communication, of getting into 
communities, working with trusted partners in communities. You 
just can't so-call parachute and expect people to benefit from 
your wisdom. You have to have a real conversation with them in 
a transparent manner.
    Dr. Walke. I would agree with Dr. Tabak. Trust is critical 
for a public health agency. There is a number of--the pandemic 
was moving quickly. The virus was changing rapidly. We were 
putting out a lot of guidance almost weekly. And it became very 
difficult, even, to find the information that was needed on our 
CDC.gov website. We have made changes. We try to be a lot more 
transparent. We have streamlined, actually, our website by 
about 60 percent. We tried to move to make it more plain 
language so it's more accessible to the American public. So, we 
acknowledge that there are challenges here, and we are 
responding to them.
    Dr. Marston. Yes, I would agree as well. I think one of the 
things that we've been working on is how to work in concert 
with individuals who are in other settings, clinical settings, 
the individuals right before us right now, people who also have 
the ear of the American people, and trying to make sure that 
we're putting out information that is both high quality, up to 
our scientific standards, and digestible.
    Mrs. Lesko. Well, thank you all for your answers. I would 
say that it is important to be more transparent--and that was 
goes back to my question about Dr. Morens, I mean, just saying 
procedures. Now maybe there's legal consequences. But that's 
like not a very transparent answer in my view.
    Also, I want to suggest to all of you, hopefully, you've 
heard it before from me is that government mandates--that 
backfired. I mean, I don't think there should be government 
mandates at all. I don't think they should be suggested because 
people don't trust the government. And so that made people less 
trustful of the government in my view. And so, with that, I 
yield back.
    Dr. Wenstrup. I now recognize Mr. Garcia from California 
for 5 minutes of questions.
    Mr. Robert Garcia of California. Thank you to our 
witnesses. I want to thank the Chairman and the Ranking Member 
of the Subcommittee for all of their work. And, obviously, 
oftentimes Members on this body and Committee disagree. I think 
it's important to recognize we lost 1.3 million Americans due 
to the pandemic, our single largest loss of life event that 
we've had in the modern era. There's over 3,000 people in my 
own city of Long Beach died while I was the mayor right before 
I got to Congress. Horrific experience to see what the pandemic 
did for cities and communities across the country and, of 
course, the world.
    I want to note a couple of things as this is our closing. 
This Committee, I think, one is--I'm hoping that there's two 
critical changes that I think are really important on the 
Federal level, bills that I've been working on. I want to note 
this for all of you. I am very concerned that still the 
Department of Health and Human Services does not have the same 
emergency buying power the Department of Defense has.
    When we went through the pandemic, much of the purchasing 
of PPE and testing went through DOD because they have emergency 
power to purchase in bulk and purchase and kind of cut the red 
tape. That power does not exist for Health and Human Services, 
where I personally and many others believe is where those 
purchases and where that direction should be coming. It should 
be coming HHS, not from DOD. At least it should have the same 
purchasing power. So that's something that we're working on. We 
have a bill on that.
    The second issue I want to note for Members of the 
Committee is we have to get to a point where we fully fund the 
CDC's National Wastewater Surveillance System. I can't express 
how important this is in preventing future pandemics. This is 
woefully underfunded. And we have a huge opportunity to allow 
and provide the CDC the resources they need to ensure that we 
are using this incredible resource now and being able to track 
viruses and pandemics to the future, and they were funding this 
at its full level, and not actually cutting the CDC and this 
program. So those are things that are very concerning to me.
    And I want to say one other thing which I think is 
important, my last opportunity. Dr. Tabak, I know you're with 
the NIH. And I just wanted you to just briefly mention what the 
NIH's responsibility is to prevent pandemics that this 
Committee is working on?
    Dr. Tabak. So, we support and conduct the research that 
informs the actions of my colleagues on this panel. We do long-
term basic discovery to learn about viruses. We develop key 
infrastructure so that we can be responsive in identifying 
newly emergent organisms. We set up appropriate model systems 
to test the efficacy of potential countermeasures. We have a 
GMP manufacturing facility. And----
    Mr. Garcia. And, Doctor, I would be correct to assume that 
this is a completely nonpartisan organization. The work is 
essential to our Nation's security and preparedness. I have met 
folks that I have worked with at the NIH and immense respect 
for the scientists, doctors, workers that are there. Would you 
agree it's a completely nonpartisan type of work.
    Dr. Tabak. Yes, we certainly are not.
    Mr. Garcia. Then I want to just leave us a final thought. 
I'm very, very concerned that someone that can be entrusted 
with Nation's health--RFK, Jr.--has recently said, and I quote, 
that he plans to have a big role in the administration as it 
relates to health, and has just days ago pledged to gut the 
NIH, firing hundreds of scientists and researchers on day one.
    [Chart shown.]
    Mr. Garcia. And I am going to show--this is from ABC News--
the headline that just appeared a few days ago. If we're 
talking about pandemic preparedness--and with all due respect 
to the Committee and the work--the fact that we're considering 
to bring somebody on with no scientific or medical credentials, 
who has falsely claimed for decades that vaccines cause autism, 
who has quite frankly said just outrageous comments about 
science and medicine, that this person would come in to gut the 
NIH, I think is shameful. I think it's shameful.
    And, Ms. Greene, you can clap all you want. But it is 
shameful; it's dangerous. And, if this Committee is about 
pandemic prevention, we should be very concerned as a country 
that RFK, Jr. could be put in charge of health when he is a 
vaccine denier and has caused great harm to the American 
public.
    I want to say just, finally, that I'm very concerned that 
someone that wants to gut the NIH, HHS, and other services 
could be put in charge of health, of any kind, in this country.
    So, I want to thank you, sir, for your service at the NIH 
and for all of the witnesses that are here.
    And, with that I yield back.
    Dr. Wenstrup. I now recognize Mr. Cloud from Texas for 5 
minutes of questions.
    Mr. Cloud. Thank you, Chairman, and thank you all for being 
here to discuss the lessons learned throughout the COVID 
pandemic. Together you all represent the bulk of the 
government's response to COVID, or you represent the agencies 
that were bulk of the response. And the American people are 
very concerned about the government's response, you know. There 
was a lot of understanding in the first couple of weeks that 
this was novel, and we had to figure it out. But, once the 
outbreak kept going, we saw attempts to cover up failures. We 
saw blatantly politicized policymaking. We saw Americans 
getting deceptive advice while their civil liberties were being 
trampled on. Federal public health agencies promoted school 
closures that caused long-term learning loss and mental health 
problems. Forced mask mandates on toddlers in the face of all 
scientific evidence to the contrary. Threatening Americans with 
the loss of their livelihood. Their businesses were closed if 
they declined new--any experimental vaccine. Along with many, 
many, many other grievances that the people would have in the 
response that we had.
    Now, we got together on Tuesday just so the Chairman can 
let us know that this hearing was going to happen, and someone 
asked the question and said, ``What do you think the lessons 
learned are going to be in the testimony?'' And I kind of 
jokingly replied, ``Well, I'm guessing like every other agency 
that makes a mistake or has failures in the Federal Government, 
they'll probably come and same, 'Well, we need more money and 
more authorities.' '' And that's by and large what the 
testimony was today. And I'm not saying those discussions don't 
need to happen at some point. I mean, it would be very suitable 
for the Appropriations Committee. But what we didn't see was an 
answer to these questions that remain outstanding for the 
American people. And, in an effort to rebuild trust, it's very 
important that we answer these questions.
    Dr. Tabak, I wanted ask you one of the things that we--that 
came up in much of our testimony--Dr. Fauci and Dr. Collins 
both indicated to this Committee that, even though their 
signatures appear on every grant, basically the process is that 
you have people researching the grants, right, at a lower 
level, and basically they put it before a committee or a peer-
review committee that receives a priority score. Then it goes 
to an advisory council. And then it goes to--at the time it was 
Dr. Fauci, for example, when we were talking about the NIH 
grant.
    Now, this is one of many cases. I've seen this in agency 
after agency after agency. These are supposed to be multiple 
levers of accountability. And what happens is Dr. Fauci, for 
example, said, ``Well, yes, my name's on it, but, you know, I 
don't have time to read every grant.'' And that's kind of 
understandable. Well, then who is responsible for it? Well, 
it's this Committee. Well, this Committee votes on it. Like 
block grants to the tune of even sometimes a hundred grants at 
the same time. They don't actually read it either.
    And so, we end up having these supposed multiple layers of 
accountability that turn into multiple layers of plausible 
deniability. So, nobody ends up being held to account. And so, 
when we're talking about lessons learned, these are the kind of 
systemic things within agencies that I would like to hear: What 
are we doing to fix these things? What are we doing to make 
sure that we don't tread on people's civil rights again? What 
are we doing to make sure that we don't threaten the licenses 
of medical professionals who are experts in the field that 
might have a different view?
    These are the kind of things that I'm wondering, how are we 
going to make sure that the government stays in check so that 
we can begin to restore the trust in the American people?
    Can you speak to the grants system, and has anything been 
done about that? Because I brought this up in several Committee 
hearings since then.
    Dr. Tabak. So, again, you described the way grants are 
reviewed.
    Mr. Cloud. That's my point, though. My point is that needs 
to change. So, you know, we brought this up in a number of 
Committee hearings how broke this process is. Are you doing 
anything to fix those things? Are you doing anything to fix 
these other--before you come in and ask is for money, we still 
have a guy who committed perjury before Congress who is still 
there. Now I understand some of that's statutory, and maybe we 
can work together to streamline that process. So, I'm not 
putting that on you.
    But, when it comes to like we're going to ask the American 
people to fund some of these ideas you have, right, I am 
concerned about the government having more data I will say. But 
what can we do in--I mean, feel free any of you jump in, to fix 
these systemic problems so we can--before we go ask the 
American people to fund this, what are we doing to fix the 
issues that tread on their rights, that took their jobs, that 
failed their businesses, that took their medical license, all 
these sorts of things.
    Dr. Walke. Thank you. I would just start and say that we 
have reflected and looked at our internal processes and made a 
number of operational changes, including related to revamping 
our communication. I talked about trying to clean up our 
website and make it more accessible. We've improved our test 
development process and had better partnerships with the 
private sector. We actually have mechanisms in place now where 
the H5N1, we are trying to work with other partners, with 
private industries and develop new tests for H5N1 and for 
Oropouche.
    We've refined our guidance processes in the way we're 
sharing with external partners and trying to make standardized 
across all of CDC and internal to CDC. When we deployed staff 
all around the Nation, we had difficulty with the way we did 
that. So, we have actually changed the way we actually are 
deploying our staff. And so, all of our staff are moving toward 
operational readiness, readiness to respond. So, we have made a 
number of changes at CDC.
    Mr. Cloud. My time is up.
    Dr. Wenstrup. I will allow anyone else to answer that.
    Dr. Tabak. Again, the changes we have made are to enhance 
our oversight of the awarded grants. Because where we ran it 
into difficulties was the failure to catch certain things along 
the way with the application that we, you know, talked a lot 
about in these hearings. And so, we do have now more fail-safe 
signals within our system to prevent oversight of not having a 
progress report done in a timely manner, making sure that it's 
reviewed in a timely manner, and ensuring that we can't refund 
the grant if all the progress reports haven't been received and 
reviewed and signed off on. Those are the types of things that 
we've done.
    Dr. Marston. Sure. We've certainly taken a look at number 
of our practices throughout the pandemic. We've been building 
on what's worked and moving away from things that are maybe not 
as effective.
    So, for example, trying to make sure that we are as 
transparent as we can be in our reviews, putting our work out. 
But then building on that and not just putting out a memo 
that's, you know, digestible to a certain portion of 
population, but actually taking that a step further and doing 
that actually in concert with our colleagues at the CDC.
    Second, Emergency-Use Authorizations. Now everybody knows 
about EUAs. But, coming into the pandemic, they had really been 
used for Zika and Ebola diagnostics for the most part. So, we 
learned a lot about Emergency-Use Authorizations, and the 
importance of communicating early and often with manufacturers 
and putting out our thinking in advance so they weren't 
guessing about what we would need to see.
    And then, third, as I said, supply chain. We have learned 
lessons about the gaps that we have in our understanding of 
where products are coming from and the vulnerability that that 
creates for the healthcare system.
    Dr. Wenstrup. If I can just add to that. I think it's 
important for discussion. I think it's in line with what Mr. 
Cloud was saying. You know, in some ways, through testimony 
from people involved, you know it would be like me signing a 
prescription I haven't read. That's a problem. That's a 
problem. The buck has to stop somewhere. And these are things 
that I think we really need to fix.
    I now recognize Ms. Tokuda from Hawaii for 5 minutes of 
questions.
    Ms. Tokuda. Thank you, Mr. Chairman.
    You know, during the pandemic, medical countermeasures like 
diagnostics, vaccines, and therapeutics were essential for 
responding to COVID-19 and saving lives. Research and 
investment into developing these medical countermeasures even 
before COVID-19 hit our shores, quite frankly, gave our public 
health workers the critical tools they needed to keep pace with 
the virus.
    So, with that in mind, I'd like to discuss efforts by your 
agencies to lay the groundwork for rapid medical countermeasure 
development for if and when, quite frankly, the next pandemic 
strikes.
    Dr. Tabak or Dr. Walke, what kind of research are you folks 
doing investing to prepare in the next generation of medical 
countermeasures for future novel viruses? And, quite honestly, 
are we already behind the curve due to cuts and misinformation 
that were experienced during the previous administration? Are 
there concerns about public acceptance of these countermeasures 
when they need to be executed as a result of a lot of the 
disinformation that we've also seen?
    Dr. Tabak. Perhaps I'll start. So, the first step is you 
have to identify the offending pathogen, and you have to invest 
in representative viruses from nine different viral families in 
order to cover the landscape of viruses that are circulating 
the globe. And, once you do that and learn as much as possible 
about them and understand their lifestyle, you can begin to 
think about where you can intervene through so-called 
countermeasures. So that's a big part of what NIH does. We 
develop model systems so that potential countermeasures can be 
rapidly developed. And then, of course, we stand up clinical 
trial networks to ultimately see if there is efficacy of 
proposed countermeasures in humans. But let me turn it to my 
colleague now.
    Dr. Walke. A couple of comments. CDC's role in medical 
countermeasure development is more on the back end after 
actually have medical countermeasures through clinical trials, 
and then they're introduced to the public. We do a lot of work 
on vaccine effectiveness, real-world vaccine effectiveness 
around the Nation. And so, we stood up those networks quickly 
to try to understand the effectiveness in various populations 
related to the vaccine. And we do similar work actually with 
other medical countermeasures.
    Ms. Tokuda. Now very briefly because I have limited time 
here. Knowing that what we know now as a result of going 
through the COVID pandemic, do you feel that we are on track in 
terms of really understanding those potential offending 
pathogens and where we need to be--when, quite frankly, that 
next pandemic could strike, are we prepared to be able to 
execute with fidelity to the public that would be accepting of 
these countermeasures as well? Just say yes or no if, right 
now, are we prepared for what will come next given our current 
capacity?
    Dr. Tabak. We're better prepared.
    Dr. Walke. We're more prepared than we were. Absolutely.
    Ms. Tokuda. OK. So, we're more prepared right now. I will 
tell you I am very concerned, as Representative Garcia 
mentioned, that the incoming administration is already 
proposing to streamline NIH, including restructuring the 
agency's budget and bypassing its intense peer-review system, 
all critical to really create these countermeasures that we are 
talking about that will save lives. I'm very concerned that any 
attempt to overhaul our Federal agencies in this matter will 
result in the loss of our best and brightest scientists, and 
threaten the quality and integrity of our agencies' research 
and ability to execute to a public that needs to hear from the 
very best and brightest in our country.
    Dr. Tabak, how important are sustained Federal Investments, 
not funding cuts, but sustained Federal investments and public 
trust in science and scientists to your agencies' work in 
preparing for future health threats. Just a brief response.
    Dr. Tabak. History has shown that the sustained investment 
is what attracts people to biomedical research and keeps them 
into the biomedical research work force.
    Ms. Tokuda. Thank you.
    And, Dr. Marston, how would funding cuts, coupled with 
anti-science and anti-vaccine sentiment affect FDA's work in 
responding to future health emergencies?
    Dr. Marston. Well, I think that one of the things that 
we've seen through the course of the pandemic is how stretched 
that we were pulling from every corner of the FDA. Funding cuts 
will result in exacerbation of that.
    Ms. Tokuda. Thank you. So honestly we need quite a bit more 
resources and capacity to really combat what will ultimately be 
on the horizon for us.
    And, while I've appreciated the forward-looking focus of 
this hearing, I must point out that the incoming administration 
poses a serious threat to undo all of the progress that our 
witnesses have discussed with us today.
    Under the false pretense of making America healthy again, 
President-elect Trump and RFK, Jr., have committed to an 
extreme agenda that promises to hamstring our Federal health 
agencies and the essential work to keep Americans safe. We 
cannot let that happen. And I urge my House Republican 
colleagues who have spoken in favor of public health and 
pandemic readiness today to stand against the dangerous agenda 
and support critically needed investments, not cuts, in 
pandemic preparedness.
    Thank you, Mr. Chairman, I yield back.
    Dr. Wenstrup. I now recognize Dr. Joyce from Pennsylvania 
for 5 minutes of questions.
    Dr. Joyce. Thank you, Chairman Wenstrup, and Dr. Ruiz, 
Ranking Member, for convening this important hearing and to our 
witnesses for testifying.
    During this Committee's investigation of the Federal 
response to the COVID-19 pandemic, it has become abundantly 
clear that throughout the pandemic, many decisions and many 
statements made by public health officials were not based on 
science. When Federal officials manipulate or ignore data in 
order to fit a narrative, it fractures the trust between the 
American people and our public health leaders, and it hinders 
our response to developing an adequate ability to address 
potential future pandemics. And the trust, we all recognize 
from this investigation, from these hearings, has been 
fractured.
    During the rollout of the COVID-19 vaccine, then CDC 
Director Dr. Rochelle Walensky reported that according to data 
vaccinated individuals both did not carry the virus and that 
they did not get sick. This is not consistent with what 
clinical trials and real-world data showed, which is that, 
while the vaccines can be somewhat effective, vaccinated 
individuals still carry the virus, and vaccinated individuals 
still can become sick, and vaccinated individuals can still 
transmit the COVID-19 virus.
    Dr. Marston, in order to prevent misleading statements, 
such as the ones that were made by Dr. Walensky, how can the 
FDA more effectively communicate the conclusions of clinical 
data used to approve new vaccines?
    Dr. Marston. Well, I appreciate your question. And, first, 
I'd like to say these vaccines--no medical intervention is 
perfect. And I think it's been said to this Committee before 
that drinking too much water can cause water toxicity, right? 
And we just have to recognize that. That being said, these 
vaccines----
    Dr. Joyce. We're not talking about water and water 
toxicity. We're talking misinformation.
    Dr. Marston. So, I think each medical intervention needs to 
be taken one by one. Look at the benefits of those and the 
risks of those. So, the benefits of these vaccines are very 
important, right? We believe that there would have been an 
additional 3.2 million deaths had the vaccine not been rolled 
out. Incredibly important, hospitalizations on top of that.
    We also need to recognize and be transparent about the 
risks that are there. So, for example, we discussed some of the 
work that we do trying to put out our analyses of risks that 
we're seeing in our various data bases, putting those into the 
public literature, the published literature; we have done that 
on a series of recent cases.
    For example, in the New England Journal, in the CDC's MMWR. 
So, we try to make sure that we're putting out that information 
in our latest thinking on a regular basis.
    Dr. Joyce. So, you talk about that collaboration.
    Dr. Walke, are the CDC and the FDA regularly communicating 
and sharing information in order to ensure that CDC vaccine 
guidance is consistent with the scientific evidence and the 
clinical data that the FDA is using to review and approve new 
vaccines?
    Dr. Walke. CDC and FDA have a close working collaboration.
    Dr. Joyce. How often does that occur?
    Dr. Walke. We're a large organization, and so we 
different----
    Dr. Joyce. Is it daily? Is it weekly? Is it twice a week? 
You talk about a close collaboration. I just need to know, as a 
Member of Congress, how close is that collaboration?
    Dr. Walke. During the COVID response----
    Dr. Joyce. How close is it now? We're talking about being 
prepared. How close is that collaboration?
    Dr. Walke. It's very close.
    Dr. Joyce. Again, timeline. We need that information.
    Dr. Walke. On a weekly basis.
    Dr. Joyce. And these are weekly meetings? Is there face-to-
face meetings that you hold on a regular weekly basis?
    Dr. Walke. At various levels of our organizations, we do 
meet on a regular basis.
    Dr. Joyce. I find ``regular'' to be a really broad reaching 
term. And, by failing to effectively communicate the clinical 
data and the results behind the COVID-19 vaccines, the CDC and 
the FDA have contributed to growing vaccine hesitancy among the 
American people, including from routine childhood vaccinations. 
The culpability lies within your agencies. And the responsible 
stewardship of Federal funds is critical to the American trust 
in public institutions. And, unfortunately, the NIH and the 
NIAD have completely failed to exercise effective oversight of 
EcoHealth Alliance when they receive grant funding for research 
of novel coronavirus, which was conducted at the Wuhan 
Institute of Virology.
    Dr. Tabak, how is the NIH improving oversight of grant 
funding to ensure the failure seen like the EcoHealth Alliance 
would never happen again?
    Dr. Tabak. We have restated the requirement that 
subawardees, which was an example of Wuhan Institute of 
Virology, are required to provide all data in a timely manner. 
We have made it clear to our staff that progress reports need 
to be reviewed in a timely manner and have put so-called red 
flags in our automated systems to ensure that a grant can't be 
renewed if there's an outstanding that has not been reviewed or 
re----
    Dr. Joyce. Please define defining manner----
    Dr. Tabak. Say it again?
    Dr. Joyce. Please define what is in a timely fashion? 
You've said that twice to me. What is a timely fashion? A 
response before the computer puts up a red flag.
    Dr. Tabak. The timing for this is--when you are coming to 
the conclusion of a year's period of funding, you are supposed 
to provide a progress report. And I believe the window is 2 
months. I would have to get back to you.
    Dr. Joyce. Please get back to us. Because you're saying, at 
the end of a year, you're given an additional 60 days to be 
considered providing timely information?
    Dr. Tabak. That's correct because it allows you assemble 
all the----
    Dr. Joyce. What happens if they don't?
    Dr. Tabak. And that's the point. Now----
    Dr. Joyce. Indeed, it is the point. What happens if that is 
not provided?
    Dr. Tabak. Then they are contacted. We try and find out 
what is the hang-up. And, if they don't provide it, then they 
cannot get the next amount of funding.
    Dr. Joyce. I think it's clear in the aftermath of our 
Federal COVID-19 response, you need to do a lot of work. 
There's significant work to be done to repair the trust between 
the American people and our public health infrastructure. And, 
in order to earn that trust, public health officials must learn 
from these large mistakes. And it is my hope that the work of 
this Subcommittee will help identify a path forward when 
responding to the next public health emergency. My time has 
expired.
    Mr. Chairman, I thank you, and I yield back.
    Dr. Wenstrup. I now recognize Ms. Ross from North Carolina 
for 5 minutes of questions.
    Ms. Ross. Thank you, Mr. Chairman, and the Ranking Member.
    And thank you so much to our witnesses for joining us 
today. Your agencies' tireless work over the past 4 years 
allowed us to overcome the COVID-19 pandemic and its 
devastating impacts on the health and the economy of our 
Nation. I would like to discuss these efforts a bit--in a bit 
more detail so that we can continue to identify essential 
lessons for ongoing work of pandemic prevention and 
preparedness.
    I'm not going to ask Dr. Tabak about the NIH's work on the 
vaccine because I think that's been covered. But I would like 
to again remind everybody that, according to one estimate, the 
COVID-19 vaccine has saved more than 3 million lives and 
prevented more than 18.5 million hospitalizations.
    But I would like to turn to Dr. Marston about how the FDA 
has continued work to review and approve updated COVID-19 
vaccines to help keep Americans safe from new variants as they 
go about their day-do-day lives.
    Dr. Marston. Thanks so much for the question. We have been 
working in concert with the CDC and their surveillance system 
to understand the viral evolution and its potential impact on 
vaccine related immunity. We have, on a regular basis, had our 
advisory committee meet and look at that information, advising 
us on what the composition of an additional vaccine should be. 
We have seen in repeated studies that those booster 
immunizations are important and that they are saving lives.
    One study in Denmark, for example, showed that individuals 
who had gotten a boost at the time of the XBB variant had one 
quarter the rate of hospitalizations of those who did not. Very 
important public health intervention.
    Ms. Ross. Thank you very much. And, moving to the CDC, we 
know that the CDC played an essential role in the rollout of 
the COVID-19 vaccine, which got hundreds of millions of shots 
in arms and amounted to the largest vaccination campaign in our 
Nation's history. Of course, we need to encourage people get 
those boosters now too. So, if you haven't gotten your booster, 
please get your booster before the holidays.
    But Dr. Walke, how did the CDC work on the COVID-19 
campaign and use that campaign to reach into communities to 
allow us to reopen as quickly as possible?
    Dr. Walke. Thank you for the question. Eighty percent of 
CDC's funding from Congress on the domestic side goes out to 
states to build state and local infrastructure and 
preparedness. Those states actually do a risk assessment and 
try to identify those populations that are at greatest risk 
when there is an emerging threat. They also do a number of 
different exercises to try to distribute that last mile of 
medical countermeasures. And so, we activate it. There are 
state and local relationships and that infrastructure to try to 
distribute the COVID vaccine. We also do a lot of work, as I've 
talked about before, related to vaccine effectiveness. And that 
was another key role, real-world effectiveness, that CDC 
played.
    We did see that it was difficult to reach some populations 
more than others. And so, understanding where those communities 
at greatest risk were, who are being affected, who were hard to 
reach, really that relationship between local and state health 
departments with CDC was invaluable to try to identify those 
pockets where vaccine was not being distributed and then to 
quickly try to rectify that situation.
    Ms. Ross. Thank you for that. And I clearly saw that in my 
home state of North Carolina. And now, of course, we have Dr. 
Cohen at the CDC.
    I also want to express how grateful I am for the CDC's 
efforts to take lessons learned during the pandemic through the 
Moving Forward Initiative and use them to inform future-
oriented policies that will leave the country better prepared 
for the next pandemic.
    To ensure and continue these critical preparedness efforts, 
Congress must act to provide additional support to our public 
health infrastructure. While public health emergencies can 
trigger critical supplemental funding for agencies, the funding 
structure is not conducive to preventing future pandemics.
    For example, CDC jump-started an innovative wastewater 
surveillance program during the pandemic through the use of 
emergency supplemental funds. Once this funding dries up, the 
agency will no longer have the resources to continue this 
program. We must ensure that tools like this are fixtures of 
our public health strategy rather than waiting for emergent 
situations to implement them.
    Another key area that the CDC has focused on is improving 
our disease testing infrastructure. To enhance these efforts, 
Congress must act to improve the supply of medical laboratory 
personnel, a profession that played an indispensable role 
during the worse days of the pandemic and is currently facing a 
serious work force shortage.
    I proudly introduced, and Dr. Bera has joined me in it, the 
Medical Laboratory Personnel Shortage Relief Act of 2024, which 
would do just that. It's clear that Congress can take steps to 
complement the tremendous efforts made by our public health 
agencies to ensure that we're ready for the next pandemic.
    Thank you, Mr. Chairman, and I yield back.
    Dr. Wenstrup. Thank you.
    I now recognize Ms. Greene from Georgia for 5 minutes of 
questions.
    Ms. Greene. Thank you, Mr. Chairman. This Committee hearing 
today is titled ``Preparing for the Next Pandemic: Lessons 
Learned and the Path Forward.''
    I think one of the greatest lessons that has been learned 
here is the government and its powerful agencies should never 
use the American people's hard-earned tax dollars to create 
viruses that can be unleashed on the world like COVID-19 was. 
This led to killing millions of people all over the world.
    COVID-19 was funded using the gain of function in a bio lab 
in China, and then it was lied about. Dr. Fauci lied to the 
American people, abusing his power and position and role, very 
powerful role paid for by the American tax people. He lied, and 
many, many people died. Not only that, schools were shut down. 
People's jobs were shut down. Employment was ended. Small 
businesses were shut down. Life as everyone knew it was shut 
down. This caused violations of people's First Amendment 
rights, freedom of speech, freedom of religion. People couldn't 
even go to the beach.
    Then suicides hit record highs. And the saddest thing is 
there were record suicide rates seen among children and a 
mental health crisis released on Americans like never before.
    Now there's massive delays in education and loss of 
learning. What was absolutely repulsive is the forced masking 
requirements of children. Children were not at risk of being 
hospitalized or dying from COVID-19, yet children became one of 
the worst victims of the malpractice and abuse of power by your 
agencies and by people in charge in many cities, states, and 
the government. It was absolutely horrendous.
    But then there were doctors that came out with treatments 
using ivermectin, zinc, vitamin D, and it was labeled horse 
paste. And those doctors were attacked and criticized and 
called conspiracy theorists. Yet, while those doctors were 
actually saving lives, these other patients were being forced 
into the hospital, put on respirators, and were actually dying.
    My own personal doctor never lost one single patient by 
prescribing ivermectin and this other protocol. As a matter of 
fact, he saved people's lives. Thank God he did that.
    The CDC even changed the definition of ``vaccine.'' The FDA 
approved an experimental vaccine through a rushed approval 
process that suppressed trials and data that showed that 
vaccines didn't work and had side effects that even caused 
death.
    Fifteen pages of known side effects the FDA wanted sealed 
for 75 years. What were they hiding and lying about to the 
American people? Well, we know now.
    Vaccines have been mandated on the population in order to 
work, go to school, and live as functioning citizens in the 
United States. Yet people who reported vaccine injuries and 
deaths on the VAERS system were ignored; they were mocked; they 
were called conspiracy theorists; and they were canceled on 
social media when they tried to tell about the horrifying 
things that were happening to them or their family members.
    The White House even accused the unvaccinated of killing 
people, calling it a pandemic of the unvaccinated. And they 
said we'll bring a winter of death for yourselves, families, 
and hospitals.
    But guess what? Vaccines didn't work. And those that were 
vaccinated, boosted, continued to catch COVID. Our own 
President, President Biden even tested positive for COVID-19 
after this summer's Presidential debate. That is unbelievable. 
And I can tell you, when you talk about vaccine hesitancy, as 
one sitting before you that never took the COVID vaccine, nor 
will I take it--thank God--I'm so glad I didn't take it--yes, 
this vaccine hesitancy has risen to new heights. And I can tell 
you right now, I'll stand here and represent all the Americans 
that do not ever want to be forced to take another vaccine that 
the government is telling us to take after they created a 
deadly virus. I can tell you right now, I'll also represent all 
the Americans that never want their children to be forced to be 
vaccinated.
    Currently, right now, the CDC is recommending the children 
as young as 6 months have two doses of the Moderna COVID-19 
vaccine or three doses of the Pfizer COVID-19 vaccine. So, 
vaccine manufacturers continue to make billions and billions of 
dollars on a vaccine that doesn't work being forced on 
children, innocent children that don't even need it because 
they aren't at risk of being hospitalized or dying from this 
vaccine.
    Not only that, vaccines need to be investigated further. 
The rise of autism, learning disabilities, neurological 
problems, and so much more that children are suffering from 
today absolutely is being forced upon these children and their 
families because of these vaccines.
    This Committee should have investigated the vaccines, and 
it was a failure to not do so. This has literally been a war on 
the American people's health, the world's health, but also a 
war on our children's health. It's a war that has been waged on 
them by our government, Big Pharma, who's making all the money.
    Preparing for the next pandemic is actually recognizing 
that the last pandemic resulted in crimes against humanity. 
People that perpetuated and continue to perpetuate these crimes 
need to be prosecuted. And that needs to be starting in the 
next administration. And I'm pretty sure our next Attorney 
General will do that. And I look forward to seeing that happen.
    Mr. Chairman, I yield back the remainder of my time.
    Dr. Wenstrup. I now recognize Dr. McCormick from Georgia 
for 5 minutes of questions.
    Dr. McCormick. Thank you, Mr. Chair. May I say it's been a 
pleasure working with you on this Committee, as well as in 
Congress. I wish you all the best in your new endeavors.
    When this pandemic began, I wasn't in Congress. As a matter 
of fact, when this pandemic ended, I still wasn't in Congress. 
I was serving in the emergency department in the Atlanta 
suburbs as an ER doc doing night shifts the entire pandemic.
    From beginning to end, we learned some things. And I am 
going to ask you in a very concise way to state what you 
learned during this pandemic. Because we come to an end. And 
really this whole Committee has been about what we learned. I 
hope we have learned some valuable lessons, and we can admit 
humbly where we made mistakes. I know doctors made a lot of 
mistakes in treating patients.
    So, very briefly, Dr. Walke, what did the CDC learn? And 
make that in 30 seconds, if you can, just an overview. What 
really did you learn that you did wrong?
    Dr. Walke. Thank you for the question.
    We learned a number of things through COVID. We learned 
that, as the virus changed, we needed to also put out a lot of 
different guidance. And, unfortunately, our guidance was more 
technical than--the public actually had difficulty 
understanding. And so, we've actually made some changes to try 
to streamline that guidance and make it more understandable for 
the American public.
    Dr. McCormick. Would you say that you could've admitted 
maybe to making some mistakes in interpreting the data and the 
science?
    Dr. Walke. You know, the COVID pandemic----
    Dr. McCormick. I hope you'll say the right answer, because 
it's going to be really important to the follow-on 
conversation.
    Dr. Walke. The COVID pandemic happened over multiple years. 
We certainly made mistakes during that time.
    Dr. McCormick. Thank you.
    Dr. Walke. We quickly tried to rectify those mistakes, and 
we learned and tried to get better throughout the response. And 
we continue to do so. We revamped our communication, as I've 
said. We've improved our test development process. We've 
refined our guidance----
    Dr. McCormick. Didn't want to know what you did better; I 
want to know what you did wrong. Because that's how we learn, 
right? I understand what you did better because we admit to our 
mistakes.
    How about the NIH, Mr. Tabak? What did the NIH learn that 
we did wrong?
    Dr. Tabak. We didn't take hold of all of our clinical-trial 
networks early on in the pandemic. And, as a result, a number 
of underpowered trials were conducted, and that sort of 
siphoned away the capacity to do the larger trials that were 
ultimately necessary. That was one thing.
    A second thing is, we learned that we needed to forge 
relationships with industry much sooner to make sure that we 
could take advantage of all of their knowledge as we, you know, 
considered different potential countermeasures.
    Dr. McCormick. OK. Thank you, both of you.
    You know, as an ER doc who basically got exposed to a 
deadly virus, saw patients who were sick, watched patients die, 
watched the science evolve, and watched my fellow physicians 
get criticized the whole time by people who were not treating 
people, that hurt me a lot. And I think it really decreased the 
credibility of people who call themselves scientists, who 
didn't even have science at the time; they had guesses. And 
they were guessing and outmaneuvering the physicians who were 
treating the patients and doing their very best.
    I'll tell you a few things that I learned as somebody who 
lived through this from the physician/treatment side.
    First of all, the CDC gave blanket recommendations that 
were not scientific at times, quite frankly. Because we didn't 
have science; we didn't know. But they still gave 
recommendations that superseded what doctors could do. And it 
made people either not trust their doctors or not trust the 
CDC. You had to choose sides then. That's wrong. It became--
instead of scientific, it became politically driven, in my 
opinion.
    I also think that we fell very short in accountability and 
transparency at the NIH. I think the way we do our grant 
system, and the way that we're trying to come up with the right 
answers according to who protects NIH rather than who protects 
the people, in my opinion, based on the relevant evidence that 
we've received while we're here.
    But, mostly, as in any crisis--doesn't matter if it's 
banking, housing, climate change, or disease--we should be 
hesitant to turn to government for the answers. Bureaucrats and 
politicians are not experts and should never be allowed to 
infringe upon our inalienable rights of life, liberty, and the 
pursuit of happiness.
    Even when it's scary, we have the right to self-determine. 
We, as Americans, must always protect freedom, whether that be 
in our protecting of ourselves, which has consequences of 
possibly income or travel, or also allowing people to pursue 
education, transportation, or the best interests of their 
business even if that requires risking their own health or 
income. That is America. That is the promise, not of security, 
but of opportunity that exists nowhere else in the world.
    Your discussion should be with your doctor, not intruded 
upon by the government that thinks they know better than both 
the doctor and the patient.
    We saw how easy it is for the government to take away our 
rights, to make our lives miserable, if we don't comply, so 
that, as Dr. Fauci said, ``We lose our ideological bullshit,'' 
quote, in order to get the favor of a government that is ruling 
instead of serving. That's what I've learned.
    Instead of turning to government for the answers, we allow 
people to determine with their healthcare professionals what is 
best. And, by the way, we may not agree, and that's OK. The 
government should never determine who's right and wrong. 
Science, experience, and treatments determine what ends up 
being right and wrong, and it's a learning process that should 
never be intruded by the government.
    With that, sir, I yield. God bless you. Thank you for this 
Committee. And let's go forth and do great things.
    Dr. Wenstrup. I thank the gentleman. I am reminded of a 
Teddy Roosevelt quote. He said, ``It's not the critic who 
counts but the man in the arena.'' Thank you for being in the 
arena during this difficult time for our country and the world.
    I'd now like to yield to Ranking Member Ruiz for a closing 
statement if he would like one.
    Dr. Ruiz. Thank you.
    I, too, want to pause and remember the millions of people 
who died due to the pandemic and their families who mourn, 
including some of the Members that sit up on this dais who lost 
their families, members in the audience, perhaps even our 
expert witnesses and staff who are here. It is very important 
that we keep front and center and remember them always.
    When the COVID-19 pandemic hit, it gripped our Nation with 
uncertainty. We knew little about this novel virus, about the 
way it spread, the danger it posed, and the damage it would 
inflict on our communities. But it was during this time of 
significant uncertainty when one thing became increasingly 
clear: Our Nation was not where it needed to be when it came to 
pandemic preparedness and response.
    But with rapid and sustained deployment of COVID-19 
vaccines and therapeutics and robust public health investments 
in the American Rescue Plan, we left the darkest days of the 
pandemic behind us.
    This is thanks in large part to the dedicated and 
hardworking members of our Nation's health agencies. I want to 
offer my thanks again to our witnesses here today representing 
some of those agencies and sharing with us the tireless work 
they are doing to prevent and prepare for the next pandemic.
    I want to make it very clear to the scientists, who never 
wanted to delve into politics, who went pre-med and not 
political science; I want to send a message to the lab 
technicians that work in your agencies; I want to send a 
message to the administrators who, day-in and day-out, want to 
do the right thing for the mission that your agencies pose; I 
want to say thank you. You are not the enemy, and you should 
never be demonized. Your work is valuable. Your work is 
appreciated. And your work is what is keeping our country safe.
    And there will be help, and there will be recognition of 
that work, and there will be a positive way forward from this. 
So hang tight, buckle up, believe in your work. Know you that 
are appreciated by millions of people in this country, 
regardless of the demonizations and the disinformation that's 
out there and the misinformation that's out there. You're doing 
good work. So, I want to thank you.
    And know that--keep your integrity, keep your character, 
and do the right thing. We have seen and investigated 
individuals here that veered from doing the right thing, and 
that is not acceptable. So, what you're doing in doing the 
right thing, being transparent and open, is what's going to 
help us through to the next pandemic.
    So--and that is why--this is thanks, what we've been able 
to accomplish, in large part to the dedicated and hardworking 
members of our Nation's health agencies. And I want to offer my 
thanks again to our witnesses here today representing some of 
those agencies and sharing with us the tireless work that they 
are doing to prevent and prepare for the next pandemic.
    Last Congress, Democrats led the House in taking meaningful 
steps toward bolstering our pandemic preparedness and response 
capabilities with passage of the Consolidated Appropriations 
Act of 2023.
    Included in this law were bipartisan provisions from the 
PREVENT Pandemics Act, which made several significant reforms 
to help ensure we are better prepared when a future pandemic 
strikes. These reforms acted to advance our Nation's biosafety 
and biosecurity, revitalize our public-health work force, 
prevent undue foreign influence in biomedical research, and 
enhance our Strategic National Stockpile.
    We didn't focus on these during these last 2 years. We 
didn't really have a conversation about the positive work that 
has resulted from that--from these laws from last Congress and 
how they're being implemented. We didn't dive into the positive 
things that we learned from the lessons learned.
    So, I just really want to highlight them there, that there 
is a whole other section of actual work that's being done. And 
there still needs to be oversight, there still needs to be 
collaboration, there still needs to be a discussion of all 
those changes so that we can make sure it moves in that right 
direction and, in fact, that we keep them, given all the recent 
threats that we've heard today.
    Because, ultimately, these policies have charted the course 
of a more efficient, streamlined pandemic response for the 
future, and they have shown what we can do when we come 
together constructively to protect Americans' health and save 
lives. And we must work to continue these efforts to strengthen 
our supply chains, develop new vaccines, and stay on the 
cutting edge with advanced therapeutics.
    As an emergency physician and a public health expert, 
developing forward-looking solutions that help our Nation 
better prevent and prepare for future public-health crises 
continues to be my top priority.
    So, I hope that today's hearing serves as a reminder of the 
important work that our Federal health agencies do for the 
American public--it's imperfect, but it's important, and the 
results have shown for itself, since we are no longer in the 
throes of this pandemic--and that Congress will continue to 
support this work, rather than manufacturing distrust or 
throwing conspiratorial accusations in our safety systems and 
public health as a whole.
    And before I end, I know we'll have another session, but 
I'm going to take advantage here and thank this hell of a guy, 
Miles Lichtman, the director on the Democratic staff team, 
Alicia Yass, Dani Walker, and Joseph Romero, who have done 
incredible work, who I'm extremely proud of, who have only made 
me a better person and a better leader and have done extremely, 
extremely important work for the American people. And I want to 
thank you all individually.
    And I also want to thank the Republican staff. I have seen 
firsthand the dedication during some of our travels and work 
that we've done. I know your heart's in the right place. Thank 
you.
    I yield back.
    Dr. Wenstrup. Thank you, Dr. Ruiz.
    In closing, I'd like to thank our panelists once again for 
your important and insightful testimony here today. I thought 
this was a very good hearing.
    I would like to thank you, Dr. Walke, Dr. Marston, Dr. 
Tabak, for coming here today to testify at this final hearing 
of the Select Subcommittee on the Coronavirus Pandemic. We 
greatly appreciate your insight, and hope that we all will 
continue to work on improving our future pandemic response and 
that we continue to learn from our past shortcomings.
    I had several reasons for not running for office again. 
Amongst them, when I was given this responsibility, was, I 
wanted it to be seen that I am not here on a political purpose 
or a political mission. I'm a physician. Truth matters. Lessons 
learned matters. All of those things come into play. Nothing 
about chairing this Subcommittee had political gain for me. But 
I did want to serve the American people and be able to take 
this after-action review and get our lessons learned.
    Unfortunately, throughout some of this, some things became 
political, unfortunately. Some people had self-interests over 
that of all of mankind. And we discovered that, and we worked 
our way through that.
    And we will have a product for the American people to 
absorb and for we as a government to absorb on how we can go 
about doing our business and how we can protect the American 
people more and save lives and be the leader in the world when 
it comes to being able to respond appropriately so that others 
may benefit from mistakes we made, that we may benefit from 
mistakes we made, and, also, it's a time to applaud some of the 
things we did right, which are many, through this whole 
process.
    I want to thank also staff on both sides. Thank you. Thank 
you all. There's been a lot of hard work put in this in the 
last 2 years.
    Some things we found, not so good. Some things we found, 
very good. And we should build on those things. We should build 
on those things.
    Politics has no place in taking care of people. That's the 
bottom line. To me, we can do better, and we're going to 
propose to do better, and try to create the environment where 
we can do better.
    The next pandemic will happen, maybe not in our lifetime, 
but let's be better prepared. There's a lot of logistics. 
America can lead the way. We can lead the way. We've got too 
many good people to not lead the way.
    So, there's been a lot of reflection today, and, you know, 
I want to go down the line, starting with you, Dr. Tabak, and 
ask that each of you will commit in the next 2 weeks, if you 
would, to provide this Select Subcommittee your top two lessons 
learned through this and how we can work together to overcome 
these issues.
    You're nodding your head?
    Dr. Tabak. Yes, absolutely, sir.
    Dr. Wenstrup. Thank you.
    Dr. Walke. Happy to do so, and thank you.
    Dr. Wenstrup. Thank you.
    Dr. Marston. I didn't realize we were going to get 
homework, but yes. Thank you.
    Dr. Wenstrup. Oh, we always have homework.
    Dr. Wenstrup. Anyway. But, you know, while today was the 
last hearing of this Select Subcommittee, our work is not yet 
complete. The Select Subcommittee on the Coronavirus Pandemic 
will be releasing its final report in the coming weeks, and in 
this report we can continue our commitment to transparency. 
We'll release our findings on the investigations that we have 
so thoroughly examined during the past 2 years.
    In addition to our findings, we'll include recommendations 
for future pandemics based on the lessons learned. It would be 
irresponsible for us not to do that. It's not enough to 
highlight what went wrong, or terribly wrong, but if we do not 
work to find ways to fix it for the future and have a better 
process, then we have wasted our time. And I don't think any 
one of us here--people that run for office, people that serve 
the American people, you do not want to waste your time.
    I look forward to releasing our final report. Hope that our 
work, which has been extensive, as you know, will be used to 
prevent, predict, prepare, and protect us from the future 
pandemic, which were my words at the very beginning.
    Thank you all.
    With that, and without objection, all Members will have 5 
legislative days within which to submit materials and to submit 
additional written questions for the witnesses, which will be 
forwarded to the witnesses for their response.
    Dr. Wenstrup. If there is no further business, without 
objection, the Select Subcommittee stands adjourned.
    [Whereupon, at 1:50 p.m., the Subcommittee was adjourned.]

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