“The Blue Sheet” Vol. 36, no. 17

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"The Blue Sheet"

April 28, 1993

According to Hall, "the goal...of the prevention
legislation is to promote targeted and effective prevention programs to reduce the number of HIV-infected
women by authorizing additional funds for HIV prevention and education efforts to health care providers that
already serve low income women."
Hall added that "reaching women with prevention
messages developed by women must be a central concern of any HIV prevention initiative."
The bill includes several HIV prevention research
programs. In particular, the bill proposes the authorization of $10 mil. to NIH to "conduct and support multidisciplinary research on preventing the infection of
women with the etiologic agent for AIDS, including
research with respect to substance abuse."
NIH's prevention research budget in FY 1993 is an
estimated $2.4 bil. In the president's FY 1994 budget
request, NIH is slated to receive $2.5 bil. for prevention.
Morella's legislation follows the introduction of Rep.
Nancy Pelosi's (D-Calif.) "Comprehensive HIV Prevention Act" on March 30 ("The Blue Sheet" April 14, p. 6).
Rep. Maxine Waters (D-Calif.) is also considering the
development of a prevention bill.
CLINTON VACCINE INITIATIVE WILL BE HEADED BY
HOPKINS/OSTP VETERAN DONALD HENDERSON
Implementation of the Clinton Administration's comprehensive childhood vaccination plan will be directed by
Donald (D.A.) Henderson, the long-time dean of the Johns
Hopkins School of Public Health and Hygiene who most
recently was an associate director of the White House
Office of Science and Technology Policy.
Henderson will aid Assistant Secretary for Healthnominee Philip Lee and is working as a consultant to
HHS until Lee's nomination is approved by the Senate.
Henderson then will become a Deputy Assistant Secretary for Science. Lee's nomination, described by one
Administration official as part of the "second batch" of
its backlogged nominations, has not yet been sent officially to the Senate.
HHS Secretary Shalala said at an April 21 joint
hearing of the Senate Labor and Human Resources
Committee and House Energy and Commerce/Health
Subcommittee on childhood immunization policy that
Henderson will direct HHS implementation of the Clinton immunization initiative.
The HHS Secretary cited Henderson's planned
appointment as an example of the Administration's
willingness to learn lessons from the past and from
other nations' immunization strategies. Henderson is

well-known for heading up the World Health Organization's 10-year, multi-nation project to eradicate smallpox. The disease was declared eradicated by the World
Health Assembly in 1980.
Shalala told the hearing that the Administration will
"use every American institution" possible to help get out
the message to families that vaccinations are necessary.
For example, Social Security offices will conduct outreach, Shalala said. In addition, Shalala met with Walt
Disney officials on April 22 to discuss how the company's programs could be involved. HHS will also talk
to well-known athletes and the Ad Council, which produces public service announcements.
At the hearing, the Senate and House panels
reviewed the Clinton Administration's vaccine immunization proposal and the three congressional bills that
have been introduced that would authorize the program.
Those bills are Labor Committee Chairman Edward
Kennedy's (D-Mass.) S 732, Senate Finance/Health for
Families Subcommittee Chairman Donald Riegle's (DMich.) S 733 and Commerce/Health Subcommittee,
Chairman Henry Waxman's (D-Calif.) HR 1640 ("The
Blue Sheet" April 21, p. 8).
The hearing also included testimony from representatives of the major vaccine manufacturers, including
SmithKline Beecham, Lederle-Praxis, Connaught and
Merck. State public health officials also appeared at the
hearing.
Universal Purchase Would Stabilize Lonq-Term R&D - HHS
The vaccine manufacturers generally supported the
outreach, tracking and infrastructure provisions of the
Clinton proposal. However, the industry representatives
maintained that the proposal for the federal government
to purchase and distribute all childhood vaccines would
not significantly improve the current low rates of childhood immunization in the U.S., and could inhibit
research and development of new vaccines.
"Study after study documents what will work,"
Connaught President David Williams testified. "More
education for parents and health care providers, outreach, infrastructure improvements such as improved
clinic hours, and less obstructive policies, like the requirement for appointments."
Merck Vaccine Division President Gordon Douglas
and Lederle President and CEO Ronald Saldarini challenged a suggestion made by HHS Secretary Shalala
that universal purchase would provide a stable environment for long-term R&D investment.
Douglas said that the budget pressure, evidenced by
what he viewed as a small increase for research at NIH
in Clinton's FY 1994 budget request, "gives us great

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