Office of the Press Secretary FOR IMMEDIATE RELEASE September 19, 2019

BACKGROUND PRESS CALL BY SENIOR ADMINISTRATION OFFICIALS ON AN EXECUTIVE ORDER MODERNIZING INFLUENZA VACCINES Via Teleconference 3:05 P.M. EDT      SENIOR ADMINISTRATION OFFICIAL:  Hi, good afternoon everybody, and apologies for the delay in getting started here.  We had some delays in the signing and some technical challenges.  But anyway, we are ready to get started. This call is on the new executive order on modernizing influenza vaccines in the United States to promote national security and public health. This call is on background, attributed to a senior administration official.  And I’m going to ask you to embargo it until the EO is officially released and announced by the White House.  You’ll receive an e-mail on that when that happens.  I expect it will be about 4:30 p.m. or earlier. So we have a variety of U.S. government officials who will brief us, plus a few others on the call to answer technical questions that you might have.  So we’ll have a Q&A at the very end of the call, but we are strictly limited to end at 3:30 p.m.  So we’ll try to keep this as brief as we can.  So with that, I’ll turn it over to [senior administration official]. SENIOR ADMINISTRATION OFFICIAL:  Thank you.  Good afternoon.  Today, the President signed the executive order to modernize influenza vaccines in the United States.  This executive order builds on the National Biodefense Strategy and the Global Health Security Strategy, and is the most recent example of the actions taken by the President and his administration to protect the national security and the health of the American people. This administration has and will continue to lead the way on innovative public health solutions for all Americans to strengthen the national security of the United States. As we all know, getting the seasonal flu vaccine is the most effective defense against influenza.  This EO directs actions to reduce our reliance on older, egg-based production, expand domestic capacity, promote uptake of influenza vaccines, and advance the development of new, broadly protective vaccine candidates. In addition to ensuring seasonal vaccines are well matched to circulating strains, more agile production will also aid rapid response to pandemic influenza, which has the potential to kill millions and cost the economy trillions of dollars. With his action today, President Trump has reaffirmed his administration’s commitment to protect the American people as he promotes American innovation and American production. SENIOR ADMINISTRATION OFFICIAL:  Great.  Thank you. Now, with that, I’m going to ask -- I’m not positive we have DOD on the line. SENIOR ADMINISTRATION OFFICIAL:  Do we have the Council of Economic Advisers on the line? Okay, so with that we’re going to turn it over to Health and Human Services.  We have [senior administration official].  We do also have [senior administration official].     SENIOR ADMINISTRATION OFFICIAL:  So thank you and good afternoon.  I’m just going to make a couple of brief comments.  I think we all know seasonal flu is a real threat to America’s health.  Every year, millions of Americans become ill with the flu.  Hundreds of thousands are hospitalized and tens of thousands of Americans die. In the 2018-2019 flu season, 36,400 Americans died.  And in 2017-2018 it was more than double. While most people who get the flu have a mild illness, for some, it can cause serious illness and even death.  Complications from the flu are more likely in babies and young children, like the ones I cared for in my pediatric intensive care unit, but also pregnant women, older adults, and people with certain long-term health conditions. Early estimates from last year’s flu season -- which lasted a record-breaking 21 weeks -- indicated that upwards of 37 million Americans becomes ill from flu, with more than half a million being hospitalized. In addition to seasonal flu, pandemic influenza is a real threat to our health and national security.  There have been four pandemics in the last 100 years.  The most severe one was in 1918, which killed upwards of 50 million people worldwide, as well as 675,000 Americans. Our current seasonal flu vaccines are safe and effective.  CDC estimates that just in 2017-2018, over 7 million illness were prevented by the simple flu shot.  But we recognize that our flu vaccines must get better and it is essential we make them more quickly, with modern technology, to be more effective, and on U.S. soil. Through today’s actions, President Trump’s executive order established a task force chaired by HHS and the Department of Defense to cooperate on modernizing our flu vaccine production, identifying objectives, and monitoring progress so that we will have a more modern, reliable, and rapid method to vaccine production, more broadly protective and long lasting flu vaccines, and, again, more domestic manufacturing capability. Now I’d like to have [senior administration official] make a few comments. SENIOR ADMINISTRATION OFFICIAL:  Thank you, and good afternoon.  As my colleague mentioned, I’m [senior administration official].  And we have the benefit as well, on the phone, today, [senior administration official]. I think -- to take from my colleague’s comments, to just point out that any benefits we get with seasonal flu with this executive order signed by the President today will be magnified during a pandemic. As my colleague mentioned, there were four in the last century.  And clearly, each year, there’s about a 4 percent risk of having a pandemic.  And notably, we're watching with great concern and vigilance events in Asia that relate to the H7N9 virus that is circulating in parts of China at this moment. The point being is, if there were to be a pandemic, we would expect that it (inaudible) the events in 1918, there could be 100 million or more Americans that would be affected by a highly virulent flu that could result in over 4 million hospitalizations, and up to 500,000 American deaths.  This is not only a great concern to us because of its direct impact on livelihood and the benefit of American people, but also on our national security. So what the executive order does very clearly -- it states that we not only need to make better vaccines for each year for seasonal flu, but also faster.  And that requires new technologies, like recombinant vaccines or cell culture-derived vaccines.  And it's a way that basically we can respond rapidly to mitigate the loss of lives and also sickness that would result from a pandemic. To put it in monetary terms, each year, the seasonal flu costs about $50 billion in direct possible costs as well as lost productivity.  In the case of a pandemic, particularly of a moderate to severe purpose or nature, it would be $1.8 trillion to $3.8 trillion of lost revenue as a result of direct costs, lives lost, and loss of productivity. So this would touch every sector of our society: food production, energy generation, and even the defense of our country by our military.  So it's a matter of grave concern, and the President's steps today will ensure that we are in a better position to respond to whatever may happen during our tenure or any future President's tenue to make America not only safe, but more economically strong and certainly healthy. With that, I'll turn my comments back to our moderator. SENIOR ADMINISTRATION OFFICIAL:  Great, thank you.  I'll check again.  Do we have anybody from DOD on the line?  And from the Council of Economic Advisers?  I know they've been trying to get in and having some technical challenges.  Are the Council of Economic Advisers on the line? Okay.  With that, why don’t we turn it over.  We'll do some Q&A. Q    Good afternoon.  This is Toby Capion calling from EWTN.  My question has to do with the composition of the flu vaccine.  I know you guys recognize that it's always changing which strains you think will be impacted each year, but is there any progress on making a better-educated guess on which strain it is?  And do you still promote the flu vaccine even if the viruses it protects from are not the viruses that are most spreading that particular season? SENIOR ADMINISTRATION OFFICIAL:  This is [senior administration official].  Yes.  I mean, obviously it is an intelligent guess, but it is based on a number of factors that actually, historically, over the years, gives us a pretty good batting average. With regard to perfecting that, I mean, obviously, we want to do better each year.  That leads to one of the points of one of our long-range strategies of developing a universal-like vaccine that actually covers a wide range and broader coverage of the flu to make it less important to get exactly the right pick. But the second part of your question was very important.  Even though the virus might drift a bit from what the vaccine selection was, it is still unquestionably beneficial to get vaccinated.  Because even though vaccines are not perfect, they clearly can not only prevent infection, but they can prevent the serious consequences, including hospitalization and death.  So we will still recommend very strongly that one gets a vaccine every year -- anyone 6 months of age or older. SENIOR ADMINISTRATION OFFICIAL:  And this is [senior administration official] here.  Just one more comment on that.  Of course I agree with [senior administration official], but part of the executive order is to create technologies that are faster so that we don’t need to start six months ago using 900,000 eggs per day.  This rapid responsive technology would allow us to better match, in a much shorter period of time, any changes in the circulating strain to what we give individuals when the vaccine comes out.      Q    Hello, this Donna Young from S&P Global News.  I did have -- first of all, I wanted to clarify: Is [senior administration official] and [senior administration official] and [senior administration official] all on the record?  So that’s my first question.      Second, I wanted to find out: Again, what will this executive order actually do that NIH isn’t already doing right now?  Like, what action will this put into motion that they’re not already doing?  And how can they do it better without the funding?  Or is the President going to actually call for more funding?  Thank you.      SENIOR ADMINISTRATION OFFICIAL:  As for your first question -- this is [senior administration official] from NSC Press -- this entire briefing is on background, attributed to a “senior administration official.”  And I will repeat that at the end as well.  So with that, I’ll let my colleagues answer the technical question.      SENIOR ADMINISTRATION OFFICIAL:  Well, there are a number of things -- this is [senior administration official] -- there are a number of things in the EO that actually fortifies some of the things that we are doing, but also calls for additional things.      Just a couple, for example: It calls for a task force within 120 days to develop a five-year plan.  And that plan needs to have an update and reporting on that no later than June 1st of each of the five years following it.  It also talks about the NIH making sure that we, as an organization, continue to pursue the strategic plan that we’ve already developed for a broad of coverage.  There are a lot of things in this plan, but those are some of the things that not only fortify what’s being done, but also talks about things in the future.      SENIOR ADMINISTRATION OFFICIAL:  Donna, this [senior administration official].  If I might add to my colleague’s great comment as well: One of the additional things, as you know very well, BARDA and the U.S. government has invested in the development and licensure of these new modern technologies to produce influenza vaccines, including the cell-based and the recombinant-based influenza vaccine.      One of the challenges we have with these newer, faster technologies is they have limited capacity right now in the United States.  And we want to be able to utilize those fast technologies when we need them for seasonal production, as well as for pandemic production.  So one of the important parts of this executive order is to have us put together a feasibility and a budget plan to be able to expand and solidify that domestic production capabilities of these faster influenza vaccine-production technologies, such as cell-based and recombinant-based.      SENIOR ADMINISTRATION OFFICIAL:  And now, Moderator, if we can pause for a minute.  I believe we might have somebody from the Council of Economic Advisers on.      SENIOR ADMINISTRATION OFFICIAL:  Hello?      SENIOR ADMINISTRATION OFFICIAL:  Hi, this it -- is this [senior administration official]?      SENIOR ADMINISTRATION OFFICIAL:  It is.  Can you hear me now?      SENIOR ADMINISTRATION OFFICIAL:  We can.  Great.  So I would just like to introduce the [senior administration official].  He was going to talk very briefly about the economic ramifications of this. And apologies for the out of order discussion, but we’ll return to questions in a moment.          SENIOR ADMINISTRATION OFFICIAL:  Thank you.  Good morning -- afternoon.  My name is [senior administration official] from the Council of Economic Advisers. Today, CEA released a paper available on our website that estimates the large health and economic losses associated with an influenza pandemic and the benefits of moving to newer vaccine technologies that would speed production and make these vaccines more effective. We estimate that the average pandemic would cost $1.8 trillion and that deaths in that -- a pandemic in the most serious case -- could be 538,000.  Moving to faster vaccine manufacturing technologies that would make a vaccine available near the outset of a pandemic would save over $730 billion, over an average pandemic.  And if that new technology also includes vaccine effectiveness by 30 percent over the effectiveness seen in the most recent pandemic in 2009, it would save $953 billion, or roughly half the cost of an average pandemic. We found that there is a lack of appropriate innovation incentives, due in part to a misalignment between social and private returns, which partly explains why private markets have failed to provide the innovation needed to reduce pandemic risk and improve pandemic influenza preparedness. Today through the EO, the administration is proposing studies and public-private partnerships and other incentives that will produce innovations needed to accelerate vaccine production timelines needed for pandemic influenza, and could also potentially improve the vaccine effectiveness for both seasonal and pandemic influenza. SENIOR ADMINISTRATION OFFICIAL:  Great.  Thank you, [senior administration official]. We’ll now return to the question-and-answer period. Q    You’re not calling people by name, so I hope you can hear me.  This is Arthur Allen from Politico.  I had a couple of questions.  One, is there -- are you asking for more money?  Because pretty much -- I mean, most of what you discussed here has already, in some form or another, been begun over the last 10 or 15 years.  Building another -- you built a flu factory for -- in North Carolina last time.  So, is this basically -- you’re going to build a new factory for somebody or put up the money for a new factory? And, I guess, yeah, the question, again, is: Is Congress being asked to put up more -- to put up more money for any of the particulars of this plan?    SENIOR ADMINISTRATION OFFICIAL:  Hi, this is [senior administration official] and I will ask [senior administration official] to add to my response.  But I think the critical thing is, is the executive order asks us in the next 120 days to evaluate what we have on hand and what we need to really meet the needs as go forward. You’re correct to say that we built capacity down in North Carolina, as well as in a couple other places.  But the question is, is whether -- even with the investment that was made during the Bush administration in 2005 and 2006, whether that was sufficient to address what is a continuing need, in terms of optimizing existing vaccines, as well as building capacity to meet what could be the real challenges of a pandemic, knowing that it’s the speed and effectiveness of the vaccine, as you just heard from my colleague at the Council of Economic Advisers, that prevents a lot of -- (inaudible) a lot of loss of money, which equates to the loss of lives and illnesses that that really represents.  And so that’s really the initial phase of this effort. And then, also, I think, the point here is to evaluate what kind of incentives, so we can work in a private-public partnership with the industry to basically see how we can optimize the use of these newer technologies that are a little bit more expensive, but probably more effective, and certainly leverage what we could do in pandemic. [Senior administration official], would you like to add anything further? SENIOR ADMINISTRATION OFFICIAL:  No, [senior administration official], I think that covers it nicely.  Unless there is additional questions. SENIOR ADMINISTRATION OFFICIAL:  Great.  Moderator, I believe we now have DOD on the line.  I’m sorry.  [Senior administration official], are you on the line? SENIOR ADMINISTRATION OFFICIAL:  Yeah.  Hi.  Yeah, I am.  Good afternoon.  This is [senior administration official].  The Department of Defense is committed to modernizing influenza vaccines in the United States in close collaboration and partnership with the U.S. interagency.  It’s a matter of national security and public health. As co-chair of the newly established National Influenza Vaccine Task Force, the department is going to work closely with Health and Human Services and interagency partners to accelerate vaccine manufacturing technology and innovation.  And because of the morbidity and mortality associated with the influenza virus, this is a readiness threat to U.S. forces.  And as a result, the department requires vaccination for virtually 100 percent of the force every year. Through enhanced research and development collaborations made possible by this executive order, we will modernize the influenza vaccine enterprise to ensure access to the vaccine, advanced agility, and rapid response to emerging influenza viruses, increasing manufacturing and effectiveness of influenza vaccines, and developing new vaccine candidates with longer-lasting immunity. These efforts support the National Defense Strategy’s priority to advance readiness of the force, providing the best possible support to our warfighters in the battlefield and back at home.  So I wanted to make that statement.  We are -- we really looking forward to working on this unique opportunity created by the current administration.    SENIOR ADMINISTRATION OFFICIAL:  Great.  Thank you very much [senior administration official].  I think we can go back to a couple more questions before we’re going to run out of time. Q    Thanks so much.  This is Jacquie Lee with Bloomberg Law.  I’m curious -- and this question is for the gentlemen who works at BARDA -- what the administration is going to do, if anything, to ensure that there’s a market for the pandemic flu vaccine?  Obviously, you can’t sell it until there is a pandemic.  And I know that with antibiotics, that’s sometimes the problem -- that there isn’t really the market for those.  But you need to have them just in case something happens.  What is your guys’ solution to do to ensure that no one goes bankrupt? SENIOR ADMINISTRATION OFFICIAL:  Well, thanks for that question.  And I’ll open it and then [senior administration official] can finish it.  I think the key thing here is the availabilities of these new-technology vaccines have been fairly limited.  90 percent of our seasonal flu vaccines come from eggs.  So our intent is to expand the market for these newer technologies. And again, part of the opportunity and direction under the executive order is actually working with CMS and HHS to basically see what we can do in terms of (inaudible) schedules that would allow for greater utility -- use of these new products that would, again, enhance the market over time. The fact is, is that these newer technologies will likely result in more effective vaccines.  And [senior administration official], you may want to talk about, specifically, some of the work that you’ve been leading as well. SENIOR ADMINISTRATION OFFICIAL:  Thank you, [senior administration official].  And, Jacquie, thanks for your question. Yes, I mean, as we’ve shown, as we developed and gotten and received FDA licensure for the cell-based and the recombinant-based influenza vaccines.  In a head-to-head efficacy trial with the recombinant-based influenza vaccine with the traditional egg-based influenza vaccine, in older populations -- people 50 years and above -- where we saw a 30 percent improvement in efficacy of recombinant-based vaccines. So there is a mounting level of evidence that’s showing that when we have a better-matched influenza vaccine, something that is afforded by using recombinant-based technologies, that that does often translate into a more effective influenza vaccine. And as [senior administration official] mentioned, one of the -- and to your question about the marketplace for pandemic vaccines -- of course we hope that we never have to use pandemic vaccines, but we do know the threat of a pandemic is there and looming.  And as history has shown us, it will happen again. But the beautiful thing about these influenza vaccines is that we use them in the seasonal marketplace every single year.  And the technologies -- the platform-based technologies -- that we’re investing in, with the cell-based and recombinant-based and the next generation synthetic-based vaccines, serve as platforms that we can utilize to make more of the influenza vaccines as well.  So those multi-purpose facilities can be using -- be used to make influenza vaccines during seasonal influenza vaccine production cycle, but those technologies and platforms might also be used to make other vaccines in that same platform or same facility as well. SENIOR ADMINISTRATION OFFICIAL:  I think we have time for one more question, then we’re going to have call it a brief. Q    Hi, thank you for taking the call.  It’s Josh Wingrove with Bloomberg.  Can I just ask, quickly, for clarification: Is there any funding associated with this EO? SENIOR ADMINISTRATION OFFICIAL:  No -- not as of yet.  And again, it’s dependent on the evaluation of what is the current status of our seasonal and pandemic influenza abilities.  And then it established what the plans are to address the opportunities to improve existing platform that exist, as well as look at what would be necessary to support universal flu vaccine research and development.  SENIOR ADMINISTRATION OFFICIAL:  Okay.  I think we can probably squeeze one more in if it’s a short question. Q    Hi, just a follow-up on the funding question.  So I think in 120 days it sounds like there is going to be a plan.  Is that plan going to include a budget for how to distribute funds, say, to improve facilities for recombinant vaccines, and then also to put into universal vaccines R&D.  Is that budget just coming out in 120 days -- the proposed budget? SENIOR ADMINISTRATION OFFICIAL:  The executive order basically requires to cost out what would be required to basically do exactly what you’re describing.  So the answer is simply, yes. Q    Thanks. SENIOR ADMINISTRATION OFFICIAL:  Great.  Great.  Thank you everybody for joining us.  And apologies again for the delay. Just to repeat, this is all on background, attributable to a senior administration official.  And we ask that you embargo this briefing until -- you’ll see a public announcement from the White House that will go out through the White House Press DL.  You can also check the White House website.  It will be posted there as well.  It should be in the next hour anyway.  It may -- it’s possible it’s already out.  But please, just hold for that release. And thank you again for calling in.  Bye bye.                          END               3:32 P.M. EDT

First Lady Melania Trump Releases Details for the Trump Administration’s Official Visit and State Dinner with Australia

Office of the First Lady FOR IMMEDIATE RELEASE September 19, 2019   First Lady Melania Trump Releases Details for the Trump Administration’s Official Visit and State Dinner with Australia    First Lady Melania Trump and President Donald J. Trump will welcome Prime Minister Scott Morrison and Mrs. Jennifer Morrison of Australia to the White House for an Official Visit and State Dinner on September 20, 2019.   Tonight, the First Lady will open the Rose Garden for a press preview of the State Dinner table setting and décor.  The Office of the First Lady shares the following details, which were all carefully selected by the First Lady to reflect the strong ties between the United States and Australia.  The First Family warmly welcomes the Prime Minister and Mrs. Morrison and looks forward to strengthening one of America’s most important and enduring relationships.   Arrival Ceremony On Friday morning, the President and First Lady will welcome the Prime Minister and Mrs. Morrison of Australia during the State Arrival Ceremony on the South Lawn of the White House.  The Trump Administration is proud to carry on the traditional military arrival ceremony, which has been part of our Nation’s history for centuries.  Nearly 500 members of the United States Armed Forces from the five military branches will be present on the South Lawn for the “Review of the Troops.” Those invited to attend the arrival ceremony include the President’s Cabinet, Members of Congress, military families, and guests of the Australian Embassy. State Dinner The colors chosen for this visit are green and gold, which are the Australian national colors.  These colors were derived from the national flower of Australia, the golden wattle, which has a yellow flower and green foliage.  The dinner is being held in the Rose Garden, which will be filled with American varieties of yellow and white roses.  Gold woven baskets filled with yellow garden roses and golden wattle signify the combined friendship and long-lasting relationship between the United States and Australia.  Ombré shades of yellows and greens were chosen for the table linens, and the tables will be illuminated with gold oil lamps.  Golden champagne grapes will be placed on top of the tables, highlighting the richness of each of the countries’ wine industries.  The china settings for the baseplate and dinner service will consist of alternating patterns from the administrations of Presidents William J. Clinton and George W. Bush.  Entertainment The evening’s performance will be the largest gathering of premier military musicians for a State Dinner at the White House.  The entertainment will feature musical groups from the United States Army, Marine Corps, Navy, and Air Force:  “The President’s Own” United States Marine Chamber Orchestra The United States Army Chorus The United States Army Herald Trumpets The United States Army Strings The United States Navy Band Sea Chanters The United States Air Force Strings The United States Air Force Singing Sergeants Floral Arrangements The Cross Hall urns will be filled with pear branches from New England. The dinner centerpieces will feature more than 2,500 roses from California in shades of yellow and Australia’s national floral emblem, the golden wattle.  The Ground Floor Corridor will feature garden roses, jasmine vines, and dahlias, all grown in the United States. Menu The menu for the State Dinner with Australia highlights the lush, late summer season across the vast lands of America.  The menu pays homage to Australia’s special blend of culinary adaptations from its various cultures, not unlike the diverse food traditions of the United States. The first course will be Sunchoke Ravioli with Reggiano Cream and Shaved Summer Vegetables.  Sunchokes, known as “earth apples,” are native to North America and will be roasted and puréed to give creaminess and sweet notes to the ravioli.  The pasta is drizzled with a lemony Parmigiano-Reggiano cheese emulsion and topped with shavings of sun gold carrots, baby kale, and sunchoke chips. The main course will be Dover Sole, roasted whole, then fileted and accented with Fennel Mousseline.  Adding color to the plate will be the tender green and yellow summer squash blossoms, which will be picked the day before the dinner.  The combination of the mild and sweet Dover Sole, the creamy fennel, and the citrusy garlic rouille is finished with an abundant variety of perennial herbs from the White House Kitchen Garden. Dessert will be an American classic:  Lady Apple Tart with Calvados Ice Cream.  The dessert will be made of layers of sliced apples with a flaky crust.  The Lady apples are sourced from Pacific Northwest and Mid-Atlantic orchards.  The filling combines unique flavors of sweet and tart with caramelized apples, cinnamon, lemon zest, vanilla, and brown sugar with hints of molasses. Wines The Spring Mountain Sauvignon Blanc 2017 is the product of Spring Mountain Vineyard located in Napa Valley, where wine grapes have been cultivated since the 1800s.  Bright floral aromas characterize this wine, and its notes of lemon zest and green grass complement the Sunchoke Ravioli. The Argyle Pinot Noir “Reserve” 2016 is the heralded result of a combination of Australian innovation and American ingenuity.  Innovation and technological advancement have long been hallmarks of Australia’s winemaking culture.  The light and lively red fruit notes of cherry and raspberry pair well with the subtle sweetness of the Dover Sole.  Notes of green herb heighten the anise flavor of the Fennel Mousseline and the fragrant flavors of herbs fresh from the Kitchen Garden.  The well-integrated tannins and minerality from the volcanic soil of the Willamette Valley add balance and smooth complexity to this Reserve Pinot Noir. Finally, the J Demi-Sec NV partners well with the Lady Apple Tart.  Notes of ripe pear and acacia honey are perfect accompaniments to the autumnal caramelized apples featured in the tart.  The creaminess of the Calvados Ice Cream is pleasantly counterbalanced by the Meyer lemon curd acidity that appears at the first sip and lingers through the intriguingly long finish. Full Menu First Course Sunchoke Ravioli Reggiano Cream Shaved Summer Vegetables Main Course Dover Sole with Parsley Crisps Zucchini Squash Blossoms Fennel Mousseline Baby Garlic Rouille Dessert Lady Apple Tart Calvados Ice Cream Additional Information The guest list and First Lady’s gown details will be released at the beginning of the dinner.

1600 Daily The White House • September 19, 2019 Video of the day: President Trump Tours Border Wall Progress

The White House • September 19, 2019 Video of the day: President Trump tours border wall progress In San Diego, California, President Donald J. Trump got an up-close look yesterday at the great progress being made on new and replacement border wall. “We’re building it at a breakneck speed,” the President said after receiving an update from Border Patrol officials. All told, the wall will “be over 400 miles. And we think we can get it close to 500 miles by the end of next year,” he added. President Trump’s goal has always been to stop illegal immigration and protect the American people. Now, with border wall construction underway, the results are undeniable: Illegal border crossings plummeted 30 percent between July and August. “Nobody is coming in unless they’re coming in legally. They’re coming in through a process,” the President said. TOMORROW: Australia State Visit begins!  President Trump and the First Lady will welcome Australian Prime Minister Scott Morrison and First Lady Jenny Morrison to the White House tomorrow for an arrival ceremony to kick off their official State Visit to Washington. The visit will be a celebration of the close relationship and shared history between America and Australia. Throughout the weekend, President Trump and Prime Minister Morrison will reaffirm our common vision for global peace, security, and prosperity. Official State Visits are large, formal affairs, as are appropriate to show respect to a visiting leader. The end goal of the occasion, however, is practical: President Trump and visiting heads of state meet for working sessions throughout any such visit. In that spirit, the weekend will be filled with major events, both ceremonial and policy-specific. In addition to tomorrow’s welcome ceremony, the President and First Lady will host a State Dinner on Friday evening. On Sunday, Prime Minister Morrison will join President Trump in Ohio to tour a new, Australian-owned manufacturing facility, highlighting the strong U.S.–Australia trade relationship and its importance for American workers. In photos: A look back at President Trump’s first State Visit with France LIVE: Watch the arrival ceremony for Australia tomorrow at 9 a.m. ET Photo of the Day Official White House Photo by Shealah Craighead President Donald J. Trump visits the border area of Otay Mesa, a neighborhood along the Mexican border in San Diego, California | September 18, 2019

Office of the Press Secretary FOR IMMEDIATE RELEASE September 19, 2019 PRESIDENT DONALD J. TRUMP IS WORKING TO MODERNIZE AND IMPROVE INFLUENZA VACCINES    “We want a safe and healthy future for every American family.” – President Donald J. Trump   MODERNIZING INFLUENZA VACCINES: President Donald J. Trump is safeguarding public health by helping ensure Americans have access to effective influenza vaccines.  Today, President Trump signed an executive order to modernize influenza vaccines and help protect more Americans through vaccination. At President Trump’s direction, the Administration will work to promote new technologies to improve vaccine manufacturing and effectiveness. This will reduce reliance on more time-consuming, egg-based vaccine production.    Improving the speed of production will enable experts to better match vaccines to actively circulating viruses, an important piece of making the vaccines more effective.   The Administration will advance the development of new, more effective vaccines. The Trump Administration will also work to increase Americans’ access to vaccines by reducing barriers to seasonal flu vaccine services.  To help put these objectives into action, President Trump is establishing a task force to identify policy priorities and monitor progress. PROTECTING LIVES THROUGH PREVENTION: Influenza vaccines are vitally important to disease prevention, yet current production methods need to be improved. Influenza vaccines are the best way to save lives, reduce the illness severity, and prevent influenza infections in the first place. During the 2017–2018 flu season, influenza vaccinations prevented up to 7.1 million illnesses, 3.7 million medical visits, and 109,000 hospitalizations. A Centers for Disease Control and Prevention study found that vaccines prevented more than 40,000 flu-associated deaths over a nine-year period. It is especially important to be able to rapidly produce well-matched influenza vaccines using scalable technologies in the event of a future influenza pandemic. Despite their important role in safeguarding the health of the American people, influenza vaccines are currently produced using more time-consuming, egg-based technology. More rapid non-egg-based production methods would give experts more time to select the most relevant strains. PROMOTING PUBLIC HEALTH: Improving the influenza vaccine is part of President Trump’s longstanding effort to combat public health threats and promote quality care for all Americans.  President Trump has released a National Biodefense Strategy and a Global Health Security Strategy to help combat biological threats and pandemics. President Trump has made it a priority to increase the quality and accessibility of care for American patients. This year, the President launched a kidney health initiative to help prevent kidney failure, improve treatment options, and expand access to life-saving transplants. The Trump Administration is working to encourage new, innovative approaches to treating childhood cancer. President Trump launched an initiative to end the HIV/AIDS epidemic in America over the next decade.  The Administration is supporting research on new treatments for opioid addiction.

Statement from the Press Secretary on the Executive Order Modernizing Influenza Vaccines in the U.S. to Promote National Security and Public Health

Office of the Press Secretary FOR IMMEDIATE RELEASE September 19, 2019 Statement from the Press Secretary on the Executive Order Modernizing Influenza Vaccines in the U.S. to Promote National Security and Public Health    Today, President Donald J. Trump signed an Executive Order, “Modernizing Influenza Vaccines in the United States to Promote National Security and Public Health.”  This action further strengthens our Nation’s public health and security by prioritizing United States Government efforts to modernize and improve the production and effectiveness of influenza vaccines to combat the seasonal flu we see every year and to combat potential influenza pandemics.  This Executive Order will also promote increased influenza vaccine immunization across our entire population. Each year, seasonal influenza vaccines prevent millions of cases of disease and thousands of deaths in the United States.  Additionally, in the event of an influenza pandemic, the virus could kill more than half a million Americans and inflict trillions of dollars of damage on our economy.  Unfortunately, many of the vaccines we use today are produced overseas, using time-consuming, egg-based technology, which limits their effectiveness and makes production too slow to effectively combat a potential deadly influenza pandemic. With today’s action, the Trump Administration will promote new vaccine manufacturing technologies to enable the production of vaccine doses faster and in greater quantities than is currently possible.  Reduced production times will allow experts to better match vaccines to actively circulating influenza viruses, making them more effective in treating seasonal influenza.  Additionally, more robust, secure, and responsive vaccines will aid the response in the event of a pandemic influenza.  Finally, this Executive Order will advance the development of vaccines that last longer and protect against a broader array of influenza viruses. Through this action, President Trump has reaffirmed his Administration’s commitment to supporting American innovation and American production and to protecting the American people.

Office of the Press Secretary FOR IMMEDIATE RELEASE September 19, 2019 EXECUTIVE ORDER - - - - - - - MODERNIZING INFLUENZA VACCINES IN THE UNITED STATES TO PROMOTE NATIONAL SECURITY AND PUBLIC HEALTH       By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 301 of title 3, United States Code, it is hereby ordered as follows:     Section 1.  Findings.  (a)  Influenza viruses are constantly changing as they circulate globally in humans and animals.  Relatively minor changes in these viruses cause annual seasonal influenza outbreaks, which result in millions of illnesses, hundreds of thousands of hospitalizations, and tens of thousands of deaths each year in the United States.  Periodically, new influenza A viruses emerge from animals, including birds and pigs, that can spread efficiently and have sustained transmission among humans.  This situation is called an influenza pandemic (pandemic).  Unlike seasonal influenza, a pandemic has the potential to spread rapidly around the globe, infect higher numbers of people, and cause high rates of illness and death in populations that lack prior immunity.  While it is not possible to predict when or how frequently a pandemic may occur, there have been 4 pandemics in the last 100 years.  The most devastating pandemic occurred in 1918-1919 and is estimated to have killed more than 50 million people worldwide, including 675,000 Americans.     (b)  Vaccination is the most effective defense against influenza.  Despite recommendations by the Centers for Disease Control and Prevention (CDC) that nearly every American should receive the influenza vaccine annually, however, seasonal influenza vaccination levels in the United States have currently reached only about 45 percent of CDC goals.     (c)  All influenza vaccines presently in use have been developed for circulating or anticipated influenza viruses. These vaccines must be reformulated for each influenza season as well as in the event of a pandemic.  Additional research is needed to develop influenza vaccines that provide more effective and longer-lasting protection against many or all influenza viruses.     (d)  The current domestic enterprise for manufacturing influenza vaccines has critical shortcomings.  Most influenza vaccines are made in chicken eggs, using a 70-year-old process that requires months-long production timelines, limiting their utility for pandemic control; rely on a potentially vulnerable supply chain of eggs; require the use of vaccine viruses adapted for growth in eggs, which could introduce mutations of the influenza vaccine virus that may render the final product less effective; and are unsuitable for efficient and scalable continuous manufacturing platforms.     (e)  The seasonal influenza vaccine market rewards manufacturers that deliver vaccines in time for the influenza season, without consideration of the speed or scale of these manufacturers' production processes.  This approach is insufficient to meet the response needs in the event of a pandemic, which can emerge rapidly and with little warning.  Because the market does not sufficiently reward speed, and because a pandemic has the potential to overwhelm or compromise essential government functions, including defense and homeland security, the Government must take action to promote faster and more scalable manufacturing platforms.     Sec. 2.  Policy.  It is the policy of the United States to modernize the domestic influenza vaccine enterprise to be highly responsive, flexible, scalable, and more effective at preventing the spread of influenza viruses.  This is a public health and national security priority, as influenza has the potential to significantly harm the United States and our interests, including through large-scale illness and death, disruption to military operations, and damage to the economy.  This order directs actions to reduce the United States' reliance on egg-based influenza vaccine production; to expand domestic capacity of alternative methods that allow more agile and rapid responses to emerging influenza viruses; to advance the development of new, broadly protective vaccine candidates that provide more effective and longer lasting immunities; and to support the promotion of increased influenza vaccine immunization across recommended populations.     Sec. 3.  National Influenza Vaccine Task Force.  (a)  There is hereby established a National Influenza Vaccine Task Force (Task Force).  The Task Force shall identify actions to achieve the objectives identified in section 2 of this order and monitor and report on the implementation and results of those actions.  The Task Force shall be co-chaired by the Secretary of Defense and the Secretary of Health and Human Services, or their designees.     (b)  In addition to the Co-Chairs, the Task Force shall consist of a senior official from the following executive branch departments, agencies, and offices:         (i)     the Department of Defense (DOD);         (ii)    the Department of Justice;         (iii)   the Department of Agriculture;         (iv)    the Department of Veterans Affairs (VA);         (v)     the Department of Homeland Security;         (vi)    the United States Food and Drug Administration;         (vii)   the Centers for Disease Control and Prevention;         (viii)  the National Institutes of Health (NIH);         (ix)    the Centers for Medicare and Medicaid Services (CMS); and         (x)     the Biomedical Advanced Research and Development Authority (BARDA).     (c)  The Co-Chairs may jointly invite additional Federal Government representatives, with the consent of the applicable executive department, agency, or office head, to attend meetings of the Task Force or to become members of the Task Force, as appropriate.     (d)  The staffs of the Department of State, the Office of Management and Budget (OMB), the National Security Council, the Council of Economic Advisers, the Domestic Policy Council, the National Economic Council, and the Office of Science and Technology Policy (OSTP) may attend and participate in any Task Force meetings or discussions.     (e)  The Task Force may consult with State, local, tribal, and territorial government officials and private sector representatives, as appropriate and consistent with applicable law.     (f)  Within 120 days of the date of this order, the Task Force shall submit a report to the President, through the Assistant to the President for National Security Affairs, the Assistant to the President for Domestic Policy, the Director of the Office of Management and Budget, and the Director of the Office of Science and Technology Policy.  The report shall include:         (i)    a 5-year national plan (Plan) to promote the use of more agile and scalable vaccine manufacturing technologies and to accelerate development of vaccines that protect against many or all influenza viruses;         (ii)   recommendations for encouraging non-profit, academic, and private-sector influenza vaccine innovation; and         (iii)  recommendations for increasing influenza vaccination among the populations recommended by the CDC and for improving public understanding of influenza risk and informed influenza vaccine decision-making.     (g)  Not later than June 1 of each of the 5 years following submission of the report described in subsection (f) of this section, the Task Force shall submit an update on implementation of the Plan and, as appropriate, new recommendations for achieving the policy objectives set forth in section 2 of this order.     Sec. 4.  Agency Implementation.  The heads of executive departments and agencies shall also implement the policy objectives defined in section 2 of this order, consistent with existing authorities and appropriations, as follows:     (a)  The Secretary of HHS shall:         (i)    through the Assistant Secretary for Preparedness and Response and BARDA:             (A)  estimate the cost of expanding and diversifying domestic vaccine-manufacturing capacity to use innovative, faster, and more scalable technologies, including cell-based and recombinant vaccine manufacturing, through cost-sharing agreements with the private sector, which shall include an agreed-upon pricing strategy during a pandemic;             (B)  estimate the cost of expanding domestic production capacity of adjuvants in order to combine such adjuvants with both seasonal and pandemic influenza vaccines;             (C)  estimate the cost of expanding domestic fill-and-finish capacity to rapidly fulfill antigen and adjuvant needs for pandemic response;             (D)  estimate the cost of developing, evaluating, and implementing delivery systems to augment limited supplies of needles and syringes and to enable the rapid and large-scale administration of pandemic influenza vaccines;             (E)  evaluate incentives for the development and production of vaccines by private manufacturers and public-private partnerships, including, in emergency situations, the transfer of technology to public-private partnerships -- such as the HHS Centers for Innovation and Advanced Development and Manufacturing or other domestic manufacturing facilities -- in advance of a pandemic, in order to be able to ensure adequate domestic pandemic manufacturing capacity and capability;             (F)  support, in coordination with the DOD, NIH, and VA, a suite of clinical studies featuring different adjuvants to support development of improved vaccines and further expand vaccine supply by reducing the dose of antigen required; and             (G)  update, in coordination with other relevant public health agencies, the research agenda to dramatically improve the effectiveness, efficiency, and reliability of influenza vaccine production;         (ii)   through the Director of NIH, provide to the Task Force estimated timelines for implementing NIH's strategic plan and research agenda for developing influenza vaccines that can protect individuals over many years against multiple types of influenza viruses;         (iii)  through the Commissioner of Food and Drugs:             (A)  further implement vaccine production process improvements to reduce the time required for vaccine production (e.g., through the use of novel technologies for vaccine seed virus development and through implementation of improved potency and sterility assays);             (B)  develop, in conjunction with the CDC, proposed alternatives for the timing of vaccine virus selection to account for potentially shorter timeframes associated with non egg based manufacturing and to facilitate vaccines optimally matched to the circulating strains;             (C)  further support the conduct, in collaboration with the DOD, BARDA, and CDC, of applied scientific research regarding developing cell lines and expression systems that markedly increase the yield of cell-based and recombinant influenza vaccine manufacturing processes; and             (D)  assess, in coordination with BARDA and relevant vaccine manufacturers, the use and potential effects of using advanced manufacturing platforms for influenza vaccines;         (iv)   through the Director of the CDC:             (A)  expand vaccine effectiveness studies to more rapidly evaluate the effectiveness of cell based and recombinant influenza vaccines relative to egg-based vaccines;             (B)  explore options to expand the production capacity of cell-based vaccine candidates used by industry;             (C)  develop a plan to expand domestic capacity for whole genome characterization of influenza viruses;             (D)  increase influenza vaccine use through enhanced communication and by removing barriers to vaccination; and             (E)  enhance communication to healthcare providers about the performance of influenza vaccines, in order to assist them in promoting the most effective vaccines for their patient populations; and             (v)    through the Administrator of CMS, examine the current legal, regulatory, and policy framework surrounding payment for influenza vaccines and assess adoption of domestically manufactured vaccines that have positive attributes for pandemic response (such as scalability and speed of manufacturing).     (b)  The Secretary of Defense shall:         (i)    provide OMB with a cost estimate for transitioning DOD's annual procurement of influenza vaccines to vaccines manufactured both domestically and through faster, more scalable, and innovative technologies;         (ii)   direct, in coordination with the VA, CDC, and other components of HHS, the conduct of epidemiological studies of vaccine effectiveness to improve knowledge of the clinical effect of the currently licensed influenza vaccines;         (iii)  use DOD's network of clinical research sites to evaluate the effectiveness of licensed influenza vaccines, including methods of boosting their effectiveness;         (iv)   identify opportunities to use DOD's vaccine research and development enterprise, in collaboration with HHS, to include both early discovery and design of influenza vaccines as well as later-stage evaluation of candidate influenza vaccines;         (v)    investigate, in collaboration with HHS, alternative correlates of immune protection that could facilitate development of next-generation influenza vaccines;         (vi)   direct the conduct of a study to assess the feasibility of using DOD's advanced manufacturing facility for manufacturing cell-based or recombinant influenza vaccines during a pandemic; and         (vii)  accelerate, in collaboration with HHS, research regarding rapidly scalable prophylactic influenza antibody approaches to complement a universal vaccine initiative and address gaps in current vaccine coverage.     (c)  The Secretary of VA shall provide OMB with a cost estimate for transitioning its annual procurement of influenza vaccines to vaccines manufactured both domestically and with faster, more scalable, and innovative technologies.     Sec. 5.  Termination.  The Task Force shall terminate upon direction from the President or, with the approval of the President, upon direction from the Task Force Co-Chairs.     Sec. 6.  General Provisions.  (a)  Nothing in this order shall be construed to impair or otherwise affect:         (i)   the authority granted by law to an executive department or agency, or the head thereof; or         (ii)  the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.     (b)  This order shall be implemented consistent with applicable law and subject to the availability of appropriations.     (c)  This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.                         DONALD J. TRUMP   THE WHITE HOUSE,     September 19, 2019.

Office of the Press Secretary FOR IMMEDIATE RELEASE September 19, 2019 ON-THE-RECORD PRESS CALL BY CEA ACTING CHAIRMAN TOMAS PHILIPSON ON THE CEA REPORT ON MITIGATING THE IMPACT OF PANDEMIC INFLUENZA THROUGH VACCINE INNOVATION Via Teleconference   1:04 P.M. EDT      MS. SLOBODIEN:  Thank you.  Thank you all for joining us today to unveil CEA's report on mitigating the impact of pandemic influenza through vaccine innovation.      Joining us for the call today, we having Acting Chairman Tomas Philipson.  We also will have, for the question and answer portion, Joel Zinberg, who is the Senior Economist and a physician at the Council of Economic Advisers.      I’ll turn things over to Tomas to get started. ACTING CHAIRMAN PHILIPSON:  Okay.  Thanks, Rachel.  And thank you to everyone for joining our call today to discuss the CEA’s report.  It’s a newly released report which estimates the potential costs of pandemic influenza.  It discusses the current lack of responsiveness in reducing the risks of such pandemics, and highlights the benefit of public-private partnerships to address this problem.  The report also sets forward the rationale and cost-benefit analysis for our government to reduce this major threat to public health if it were to occur. I’ll begin by providing a brief overview of three major components of the report.  First, we estimate the potentially large health and economic losses in the United States associated with influenza pandemics and discuss why the most commonly used vaccine production technologies are unlikely to mitigate these losses because the production process is too slow. Second, we estimate the value of new vaccine technologies that would make vaccines available more quickly and thereby improve their effectiveness in moderating the risks of radically emerging pandemics. Lastly, we argue that the private market incentives may be insufficient to develop new vaccine technologies or promote the uptake of existing, faster, but more expensive technologies, despite their large expected value to society.  This is because vaccine innovators only get rewarded when a pandemic occurs, even though they provide great value in terms of risk reduction when pandemics do not occur.  We therefore argue that public-private partnerships to spur innovation may be valuable to decrease the impact of pandemic health risks. The report first addresses the health risk of potential pandemics.  While millions of Americans suffer from seasonal influenza every year -- commonly called “the flu” -- there is a more deadly and costly form of flu -- pandemic influenza -- in which a new influenza virus could spread rapidly throughout the population.  Historically, the chance of a pandemic influenza may be low -- roughly 4 percent per year -- but our nation is unprepared for such a catastrophe. For example, the so-called “Spanish Flu” pandemic of 1918 sickened approximately one-third of the world’s population, killing an estimated 50 million people, including 675,000 Americans.  As a result, life expectancy in the United States fell by 12 years. The Council of Economic Advisers estimates that the cost of a modern influenza pandemic per episode could range from $413 billion to over $3 trillion, with an average cost of $1.8 trillion, depending on the transmission efficiency and virulence of the particular influenza virus, or in other words, how easily the virus is spread and how serious the infection it generates is.  These costs include direct medical costs, reduced productivity, and the cost of fatalities using standard measures of mortality costs.  This is substantially higher than the estimated $361 billion cost of the average seasonal influenza. We assume in a single wave of infection over the course of about half a year, in the most serious pandemic scenario, more than half a million Americans would die. The most effective way to combat an influenza pandemic is with large-scale, immediate immunization.  Unfortunately, with the current vaccine technologies, our nation is not currently prepared to deliver a sufficient number of vaccine doses quickly enough to stop the rapid spread of a pandemic virus. Current vaccine production for the seasonal flu primarily relies on using chicken eggs, which can take half a year or more to produce sufficient doses of the vaccine.  Half a year would be too slow to combat the rapid spread of an unexpected and highly contagious pandemic virus, no matter how effective a vaccine was.  Adequate doses of vaccine would only arrive after new infections have peaked. Additionally, current slow egg-based production may impair the effectiveness of influenza vaccines for both pandemic and seasonal influenza because targeting the vaccine to an emerging virus must be done quickly. Increasing the speed of influenza vaccine production is, therefore, critical to combating a future pandemic and better to target seasonal flus.  Therefore, the second part of the report estimates the value of such improved vaccine technologies. If a pandemic occurs, faster production technologies that could deliver sufficient doses of vaccine at the outset of a pandemic would produce a $730 billion benefit over the course of an average pandemic. Combining faster vaccine production with a 30 percent improvement in vaccine effectiveness far over the last influenza pandemic, which occurred in 2009, increases the benefit to $953 billion –- about one-half the cost of an average epidemic -- or pandemic. However, these benefits dissipate quickly.  The average savings forgone per week of delay in vaccine availability during the first 12 pandemic weeks is $53 billion per week, declining to $26 billion during the following 12 weeks, due to following the peak of the epidemic. Since pandemics are rare, their true expected costs, before any potential occurrence, must be discounted by the discussed 4 percent annual probability of a pandemic.  CEA finds that the expected value of having a better and faster vaccine available at the outset of a pandemic is $29 billion, which amounts to $89 per American. Adding a 30 percent increase in vaccine effectiveness increases the expected value of an improved and faster vaccine to $38 billion, or the equivalent of $117 per American. New and existing vaccine production methods like cell-cultured and recombinant vaccines may cut production times and improve effectiveness compared with egg-based vaccines.  While these new vaccines are more expensive than egg-based vaccines, CEA finds that their current per-dose price is far less than the discussed expected value of having a vaccine available at the outset of a pandemic. Nevertheless, the market share of cell-based vaccines is only 10 to 15 percent, and of recombinant vaccines is 1 to 2 percent. Lastly, the report discusses the lack of appropriate innovation incentives that exist for mitigating pandemic risk.  In the report, CEA argues that the private market has not embraced these new technologies or encouraged other innovations because of a misalignment between the social and private returns of developing and utilizing newer vaccines. The private market does not get rewarded for the insurance value to society of mitigating future pandemic losses -- a value that accrues regardless of whether a pandemic occurs or not.  Vaccine developers only realize sales if a pandemic occurs, even though an effective pandemic vaccine would eliminate the health threat of a pandemic. To put it simply: Provisional insurances, such as (inaudible) life insurance, reduces the financial risk for rare events, and the insurance is therefore valuable even if the risk does not turn out to materialize.  Pandemic vaccine innovators provide a similar insurance value to society in terms of health risk, but they’re sales-driven, R&D decisions that will not be impacted by it. The lack of appropriate innovation incentives partly explains why private markets have failed to provide the innovation needed to reduce pandemic risk and improve pandemic influenza preparedness.  Public-private partnerships were key to developing existing cell-based and recombinant vaccine technologies.  These partnerships will be key to providing other innovations needed to accelerate vaccine production timeliness and a timeline needed for pandemic influenza, and could potentially improve vaccine effectiveness for both seasonal and pandemic influenza. This concludes my discussion of the report.  But we will be happy to take some questions. Q    Yeah, hi.  I have two question.  One, a few weeks ago, several of us, I think, were told that there was going to be an executive order related to research on the universal flu vaccine, or on improved flu vaccines.  And I was wondering if you could comment on that or tell whether that’s still in the works or how that relates to this current report? Second, the -- you mentioned in the report, the 20- -- 2006, I believe it was, legislation that puts many billions of dollars into improving vaccines.  You mentioned that that it’s done that job partially.  Are you advocating just more money be put into these public-private partnerships, or something more -- a larger sort of structural change in how that’s done?   Thank you. MS. SLOBODIEN:  Arthur, for the question you had about the EO, I would refer you to the White House Press Office for that. And -- I’m sorry, hold on one moment.  And the second one is best for us not to comment on it.  I would also refer you to the White House Press Office. Q    Hi.  Thank you again for taking the time on this.  Can you just say, essentially, what this boils down to?  This report is recommending that in order to have a breakthrough, both for pandemic situation but also breakthroughs that would help in the seasonal situation, that essentially private markets need more of a nudge of some kind?  There needs to be a new incentive if they're going to make breakthroughs here that are worth having?      ACTING CHAIRMAN PHILIPSON:  Yeah.  That’s pretty much -- I mean, we document that this benefit from these new technologies -- we document that they're not used, and we're basically providing a cost-benefit rationale for greater innovation and use of those technologies.      Q    Hi, thanks very much.  From my understanding with conversations with people at the NIH, we're still a few years away from a universal flu vaccine, scientifically speaking.  I'm curious how, whether or not -- how much money needs to be dumped into that before that timeline can be shortened.      ACTING CHAIRMAN PHILIPSON:  Yeah.  So in general I would leave that to HHS to address, in terms of allocating the funds for this.  And we're, in this report, laying out the value of that potential effort.      Q    Gotcha.      Q    Yeah.  Hi, I was just wondering if you could disclose, or if you had any more information about why the Flublok vaccine, which seemed to be, you know, able to be produced much faster and also was more effective had so much trouble getting traction in the market? And if you could specifically talk to -- I mean, I understand it's somewhat more expensive, but how would you ameliorate a situation like that?  I mean, we do have these vaccines out there that seem to be better already, but they don’t have much market share.  I think Flublok is produced by the company that makes most of the egg-based vaccines.  Does that have anything to do with why it's been sort of tamped down -- its production? ACTING CHAIRMAN PHILIPSON:  Yes.  So we discussed some of the barriers to adoption and innovation in the paper.  One, for the adoption piece, is the pricing of it and the reimbursement, which we'll also go through in the paper.  I think that’s the major one that is hindering its further adoption. Q    Hey.  Sorry, when I was trying to put through a question before, I guess I had my phone on mute.  So the question I had was: Was this report put together to back up the need for the executive order that there's going to be a later call on today? MS. SLOBODIEN:  Donna, the nature of the Council of Economic Advisers is to provide information and economic analysis to the President.  And so the report is consistent with that. OPERATOR:  And we have no further questions in queue. MS. SLOBODIEN:  Thank you all for joining us.  You can find the CEA report on CEA's website.                            END                 1:20 P.M. EDT

Eight Nominations and Three Withdrawals Sent to the Senate

Office of the Press Secretary FOR IMMEDIATE RELEASE September 19, 2019 NOMINATIONS SENT TO THE SENATE:      Robert Anthony Dixon, of the District of Columbia, to be United States Marshal for the Superior Court of the District of Columbia for the term of four years, vice Michael A. Hughes, term expired.      Danielle J. Hunsaker, of Oregon, to be United States Circuit Judge for the Ninth Circuit, vice Diarmuid F. O'Scannlain, retired.      Grant C. Jaquith, of New York, to be a Judge of the United States Court of Appeals for Veterans Claims for the term of fifteen years, vice Robert N. Davis, retiring.      Robert Joseph Kruckemeyer, of Texas, to be a Member of the National Council on the Humanities for a term expiring January 26, 2022, vice Dorothy Kosinski, term expired.      Scott J. Laurer, of Virginia, to be a Judge of the United States Court of Appeals for Veterans Claims for the term of fifteen years, vice Mary J. Schoelen, retiring.      William Joseph Nardini, of Connecticut, to be United States Circuit Judge for the Second Circuit, vice Christopher Droney, retired.      Mitchell A. Silk, of New York, to be an Assistant Secretary of the Treasury, vice Heath P. Tarbert, resigned.      Daniel Mack Traynor, of North Dakota, to be United States District Judge for the District of North Dakota, vice Daniel L. Hovland, retiring. WITHDRAWALS SENT TO THE SENATE:      Jeffrey Byard, of Alabama, to be Administrator of the Federal Emergency Management Agency, Department of Homeland Security, vice Brock Long, resigned, which was sent to the Senate on May 13, 2019.      Heidi R. King, of California, to be Administrator of the National Highway Traffic Safety Administration, vice Mark R. Rosekind, which was sent to the Senate on January 16, 2019.      Thomas Marcelle, of New York, to be United States District Judge for the Northern District of New York, vice Gary L. Sharpe, retired, which was sent to the Senate on January 23, 2019.

First Lady Melania Trump Attends the Reopening of the Washington Monument

Office of the First Lady FOR IMMEDIATE RELEASE September 19, 2019

First Lady Melania Trump Attends the Reopening of the Washington Monument   WASHINGTON, D.C. – This morning, First Lady Melania Trump participated in the ceremonial reopening of the Washington Monument.  The national landmark had been shut down for more than 37 months for renovations and additional construction.  The First Lady was joined by Secretary of the Interior David Bernhardt, Assistant Secretary of the Interior Rob Wallace, National Mall and Memorial Parks Superintendent Jeff Reinbold, Deputy Director of the National Park Service Dan Smith, and fourth graders from a local elementary school. Following a ribbon-cutting ceremony in front of the newly constructed visitor screening facility, the First Lady made a ceremonial first ride with the students to the top of the monument.  In line with her Be Best initiative, the First Lady also distributed “Every Kid in the Outdoors” 4th Grade passes.  This program provides free access to fourth graders, and those accompanying them, to more than 2,000 federal recreation areas including all national parks.  The program focuses on helping kids engage with nature and the environment.  Supported by various federal agencies, the program aims to establish a life-long connection between children and the American outdoor heritage.

Office of the Press Secretary FOR IMMEDIATE RELEASE September 19, 2019

President Donald J. Trump Approves Illinois Disaster Declaration   Today, President Donald J. Trump declared that a major disaster exists in the State of Illinois and ordered Federal assistance to supplement State and local recovery efforts in the areas affected by severe storms and flooding from February 24 to July 3, 2019. Federal funding is available to State and eligible local governments and certain private nonprofit organizations on a cost-sharing basis for emergency work and the repair or replacement of facilities damaged by the severe storms and flooding in the counties of Adams, Alexander, Bureau, Calhoun, Carroll, Cass, Fulton, Greene, Hancock, Henderson, Henry, Jackson, Jersey, Knox, Madison, Mercer, Monroe, Morgan, Pike, Randolph, Rock Island, Schuyler, Scott, St. Clair, Stephenson, Union, and Whiteside. Federal funding is also available on a cost-sharing basis for hazard mitigation measures statewide. Pete Gaynor, Acting Administrator, Federal Emergency Management Agency (FEMA), Department of Homeland Security, named Ms. Nancy Casper as the Federal Coordinating Officer for Federal recovery operations in the affected areas. Additional designations may be made at a later date if requested by the State and warranted by the results of further damage assessments. FOR FURTHER INFORMATION MEDIA SHOULD CONTACT THE FEMA NEWS DESK AT (202) 646-3272 OR FEMA-NEWS-DESK@FEMA.DHS.GOV.