In a demonstration of our enduring friendship and important bilateral partnership, U.S. Ambassador to Lebanon Elizabeth Richard broke ground today on the new U.S. Embassy compound in Beirut, Lebanon.

The multi-building compound will be located in the suburb of Awkar on a 43-acre site. The compound will provide a safe, secure, sustainable, and modern platform that supports U.S. Embassy staff in representing the U.S. Government to Lebanon and in conducting day-to-day diplomacy.

Professionals from the United States, Lebanon, and other countries will work side-by-side to complete this new diplomatic facility. Morphosis Architects of Culver City, California, is the architect for the project. B.L. Harbert International of Birmingham, Alabama is the construction contractor.

Since 1999, as part of the Department’s Capital Security Construction Program, the Bureau of Overseas Buildings Operations (OBO) has completed 135 new diplomatic facilities with an additional 50 projects now in design or under construction.

OBO’s mission is to provide safe, secure, and functional facilities that represent the U.S. Government to the host nation and support our staff in the achievement of U.S. foreign policy objectives. These facilities represent American values and the best in American architecture, engineering, technology, sustainability, art, culture, and construction execution.

For additional information, please contact Christine Foushee at FousheeCT@state.gov or (703) 875-4131, or visit www.state.gov/obo.

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External links to other Internet sites should not be construed as an endorsement of the views or privacy policies contained therein.

MR STROH: Thank you very much and thanks to all of those who have joined us this afternoon. I’ll introduce our speaker first and then lay out the ground rules very briefly. Today we’re joined by Patrick Murphy, the Deputy Assistant Secretary of State for Southeast Asia in the Bureau of East Asian and Pacific Affairs. This call will be conducted on the record, and we’d ask that we observe an embargo until the conclusion of the call.

And with that, I will turn it over to Deputy Assistant Secretary Murphy.

MR MURPHY: Thank you and good afternoon, all. I’m very delighted today to spend a little time talking with you about U.S. engagement in Southeast Asia. I think there is no better place to start than with today, April 20th. Out in the region, we have our Vice President currently conducting his first trip to the Asia Pacific region and has spent a very productive day in Indonesia.

And in Jakarta his visit has bilateral and multilateral dimensions to it. He met with President Jokowi. He made a visit to the ASEAN Secretariat. He engaged with youth – Indonesian youth – who participate in our Young Southeast Asian Leaders Initiative. He visited the largest mosque in the country – the country which happens to be the largest Muslim-majority country in the world.

So all of these dimensions were at play, and of course, he made a very important announcement on behalf of the President while he was there that the President is committed to going to Vietnam for the APEC Leaders Meeting and to the Philippines for the East Asia and U.S.-ASEAN Summits, all of which take place in November – a very welcome announcement by our friends and partners and allies across the region.

So stepping back a little bit from today, looking more broadly across the year, it’s an important year. ASEAN will celebrate its 50th year of existence, and the United States and ASEAN will celebrate concurrently 40-year anniversary of relations. So we have lots going on.

Secretary of State Tillerson has already hosted the Washington-based ASEAN ambassadors, and he will be hosting the ASEAN foreign ministers here in Washington on May 4th. That’s just two weeks from today. The Secretary himself is also committed to going to the Philippines in August for a range of multilateral meetings, including the ASEAN Regional Forum and then the various ministerials that encompass the U.S.-ASEAN relationship, as well as the East Asia Summit, the Lower Mekong Initiative.

The Secretary of State has, to this date, already hosted several of his counterparts – foreign ministers from Malaysia, Singapore, and also today, from Vietnam. Deputy Prime Minister and Foreign Minister Pham Binh Minh visited the building here at the State Department earlier today.

With all of these engagements and interlocutors and partners and allies, the discussions are very wide-ranging. We’re talking about trade. We’re talking about security, how we work together to address a whole range of threats, like proliferation; terrorism; maritime disputes; trafficking of all nature – trafficking in persons, in illicit narcotics, and in wildlife; infectious disease; law enforcement; and the like.

It’s not just the State Department and the Vice President and the President, but many others are engaging in Southeast Asia as well, including my counterparts from the U.S. Trade Representative’s Office. Admiral Harris, our Pacific commander, was out to Thailand a bit of – a time ago. Secretary Mattis – Secretary of Defense Mattis has made a commitment to go to the Shangri-La Dialogue in Singapore.

So, in brief, a lot’s happening with this region that reflects our sustained engagement and the full range of our efforts to advance U.S. national security interests. I am delighted to take questions.

MR STROH: Thank you very much. And with that, we’ll open it up to questions.

OPERATOR: And ladies and gentlemen on the phone lines, if there are any questions at this time, please press * followed by the 1 on your touchtone phone. You’ll hear a tone indicating you’ve been placed in queue. Once again, if there are any questions from the phone lines, please press * followed by the 1, at this time.

And our first question comes from the line of Nike Ching with Voice of America. Please, go ahead.

QUESTION: Thank you very much for the briefing. The first question is now that the United States has withdrawn from TPP, what should we expect from the prospect of a bilateral trade deal with Vietnam and the free trade agreement with – between the United States and some of the countries from Southeast Asia? Thank you.

MR MURPHY: Thanks very much, Nike, for your question. Trade is very important to the United States, particularly with this region. The ASEAN collective represents in its unity a massive trading partner and is the source of a lot of U.S. investment there. The volume of trade supports over half a million American jobs across all of our 50 states, and the ASEAN countries buy over $100 billion of U.S. exports each year.

We want to expand the trade, and we want to do so in a way that’s both free but also fair. You asked the specific question about the Trans-Pacific Partnership, and it’s our view that our withdrawal from it does not change our commitment to the region writ large and a rules-based economic order. I think what we are talking about with the countries is how to proceed in a way that’s beneficial to ensure fair trade so that the United States has equal access to the markets in the region as they have access to our market.

And there have been some challenges. I think it’s been discussed quite broadly that there are a number of countries in this region that enjoy a substantial trade surplus with the United States, and that’s a disadvantage for us. So we will be having these kind of discussions on how we can level the playing field so that American companies, products, and services can compete evenly.

And I think what we find in the region is a great desire to proceed with trade discussions, whether they are of a multilateral nature or a bilateral nature. Of course, on the United States side, we’re still formulating broader economic policies and the broader economic team, getting individuals confirmed and into senior positions and places. But I can assure you that in our discussions heretofore with our partners, it’s robust and constructive as all sides come together in pursuit of expanding good trade.

MR STROH: The next question, please.

OPERATOR: And we do have a question from the line of Matthew Pennington with the Associated Press. Please, go ahead.

QUESTION: Hello, Patrick. Thanks for doing the call. Can I ask, is the President planning to attend ASEAN Summits, East Asia Summits every year, I mean, or is this – is this a one-off event? And perhaps you could talk a little bit more about the purpose of the meeting between the ASEAN foreign ministers and Secretary Tillerson that you say is going to happen on May the 4th. Was this a U.S. idea or was it ASEAN’s idea?

MR MURPHY: Thank you very much, Matt. Nice to hear from you. Look, going forward, I think it’s hypothetical on United States participation in any summit that falls in subsequent calendar years. I think what’s important about the commitment that the Vice President has announced today is that it’s a commitment that comes quite early. November, six months down the line, is quite some time away. There are a lot of issues around the world to contend with and even in the region before November arrives.

But it is a firm commitment about our engagement to the region. It’s a coincidence that both APEC and the rest of the summits take place in Southeast Asia this year. Of course, APEC rotates among its many 20-plus members. This year it happens to take place in Vietnam. So it’s very good news for our engagement in Southeast Asia. Vietnam will be the Leaders Meeting; the Philippines will be the host to the twin summits, both U.S.-ASEAN and the East Asia Summit.

So I think the firm – the announcement today is the news that we are committed to this region and we’ll take those summits as they come.

Secretary Tillerson received a request from the ASEAN foreign ministers, who offered, on their part, to come to Washington to see him early in the year, prior to the planned multilateral meetings that take place in August in the Philippines. Secretary Tillerson readily agreed. So at the end of the day, he will be hosting them, but he agreed with their request to meet in a special session that will take place on May 4th. I think we’ll be very delighted to have the foreign ministers here. Some of them, of course, will be coming back, having already been in Washington in recent weeks. And that will be a very important opportunity to discuss the challenges, the opportunities, and our cooperation in the region, again, before the more formal meetings that take place in August in the Philippines.

MR STROH: Thank you very much. Next question, please.

OPERATOR: And we do have a question from the line of Nick Wadhams from Bloomberg News. Please, go ahead.

QUESTION: Hi. Thanks very much. I’m wondering if Secretary Tillerson has had sort of a revised opinion or sort of policy on where things stand with the Philippines in particular. In his confirmation hearing, he said when asked about President Duterte’s drug war that further facts from the ground are needed before commenting. So what is the State Department’s current stance on the killings that are happening in the Philippines as a result of that drug war? And does the U.S. still believe that there is a longstanding friendship that exists with the Philippines? Thanks.

MR MURPHY: Yes. Thank you, Nick. Let me take your two questions in reverse. The United States and the Philippines have a very longstanding alliance, a relationship built on shared sacrifices, common values, and friendship. When you look across the range of our ties, they are some of the most robust anywhere in the world, much less the Asia Pacific region. The people-to-people ties are particularly noteworthy. Somewhere between 4 and 5 million Filipino Americans here in our country; several hundred thousand Americans live there. And the ties between academic institutions, business, commerce, tourism in both directions are quite substantial. And it’s an alliance that has produced a lot of results for both countries. As I said earlier, many shared sacrifices when you look back to World War II and other areas of challenge across the region. This is a friendship that’s very enduring, and it’s a relationship that we continue to pursue in our national interests.

When it comes to the drug war, I’ll first say that the objectives are objectives that many of us can share. The Philippines has a serious challenge, a serious problem, with illicit narcotics. It’s eroding communities; it’s closely linked to crimes of a wide nature, including killings. We have a drug problem here in the United States, so not only do we sympathize but we want to work together in addressing the shared objectives of eliminating the scourge of illicit drugs. And we can help the Philippines with drug rehabilitation, with the traffic and flow of narcotics across borders and the like.

We, however, do have a very sustained and deep concern when elements of the drug war are operating outside the rule of law. The growing number of extrajudicial killings is troubling. This has been the focus of many voices inside the Philippines itself, whether it’s civil society, legislative figures, the church, and other organizations, and of course, internationally. We have raised those concerns publicly and privately, and we will continue to do so. We are urging the Philippines to follow up on its commitment to investigate extrajudicial killings, whether they’re committed by law enforcement or of a vigilante nature. So I think those concerns are quite sustained. And Secretary Tillerson, now that he is Secretary – there is a distinction between being a nominee and being the Secretary – is our leader on this policy. So we will continue to work with the Philippines on shared values and objectives and urge that the country address this particular concern in its drug war.

OPERATOR: And we do have a question from the line of Manik Mehta with Bernama. Please, go ahead.

QUESTION: Hello?

OPERATOR: Mr. Mehta, your line is open. Please, go ahead with your question.

QUESTION: Yes. This is Manik Mehta of – in New York. I have a two-part question. The first question relates to the visa exclusion of Malaysian citizens. As you know, the U.S. administration has been discussing with the Malaysian Government about letting Malaysian passport holders arrive in this country without a visa. This has been going on for two years, and I would like an update on that.

Secondly, we are having this APEC conference coming up in Vietnam. Will there be any discussion on expansion of APEC to include very strong and potential candidates like India, which has been knocking on the door? Thank you.

MR MURPHY: Thank you for your questions, Manik. I think I’ll be brief because both of these topical issues fall to other experts within the Department of State, but I can say something.

First, on Malaysia, I want to correct a perception. We don’t have a visa exclusion of any nature in place for Malaysia. Malaysians enjoy ready access to the United States and come here in great numbers to study, for tourism, for business, for official engagements. I think what you’re referring to is the Malaysian pursuit to join our Visa Waiver Program. And the Visa Waiver Program has a number of requirements, and Malaysia continues to address those requirements. But I will leave to my experts in Consular Affairs to address the kind of specifics.

I think in similar fashion, Manik, when it comes to APEC and expansion, like we have our APEC ambassador, my colleague, Ambassador Matt Matthews, and his team can probably address that more specifically. But I will say this about APEC: This is the preeminent economic organization for the Asia Pacific. There are a good number of members in the Asia region, in the Southeast Asia region. We view this as an important forum to address common opportunities and challenges. And we are delighted that Vietnam is the host this year of APEC. They do a terrific job hosting multilateral events from a logistics perspective and also from a policy perspective. They’ve proven to be with us, the United States, a growing and important partner, and we’ll be working with them closely to help ensure a successful APEC Leaders Meeting in November.

OPERATOR: And we do have a question from the line of David Brunnstrom with Reuters. Please, go ahead.

QUESTION: Yeah. Hi. Thank you very much. Just wanted to ask, during – sorry – in the ASEAN talks were meeting with the Secretary of State, whether you expect the South China Sea to be a topic there. And, I mean, what is the position nowadays with FONOPs? We seem to be fairly overdue for a U.S. FONOP, and is there a danger of creating perception that maybe the relationship with China is more important than ASEAN concerns about the South China Sea?

MR MURPHY: Thank you, David. I think when it comes to a variety of security challenges in the Asia Pacific, we use every opportunity to raise them. As I mentioned earlier, that could range from proliferation to terrorism to maritime disputes. We never miss an opportunity with our friends and partners and all members of the Asia Pacific community to discuss them. So indeed, when the Secretary of State hosts his counterparts from the 10 ASEAN countries in early May, we can very much expect that the South China Sea issue will be addressed and talked about very frankly so that we can all continue to pursue what we hope will be the inevitable outcome, and that is peaceful resolution to these disputes, and in the meantime, adherence to the rule-of-law, rules-based principles that the United States and ASEAN have heretofore very much agreed on.

With regards to freedom of navigation operations, I think with the specifics, the timing, and the parameters, I’m going to leave that to my colleagues and counterparts at the Department of Defense. However, it remains a matter of U.S. policy that we will continue to use FONOPs, which is our right and our responsibility. We will continue to sail and fly where international law permits. I think that’s our longstanding policy and that remains the case.

We believe that the South China Sea should be the scene of unimpeded commerce and travel. And many countries, the entire international community for that matter, relies a great deal on unimpeded travel and commerce through this region. And we believe as an Asia Pacific nation that we have a role to play in this regard. So I think you can see that FONOPs will continue.

QUESTION: Thank you.

OPERATOR: And we do have a question from the line of Barbara Usher from the BBC. Please, go ahead.

QUESTION: Thank you, just a brief one: Can you tell us the reason stated by the ASEAN ministers to have this summit with – or this meeting, sorry, with Mr. Tillerson? What was their overriding concern or objective in wanting to meet him as a group? And what else would be on the agenda besides the South China Sea? Is there anything in particular, especially from the America or the State side that needs to be addressed?

MR MURPHY: Yeah, thank you, Barbara. I think on the part of the ASEAN countries, it was a very genuine, heartfelt request to engage with the United States. I think they recognized we’ve had a political transition in Washington. We hear consistently from them that they value U.S. engagement and presence in the region. And they wanted to make it clear early on that as a strategic partner – ASEAN has been a strategic partner of the United States – they wanted to continue with the United States administration, the new administration, this partnership, this relationship, and to ensure sustained U.S. engagement in the region.

I think I’ll be a good diplomat here and not reveal the entire agenda plan for May 4th, but I think I am on good ground in saying that we will discuss a very wide range of areas of cooperation and challenge, and among those challenges I’ve already addressed a few. These are difficult times worldwide and Southeast Asia is no exception. This region faces challenges from traffickers, from crime in general, from terrorism, from territorial disputes. And I think we can envision all of these topics will be the subject of discussion.

OPERATOR: And with that, for closing remarks, I’ll turn the conference back over to Mark Stroh. Please, go ahead, sir.

MR STROH: Thank you very much. Thanks to our speaker. Again, you were speaking with Deputy Assistant Secretary of State for Southeast Asia Patrick Murphy. We will now conclude this call, and with that conclusion, we will have lifted the embargo. Thank you very much, everyone. Have a nice day.

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Ambassador Thomas A. Shannon, Under Secretary for Political Affairs, met today with Albanian Foreign Minister Ditmir Bushati to address common interests in our bilateral relationship and the region. The Under Secretary reaffirmed the close partnership between the United States and Albania, our strong support for Albania’s judicial reform efforts, and our shared commitment to democratic values, the rule of law, and respect for human rights. Ambassador Shannon also emphasized the importance of all political parties in Albania participating in the upcoming parliamentary elections.

The Office of Website Management, Bureau of Public Affairs, manages this site as a portal for information from the U.S. State Department.
External links to other Internet sites should not be construed as an endorsement of the views or privacy policies contained therein.

The Department of State has renewed the Charter for the U.S. Advisory Commission on Public Diplomacy. The bipartisan Commission appraises U.S. government activities intended to understand, inform, and influence foreign publics. It may conduct studies, inquiries, and meetings, as it deems necessary. It may assemble and disseminate information and issue reports and other publications, subject to the approval of the Chairperson, in consultation with the Executive Director. The Commission also may undertake foreign travel in pursuit of its studies and coordinate, sponsor, or oversee projects, studies, events, or other activities that are necessary to fulfill its functions.

The Commission consists of seven members appointed by the President, with the advice and consent of the Senate. The members of the Commission shall represent the public interest and shall be selected from a cross section of educational, communications, cultural, scientific, technical, public service, labor, business, and professional backgrounds. Not more than four members shall be from any one political party. The President designates a member to chair the Commission.

The current members of the Commission are: Mr. Sim Farar of California, Chairman; Mr. William Hybl of Colorado, Vice-Chairman; Ambassador Lyndon Olson of Texas; Ambassador Penne Korth-Peacock of Texas; Ms. Anne Terman Wedner of Illinois; and Ms. Georgette Mosbacher of New York. One seat on the Commission is currently vacant.

To request additional information about the U.S. Advisory Commission on Public Diplomacy, you may contact Executive Director Shawn Powers at PowersSM@state.gov.

The Office of Website Management, Bureau of Public Affairs, manages this site as a portal for information from the U.S. State Department.
External links to other Internet sites should not be construed as an endorsement of the views or privacy policies contained therein.

MODERATOR: Thank you very much, and thanks to all those who’ve joined us this afternoon for our on-the-record conference call on biosecurity. The first thing I’d like to do is introduce our two speakers this afternoon. We’re joined first by William A. Walters, M.D. Dr. Walters is the managing director for Operational Medicine at the Bureau of Medical Services here at the U.S. Department of State. We’re also joined by Joseph P. Lamana, the director of the operations division of the Office of Emergency Management in the Office of the Assistant Secretary for Preparedness and Response at the Department of Housing – excuse me, Health and Human Services.

As a reminder, this call is on the record, and we will embargo this call until the conclusion of the call. And with that, I’ll turn it over to Dr. Walters.

MR WALTERS: Thank you. President Trump has placed significant emphasis on keeping Americans safe. Secretary Tillerson has identified safety as a core value for the U.S. Department of State. The department holds a mandate to promote the safety and security of U.S. citizens traveling, working, or residing overseas, including those who courageously volunteer to respond to public health emergencies such as the 2014 Ebola outbreak. During that outbreak, the department leveraged a nascent capability for biocontainment medical evacuation to support over 30 partner nations and organizations. In partnership with the Department of Health and Human Services and the international community, the Department of State coordinated the evacuation of 46 health care providers infected with or exposed to the Ebola virus, enabling for the first time the international response that ultimately contained the West African Ebola threat.

The Department of State maintains the world’s only all-hazard biocontainment transport capability through our contract with Phoenix Air Group in Cartersville, Georgia. While the Phoenix Air Group’s small-jet biocontainment capability received a fair amount of press coverage during the outbreak and performed flawlessly during dozens of evacuations, it was clearly – it was clear early in the outbreak that a larger transport capability was needed.

The Containerized BioContainment System is the product of a $5 million public-private partnership between State and the Paul G. Allen Foundation. The CBCS, Containerized BioContainment System, was designed as a first-response capability to manage clusters of patients during the first days of an outbreak, whether intentional release or naturally occurring, allowing international responders to focus immediately on containment. Developed in response to the Ebola virus disease epidemic, the CBCS represents a revolutionary step toward meeting the biosecurity needs of the future, assuring the United States has the strategic options necessary to lead or support the next global response.

On April 10th, 2017, an interagency task force jointly led by the U.S. Department of State’s director of Operational Medicine and the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response initiated the largest overseas biocontainment exercise in history, designed to assess the readiness of federal, state, local, and private partners to respond to an outbreak overseas. This exercise, Tranquil Shift, tested the U.S. Government’s maximum lift capability in response to a simulated outbreak of a highly contagious pathogen, deploying a combination of Aeromedical BioContainment Systems used during the Ebola outbreak and Containerized BioContainment Systems to evacuate 11 simulated American patients to Ebola treatment centers across the United States. On April 11th, a total of five aircraft – two 747s and three Gulfstream IIIs – departed Atlanta, Georgia, traveled to Dakar, Senegal, where they prepared for the evacuation. On April 12th, all these aircraft flew to Freetown, Sierra Leone to pick up their patients and flew on to Washington Dulles Airport to clear customs.

Once the aircraft, patients, and crew had cleared customs, they flew on to one of five receiving facilities across the country, including Bellevue Hospital in Manhattan, Johns Hopkins University in Baltimore, University of Minnesota Medical Center in Minneapolis, and Denver Health Medical Center in Denver, and the University of Nebraska Medical Center in Omaha, to transfer their patients to waiting ground ambulance crews. The scope of this exercise is unprecedented and a testament to the lessons learned and the changes made in the aftermath of the Ebola outbreak.

I’d say this: Tranquil Shift prepares us today for what we were largely unprepared for in 2014. This is not about Ebola. This is about the Middle East respiratory syndrome coronavirus, MERS-CoV, in Qatar, with outbreaks every month for the past several months; Lassa fever in Benin, Togo, and Burkina Faso from February of this year; plague in Madagascar in December of last year. Infectious disease outbreaks happen all the time. They’re usually contained, largely to the efforts of local health systems augmented by international health responders. The United States Government has a responsibility globally and to its American citizens to continue to support those ongoing efforts to prevent catastrophe in the future.

I’ll pass it off to Mr. Lamana to talk about ASPR’s role. State takes – sort of initiates things overseas, manages the transport, gets them through customs. When that plane lands and those patients are offloaded, it’s HHS ASPR that picks up the ball and carries it the last mile.

MR LAMANA: Thank you. So I’ll start by saying that in 2006, the assistant secretary of preparedness and response was – the office of – was created as a result of the Pandemic All Hazards Preparedness Act. So it was fairly consistent with what this exercise was attempting to prove, was our ability to manage public health and medical crisis here in the United States. The ASPR was created as a lead for HHS for preparing and responding for and recovering from health effects from disasters and public health emergencies, which in this case was the simulated 11 patients across – over in – outside of our borders.

So the United States has the ability to – our preparation and ASPR’s preparation to prepare for here back in the United States with hospitals that can be ready to go in case there is a bio disaster somewhere. We picked five specific regional Ebola treatment centers, of which there are actually 10 across the country, but for this exercise we used five.

ASPR’s role in this exercise was to coordinate that transportation and reception once the patients were dropped off here in the States. We have various folks that are regionally located to be able to do that coordination with those 10 Ebola treatment centers, and that was what we set out to do during this exercise, was to be able to coordinate that local ground transportation from the airport to the regional Ebola treatment center. Part of that is ensuring that those regional Ebola treatment centers are adequately informed, notified, and then through the ASPR and through the grant funding that we have available in ASPR, we were able to provide some grants to these facilities – some grant funding to these facilities to be able to prepare their biocontainment units, train staff, and build the necessary plans to be able to do the reception.

So all in all, it was a good handoff from State to HHS in this exercise.

MODERATOR: Thanks, gentlemen. And I would love to open it up for questions now.

OPERATOR: Ladies and gentlemen, if you wish to ask a question, please press * then 1 on your touchtone phone. You will hear a tone indicating you’ve been placed in queue. You may remove yourself from queue at any time by pressing the pound key. Once again, ladies and gentlemen, if you have a question, please press *1 at this time. One moment, please, for the first question.

Our first question comes from the line of Matthew Lee, Associated Press. Please, go ahead.

QUESTION: Hi, thanks a lot. You mentioned in your opening remarks that the President is very committed to the safety of the American people. And I’m just wondering how this fits into that, given the fact that during the Ebola crisis, when the previous administration was bringing patients into the United States, the President was – the current president was very critical, saying that Obama was incompetent, that this was a huge mistake to bring these people here. Has that position changed as far as you know, and did the – was the White House aware that this drill that you were doing last week was actually going on?

MR WALTERS: Matt, thank you very much. So what I would say is this capability, at the time, two thousand – early in 2014, early in the outbreak, was largely unproven. It had been developed during the SARS outbreak and H5N1, and early on a decision was made that we were going to reach out and fulfill our commitment to American citizens overseas, and that’s what we did. And ultimately, Brantly, Writebol, and some 40 patients afterwards were safely transported. That changes the perspective. The doctrine at the time was we don’t transport Category A pathogens. We’ve learned. And what we know now going forward is that it can be done safely as long as these exercises take place, that the stakeholders are identified early, that there’s careful coordination. There is no room for mistakes on these, but the mortality rate for Zaire strain Ebola in West Africa in 2014 was 70 percent. The mortality rate for patients that we got to within seven days of onset of fever was zero. That was a game changer that nobody saw coming, but we learn, we adapt, and we move forward.

QUESTION: So the White House was or was not on board with this?

MR WALTERS: I can’t speak for the White House on that.

MODERATOR: Next question.

OPERATOR: Our next question comes from the line of Carol Morello, Washington Post. Please go ahead.

QUESTION: Hi, thank you for doing this. I was hoping you could give a few more details about the experience on the ground and how various people and institutions performed, from the hospitals to getting people through customs. Were there any glitches along the way, or anything that you learned? I was just looking for some more details of what the experience was actually like.

MR WALTERS: So Tranquil Shift is the third exercise of the Containerized BioContainment System. And the first exercise was last August; the most recent exercise was in April. With each exercise, just as with each evacuation during the outbreak, we learned things. This is an – a complex aviation operation. Airplanes have mechanical problems, electrical problems that have to be resolved in the midst. Negotiations with the Governments of Dakar or Senegal or the Government of Sierra Leone, these things – there were glitches, absolutely, and we worked through them as only the State Department can, working on the ground between the U.S. embassy, the government of, the civil aviation authority, ministries of defense and so forth.

So yeah, there were lessons learned. We are adapting our operations, but these were all things that we had seen before in previous real missions, and we had a game plan for them.

QUESTION: What were some of those negotiations involved with the governments of – in Senegal, Sierra Leone, what were the glitches?

MR WALTERS: We were able to – not so much glitches as anticipated friction points. So we moved a large number of Americans into Dakar – Senegal, put them up in a hotel overnight for crew rest and then had to bring all through in one giant horde through security and facilitate that. We anticipated that would be a friction point, and so we had ground – we had handling folks there to facilitate movement through the airport.

At the same time, one of the G-IIIs had an electrical issue. Well, that drew one of the handlers away from the crowd and caused a delay getting through the airport. We had anticipated that, so we made the flight schedule a little bit flexible in order to stay roughly on schedule. So it’s those small details that you get in these exercises; these are not big showstoppers, there were no big showstoppers. We worked through it and that was it. But as far as patient care, safety of operations, there were no lessons learned; there were lessons reinforced.

MODERATOR: HHS?

MR LAMANA: Yeah, I think that the one aspect I would say is when we started this operation we had the capability to move one patient at a time. And that was a lot easier to have to manage one aircraft, one patient. Getting one patient from the wherever – from out in the bush, to the aircraft, that always seemed to be a little bit of a challenge, but once they got to the airport and got to the aircraft, that was fine.

Now, we’re dealing with, in this last exercise, to move 11 patients at one time. That adds to the logistics of what you’re trying to accomplish, and it is no small feat to be able to do that. This is the – what we had before was good in the sense that we had a capability. Now, we’ve got a broader capability, a much better capability than what we had before.

MR WALTERS: I think one of the other points that we – that was reinforced in this exercise is that no single federal agency is capable of doing this type of operation safely. What Tranquil Shift did is what the Trump administration has been pushing all along. What you saw was six different federal agencies, the leads being HHS and State, working hand-in-hand very tightly, minute by minute, hour by hour, over the course of four days to make sure that all of the logistics fell in place.

MODERATOR: Thanks. Next question?

OPERATOR: Thank you. And once again, ladies and gentlemen, if you have a question, please, press * then 1 on your phone. Our next question comes from the line of Ike Swetlitz with Stat. Please, go ahead.

QUESTION: Hi, thank you. So I had two questions, actually. One was – I just wanted to confirm, these simulated patients, were these real people that you were transporting? And then, what exactly is a Containerized BioContainment System, and what was the $5 million spent on from the Paul Allen Foundation that you mentioned?

MR LAMANA: Thanks, Ike. So two questions; your first was: Were they real people? And the answer was yes. In the last exercise, Tranquil Surge, we used two volunteers and one mannequin to exercise different non-ambulatory capabilities. In this one, they were all volunteers, they were all real people, and they were all ambulatory, as all of the Ebola patients were at the time – and frankly, looking forward, almost regardless of the pathogen involved, most likely will be in the future.

With regard to what is the Containerized BioContainment System – so the airborne – Aeromedical BioContainment System that we used during the Ebola outbreak is a soft plastic tent that is set up inside a steel frame. And it’s good for what it’s good for. It’s good for single patient movement and a specifically engineered aircraft. What the Paul Allen Foundation allowed us to do is open the aperture wider. What other pathogens did we have to worry about and how did – how do we move four people at a time, and how do we not tie it to a specific aircraft? The CBCS is a 40-foot long container built to ISO standard, so think the back of a tractor trailer.

Inside that – and there will be some photos that go out from the press office – inside that 40-foot container are three chambers. There is a large chamber where all four patients are cared for in an ICU-like environment, there is a middle chamber where the staff members don and doff their protective equipment, and then there is a smaller chamber where once out of their protective equipment, they can rest and sort of set up a crew rotation.

The CBCS can be loaded onto a number of different aircraft; it’s not tied to a specific aircraft. It was designed that way. It can be used on a 747-400, an Ilyushin-76, an Antonov, a C-17, or a C-5. When it was built, it was – it went through the C-17 “safe to fly” program through DOD, working – so we worked closely with DOD in its design and testing. But it is specifically designed for State Department requirements to load aboard non-military aircraft so that we can get into places where the U.S. military may not be welcome for the next outbreak.

QUESTION: Okay, and it is ready for deployment right now?

MR LAMANA: It was ready for deployment about six months ago, and it’s been deployed now. We’ve flown it three times.

QUESTION: Three times outside of the simulations?

MR LAMANA: No, it has never – it has not flown an infected patient.

QUESTION: Okay, okay.

MR LAMANA: We had the ribbon-cutting on this in May of 2015, so it is ready for use now and it has been since then.

QUESTION: Okay. Thank you.

MODERATOR: Thanks very much. And going to our last question now.

OPERATOR: Our last question comes from Laurie Mylroie with Kurdistan24. Please, go ahead.

QUESTION: Hi. Thank you for doing this. My question is probably more for Dr. Lamana. You’ve talked about – well, let me say I was at – I heard Secretary Kelly speak earlier this morning, and he was asked what the thing that most frightens him is and he said it’s, like, biological agents being taken across the southern border for terrorism. And I wonder if you would agree with that assessment that biological terrorists, the agents being brought into the country, are a very serious threat, and do you think we are prepared for it?

MR LAMANA: Well, thanks for the question. Unfortunately, I haven’t seen those remarks, so it would be probably inappropriate for me to be able to comment. But I know we built the system the way we did to be able to manage, as Dr. Walter said, pretty much what the next crisis is, not just Ebola but any Category A pathogen that we may be faced with in the future.

QUESTION: So you think, like, if there were a biological terrorist attack in Washington, D.C., the plan that the city has laid out – everyone should follow the evacuation routes – would work and those would – streets would not become parking lots?

MR LAMANA: Again, unfortunately, I can’t speculate on that either, because I haven’t seen the local plan. Every one of the – and I know that this is a challenge, and I know every local community, every state, every region is working on what their response plans are. I know that some are very thorough, very well written, and others are still in the process of trying to refine them. That was one of the benefits of this exercise, was it gave the state and local authorities an opportunity to be able to test their plan and to see whether or not what they have written will fit with the scenario that we laid out. And hopefully in future exercises, we’ll be able to continue to refine those plans. So unfortunately, I have not seen the plans that you’re referencing.

Dr. Walters?

MR WALTERS: All I would say is that whether there is an outbreak in Paducah or in Pretoria, at the end of the day, there will be a requirement for safe and effective and efficient movement of patients to the appropriate care. We can’t have a biocontainment unit in every hospital across the United States, so regionalizing it and then having safe transport mechanisms is going to be critical now and in the future.

QUESTION: Thanks.

OPERATOR: Thank you, ladies and gentlemen. We have no further questions from the phone lines.

MODERATOR: Okay. Thank you very much, Operator, and thanks to all those who joined us on the call. As a reminder, this was on the record. And the embargo, now that the call has concluded, has been lifted. Thanks very much.

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