like there can be, as i said, a happy compromise. >> host: and finally, paul jacobs, has qualcomm helped to develop a south, southern california silicon valley because of your size and where you're located? this. >> guest: certainly a lot of companies that have spun off a bit. we've also attracted a number of telecom companies into san diego, so san diego is very well set up for wireless, but it's also interesting that it's very well set up for biotech which has a little less to do with us, but, in fact, what we're looking at going forward is this whole notion of wireless hell as being something that'll get centered in san diego and has a big opportunity. and the notion there is you may wear sin sores on your body or in the environment that will actually talk to your phone, monitor things and talk to your health care provider when it needs to. i think there's a huge opportunity there. there's certainly a huge need for cost savings and

productivity improvements in if health care, so this is another area that i think san diego will get known for. >> host: and all of those devices will use more spectrum. >> guest: more spectrum but not necessarily always cellular spectrum. we're looking at things, you know, if you have a body-worn sensor that you have, you know, stuck on your skin, it may talk over a different technology to the phone, and then the phone will talk cellular to the network. so there will be wireless embedded in these things, it's not all the going tock the cellular radio. >> host: paul jacobs is chairman and ceo of qualcomm, paul kirby is with "telecommunications reports," thank you both for being on "the communicators." >> guest: thank you.

>> see what people are watching on the c-span video library with the most shared. it's right on our home page. click our special 2010 election analysis tab to view our continuing coverage of the midterm elections. watch what you want, when you want. >> in this week's question time, australian prime minister julia fill ard answered questions on

the imf and world spank and the operations of australia's troops in afghanistan. from the australian parliament in canberra, this is a half hour. >> hello, i'm david spears in canberra. over the next half hour we're going to show you highlights of the latest edition of the australian pardon mement. nine years since the war in afghanistan began, the australian parliament held its first debate on australia's role there, and while the parliament can't decide whether australia should or shouldn't be involved in a war and there were no binding resolutions in this debate, it was one which saw overwhelming bipartisan support for australia staying involved. the labor minority government and the conservative coalition support our role there, only the minor party, the greens, say we should get out. we also saw the treasurer, wayne swan, update parliament on his

recent imf and world bank talks in if washington. the government defended its plans to set up a regional processing center in east timor for asylum seekers continuing to come to australia in increasing numbers. and the government spelled out its plans to put a price on carbons as part of it efforts to tackle climate change. here, now, are the highlights of the australian parliament. ♪ >> my question is to the minister for defense. given that one of the updated rationales for our involvement in afghanistan is the propping up of the karzai government, is the government concerned about the reported level of corruption to the highest levels of the karzai government, and does the government agree with the u.s. general david petraeus' comments that the afghan government is a criminal syndicate?

>> the minister for dee fence. -- defense. >> well, mr. speaker, i thank the member for his question. the very clear rationale for australia's involvement in afghanistan is that it is in our national interest to be so involved. it is in our national interest to support a united nations-mandated international security assistance force, a coalition of 47 countries mandated by the united nations. that coalition including our alliance partner, the united states, to seek to stare down international terrorism. and these issues will, no doubt, be very broadly and widely debated by the parliament in the days ahead. let me come precisely to the question that the member has raised in respect of the karzai government. as members of the house might recall, pote before and -- both before and after the recent presidential election which saw president karzai reelected, i said very clearly on a number of

cases that australia, the australian government, the international security assistance force and the international community expected to see, expected to see considerable and substantive improvement from whatever afghan government emerged from that presidential process, whether it was a reelected karzai government or some other government. we expected to see substantial improvement on corruption, on governance, on human rights issues, in many particular the treatment of women and the treatment of girls especially when it came to matters like education. i said that on behalf of the australian government and on behalf of australia, both domestically and internationally. but before president karzai's facing the election and after his re-election. and the position of australia and the position of the australian government has not changed one iota in that respect. >> thank you, mr. speaker. my question is to the treasurer.

are the treasurer update -- will the treasurer update the house on the state of the global economy and what it means to the government's reform agenda? this. >> treasurer. >> yes. i thank the member for his very important question about the global economy and what plans the government has got to broaden and to strengthen our economy. mr. speaker, last weekend i attended the imf world bank meetings in washington. it's a good opportunity to take the temperature of the global economy, to talk to fellow finance ministers about the economic outlook, and, of course, to share the australian economic story. now, it's incredible to think where we were in the global economy just two years ago. just two years ago last weekend in washington there was a g20 finance ministers meeting, an emergency meeting which was attended by then-president george bush. and what the global economy was contemplating at that time was

the collapse of global financial and stock markets and a drop in global demand. and it is pretty incredible to see how far the global economy has come in those two years. of course, last week two years ago we moved decisively to put in place our bank guarantees to help credit plow to the australian economy and, of course, we announced our stimulus package, phase one. but, of course, in if two years the global economy has come a long way, and of course so, too, has the australian economy. but i guess the message that came out of this meeting over the weekend was that there are still risks, or there is still risk in the global economy. and while it is recovering, the global recovery is fragile and uncertain. and, indeed, the imf has concluded that the risk has intensified, particularly when you look at what's going on in

the european economy and, of course, in the united states' economy. in those economies you're looking at near double-digit unemployment and, of course, in some countries even more. this is how the chief economist of the imf summed up situation: the result is a recovery that is neither strong, nor balanced and runs the risk of not being sustained. in most advanced economies, weak consumption and investment together with little improvement in their exports are leading to low growth. unemployment is high and barely decreasing. mr. speaker, there couldn't be a sharper contrast with the australian situation. strong employment growth, strong economic growth, strong economic growth compared to all other countries in the oecd. what they talk about in if washington is what australia has done is clearly something special. mr. speaker, truly something special. and, of course, part of the success here is that while we

put in place the stimulus, we also put in place our plans for recovery. the fastest fiscal consolidation that we've seen since the 1960s. bringing the budget back to surplus, bringing the budget back to surplus, making the investment ts in infrastructure, putting in place a tax system which is competitive to broad season and to strengthen our economy. this is the way forward for australia, and the contrast with all of those other countries of the imf could not have been more stark. >> my question is to the minister for climate change and energy efficiency. what does recent economic research into carbon prices within our competitor economies indicate? why, minister s a carbon price important for business certainty? >> the minister for climate change and energy efficiency. >> thank you very much, mr. speaker. and i thank the member from melbourne ports for his

question. mr. speaker, today a report has been released by the climate institute, it's a report prepared by an organization known as vivid economics. it's a well-respected organization from the united kingdom which does research into climate change/economic issues. and the report that's been released today is an analysis of the implicit carbon prices that operate in a number of key economies with which australia trades. the study is, in fact, one of the first efforts, i think, that's been made to quantify the costs of policies to reduce emissions or to establish what carbon prices there are, in particular economies including countries important to australia including japan, the united kingdom itself, the usa and china and south korea. the vivid economics report has found that countries around the world are of course, already taking steps to reduce their

carbon pollution and, thereby, moving to cleaner energy sources and effectively having a carbon price in their economies. and importantly, it indicates that countries with which this country trades, with which australia trades like china and like the united states already have implicit carbon prices within their electricity sectors. and as foreshadowed, this is a matter, of course, that is of interest to the multiparty climate change committee that the government has established to consider the issue of the introduction of a carbon price and a matter that the government has responded to in response to a request by the member for new england to do an independent analysis of what carbon process would be operating with some of our major trading partners. mr. speaker, in be -- our economy a carbon price will not only create an incentive to reduce pollution, but it will also provide certainty for investment by the business

community. it will also increase this country's long-term competitiveness because it will drive investment in clean energy, and it will make australia an attractive investment place for, in which companies will do business. now, the energy company agl, one of our major companies operating the energy industry, estimates that uncertainty caused by the delay in implementing a carbon price in our economy could cost consumers up to $2 billion a year in higher electricity prices or around $60 per household in the year 2020. the treasurer shakes his head, i'll explain. that is because investment in new baseload electricity general ration is being deferred because of the uncertainty generated by lack of a carbon price in our economy. that is we have further

commentary from the other side. it is not rubbish. if you engage with the major players in the energy sector, they will tell you that is the case, and they will tell you that is why they support the introduction of a carbon price into our economy. it only -- the interjections, mr. speaker -- >> order. the interjections should cease. >> only serve to everyone sides how out to -- emphasize how out of touch those others are with mainstream business in this matter, they're out of touch -- >> order. >> and their position in opposing a carbon price in this economy is -- >> [inaudible] >> irresponsible. >> my question is to the prime minister. i refer to prime minister to her proposal for regional processing center in east timor. would the prime minister define which countries constitute the region under her proposal? >> the prime minister. >> a crackerjack committee today. [laughter]

>> order. prime minister has the call. [laughter] order. >> thank you very much, mr. speaker, and i know the deputy leader of the opposition, like the minister for foreign affairs, has flown over a lot of countries in the last few days, but australia's in the same place it was when she left, so on that basis, on that basis, of course, that australia -- >> order. >> we live in the same region. [laughter] now, given we live in the same region, you know, how would you like to define it? asia pacific might be the kind of way you would define it, i think. i think, you know -- >> order. order! >> we will -- [inaudible] but, of course, there are formal process -- >> order. >> -- including through the barley process that the immigration of -- minister of

immigrationing has referred to in the his various statements, the minister of immigration has also, of course, been involved in dialogue in the region prior to the parliament commencing its sitting. he was in delhi, he was in kuala lumpur and in jakarta pursuing these discussions. >> order. >> we are, obviously, predominantly interested in the countries through which people transit, the most common routes of movement for irregular people movement. you would expect that to be our prime area of interest, but in terms of working across the region, we obviously want to work prodly with regional before broadly with regional partners and neighbors. >> mr. speaker, my question is to the prime minister. i refer the prime minister to the head of rio tinto's words last night, if you can't trust the government, who can you trust? i ask the prime minister, why has she reneged on the

government's preelection deal with the mining industry? >> order. the prime minister. >> thank you -- [laughter] thank you very much, mr. speaker. my colleagues are assisting me by reminding me how extraordinary it is to get this question from the leader of the opposition given his statement on accuracy and truthfulness during the course of the lead up to the elections -- >> order. >> but putting that to one side, the answer to the member's question is this, and it's exactly the same answer as i gave yesterday. the government is working through with its policy transition group. don argus, of course, is leading that. the minister is working alongside don argus. the issue that the lead every of the -- leader of the opposition is referring to about the implementation of the arrangements is being worked through in the policy transition group, so we will keep working through, mr. speaker.

we will keep working through to deliver the legislation as promised to this parliament. >> the leader of the opposition. >> supplementary question for the prime minister, mr. speaker. >> leader of the op is us. >> is she insisting on an interpretation of an agreement clearly at odds with that of the mining industry, clearly at odds with the statement of the heads of agreement because she knows that it is necessary to have her interpretation to protect the return to surplus by 2012-'13? >> the prime minister. >> thank you very much, mr. speaker. once again i would refer the leader of the opposition to what i said in the parliament yesterday and what i said at a press conference yesterday which is that it, obviously, is not the government's intention to have state governments able to change royalty arrangements in a way which means the federal government foots the bill. we are working through in the

policy transition group on implementation. we will work through with australian mining companies. now, i know that it's the leader of the opposition's stock in trade to overstate everything, to be constantly claiming crisis and carry on. there is no need for that, mr. speaker. we are methodically working through. >> my question is to the prime minister. i remind the prime minister that the canadian government has just introdiscussed five -- introduced five-year temporary visas to deal with an influx of some 500 asylum seekers. given that five and a half thousand illegal boat people have arrived this year including four boats in just four days, why won't the prime minister reintroduce temporary protection visas? the policy worked before, and it can work again. >> order. the prime minister. >> thank you very much, mr. speaker, and i thank the leader of the opposition for his call. for his question. i am aware of the changes being

contemplated by the canadian government. in fact, i did seek some advice from our very own immigration officials as they put together this suite of changes. and if leader of the opposition was to be honest and accurate and detailed with this parliament and went through it change by change -- >> order. >> -- what he would recognize is that the canadian government has gone for a different mix of measures. in some areas, for example, they have taken a different approach. for example, in this country we have mandatory detention. we deal with people's processing to finality whereas my understanding of the canadian approach is that their going to put a one-year time limit on such detention so that there are differences. but we here in australia need to make the decisions that we believe are in our nation's interest, that are the most effective range of policies, and

we need, of course, to implement solutions for the long term. which is why as a government we are working on the regional protection framework and regional processing center. it's why we have announced our long-term strategy for detention. it's why we've announced some new arrangements for children, and i am yet to understand with any precision or clarity where the opposition stands on those changes. if leader of the opposition was being honest about this rather than the simplistic comparisons with only one aspect of the new canadian proposals, what he'd actually be saying to the australian people is this is a complex problem. there is no one policy measure that provides the solution, and there's certainly no one three-word slogan that does. >> the leader of the opposition. >> mr. speaker, my question is to the prime minister. i refer the prime minister to

her preelection commitments to fix the mining tags, to rule out a carbon tax and to stop the people smugglers. and i remind her that since the election the mining tax deal has unraveled, she's ruled in a carbon tax and there are 24 votes with 1209 people on them. so i ask, when will the prime minister stop complaining and start governing by introducing policies that will fix this mess? >> the prime minister. >> thank you very much, mr. speaker, and i thank the leader of the opposition for his question and let's go through it piece by piece. the minerals resource rent tax is being consulted through the policy transition group. >> order. >> and the legislation will be brought before the parliament. then, of course, the opposition will face a fundamental choice whether they will continue to maintain their opposition to a tax that australia's biggest miners have agreed to pay,

whether they will do that and stand in the way of -- >> order. >> -- to achieve balanced economic growth and stand in the way of tax breaks for small business and stand in the way of better -- [inaudible] and stand in the way of $6 billion of productivity improving infrastructure. that, of course, will be a choice for the leader of the opposition. on the question of tackling climate change, i don't believe in the leader of the opposition's simple slogans. i believe in using the opportunities of this new parliament through the multiparty climate change committee -- >> order! >> -- to address the question of pricing carbon. and, of course, i reiterate the leader of the oppositioning. if he ever wakes up to the fact that the reform road is not a demolition derby, if he ever wakes up to that fact, then he will be welcome to join with the

government -- >> order. >> -- pricing carbon to join the multiparty climate change committee and actually to do something constructive rather than seek to rake. and on the third point that the leader of the opposition raises, what i said to the australian people before the election when i spoke at the lowy institute, what i said to them was this was a complex problem. unlike the leader of the opposition, i was not going to use simple three-word slogans. unlike the leader of the opposition i was going to be truthful -- >> order! >> -- truthful about the dimensions of the problem. i would not use terminology -- [inaudible] i would explain factually to the australian people the dimensions of the problem and the regional protection framework and regional processing centers that i believe is important to the

solution. >> members -- >> of course, we have worked on that methodically with the minister for immigration in the region just before the parliament sat pursuing dialogue on these questions. now, at some point the leader of the opposition needs to think through whether, really, his political cause by being someone who is known for raking or whether his political cause is advanced by returning to the liberal party which was a reform advocating political institution. and i say to the leader of the opposition as i said last night, for us to -- [inaudible] prosperity coming out as we have as strong from the global financial crisis we need to keep walking the reform road. now is not the time to lead the liberal party away from the post-1983 --

[inaudible] on economic reform. now is not the time to lead the liberal party into economic -- [inaudible] now is not the time to conclude that the way forward for the liberal party can conduct itself as a demolition derby -- >> order. the opposition. >> my question is to the foreign minister. i refer the minister to last night, that he opposed the east timor detention center policies stating that it will go off like a fire cracker in east timor's domestic policies. given that the foreign minister was right and the east timor parliament has passed at least two resolutions opposing the detention center, why won't the government drop this doomed proposal? this. >> the minister for foreign affairs. >> mr. speaker, as i've said to this house before and elsewhere beyond the house, the reason the government including the prime minister, the immigration minister and myself support a

proposal for ritual processing center is, one, it is compatible with the u.n. convention on refugees, two, it is also capable of obtaining the support of the international organizationing of migration and, three, it also has the support of regional countries. now, mr. speaker, the honorable member raises that latter point in terms of reaction for regional countries. i'll draw her attention to the response of the president of east timor, the statements made by the immigration minister concerning the reception of the -- >> order. >> as a basis for further consultation, discussion and negotiation including -- >> order. >> can i also say to the leader of the opposition that it is natural in any country when we are dealing with questions of asylum seekers that there will be democratic debates which

occur in those countries. i would report that as natural and normal in this place, it is natural and normal in east timor, it is natural and normal in any country. the government needs to support this policy because it is consistent with the three principles i enunciated before, and i'll withdraw the deputy leader of the opposition's attention the reason why the previous government ignored the convention. it was not a -- [inaudible] the unhcr ceased to process asylum seekers because of its concerns about the then-government presenting arrangements on them and filed all basic humanitarian and international legal tests, tests which this government takes seriously and forms the basis of a government counterapproach to this challenge which faces not us, but other country around the world. >> my question is to the minister of defense. will the minister update the house on the force protection measures being implemented for

our troops in afghanistan? this. >> the menster for defense. minister for defense. >> well, thank you, mr. speaker, and i thank the member for his question. it's one of the government's highest priorities to insure that we can do everything possible to protect our troops in the field in afghanistan. this is also one of the highest priorities of the chief of the defense force and the service chiefs generally. the member asked me about measures which are being implemented. members might recall that in the budget of this year, may of this year, the government announced the adoption after a review requested by my predecessor, minister faulkner, adopted a $1.1 billion enhanced new measures as far as force protection for our troops in afghanistan was concerned. this added to about half a billion dollars worth of existing measures, so in the budget this year we saw over the financial period of 2009-2010 through to 2012-2013 some $1.6

billion worth of enhanced measures for force protection. of the 48 measures announced or effected in the budget, the department and the cdf implemented a very tight timetable and a rigorous schedule and a rigorous system of monitoring to insure that these measures were introduced as soon as practically possible. there's some interest in the implementation today because yesterday as a result of the request by a number of media outlets requesting the incoming government brief from the department of defense, a redacted version, so-called redacted version, in other words, with national security and sensitive matters eliminated, a redacted version was supplied to media outlets which contains a schedule of the implementation of of these measures. of course, some time has e elapsed since the presentation of the incoming government brief, and the advice i had from defense yesterday and today is that of the 48 measures that were announced effectively in

that budget, 36 of the 48 have either been completed or are on track. there are 12 in respect to the monitoring program which has issues of concern, a couple of which go to timing, and so far as timing is concerned, there are concerns about the delayed implementation so far as additional protection measures for buildings that our troops occupy or live in and also some highly-technical measures so far as electronic triggering of improvised explosive devices. ..

>> so far as the protection of our troops is concerned. it's also an important one, mr. speaker, as the chief of the discourse has made clear consistently most recently added estimates and this government has made clear these matters are under review because circumstances always change. the threat is ever there. the threat is ever present. >> just a couple of seconds left in this australian parliament question time. we will leave it at this point and go live now to the house of commons. to hear from for secretary william hague. is testifying this morning before the foreign affairs committee about the progress of british forces in afghanistan and his government to government policies toward pakistan.

this is live coverage on c-spa c-span2. >> it's often put to is the al qaeda and taliban are being grouped together when it's well known that they are very different, different beings. the government justifies its intervention in afghanistan, they were there, al qaeda would return to afghanistan and pose a threat to national security. but a number of our witnesses have disagreed with this premise. what evidence have you got to suggest al qaeda, not taliban, al qaeda will return to afghanistan? >> it's impossible to have direct evidence of something that would happen in a situation. but we do have the experience of what happened before, before 2001, when most of afghanistan was an up and -- ungoverned state or taliban governed state.

we know al qaeda were able to set up their training camps and bases there. now based on that experience, it must be a reasonable suspicion that the same thing what happened again, particularly where al qaeda felt pressure in other areas. and so it would be a rash of service who said he knew this would not happen. and it is fair to set any conditions that president karzai has set out for political settlement in afghanistan, that taliban and others associated with them should renounce al qaeda and renounce violence. so i think that is the line of reasoning. >> he said he didn't think they would return. >> well, under conditions he said, and he said that condition for a good reason. >> could you answer the question regards to military situation,

the question that was posed on wednesday last week, and that is successful counterinsurgency operations in the past, have suggested that not one of the preconditions, control of the borders, high density levels, credible government, support the majority of the population exist in afghanistan. so why do you think the military in particular is so optimistic they can achieve a successful outcome? doesn't beg for more assessment? >> it remains in any realistic assessment phenomenally difficult task. the task we're engaged in in afghanistan. some of the fact is you quite rightly described, nevertheless, all of those factors are being addressed at one way or another. the build up of the afghan

national security forces is very substantial, as you know, and as you will have seen on your visit to afghanistan. the afghan national army is not 144,000, 10,000 ahead of where they were meant to be at the time. the afghan national police is stronger than was anticipated now. the attrition rate in terms of people leaving these sources is diminishing. the legitimacy of government and operation of government and a province like helmand seems more widely accepted that it was a year ago, or two years ago. so progress is being made in many of these parameters. even cooperation of the countries, the afghanistan-pakistan transit trade agreement working with regional neighbors is an area of greater strength of the afghan government than before. so they all remained very difficult, every parameter remains very difficult. but i think it's fair to argue

that there in case, progress is being made in all of these ways. so success remains very difficult. in afghanistan, but it is by no means impossible. >> one of the things that has played our presence in afghanistan is the over optimistic assessments since our progress there. we are all please obviously the more realistic situation there now, although some of us need to be more realistic. but does this suggest in the path of the military, the driving strategy, as opposed to politicians? >> well, to take several parts of that, because i agree, sometimes it hasn't been an overoptimistic effect before we are trying to avoid that, learning the lessons was happened in the past.

i go to the first of our quarterly review. it was in the week where your committee was visiting afghanistan, and i apologize for that, because of the pending review of the previous week and my visit in the middle east the following week. i will try to capture in the caching next time, the course of the review. but i hope, i think it was regarded by the house, a frank assessment of where we are and not so stating what is being achieved by showing the progress as we made in several areas, and much more needed to be done, for instance, in the area of corruption and governance. and we'll carry on in that vein with our assessment. not encouraging false optimism, but not being blind to good news either. because there are those, there are often more successes to talk about than featured daily in our media. so i think it's important, hopefully we are getting that right, getting realistic in our

assessment. what were the military driving -- you may need to wreck that -- you have directed it to one of the officials who served in the last government, but to members of the last government more than to the current government, it's very important on an issue like this that military and political leaders work well together. that political decisions are well informed by military assessments, otherwise of course politicians can make rash decisions without sufficient military awareness. but i think now the way in the u.k., we have our own national security council, the chief of defense staff, heads of intelligence agencies sitting together on this and other subjects, on a very regular basis. that we have the correct balance and have decisions are made. >> can we just explore very

briefly the extent to which perhaps counterinsurgency operations are undermining our political goals? will happen is half some military, politicians must provide -- a negotiated settlement i think, and here the military seem to be targeting taliban leaders as the decapitation policy in place. do you think that is constructive for a negotiation settlement? and what extent can the u.k. actually influenced the u.s. in its approach to the taliban in the sense that these publicly they have been reluctant to negotiate? >> so the u.k. can in the passionate influence the u.s. the prime minister goes to great deal. i'm heading to the united states where today. this is top of the list of my

topics to discuss with secretary clinton. and we have a multitude of contacts at official level and between our intelligence agencies, and so on. but i do very much agree that it is important to keep the taliban under maximum military pressure, and, indeed, to intensify the pressure in the coming months if we are to come to a negotiated political settlement, ultimately. so i would, in fact, set the premise of a policy of your question, that conducting combat operations against the taliban reduce, reduces the chances of a political settlement. i think military success and intensified military pressure is an important component of bringing about a settlement. the taliban should expect intensified military pressure, and even greater pressure on them in the coming months in the

out of a political settlement. >> and finally, do you accept that when a negotiated settlement takes part and takes hold, it will have to obviously reflect reality on the ground, on negotiations with taliban, negotiations with regional warlords, et cetera, but is it not possible to have a negotiated settlement and still retain the ability to take on al qaeda perhaps using special forces, should they ever returned? what i'm trying to get to hear is, splitting time between the taliban and al qaeda. there's no doubt that reconciliation, negotiated settle as he take place with the taliban. that doesn't mean we have to make peace with al qaeda. and kelly not engineer, not be on the demand, where but at the end of the day we retain the military capacity to take on al qaeda, should they ever

returned, while progressing the negotiation settlement with the taliban and order to engineer some sort of success? >> well, yes, i would hope that is possible. it's highly unlikely, it's possible in the foreseeable future to negotiate peace with al qaeda. that would be fundamentally against the believes of al qaeda. it may be possible to do so with taliban, or with the parts of the taliban. we don't know whether that is possible. but it is certainly desirable under the right conditions. and now one of the conditions i refer to are your that president karzai has set alongside respecting a constitutional framework and renouncing violence, is cutting ties with al qaeda. so yes, such a settlement would require a distinction to be made between those who are reconciled and those who are committed to al qaeda.

>> fonseca, if i may. i think one factor when looking at the prospects that you gave is the level of pipe support for the taliban which is around 10%. so it varies. in different parts of the country. i think the other thing we need to consider is that parts of the insurgency have active links with al qaeda now, not necessarily inside afghanistan, but certainly links emanating from pakistan. and if one looks at president karzai's conditions about renouncing links with al qaeda, i think what also would love to see security council resolutions and suffice of 9/11 that you'll find the taliban getting up al qaeda, a step the taliban didn't take. so that the real questions about to what extent what is taliban assurances that would be capable of being carried out? >> thank you.

>> the nature of this insurgency, we understood from what we were were talking, there are three different insurgencies in the haqqani network, and there is the pakistani-based palestinian. maybe there are more. perhaps. is it your strategy to get all three of those components into a political process, or are you trying to split them and get some of them on the basis of that, and at least reduce the clash of the conflicts going on? >> well, we're trying to create the conditions for a -- the military campaign is a very important part of that for a reason i was referring to earlier. if not within our control who wants to enter into a settlement. whether all of those groups and for the groups or any of those groups who wish to do so. that is up to them to decide whether they wish to be part of

that settlement. so we might wish for however many groups to be enrolled, but, so we will see how the circumstances develop. >> finally, in your earlier answer, he referred to the growing training of the support of the afghan national security forces, either virtually none sovereign posturings in those agencies and that the only pashtuns are from the eastern and north of the countryspeak with a remains the case that the southern pashtuns are way underrepresented in the national security forces. a few percentage i think of afghan army, 3%, although more than 40% of the army would be pashtuns of other origins. so when you say the only other pashtuns are from other areas, you talk about -- yes, that

remains a weakness. it's an important one to address over time, and, but it has to be seen against the context of the very rapid buildup of the afghan national security force is, and a huge in improvement in the training of officers that we've seen over the last year. >> secretary, do we have a contingency plan if we get through to 2015, we -- how we going to contain and manage the situation in 2015 if the counterinsurgency strategy doesn't work? >> well, of course we're working very hard to make sure it does work, and remember that a key component of this is the forces that we're talking about. that the afghan national security force is will be over 300,000 strong by the end of next year. nevermind by 2014.

the training of officers in the afghan national army is up to 700% over the last year. now, this is a very important consideration. this is an army becoming much larger than ours. that i think is crucial, that buildup is crucial to the afghanistan, whatever happens, so that afghans can lead and then take their own security operations from 2014, in line with president karzai's objective, a respective of arriving at a political settlement. so you can think of that as the next line of defense after international thought it spent on train on train on train on

train -- [inaudible] >> well, we made it very clear statement perhaps not being involved in combat operations in 2015, although that does not preclude the manner in a training role, for instance. but yes, i think the long-term outlook, if they were to be no political settlement, is the afghan national security forces become large enough to be able to hold their own in afghanistan. that does not mean there would be a peaceful afghanistan. it does neither would be an afghanistan where the government would run wide enough for the government to be able to resist being overthrown by force. >> will we be asking from the british military, that troop

numbers, 2013, in 2014 -- [inaudible] >> also in the national security council, of course. that is now the core of an which such matters are decided. so yes, the prime minister will certainly, secretary of defense will set forward the plan for the next few years. it's quite hard to foresee at this point the level of resources and the nature of activities regarding 2013-2014. of course, it is clear that we should have a larger and larger training role, and as you know, the defense secretary has announced movement of more than 300 personnel into a training role just in the last eight months. but yes, the security council will examine the plans for our deployment overtime. >> if i may, that is on the agenda of the national security council over the next few months. and troops will be linked obviously.

>> can we then just get exactly what the 2015 deadline is? what is a? when is it? exactly -- >> the prime minister and i have stated it, by 2015, we will not be engaged in afghanistan in combat operations, or in anything like the numbers that we have there today. and as i was saying to mr. stewart, does not mean that we will not be there in other forms in training wrote and so on, but i don't want anyone to underestimate the clarity, or view the clarity of it. and the prime minister said that very clearly in meeting. and that is what we will stick to. >> when? 2015? that is 12 months longer. there's a general election in may 2015, isn't it a?

>> i don't think -- >> january 2015? >> i don't think that's correct to try and hone in on the actual day in 2015, particularly since we're sitting here in novembe november 2010. this is quite a long way away. in fact, it is further in the future as you all well know that our whole operation and how month are in the past. so it is a long time into the future. but we don't anticipate in the new future setting a particular month or week. >> who took the decision? >> the decision is taken by ministers and the national security council in the cabinet led by the prime minister. >> taken in the national security council speak was taken by the prime minister in consultation. [inaudible] >> yes. >> who were you consulting? >> a four he made his announcement. [inaudible] >> i'm sure he was consulted, but i can't sure when everyone

was consulted. >> look, i mean, we are there as part of a coalition force with very significant part. and we always try to be good partners, have a, as a country in the coalition, activities and international affairs. no conceivable possibility that that will be changed, let's say, in a nato discussion takes place about the need to change because deadlines are not being met. american request, because we simply can't get in position. or the afghan national army, afghan national security forces are capable of standing up on their own. no conceivable way that that is going to be ordered. it's set. it's finished. that's it. it's a deadline. we will not be changing any circumstances. >> it won't be changed at the

prime minister has been very clear about that. it is a change of politics. there are several changes. we have double operations for the troops. redeploy away from certain areas of helmand to concentrate on other areas. you know, several changes in policy on afghanistan, and yes, this is one of the. and people can argue advantages and disadvantages to a. mr. ban has done that as well on the floor of the house. we will make the most of the advantages of this policy. it is clear to all concerned what our intentions are, what we're going to do by 2015, to our allies, to the afghan government, and we don't want anybody to be any doubt about that. there are other allies in nato who also stated specific timing so the deployment of their forces. we will buy that had been in helmand for most long, 50% longer than the entire second world war, and we feel it right to say that by then we will not

be engaged in combat operations. >> this is a big change of policy, isn't it? [inaudible] we were halfway out before the change of government. this is the change, really. >> is an important change and is a change we will stick to. >> why did we think that was helpful? we did it to put pressure on the karzai government, but didn't take the pressure off the taliban, off the insurgents? >> i think insurgents will find in line with our earlier discussion that they are under intense pressure over the coming months. there is no relaxation in the british or coalition military. in fact, since it's only recently as you know, really all the forces of the commanders have been available in afghanistan and that pressure

will intensify over the coming months. and even over the coming years when that is added to the increasing role of the afghan there should -- afghan national security forces that they are quite wrong to conclude that anybody can relax, that everybody on the other side can relax in any way, because we've made an announcement about 2015. a it does mean with absolute clarity for the afghan government that they know that is the length of our combat commitment. our allies know that, too. and there are advantages to that, as well as of course the arguments against it that others have put. >> i was ever going to say that the summit takes place later this week will endorse the 2014 target date for transition and all of nato's efforts will go into making sure that happens. >> i mean, that's been known for quite some time. other nations, the dutch,

canadians are leaving in response, there was some indication that would have to be a plan between now and 2015. how are we going to do this, the withdrawal of other nations? there are relative means. the dutch in the canadian our very, very significant contributors. >> yes. and i certainly hope some of the countries will be able to sustain some substantial training growth. >> we've been discussing that with them, and it would be highly desirable, given the extent of canada's cod division over the last few years, if they are able to do that. i think that would be very welcome. we have been discussing that with the canadian government. there are, as you say, a growing number of nations overall, although not all make military

country vision, since there are at the moment 48 contributing nations, there are more at the moment than there have ever been. i thought that can easily be overlooked. but in the cases of canada and the netherlands, a good deal about their notice, intention. but from an operational point of view, given the increase of the forces from the united states and seven other countries, the operational gaps will be filled. there is no doubt about that. >> foreign secretary, you've touched on the fact there is a lack of trade in afghanistan, something that was quite apparent in both the police and army, the afghan army, the quality of training is at a time the people will ask a train, and others, was a very of small amount of time.

can you explain why that's the case? and secondly, it would seem that a way of change between 22014 and 2015, not just, but the quality of training, because when we talked, for example, the pakistani generals, they said they were quite impressive, though as to what we're doing is creating can improper, not troops because of a small amount of time that has been given to the trainers and troops. unit, many of the afghan police were being returned, where had no idea of the job they intended to do. their pay at one stage was so poor that it was below the living wage which encouraged theft and extortion. can you just explain to us about the policy now, why we spend billions of pounds that we haven't got such good records in

training? >> it remains a huge challenge, i mean, you are quite right to highlight a. i don't want to say in any way that this is an easy process, although we achieved our objectives on training. there are improvements have taken place in recent time. [inaudible] [bell ringing] >> one of those is the pay of the afghan national is being increased and improved. your quite right on one of the difficult has been, that is the more attractive for people to do other things. afghan national police souders has been increase. training programs has been improved. and recruitments than has generally exceeded the target.

and i mentioned briefly the attrition rates before. the average attrition rate has gone down to 1.4% a month in the case of the afghan national police, which is is a series improvement of how it was in past years. there is also increased attention being given to the training of noncommissioned officers and officers, which, of course, are key to the quality and to the leadership that is necessary. so people are not in the phrase that you have given. i mentioned some of the figures, were given more in increase of the ncos in the afghan is up 70% since november of last year, and officers of 175%. so that will lead over time to policy, any other important thing that is happening is a partnering of afghan national

with british troops. most of them were, british troops going forward is in partnership with the afghan national security forces. i pointed out in my review statement to the house three weeks ago how the operations conducted recently have been led by the afghan forces, for the first time in a very significant way. and so i think as you have all sides of improvement. there is a level of training, the same level you could get in a european or american army, well, no, it is because your the emphasis is on driving as rapidly as possible. but you can see from the figures on giving, the quality of training, the quality of training, and the way in which the troops and afghan forces then gain experience alongside nato troops, all gathering pace in improving. >> one thing about afghan troops are taking the lead in operations in around kandahar,

and that is quite successful. >> 50% of the operations have been led by the afghan national forces themselves. >> just to make the point, foreign secretary, since we've been there, people responsible for the training and troops in afghan were complaining bitterly about the lack of resources even now as we speak. can i just moved onto, talk about the police, the government itself. one of the important things of the afghan people have to face in own government, we heard an awful lot about corruption, about malpractices of the afghan government. what have we been doing, what can we do in the future that will build on faith in their own, the afghan people in their own government? >> this is one of the areas where much more progress needs to be made. by the way, i wasn't i doing in my career and that everything was fine of trading that the problem was passionate every

major huge challenge that i take nothing away from -- [bell ringing] [inaudible] >> your quite right to say that training requires increase exponential attention. but on governments, on corruption, a greater effort needs to be made. that some progress is being made, some of the commitments into the time of the kabul conference in july, our being met. and we've seen over the last few months some of the afghan ministers and declare their assets in public. we have seen a great improvement and transparetransparency. for instance, in the military of mine, more than 100 new contracts were placed openly on the internet for people to examine. that is the kind of practice

which may help to combat corruption in the future. so certainly some progress is being made. nevertheless, we have seen anything surrounding the kabul bank and other institutions, very depressing news. and so we do call on the government of afghanistan to make greater progress in this area, and to continue to try to win the support of domestic and international opinion. >> i heard your statement in the house of commons as i was present, and i thought a very franklin. you touched on good governance and again now. what precisely do we mean by good governance? how can -- how do you feel it is succeeding in getting good governance?

for instance, being respect for human rights, respect for women's rights? and i would hope maybe that's topics you might raise with secretary of state clinton if you see her, because obviously she is very concerned. what does good government mean to you? >> that's like a wide philosophical question, but to begin with in afghanistan, it means the basic things that we take for granted here like government being present at all. and here i think we can see some of the progress that is being made. there are 10 district governors installed in helmand, for instance, compared to only five in europe who are able to operate. there are 26 afghan ministries, now represent in lush car. so government is more present and certainly very difficult areas of the country like element that was a year or two

ago. i think a second requirement is in the area we have just been addressing of people being able to have confidence. that it is not corrupt, that works in the interest of the people. there is much more to do, afghanistan remains them to the bottom of the scale on international for levels of corruption. and has improved a little bit. i think on the world index for doing business, for ease of doing business. it is improved to 160th in the world. instead of 168th. [laughter] it has moved in the right direction. it is moving in the same way and corruption as well. so we see a little bit of progress there. and then it means those other things that you're talking about, i've yes, respect for

minorities, respect for human rights, including women's rights. and as you know, quite a lot has been done in that it the united kingdom strongly encourages that and has funded projects which do encourage women's participation in afghan society and politics that they may be an answer to one of your questions a couple weeks ago that i pointed out, the improved participation of women in the peace jerker, in june, but there's also been an increase participation by women in the recent parliamentary elections. and i think it's very important that we continue to encourage these things so that it becomes part of the fabric of afghan society. before and during the time a clinical summit is created. >> you may be aware of the age of foundation poll which measures a number of things. were the things that measures is the conference of the afghan people in their government. this has got out 5% over five

years. it's only 47%, but the trend is upward. >> probably more than many governments in the world. [laughter] >> just returning to questions, just for clarification. 2015 deadline, that applies to secretary forces as well, all combat troops speak with we don't have a comment as a former defense secretary knows. >> so, it's not clear as to whether or not it applies to special forces speak what's on the giving you an edge that i may give you a clear and deliberately. [inaudible] >> to the united states is the most important power in coalition, but there are lots of reports about internal divisions within the u.s. administration. and we heard in private, many places, people saying, and it's

also in the record publicly about what this is referred to incoherent and contradictory decisions within the u.s. administration. how committed it the u.s. to reconciliation as a strategy speak with the united states is committed to reconciliation. and they're very much also committed, as we are, as i answer to are the questions, to intensify the military pressure on the taliban. those things are not mutually opposed goals for the reasons i get our gear. they go together, the chances of reconciliation are increase by an effective military campaign. is there often a debate within the u.s. government about this or other foreign policy issues? yes, there is a. of course, the united states is the kind of society and governmental system in which any debate about foreign policy often serves in public that you would expect that are such as

important as this to always have unanimous agreement in advance of any discussion. but the united states is in favor of the process of reintegration and reconciliation. >> but is the u.s. in favor of the same approach of this government, which seems to be we should be working on reconciliation now? as opposed to a few which seems to be quite strong held by some in the u.s., that you need to change the balance before you go down that road. >> well, sometimes this is an academic argument, of course. because it's not possible to commend the timing of a political settlement. that will be important for the military effort to continue and to intensify, i believe to make that settlement possible. nevertheless, i would say, to answer your question, there is a disagreement here between the leadership of the u.s. and u.k. governments. the prime minister and the president discussed such issues regularly, and they are in strong a cord about it.

and we do discuss it, intend to discuss it privately rather than through giving speeches directed at each other, which i think is the right way for close allies to deal with it. but we are not engaged in an argument about this at the moment. >> would you agree that the u.s. needs to be directly involved in discussions with the taliban, in order to get a solution to this situation? >> this has got to be an afghan led process. there is no doubt about that. an afghan led process will bring reconciliation in afghanistan. we facilitate that process. we think it is appropriate. >> you mean the u.k.? >> i mean the u.k., but unisys also has agreed to the policy and is in the same position. but it has to be, it has to be an afghan-led process.

>> are they facilitating as well just we? >> they agree with our policy. >> that was not my question. >> he has said -- president karzai contact and provide practical assistance, and that in clue to the u.s. as well as other isaf members that. >> i that we're going to get a better answer than that. [inaudible] >> no, i guess you it's the same policy as we have. >> but insurance of contacts and what's being done to try to contact element within the insurgency of the taliban, is it the case that the u.s. is actively engaged in that process at this time? >> i think, i know we will have a private session later, mr. chairman -- [inaudible] >> i don't think it is right to go into public about any operational details of these matters. >> foreign secretary, i would

like to ask you about the hearts and minds of the afghan people. there's like 10% support. [inaudible] the society has stated it is one of a series things of afghanistan in many respects, the united kingdom and its allies are losing the war -- is about to? spent i think we are to be able to do better. in the coming months and years, and communication, and the strategic communication of what our objectives are, how we are achieving them, how the nation's

of isaf and, indeed, the afghan government are working together. i think it has been one of the weak areas in recent years, and i think it needs further attention. we are giving attention to that end the national security council, from the uk's point of view. i recently raised it with the nato secretary-general, something that requires better international coordination as well. so yes, it is a weak area, and conflict indications is a vital consideration. both of our own countries, and of the country where that conflict is taking place. so i think there is room for improvement. now, that's not to say that quite a bit has been achieved. as in so many of these fields there remains enormous challenges, but some progress has been made. particularly in the creation of a more vibrant media in afghanistan and the axis of in

afghanistan to news outlets in a variety of sources of information, that they have at their disposal. all of those things have improved, but yes, i think more attention is needed in this area. you're quite right to raise this question. the first part, i think, go back to the first part -- >> you said support for the taliban in afghanistan was 10%. i was interested at all if you thought that it was increasing, decreasing, or stable, 10%? >> i don't know whether we have any figures on that. polling is not an exact time in --'s. we don't have a poll which shows is whether it has gone up or down in certain areas. and in some areas it is high than 10% and a some areas -- [inaudible] >> how can you say it's 10%? is increasing?

are we losing the war on hearts and minds? as a good example, afghans think about we are going -- [inaudible] >> there wasn't a poll. there has been very service, but let's think of other ways of, if you look at how many, of course, the area which were privately concerned with, where british troops are concerned, in -- hundreds of people make their ways to the district center every day up from a trickle previously. in other areas, over 800 locals, a few months earlier, that would've been impossible.

so these are not polls, but their indications of how life on the ground can change come and winning over people. still again, an enormous challenge in helmand. but considering that we have 135,000 children enrolled in schools across the province, which is a 250% increase on last year, it indicators like that is some indication of how normal life has changed for the people on the ground. and that may then give some indication of whether they have confidence in what is happening. >> it seems to me that this is international attention. through diplomatic means, the diplomats in afghanistan, short-term, for any bit period of smalltime, they are oddly

very shielded from whatever the afghan people, how can it be expected to win the hearts and minds from the taliban and local villages of that country speak as we work a lot of several different levels, diplomats in kabul are engaged in making sure that media throughout the country understand what we are doing. but, of course, i think it would be wrong to say that diplomats and others, the people who work for instance, in provincial reconstruction team, are working based in flash car, are working daily at local and -- lashkar gah, daily and local problem. deal with locals and other elders about every issue concerning local society and the services provided. and that is a fundamental part of winning over those hearts and minds. karen, do you want to add the details of that work.

>> certainly some of our diplomats and colleagues in the stabilization unit go out and facilitate local shura helping to find transfer, help in getting people together, if ask him helping people to run a meeting. and they are out there everyday in places like lashkar gah. one of the areas that we find if you like the local authority really has to compete with the taliban is in the area of local justice. the taliban have these motorcycle course that they provide justice very quickly. so a lot of our records and those of others goes into helping the local community stand up, which might think up of as traditional justice so that people can get decisions quickly. people suffer from intimidation from the taliban. when asked people what their main concern is, security comes out as one of, the major concern. so that's what we're engaged in.

is trying to provide security for local areas so that they can go about their normal business. for example, in kandahar major general nick carter, his team were involved in building houses and offices for the district governor so that they could do their business, protected from intimidation. and the foreign secretary was saying, we can increase in the number of people coming to the district governor, the provinciaprovincial government rather than the local warlords to help. >> we often hear from diplomats, who are only there for a short period of time, didn't even know the language. [inaudible] >> many of the diplomatic corps don't know the language. >> well, it an ideal world everyone would speak the local language, but that would require being able to repair hundreds of diplomats long in advance.

of course, these are difficult postings where people serve usually for a year in kabul, with the option of another year, or six months in lashkar gah with an option of another six months. they are difficult hardship posting so it is difficult to turn over the personnel pretty regulate. so they have a disadvantage with new people that have to learn local culture and get to know the local leaders. i think you can see that is the only practical way in which we could do it spent excuse me, we do have a couple of speakers in each place in lashkar gah and in kabul, and we have some very good locals who are bilingual. >> thank you. >> general caldwell in his presentation, commanding the training, points out that he's already quoted 250 times short, we'll be five on a traders sure

that within a year we will be 900 trainers sure. the united states is looking for more support and training. at the same time,. [inaudible] can we not be looking adequate opportunity here to shift more and more towards training? >> we have done so, of course, already, the defense secretary mentioned order, the defense defense secretary sent well over 320 more u.k. personal with the devoted entirely to training. and it doesn't matter, this will require a lot more resources by the improvements made over the last year. i think it's an important topic for a nato summit that is coming up at the end of this week. of course, the prime minister, defense secretary and i will attend. so yes, needs more attention. doesn't mean that over time or other british troops may be engaged in training quite well,

there is a serious possibility of that, but we have to do that working with our allies, coordinating with our allies. and so all that we can announce for the moment is that figure. >> foreign secretary, the public in this country rather think we have taken on more than we can chew in afghanistan. do you think we have been overambitious? do you think our ambition should have been more modest? >> i think our ambition is our right one, provided we understand our ambition is our own national security. and that our objective is to achieve a situation in afghanistan where afghans can conduct their own affairs without presenting a danger to the rest of the world. that does not mean we necessarily arrive at a situation when every valley in afghanistan is entirely peaceful. where there are no difficulty in the governance of afghanistan, where it has reached a point

where it's not 190th on the corruption league, but 10th or 20th. those aren't very, very long-term objectives and so as long as our objective is realistic, then i think it is right to be what we've done since 2001. and this was a response to the event of 9/11, when it began. and then from 2006, never to stabilize the situation in other areas of the country. so provided we have a clear measure of objective, it is not overly. >> do think there are lessons to be learned for future situations where conflicts need to be resolved? what lessons speedy's i'm sure there will be many lessons to be learned, and some of them will require the wisdom of being able to look back on all of this in the future. to start with the lessons of the highest level, this country

needs to put as much resources as possible into conflict prevention around the world. so as we can see how expensive it is, how it costs us dear and human life as well as in financial terms, and in financial terms to engage in long-term substantial conflict. and i'm sure you would have heard what the prime minister has attempted up in more of international development, world conflict prevention. we are working very hard at the moment in the foreign office on the situation in yemen and sudan. that's why i am there, tomorrow i will cheer the u.s. security council on sudan about conflict prevention is what we are concentrate on. so that is one of the first lessons. they won the doubt the other lessons about how a military intervention should be handled, if it has to take place. there will be lessons from iraq. the chilcot inquiry is looking at at the moment.

i'm sure there'll be lessons about how many as well, about the initial deployment, and about many, many decisions taken since then. but it is, i think, really we have to concentrate in the government in finding our way to success in this situation, and that's got to be our prime concern. >> we do have a union in the foreign office that -- this will look at the results of the ira iraqi. >> i want to step back because i think that's one of the lessons that can be drawn from iraq as well. how people speak local languages. the last foreign affairs committee said the ability engage with afghans in key local language is crucial in afghanistan. we are concerned nearly eight years after intervening in afghanistan they still have no

pashtun speakers. what is the situation in 2010? >> this is a vital importance for the foreign office, and it's a wider subjected than the situation in afghanistan. we are a country noted for our language skills among our diplomats, when compared to many other nations of the world. but i was very concerned by the closure of the foreign office language, school. i've been looking in recent weeks at the language arrangements in the foreign office that is quite, back together again and we have all the budgetary constraints on government that we have now. but i'm casting a critical eye over the current arrangements to see how they can be improved. then coming to the level of the specialism in this area, you're quite right, the committee has highlighted before the small number of speakers of the relevant languages.

karen pointed out on this one are depression that we do have some people who speak local languages, and we make a great use of interpreters. can't give any more up-to-date figures than that, but i would point out, with a huge number of our diplomats who need to be deployed to a situation like this, and the inevitable human need to overtake them quite quickly, it's unlikely we will arrive at a situation where a large proportion of those diplomats will become in the local images of afghanistan. i think that is realistic. karen, can you add to that? . .

>> and so it's very evident to me n my visits to iraq and i imagine the same would be true in afghanistan. >> i do see the point about that, although i was impressed we have some incredibly hard working people in afghanistan, and i am always enormously impressed, as i hope you were on your visit, by the utter dedication under very, very difficult circumstances. certainly, i think the committee is right to raise the point about the length of deployment. this has often struck me in the past looking at the length of service of the american military commanders in these situations who can go on for a very long

time, although with substantial breaks back home. they organize it in a different way. but i am not averse to looking at how we can improve this in the future. >> if i could get back to that, mr. chairman, just on the language speakers. because of the program the foreign secretary's mentioned in his fresh look at this, more people will be trained in afghan languages over the coming years, though it's obviously not something we can put right instantly. but the proportion of speakers in the embassy, we would call it a hard language, it's roughly equivalent to hard language speakers in our other postings. admittedly, afghanistan is more important, but it's certainly not disadvantaged because it's a conflict zone. >> are you able to give us a breakdown -- >> i can certainly do that, but i'm afraid i don't have it in my head. the additional advantage in using afghan interpreters in an

attempt to be assuring to the local communities, the ministry has found it tends to build interest and confidence, so we do rely on our staff quite considerably. on your point of not letting lessons be lost through continuity of posings, absolutely. we are trying to see if we can somehow link postings so that someone would do a rotation in afghanistan, come back to london and work on the issue, and conceivably even share a posting in afghanistan. what they came to realize are not just on young people who have no family attachments, but we do want to try to get more experienced diplomats there. more experienced diplomats tend to have families, so we need to try to get that balanced right as well. >> just a quick order -- >> [inaudible conversations] >> coming back to the 2014-'15 deadline when you say it's without question we will end, we will withdraw combat troops, we went into afghanistan because it

was a fail state, and we thought that the terror attacks would come on to our own country if we didn't take action. what will happen in a situation where that happens again? do you rule out or does the coalition rule out putting troops on the ground if situation -- what went as bad as it was previously? >> we're clearly aiming here to create a completely different scene in afghanistan from anything that prevailed in the recent past. i've given figures earlier for the anticipated strength of the afghan national security forces just by 2011, let alone by 2014. i've indicated how they're already beginning to be able to conduct the majority of the operations such as in the operations that karen was talking about earlier. and so our objective is, and it's an internationally-agreed objective, to create by 2014 a situation where afghan forces can lead and sustain their own

operations throughout afghanistan. and it's consistent with that, therefore, for us to say what we've said about 2015 and to believe that if we achieve those objectives with regard to the afghan national security forces, we won't be placed again in the situation of 9/11. >> but the 2014-'15 deadline is set regardless of the situation that you find whether afghan army and police are ready to take over, whether they're able to take over. so it's possible, didn't say it's likely, but it's possible that the situation may deteriorate. at that point would you rule out coalition troops being used again? this. >> this is a clear deadline. no one should be in any doubts about this whatsoever. let everyone's mind concentrate on this. the afghan government, our allies if necessary, this is absolutely clear what we've said about 2015. the prime minister was here, he

would put it in equally trenchant terms. >> how would you stop terrorist attacks coming to the u.k. if we have a failed state again? >> well, i commented about the situation in 2025 or 2035. we're trying to create the conditions here in which we don't have a failed state, in which we have a state with one of the largest armies in the world able to conduct its own affairs. at least to the extent of not being a danger to the rest of the world in be line with the -- many be line with the national security objective, the realistic objective that i set out earlier. i think that is a realist oibtive e -- realistic objective. >> thank you. >> can i just return to the issue of hearts and minds and the situation of civilian casualties, reports we've gotten many this committee e are casualties are going up, and this, in many ways, makes it easy for the taliban to make us

look like an occupying government, etc., etc. history would suggest, you know, those countries, regimes that have militarily engaged with the west in the past, the old system has survived. communism has survived, cuba, north vietnam, north korea, perhaps even china. it fosters a sort of feeling of mistrust which plays into the taliban's hands. is there anything we can do to break into this cycle? >> well, so much of what our military effort is directed at doing working with the provincial reconstruction teams is to break into this circle. as you know, the military strategy adopted at the highest level was redefined to be counterinsurgency involving the protection of the local population. isaf forces go to great lengths to protect local populations. they often take losses to protect local populations. the majority of civilian

casualties are caused by the other side and they are caused by the ieds of the taliban and others. so i think it's very important to remember that, that we are the forces safeguarding the civilian population wherever possible. and i think karen may have the figures here, but i think it is around 70% of the civilian casualties that are caused by taliban acttivities and ieds. >> that's right. 70% of the casualties caused by the taliban, and the figure has gone up this year, but that's largely due toen increase in -- to an increase in the taliban attacks. i think it's helpful to point out that, of course, any casualty that is caused by isaf is accidental. it is regrettable, and we've said so in the security council. as the foreign secretary said, we take all steps possible to minimize the risk that there will be accidental casualties,

that the taliban, by contrast, actually go out and target civilians. >> we spent the last 55 minutes looking at afghanistan. for the last ten minutes before we go into the private session can we have a look at pakistan? mike. >> we've already asked you in the september your reaction to the prime minister's statement in india in which he referred to pakistan looking both ways and alleged that they were exporting terror to india, afghanistan and elsewhere in the world, or certainly it could be interpreted that way by the pakistanis. was he wise to make that remark in india? >> yes. a good foreign secretary will affirm the prime minister's always wise. [laughter] to make remarks. [laughter] and then i think they were remarks which were wide ri supported and respected around the world, and it was said at the time by some commentators that that had damage relations

with pakistan. i have to say in recent months relations between the u.k. and pakistan have been excellent. cooperation between our two goths has been excellent -- governments has been excellent. so if there was disquiet in the pakistani government about that, it has been more than overcome by the work that we have been doing together since then. >> we've had evidence from a number of sources that say that pakistan doesn't fully cooperate with the u.k. on counterterrorism issues. what's your reaction to that? >> well, there is a new demand for cooperation on counterterrorism operations, very much on an operational basis. and, again, i don't think -- i can't go into the details of that in public, but certainly i would say that the cooperation on counterterrorism with pakistan has substantially

improved in recent times. >> would you say, however, that it's not yet as unconditional and full as it might be? >> well, those things can be quite difficult to assess. it's often hard to be sure whether a country's giving all the information and cooperation that it could give. but nevertheless, i do stress, again, that we have, we have no current reason for complaint about that, and the cooperation has improved. >> it was put to us in pakistan that the pakistanis would like some sophisticated equipment so that they're able to do the job themselves much more effectively. do we have concerns that we don't want to give certain equipment to pakistan because we're not quite sure where it might end up? >> [inaudible] >> yes. >> president zardari was complaining, he was saying he'd like to have access to the drone technologies.

>> right. well, of course, the technology from this country is very carefully controlled, and we will look from it from a friendly country and all requests, but i'm sure you understand how carefully we control those things. >> but the point was made to us, look, you're asking us to do a job out here on the northwest frontier, but you're not giving us the technology we need. is there a case of we could be doing more to help them on the military front? >> well, i think we will always be careful in selling advanced technology and to many nations around the world. and, of course, we will have to be careful in this case. >> can i just answer that we are getting by the e.u. export regime and some of the other regimes as the foreign secretary was saying. president czar da by has been worried about the keg ration of equipment among the pakistani armed forces. some of that relates to very

sophisticated technology, some of it is more basic. the ministry of defense got a review on what help they can give to pakistan across the board, a i number of areas not just provision of equipment. >> the pakistani state or some of its agencies were involved in setting up the taliban in afghanistan. they did so at that time with western support. because they were used against the soviet union. how confident are we now that elements within the pakistani state, in particular the isi, are willing and able to tackle those insurgents given their close historical links with them? >> well, i think we have seen a sharply increased willingness in pakistan to tackle insurgency in many different forms. and you're familiar, of course, with many of the military campaigns that they have undertaken and, indeed, the huge

losses on the pakistani military have sustained. and i think it's very important, always, to recognize that. and so pakistan, i think, has a state, the government of pakistan including its intelligence services can now see very clearly after some of the terrible terrorist incidents they have themselves experienced the importance of tackling insur yen si and instability. >> and they've lost lots of people against the pakistani taliban. the question is are they prepared to act against the afghan taliban which might be a kind of proxy for an organization of which they could still have some influence in the future? this. >> well, again i would say that the cooperation between our countries has improved in this area. but i would stress of course in a political settlement of afghanistan which we have been discussing earlier, the support and the active support of pakistan because of links that

were established over a long time will be very important. >> >> is it a case of willingness or capability to take on the afghan taliban? the pakistani military have been pretty heavily involved though not totally successful in north waziristan, and yet we've still got baluchistan which is the main base of the afghan taliban. do you think it's a willingness and lack of capacity or do you think that it's -- [inaudible] >> well, the military capacity to deal decisively with every threat in that kind of terrain is, of course, quite difficult to come by. so i think that always has to be understood. this is one of the most difficult areas in the world, again, as you know very well know as a former defense secretary. one of the most difficult areas in the world to control by military means.

nevertheless, we have seen a greater increased willingness on the part of pakistan to confront insurgencies on their own territories to take action against terrorist groups. so i think i would like to emphasize that rather than be critical today that we have seen very important steps forward in tackling terrorism by the government of pakistan and, of course, we want those to continue. >> -- [inaudible] but they point out to how many people they've lost in action and taken against the insurgency. they complain about the borders and the lack of border control, and they highlight how many border control people they've got on the border between pakistan and afghanistan, and they highlight the difference

between our forces and their own. is there anything we can do to make the border more secure than it is now by putting more emphasis on the need to keep it tighter boundary than we've got at the moment? >> well, there may be over time. and, of course, there have been discussions about this between afghanistan and pakistan. which we very much encourage. again, it is following up a point i made to mr. ainsworth, this is one of the most difficult borders in the world to police. in some cases there would be argument about exactly where it was. but certainly there have been international initiatives to improve cooperation on the borders, and we encourage those. karen, do you want to add to that? >> just to amplify that point, foreign secretary. the initiative that the canadians started about improving cooperation on the border between afghanistan pakistan, the international monitoring can help, and we're hoping the french will continue

that under their g8 presidency, and there is something called the dubai process which also looks at the same issue on a slightly larger basis. so these things will continue, we hope. >> while we were in islam brad, the pack -- islam brad, the pakistanis were pretty clear they wanted to be involved. do you think we can trust them to be in on this broker? [laughter] >> well, i hope that in the region, i hope all nations in the region including pakistan will be able to play a supportive role in a political settlement. in afghanistan. but i think we should be careful about defining who is a broker in bringing about such a settlement. this has to be an afghan-led process of reconciliation. >> exactly. and do you think the comment on u.s./pakistan relations here.

they seem to be at loggerheads. we picked up hostility to the united states despite the fact that a substantial amount of aid is given by the united states to pakistan. we've got a role here, at least i believe we've got a role here. do you agree that we could be encouraging afghanistan -- pakistan and the united states to communicate better with each other so they can then work jointly towards a settlement? >> yes. i think the governments of pakistan and the united states do communicate effectively with each other. it is very important for the united states and the united kingdom to explain to the people of pakistan what we are doing. and i strongly welcome the visits of fellow parliamentarians to pakistan. we have had, as i think was set out in memorandum sent to the committee, a large number of ministerial visits to pakistan under the new government, and on many of those visits we have gone out of our way to spend our time on the media in pakistan.

i think i did an exceptional number of interviews on my visit to pakistan to explain to the people of pakistan about the role of the u.k., about the the extent of the assistance we are giving with education in pakistan. since then, of course, britain is one of the countries that has led the way in responding to the disastrous floods in pakistan, and so i think the u.k. and the u.s. and our allies have to communicate that as effectively as possible. and alongside a close relationship with india, to build a long-term strategic partnership with pakistan. those things go indices pence my together. >> president zardari said he wanted to address this committee, and we will facilitate that. foreign secretary, you said you'd like to sit in private, and so could i ask the public if they will vacate the gallery?

be thank you very much. >> you've been watching a british foreign affairs committee looking at pakistan and afghanistan. members heard from the british foreign secretary, william hague. we have more british programming every wednesday with prime minister's question time. it airs live starting at 7 a.m. eastern right here on c-span2. while the u.s. senate gavel back for legislative work today following an extended break for the 2010 midterm elections. >> c-span2, one of c-span's public affairs offerings. weekdays, live coverage of the u.s. senate and weekends,

booktv. 48 hours of the late e nonfiction authors and books. connect with us on twitter, facebook and youtube and sign up for schedule alert e-mails at c-span.org. >> the national transportation safety board recently held a conference examining older drivers and related safety issues. a panel now discusses some of the technologies being developed to prevent crash injuries to older drivers. this is about an hour and 50 minutes. >> welcome back. and i really appreciate ms. hawke allowing us to show the film. i thought it was a great personal story about the decision all of us are going to face, and it was very well done. so this panel, the second panel for today is is going to discuss occupant protection for aging drivers and passengers. the panel is is going to explore the details of decreased injury tolerance with age and the complications associated with

recovery given crash injuries. the panel will also focus on the current limitations in occupant protection systems for protecting older adults and new technology that can be incorporated into the vehicle design to improve the outcome for older adults in a crash. dr. poland and gasher have prepared questions for this panel. will you, please, introduce the panelists? >> thank you, chairman. if it's all right with you, i plan to introduce each panelist before their opening remarks, so to begin, dr. stuart lang is directer of the university of michigan program for injury research and education as well as the directer of research for acute care surgery. dr. wang, would you, please, begin your introduction to this panel? >> thank you for that introduction. i'd just like to comment that this morning i very much enjoyed

the panel discussion certainly on the front lines of taking care of elderly patients. it seems to me that the elderly problem continue to be quite substantial. most of my unit these days is is full of geriatric trauma patients. i'd like to begin by speaking a little bit more specifically regarding the issue of fragility and aging. elderly individuals are more fragile in that they sustain more severe injuries given a specific mechanical load. they break more easily. and this is different from the fact that the elderly individuals are also more frail in that they experience a worse outcome given a certain injury, they do poorly. what's important is that there is very substantial variability between individuals, and i'll touch on that. now, let's touch, first, on the issue of fragility. we all know that older folks tend to break more easily, but it's very important to touch on the fact that they don't break more easily in every single

specific location. so if you look at the nas data, this summarizes crashes over a period of ten years that we looked at, and these are just for belted drivers in frontal crashes at 30 miles per hour. across the bottom there you see the age, and on the y axis you see the predicted risk of a plus injury. the one place where you see it going up the greatest and the quickest is in the thorax. and if you look at specifically thoracic injuries, what you see is that rib fractures are very, very frequently observed in the most elderly population. and i'd like to relay a common story that we see all the time in the surgical icu, and there's been a motor vehicle crash. patient comes in the with chest injuries, and in the elderly these almost always involve rib fractures. and because of these rib fractures, it causes a lot of pain. they end up on the ventilator

for support. once they're on the ventilator, you have difficulty clearing secretions, and we know the longer they're on the ventilator, the more likely they are to get pneumonia. we also know that elderly patients have limited fizz logic reserve in a lot of areas and what typically happens is after a period of time in the icu where their different organ systems are being stressed, they experience organ failure and not infrequently in death. so this is a slide to summarize some of the things we find. if you look on the upper left you see the very nice looking ribs on a younger person, and on the bottom left you see that they're quite muscular with very prominent abdominal muscles in particular. if you look on the right you see an older chest with these ribs that look rather moth eaten. you see there's a difference in geometry, and if you look on the bottom right you see almost a transparency of the abdominal

muscles, okay? and that's because it's become infiltrated with fat, and this is wayed on the ct -- based on the ct setting here. it looks transparent. the muscles have become replaced with a lot of fatty tissue, and that happens in that intercostal muscle on ct scan. this is important because the muscles and hard tissues together are what is able to resist injury. now, this issue of muscles is something we've been looking at quite closely, and we've found that it very significantly effects both fragility, as i mentioned, and also frailty. we know it effects fragility because the less muscle they have, the more likely they are to get fractures, but it effects frailty as well. we found that body condition in the specifically core muscle mass predicts survival after surgery. as a surgeon, we inflict trauma on patients all the time, we just hope that they can recover from it, that there's some sort of benefit from it, okay? and for many, many years we've

been trying to find the best predicters of frailty. and what we find is that body factors, particularly muscles, are much more predicters than models in incorporating age or core morbidities, okay? we've been looking at a core muscle, and if you look at it -- and this is on the upper right there -- is a chart showing mortality on the left. you can see it gets up between 60 and 70%, okay? and across the bottom arer the styles of core muscle area. and what you see is the people that have the smallest amount of core muscle experience the highest level of mortality. this is by far the breast -- best predicter we've ever found to predict mortality in the icu for respiratory failure. you go, that's nice. this is for abdominal ayore tick surgery repair. after an elective ab mom call the aortic repair.

and we go on. this is for liver transplant, okay? and it's the same exact thing. we found the same thing after pancreatic transplants, after major abdominal surgeries, after many things. so let me give you a scenario. you're hiking with two friends in the grand canyon, you're bitten by a snake, and you need to get antivenom in this two hours or you're not going to do well. if all you have is age, that seems to be a pretty simple solution, right? give you a little bit more information. by weight, and i'm not really stacking the deck here, you have a friend who's a bit overweight and the other guy's normal, the younger guy is a couch potato, he plays video games all the time whereas the older guy likes to exercise quite frequently, does a lot of hiking, walking, biking, okay? habits, the younger guy's a smoker and a drinker, the older guy is a nonsmoker, okay? and in terms of medical condition, they're both diabetics, but the younger guy happens to be very noncompliant, and the older one happens to be

diabetic who's controlled just on diet alone. now, who would you send, okay? for me, we can argue about this, but i would send b. but i think all of you despite the large disparity in age, you kind of gave a little thought after you got the additional information. and i would say that what we found is that their bodies would be very difficult on ct scans. it's not the fact that they have a comorbidty but how they deal with it. from a trauma surgeon's perspective and all i'm interested in is saving lives and i don't -- they come to me after having sustained their injury, and what we have found is what really matters is the body condition and not the age. okay? and what we have learned to do is to focus on the individual patient. medical treatment over the last several decades has gotten better, and i think a lot of that has been because it's become more personalized. we know the population is comprised of a diverse group of

individuals and it requires the differences between individuals be taken into account. treat the patient and not the disease is what they teach us in the medical school. and that brings us to the issue of crash injury and potentially dummies. in the past i think the population of america was like this, and this is not to scale, but i would say that in the last several decades the population has certainly gotten to be more, there are segments of the population that are more fragile or frail because people are living longer, life is safer. there's also a substantial amount more of variability, just think about obesity. the size of the patient population, the individuals have changed substantially. and while crash dummies are very nice and represent a standardized segment of the population, my personal opinion is that this is going to become a problem as the population becomes even more fragile and frail and there becomes, and there is even more patient variability. so in summary, age is a very poor distributer of -- drink

scripter of -- descriptor of condition. patient variability is a fact of life and must be addressed. it can't be ignored, it can't be averaged, it can't be designed, and it can't be regulated away. and in medicine we've improved results by personalizing or tuning the handling and treatment of vulnerable populations such as the elderly. my assessment is that current crash injury databases collect no specific or objective data regarding occupant characteristics, even the best provide, if possible, age, height, weight and just a number of co-morbidities, none of which are sufficient. we need a more detailed and in-depth understanding of this complex problem in order to improve treatment and prevention, and i think that the federal agencies, the national institutes of health including the cdc that have the necessary scientific and technical expertise in live human disease

research should take a greater leadership role to address this growing public health problem. thank you very much. >> excellent. thank you, dr. wang. i'd like to proceed with our second panelist. our second panelist is dr. richard kent, professor of mechanical and aerospace engineering at the university of virginia with additional appointments in biomedical engineering and emergency medicine. he is also head of automobile safety research at the university of virginia's center for applied biomechanics. dr. kent, could you, please, proceed with your opening remarks? >> yes, thank you, dr. poland. sort of following up on what stu started with, i'm going to talk a little bit about some of the characteristics of our body that change as we age, and certainly they are related to individual variability as well as well, bue are some thicks that generally trend with aging that have

important consequences for crash protection. and i'm going to start reiterating one of the points that dr. wang made because i think it's a critical one, and that is this change in the distribution of injury pattern. this happens to be the pattern of injury by body region for drivers that are killed in frontal crashes. this is not the risk of injury, this is the proportion of injury given that an injury happens. and we see this general trend periodically of head injuries decreasing as age increases whereas thoracic injuries make up a larger proportion as ij increases and persists. it's not just fatal injuries to drivers in the frontals, it's persistent by crash mode and, in fact, persists in the all sorts of traumas including falls or motorcycle crashes, so this seems to be an intrinsic aspect of aging. over 75% of those injuries are rib fractures, and if you look

at the injuries that older folks die of in the hospital, they will frequently die of injuries that are no more severe than rib fractures, so it's not, you know, massive cardiac lacerations or things like that that are killing folks, it is rib fractures and developments from them. i think the other thing that's important to recognize here is that this injury distribution reflects really three somewhat independent aspects of aging, and dr. wang touched on a couple of those. the fragility issue, which is the risk of sustaining injury given the exposure. the frailty which i think is an additional probability, the probability of not doing well if something happens. and the third thing is the environment which as we heard a bit this morning and we'll hear more about this morning changes also with abling. and the -- aging. and the biomechanics, i think, can help us understand the fragility part and why it is it is easier to injury a person as

they age, again, given the individual factors as well. i want to talk about this issue of length scales. this is a way engineers tend to think about things. if we start at the very smallest length scale, we can look at things like material property changes in the human body, and we're all very aware of things like osteopro sis that are correlated strongly with age. also the percent of the bone that is the inorganic compound, so the min call goes down with aging. those are separate and distinct characteristics that both change with age and both tend to reduce what we call the fracture toughness of bone. and, in fact, there are other factors. it seems like every time we learn something new about aging, it turns out to be something that reduces fracture tolerance or toughness in the pone, so even thing -- bone, so even things like cross-linking, all of those things tend to decrease the fracture toughness of bone,

and we've yet to find many things that happen with aging that increase it. and then there are also, if we keep moving up on this sort of idea of length scales, if we go to the cross-section of a rib, for example, so we've gone up now, we're not looking at a material, we're looking at a structure. and what i'm showing on the lower right-hand corner of this slide here are micro ct images of the cross-sections of ribs. and on the left you see the rib bone from a younger individual and on the right from an older individual. and what you see is this, this cortical shell, the lode-bearing part of the bone that shows up in these images has decreased in thickness from young to old. and this is a significant trend that's been observed in lots of populations. i'm showing you a scatter plot where you can see the individual variability that dr. wang was talking about, but also a general trend to decrease in cortical thickness. what happens there, essentially,

is the way your bone grows is bone is deposited on the outer surface of the bone, and it's absorbed on theticker surface. the bone grows. what happens when you reach adulthood and on into seven sense is the resorption on the inner surface continues. the bone essentially eats itself way from the outside, so you have bones that have a cortical shell that thins with aging. and then we can go up to larger scale changes. dr. wang showed a nice example of a change in rib cages. i'm going to show you one that's even more dramatic if you can run those videos. these are ct scans -- well, they were. maybe they don't -- maybe we can go to the next slide which is just an image capture from those videos. but what you see on the left is a ct scan of a rib cage from a 17-year-old and a rib cage on the right from a 64-year-old. and in addition to sort of the

porous appearance that dr. wang mentioned, you can see a pretty dramatic change in the shape of those rib cages, and we have found that the ribs tend to get more horizontal or perpendicular to the spine as one ages. you can see this probably anecdotally it manifests in sort of a barrel-chested appearance as we get older. and if you look at the way, for example, a seat belt might load something like those two structures, in the case of the left that seat belt load is going to introduce deformations like rotations at the spine which is the kind of rotation that ribs do very well. that's what we do when we breathe, so that's a kind of loading that the rib cage can tolerate. on the right you can imagine sort of deforming that chest like a barrel where you're putting the stress true the ribs themselves -- through the ribs themselves. so structurally, this structure is at a disadvantage for an tier y'all loading. and so just to conclude, then,

the biomechanics are -- of aging are a challenging problem, but i think they're key to the passage of safety for older drivers. we did a study where we suggested the aging of america over the past decade generated about half as many serious injuries as spell usage presented. this is a pretty big deal and, again, understanding the biomechanics is a key part of the solution andic corporating it into things like federal standards and safety countermeasures is important, so thank you. >> thank you, dr. kent. our third panelist is mr. steven rodella, chief of the human injury research division at the national highway traffic safety administration. prior to coming to nhtsa in 2002, he worked at general motors research labs, easy engineering and at trw automotive addressing biomechanics analysis and restraint system design and performance.

could you, please, continue with your opening statement? is. >> my pleasure, dr. bo land, thank you very much for inviting out. an approach that we've identified for research has two goals, eliminate crashes due to aging and reduce injuries due to aging. a fourfold process could entail understanding the problem by day that, older occupant safety, older occupant data and safety. specifically the biomechanics research we're currently working on at nhtsa. in terms of data, there's an extensive body of existing research that has identified through mass studies and other with respect to injury incidents, but the crash injury engineering network that is part of nhtsa's data and analysis can inform us more, and i'll touch a

little bit on how we'll use that today that in the future. -- data in the future. with respect to both gender and body mass, pre-existing medical conditions and co-morbidities as dr. wang mentioned, and also to dive in depth more to causation and mechanisms with respect to crash severity. regardless, the analysis does show that age effects severe injury outcome in almost every crash mode. an example follows. there's some work that was done by the university of michigan to look at wined ciren analysis. nass gives us the power of national representation, and we look at the risk of chest and head injuries and when you control for whether it's gender, belt use, the driver of a normal vmi and the passenger in if a side impact typical of currently regular -- regulated condition,

the author asic and head injuries dominate. in fact, it's almost a fivefold increase for injury in thorax and at least a twofold injury in risk of serious head injury in the older population. everything else being equal. when you look at just nass data and look at rib fractures as a function of both age and crash severity, it does go up in the all age groups, but even at the low crash severitieses -- sorry. i went backwards. there we go. even at the lower crash severities, the increased risk for older folks goes up to at least 15 president. this indicates a low percentage risk, we should perhaps do something more in this area with respect to both crash types as well as dummy development because our dummies currently only look at crash beads in the moderate to high severity range. so emphasis on older occupant

research that we do at nhtsa is data, as i mentioned earlier, looking at injury causation and mechanisms. we have over 300 cases of older occupant injuries with in-depth analysis, and we'll be publishing extensively off this work in the future. with respect to injury biomechanics, we're focusing on author asic injury rebel. as i mentioned the previous slides, those are the two areas where we see the most potential for older occupant protection. we're evaluating crash dumbny response, the current dummies we have, the suitability of those dummies to predict older occupant injury as a result of the analysis we do with ciren and nass data, and we'll determine if we need to revise criteria based on age. one thing that's apparent, the use of computer models must increase, and using human occupants is, we i this, a -- we

think, a frontier that needs to be explored to evaluate restraint systems and vehicle designs in the future. we're characterizing age and gender changes in rib cage of ages across all ages from the youngest to the oldest, we're collecting ct scans to develop parametric rib cage models with using input such as age, gender and the size of the occupants and then changing the shape, the mesh size, the density of the bone as dr. kent mentioned, the density of the bone and other mechanical properties to create a model that can then be used in a variety of restraint and vehicle conditions. this video which, thankfully, works from my computer, indicates what dr. can't was trying to say. as you get older, the protection in the restraint and interaction will change as the occupant ages. similarly, for head injury research we're characterizing age and gender changes to the head and brain.

we're taking ct scans of a variety of occupants from the youngest to the oldest and developing a parametric head computer model. input such as age and gender and other size information that we get from the ct scans will go into a brain model where we're change the shape, size and density, thickness of the bone, the thickness and changes change see in the morphology of the brain and input into the simon brain injury model to help us predict brain injury in older occupants as well as younger occupants and see what the differences might be as a result of input. so in summary, we have identified an approach to older occupant injury research. we want to understand injuries and the causation as a path to future development of product. as i said, brain and chest injuries. this will, again, help us determine what dummies we need to use, models, test procedures to test the severity of injuries for older occupants. thank you. >> thank you for that overview of nhtsa's biomechanics

research. our final panelist is dr. stephen rouhana. he is senior technical leader at advanced engineering. he has also helped ford lead the development of inflatable seat belts and pediatric crash dummies. your opening remarks, please. >> thanks for inviting me. i'm going to talk about taking what we've just heard from the other three panelists and putting that into systems in vehicles that can actually make a difference, we mope. we hope. excuse me. if i can start with a look at a summary of what goes on with aging. three takeaways from this slide. young kids think they know how to drive but don't have the experience, and they drive too fast. this is the fatality rate, by the way, per 100 million vehicle miles versus age. and older outs, as you see 85 plus, they don't get into as many crashes, but they are

overrepresented in terms of the fatalities x. then the third thing to take away from this, this is the only piece of scientific analysis that shows there's a benefit to middle able. in the 1970s, renault put load-limiting seat belts into an experimental fleet which they then allowed people to drive, and every time there was a crash, they studied the injuries and the crash schematics. and when i was at general motors in my former employment, we did a study that looked at the survival of the forces that people were experiencing and the injuries that they experienced, and we came up with a relative tolerance graph shown here. so in the age category of 16-37 if that's the best you can do in terms of your tolerance to belt loading, by the time you're in the age category of 36-65, you have half the ability to withstand belt loading on your chest, and by the time you're over 65, you have one-quarter of

the ability to withstand belt loading. this was work done at my current employment at ford motor company. they looked at nass data and did a whole set of models using mathematical models under similar crash conditions to what's found in the field, and this shows a serious chest injury risk as a function of 50th percentile crash detection. and if you're 20 years old and you have a, and you're in a crash in which a hybrid three dummy would get 60 millimeters of chest deflection, if you were a 70-year-old in that same crash, i'm sorry, if you're a 20-year-old, you would have a 25% risk of injury when you get 60 millimeters of chest deforest, and when you're a 70-year-old, you would have about a 90% risk of chest injury in the same crash with the same chest deflection.

so we wondered, is there a way to reduce the chest injury risk for older occupants, and we answered that with maybe with an inflatable belt. this was in the context of a research project to try and enhance not just safety for aging people, but safety for people in the rear seats of our vehicles. and so what is an inflatable belt? it's a tubular air bag sandwiched between two pieces of shoulder belt letting. in the case of a crash, the air bag inflates across the chest within 10-20 milliseconds. and this is what the system looks like. you can see there's a shoulder belt retractor, and then there's standard webbing which goes to a d ring which is the little loop that holds the belt to the b pillar of the vehicle, and then the shoulder portion of the belt actually has an air bag placed inside that inflates to about 6-8 inches in diameter. then on the left side there's a lap belt retractor and a standard lap belt. the lap belt does not inflate.

this is a little close-up of the inflater and the latch plate and the buckle. so the inflater is actually attached to the buckle, it's a store gas canister with inert gas that upon a crash receives an electrical signal from our crash module, restraint control module. the electrical signal fractures the diaphragm in that canister and allows the gas to flow through the latch plate to inflate the shoulder belt. this is a video of the inflation as it occurs. so you see the gas in the canister, a crash occurs and the diaphragm bursts. the gas flows through the buckle, true the latch plate into the shoulder belt and inflates within 10-20 milliseconds. now, i'm going to need to come out of my powerpoint presentation and play this in windows media player here.

this is a crash test that we've done with a small female dummy on the right side and a 6-year-old child dummy on the left side showing the inflation in slow motion. and one of the things you can see is that we capture the chin, and that reduces the forward excursion of the head. we also expand the area of the belt on the chest by five to seven times which reduces the pressure on the chest to one-fifth or one-seventh of what it would be normally, and that reduces the likelihood of injury. can i go back the presentation? yeah. so some of the benefits we expect from inflatable belts are because we're inflating the shoulder portion, it increases in size. it also as it increases in this diameter, it pulls the ends of the belt closer together which takes slack out of the system. and we have a load limiter associated with it to help reduce the chest loads. then the increased size of the bag helps reduce occupant head

excursion. we reduce that pulling on the neck so we limit the occupant neck loads, and by the increase in the sigh of the bag -- size of the bag, we reduce the risks of chest injury. this is from a frontal crash test using the 208 pulse, and these are just some of the results we've normalized everything to the standard belt which is in red, the inflatable belt is in but. so you can see that the head injury criterion or hic has been reduced by about 60%, the chest acceleration and more importantly the chest deflection which we believe is the right measure for chest injury has been reduced by about 40% with the infreight bl belt. and i'm happy to say this system is going into production in the 2011 model year ford explorer which should be out in the first quarter of next year. it's optional currently in the second row outboard seats, but we feel it will have great ability to protect older occupants by reducing their

likelihood of chest injury which, as you saw, is one of the major problems for older adults in car crashes. thank you very much. >> thank you, dr. rouhana. gentlemen, thank you so much for a comprehensive overview of a clear hi challenging -- clearly challenging problem. chairman, i'm going to try and restrict my questions to a period of time to give the parties time, but i feel like i could talk about this all day. i think it's interesting that you have separated out fragility and frailty. this morning when we were hearing the discussion, it seemed like those two words were interchangeable, and i guess what i'm gathering from what you've presented is that fragility is the chance for me to get an injury given i'm in a certain type of a crash. and that frailty is the outcome once i have that injury. if i have a rib fracture, how likely am i to recover from that injury, is that correct?

>> okay. so, yeah, so i would say that was actually very well stated. and, in fact, we have done some work looking at the relative importance of these two things as one ages. i don't know if we can pull this slide up here that i'm showing, but we looked at, again, sort of mathematically describing this phenomenon where this thing we're calling fragility would be expressed as a risk of injury given an exposure and the, and the frailty metric would be a conditional probability of death given an injury. and what i'm showing you here is the rate at which these two things change with age. so here i'm showing the relative probability of any injury, of an injury given exposure, that's this fragility measure in this dashed line. and this frailty metric which is the probability of death given an injury. and i'm normalized everything to one at age 20. and what we see is this fragility issue, this risk of

getting an injury in the first place goes up by about a factor of eight over the age from 20 to 80 whereas the frailty thing, you know, the risk of dying once you get an injury only goes up by a factor of two. so in terms of what's more important in aging or what changes more with aging, we found it to be more this fragility issue. >> okay. so you're basically saying that we need to prevent the injury from happening in the first place. it's not that we need to improve the medical treatment in a certain way so that the outcomes are better, but it's prevent the injury in the first place. >> i mean, they're both important but i would say maybe that's more important, yeah. >> okay. you've talked a lot about different types of injuries, and i'm going to maybe have a couple questions hidden in here. and you've talked about chest injuries. so i guess my first question to you is when i'm looking at trying to prevent injuries to the older adult, what part of

the body am i most interested in? is it the chest or is it the head? typically, i hear for children i want to protect the head, but is it different for older adults? is it not the head that's the most important part of the body to protect anymore? is. >> i think we clearly heard the chest was probably the major one. the injuries that we see and, in fact, every case that we've seen with any older occupant who has a chest injury, and getting to the point that rich made a little while ago about frailty, we see that for a given age or injury like chest injury, their outcome not just in terms of death, but quality of life is much more reduced for the older occupant than the younger occupant. so i would say that the chest is definitely the top and head not far behind. >> okay. so just to be clear when we talk about chest injuries and then we go into rib fractures, if i sustained a rib fracture, is that an injury that i may die from, or is it only like i think

dr. wang talked about this earlier, is it only because of these additional complications with breathing difficulties because it's difficult to get a deep breath because my chest hurts because i fractured my ribs, and then it leads to some complications or is a rib fracture just a really, really severe injury and people die there this? >> the patient's condition has a very substantial influence on the outcome after rib fractures. so we see football players all the time at the university of michigan with some bruised ribs or rib fractures or some younger people that fall off their bike, and what we typically do is, you know, give them some motrin, ask them to take a nice hot soak, that they'll be sore for a couple of months, but that it'll get better. they're in a bit of pain, but certainly they can manage it with some pain medication. what typically happens with an older person is they have very limited cardiopull my their reserve, so you need to be able

to breathe, you need to be able to move your chest to expand it out, you need to pull down on your diaphragm in order to pull the air in, and you only have enough oxygen in your system to live for a couple minutes, so this is something you have to be doing all the time. what we find is the older folks tend to have a limited reserve, okay? so when they get a couple rib fractures, pretty soon they're not moving their air very well, they begin to desaturate, and then that whole vicious cycle that i showed then occurs. so it's much, much more impactful in a older person than it would be in a young person. >> okay. so you're telling me that i need to protect the chest and that older adults typically have rib fractures that can have a very poor outcome for older adults, and you've also told me that the, as people age they don't tolerate belt loading as well as they do when they're younger. so, dr. rouhana talked about

this a little bit, something that can be done to try to decrease the belt loading. are there additional options for us to look at to be able to make the belt system, to make older adults more toll rapt of this belt -- tolerant of this belt loading? we want everybody to wear seat belts, but we don't want them to cause injury in the and of themselves. >> mr. i think the data shows that you're almost always better off with the seat belt on even if you're an older occupant. there are many technologies that are currently available or being researched on to address this frailty of the chest or, sorry, fragility of the chest. many vehicles today there are load-limiting shoulder belts. so as you move forward in the crash, you'll apply a load to the seat belt, and the load will build up to a certain value, and then the belt will start to -- in a controlled fashion -- pay out, and that keeps the force at a constant level, hopefully at a

level that's lower than required to break your ribs. but as all three of my colleagues have shown, the rib cage really deteriorates with age. and so that load gets lower and lower as you get older and older. so force limiters can only go so far, so low in terms of the force before you start allowing the occupant to have too much excursion forward in which case they may start going through the air bags or hitting things in the compartment that you don't want them to hit. and head injury could be the problem. so load limiters are one mechanism or tool in the arsenal. we've also been doing research on what are known as four-point belts which are double shoulder belts. we got that from racing. we've done a lot of studies, gm's done a lot of studies looking at race drivers, and you see these crashes all the time. they're 200 miles an hour around an oval, the car crashes, parts fly everywhere, and people get up and walk away. we've been trying to find out what is it in that environment

that we can pull into the passenger car environment, and one of the main things we have considered is the double shoulder belts. so the four-point belt is two shoulder belts connected at the lap. ..

>> but the load limiting, there are assistance now that are extremely clever with regard to load limiting. one system we looked at in my laboratory is a load limiter that it has to load limit based on speed of the crash. so you only get as much as you need. and a low severity crashed the belt load will be quite low. that's good for everybody but it's disproportionally good for older people because they tend to get hurt and lower severity crashes. if you can offload the chest, it is not needed, that should have a disproportionate benefit for older folks. that's a think much more better technology than the full adaptability that steve was talking about. >> so i guess it's kind of a pie in the sky question, you know, you talked about how age isn't necessarily the predictor but it's the condition of the body. is there some way, again, kind of pie in the sky type of sub

process, that you can measure the condition of my core muscles like dr. wang was talking about, some measure that can give some prediction of my outcome and then have my car no -- my car know what im so what i'm trying my car or when my husband is driving the car, or when my mom drives the car, that these intelligence systems can appropriately deployed to maximize the benefit for the driver or the passenger? >> there are a number of different techniques which i think are becoming available. for instance, we've processed so far about 10,000 ct scans, full body ct scans on surgical patients and trial of patients. we are getting a better idea now on being able to predict sort of a condition based on measurement of specific points. so it may be fairly simple in the future, just to show up at a

dealership or any place, you, people get old densitometry readings legally. there are now over some machines which are very fast, painless and obviously without exposure to radiation which can measure core muscles very quickly. and with a few parameters measured on the outside i think it's fairly feasible to come up with an objective measure of subjects condition of a patient's condition. and i think that could be used to adjust some of the settings as doctor can't talk about. >> spent i think we do need technology though the biomechanics is probably decades behind in terms of what you do with that information. i think it is technology that contained all sorts of things about a person. the question is what do you do. questions of individual variability and tolerance and we put notes on an individual are certainly yet to be answered.

>> i guess that kind of leads me to my next question, which is, i'm going to address it, doctor kent and the others will probably want to join in as well. but we seen a lot of advancements in child safety. some of that is because of the amount of testing that's involved and the encouragement of these systems to become excellent to provide detection for children. are the tests, the insurance institute has a best pick, in cap as a star rating system. is there something that manufacturers can design to encourage them to adapt their vehicle to better address all the adult? and along what dr. kent was just in, do we have the technology that by mechanically assess is that if you make a change do we know what the injury value needs

to be? do we know how much chest deflection is okay for an older adult to be able to even have some sort of a rating system? >> there are several parts to the question. i will try to remember them all. the first is, is there some survey standard protocol that we used to assess our vehicles for elderly occupants. and the answer to that is really no. in cap, the ihs testing doesn't really address older occupants%. that said, we are doing research, we just published some research last week, in fact, on a body model that we have determined what its ages and and we've made a younger version an older version so we can go ahead and look at different restraint systems with two different versions and see if they affect the aging population. the other part of this equation as the biomechanics is ergonomics. we do a lot in our research to try and make our vehicles

friendlier for older people to drive, bigger numbers and things like that on this pedometer and look at ingress and egress issues that that's probably a different subject for a different day. that i answer all the questions? >> yes. and i'm ask for also being, being heard along a little bit here to keep us on schedule. so i like to turn over to my colleague, doctor mitchell garber to cvs some follow-up questions based on our discussion so far. >> like dr. poland and perhaps unlike many others in a mighty talk about this worst of all the as well. but in order to get as many want i think i just have one point of clarification i want to go in the mid-i will come back at the end after the parties and perhaps the board has discussed this. you talk about fragility and frailty, and you give very specific definitions of those terms that i think we all have in our mind the 80 year-old great-grandmother when you talk about that. that's who we have, that's the picture that we look out and

think of. and, in fact, we are sitting epidemic obesity in this country, particularly in the aging population listings and become obese. i don't think we tend to think of those people as fragile or further i'd like for you to address how those terms may apply to that population as well, because again it's hard to think of a 280-pound great-grandfather as being fragile or for help when, in fact, they may be an increased risk. perhaps you could just discuss that a little bit. >> okay, there's a lot and the answer to that question, but -- so, in looking at this issue, what i found is that the literature is absolutely replete with studies showing that obesity is an independent risk factor of death following a car crash. but the literature is sorely lacking studies of which of the factors is it, is the fragility of royalty? and if you go into, yeah, it's a

difficult question to study because the question of what's the risk of getting an entry in the first place is a hard one to answer because when they're really good set of data but once you start looking at injury the question gets much more murky. so pretty much all the literature is sort of contaminated with this combining of serious injury and death, and so was it incorporates is fragility and frailty, you know, from some of the limited biomechanical studies we have done in our lab we see a obesity makes the bones a lot stronger. if i test a rib cage from an obese cadaver, those rates will be stronger than a comparable rib cage from a thin person. it's the way boner remodels that it's been carrying load around. the bones tend to get bigger. are thinner all sorts of issues about how people move in crashes in a disadvantage obese person in terms of restraint performance that is a complex question, and they think getting at the answer to your question, it's difficult and we don't it

now. >> if i could address that a bit. the obesity epidemic, we have been certainly seeing, and what we noticed is highly correlated with an increase in severity and also the number of lower extremity factors. where it begins to play in from our perspective is i think in the obese population, well, in the elderly population, obesity plays a much greater role in terms of frailty. that's because in the heavyset population, what we typically have is they are little more fragile and they get lower extremity into the potential happen is the obese folks have a much more difficult type getting back to weight-bearing. what the typically means is a very prolonged hospital stay. during which there are complication rates go up markedly. on top of that when you have a very heavyset person who has a difficult time we buried him and the elderly just generally can have a harder time recovering

strength, so that means a very substantial impact on their long-term sort of quality of life. okay? i would say certainly the elderly obesity as having a very substantial impact on frailty even more so than fragility, even though we could see fragility of fact. >> i think rich is right that it shows up in every analysis. we did something with roll over were the most severe cervical spine injuries when we look at the population, they were the oldest group of people and also the fattest people. so it is shows up over and over again in these analyses. >> chairman, i would like to turn it over, please. >> well, thanks a lot, guys. i think you have encouraged alll the other resolution to get a little more exercise and build of our core strength that so a lot of yoga in my future. i've been asked to make sure that each of the parties,

spokesperson for the table, if they could please identify themselves by name and the organization for the people who are watching, who are not here with us. we would go to the first table. >> i'm beth whitaker highways administrations office of safety. we have one question from our table. no? do you have one? just one. funding for crash biomechanics has increased its daily over the decades with a handful of government agencies and a couple of larger car companies doing the work. i should have let john reed this question. how can we best maximize the effectiveness of our research efforts to lead to argue deployment of technological improvements? >> okay. i will take stab at that. the answer is correct. there's been a large emphasis in the last several years on crash of points and active safety

technology but when you go to concerts worldwide, and recent i have, the number of people doing research or collaborating is still quite high and they're still, all of us in the committee there's a lot left to do. what we're finding and what we're trying to do is more international collaboration. we started some collaboration in rear impact dummies inside -- side impact dummies. we have been meeting quite regularly for the last year. there are consortium in europe that are joined together companies from academia, governments to look at biomechanics research and we're starting to join those things as well. to leverage the dollars around the world in this area, so that's one area that we can best maximize our resources. >> i guess i would like to weigh in on this one, too. we continue to do research at ford, but they used to be much more public money for research and this problem. and injury from automotive crashes is the number one cause

of death between the age of one and 34. and it's not getting the attention i think that it needs in terms of the public dollars that are out there for research. compared to some of the better known causes that are out there, that are getting funded. so i think there is a lot of room for improvement there. >> maybe i can just come from the perspective of the guy chasing the money. as a university research lab, i certainly have noticed the absence the non-anon, and a couple of comments. one is that in recent years, in particular, there's been sort of an increased level of funding coming out of the dod and other sort of military focus groups, and it's because, you know, crash injuries are a big deal in wars and this kind of thing. there has been a bit of an increase in their in terms of the ability to look at some of these questions. another thing that is recently

been discussed is the va, you know, veterans, disproportionate crash involvement and the va also have tons and tons of money. and this might be a good way to spend it, frankly, if you try to keep these guys out of the hospital. so has been some of these more military focused areas where we have been trying to proceed down these paths that are maybe tried a. i just heard they had a record profit this quarter, so i don't know. [laughter] spent we will see if that translates into a research budget. >> can i do a follow-up, chris? >> please. >> the other part of the question was, how do we maximize the effectiveness of the money we already have. i think steve has hit on it by seeking out collaborations where we maximize the number of people and the number of labs that are participating in each person bring their own perspective and can contribute. >> one thing we did recently was have a focused thoracic injuries

research symposium out in arizona, and you find that people are doing some of the research around the world, and the best thing to do is say, let's not be redone and try to focus people in different areas so we can maximize the results. >> it turns out we do have another question at our table. for doctors whining and can't. how truly modifiable our fragility risk factors for older adults? the first question. and the second one is our older women at greater risk due to greater reductions with bone mineral density, off to process, >> i would try to address the first question as to how modifiable are they. we are in the process of studying that right now. we certainly think that, for instance, we've been seeing these very substantial effects on core muscle, on operative outcome. we believe a substantial number of those things could be addressed whether it is by

intervention placing and on searches for answers can be delayed so that people can get condition. obviously in the trauma situation that's not possible when these patients are coming in. and i think i'll say that you can't really, you can perhaps modify the entire population in general, is one thing. i believe however, and would with a lot of automotive engineers in southeast michigan and elsewhere, i believe there are a substantial number of technologies which are i think on the near horizon which, if they are adapted for a more elderly and more frail occupant, i think it provides substantial benefit. so i think in that way, as i think a smarter, more tuned vehicle system can prevent a number of entries because you don't have time, the patients will come in because of the comment and you can't say you'll get into a crash into mud figure go out and do exercise. however, the frailty issue can be addressed over the long term. i think there are interventions

whether nutrition or exercise, specific regimens where they can be addressed. >> and the second part of the question, are there older women at greater risk due to greater reductions in both? >> well, we do see that. we see that trend. what we see is actually an equally large contribution from a muscle mass and conditioning. as i mentioned we have processed over 10,000 total body ct scans can and we see very substantial differences. the other thing that's interesting is men and women are quite different, and they get -- surprised. newsflash. but they get completely different patterns of injuries. so men and women get very, there are certain types of crashes where men will get, for instance, in a frontal crash, let's get away from the chest a little bit. and a frontal crash, men will tend to get fractures. where as women rarely, the odd

ratio is it's about nine to one. if you flip it around by side impact crash it's about nine to one females it was interesting its younger female. that are more likely to get some of these other factors. so while osteoporosis in general goes down, there's much more substantial gender differences which we are only now beginning to get an inkling of. >> made one quick comment on that. i had to hear that illustrate, i think the answer to question on the gender question is it should. but it often doesn't benefit itself in very clear ways. what i'm showing you up here is relative risk, again, plots of the function of age. this came out of combining a whole bunch of exposures, motorcycle crashes, falls. there were attempts major to control for exposure. this is the risk of injury getting a comparable exposure. as a function of age. on the left is men and on the

right is female. all of it is expressed relative to men at age 20. it's a lot, but the point is that women have about a 20% greater risk of dying at a given exposure, and his almost constant across the entire h. specter. it almost maintains into preadolescent, that that ratio stays reasonably constant. and i cannot tell you why. certainly, things like osteopenia and author process, to manifest themselves in women. and the other thing that tends to make that a difficult question to add is there's this whole size issue where has meant a bigger. and so this is simply a size manifestation or is there some gender news issue in here? and i would say getting to a quantitative answer to that is probably in the future. i don't think we have a good one now.

>> i don't like those numbers too much. thank you for your questions that any more questions at the first able? we will go to the second table. and if you could also identify yourself with your name and your organization. >> nancy bell from aarp. at the first question for the whole panel, with an older crash dummy aid in the development of more effective occupants, protection for older drivers and passengers? what is involved in aging a crash test dummy? doesn't older dummy change the injury criteria in the injury criteria performance level for procedures, and what affect if any does it is have an current vehicles at the time had? >> a lot of questions. good questions, too. i'm not sure i would want to go to an old crash test dummy. i know there is some thought about that. i think the best way to handle

this might be by modeling. as i mentioned, which is made an old version of our human body model, and can use that to stay in the various restraints. and older dummy wouldn't look like a dumb with perhaps different response force reflection properties of the chest. it may have different red angles as both dr. wang and dr. kent has shown that the red angles change with the function of age. the injury is quite a would most likely medicine. i think chest deflection is a criterium of interest for all people as well as young people. did not cover it all? >> would they be any -- affect on vehicle designed? >> that's a tough question to answer that one of the things that hasn't come out is, it sounds simple that we can have systems that automatically adjust for an occupants age, but it's not quite that simple.

because it is only one of the variables in crashes. the amount of them you have any vehicle limits how far you can allow the occupant to move. said every low shoulder built, and if you make them really low for an older person, as i said earlier, you end up with a lot of extras and. all crashes are different. of course, he had angles to crashes, crash pulses are given. there's a lot of factors that have to be factored into this adjustable restraint system. that make it a little more challenging. it's not easy we couldn't do but it will take significant amount of effort i think to do an adjustable system in that regard that encompasses everyone. biobarrier bag is enormous. we have to accommodate from the smallest occupant to the largest occupant. and from age eight in most states on award to the oldest person who is in a vehicle has to be accommodated. and there are all sorts of different shapes and sizes.

it's a complex problem. >> one of the things we're kind of -- the effect of these restraint system because of the way the dummy is designed and the way it measured. current crash test dummies only measure one spot. we had a project of advanced crash dummy that looks out with better angle properly like humans and measures at four different locations. this slideshow some advanced technology where we're putting leds on each of the ribs of the dummies and we can measure deflection at any point along the red in three dimensions. the question we don't know what it actually means that we know the chest to flex a belt is loading. we have pictures of these amazing pictures of both human subjects and dummies and the amount of reflections you can see. now in three dimensions at multiple spot. i think it will make us evaluate restraints in a different way by having a more advanced

capabilities and a dumb and more advanced by terry and was up to work on what the criteria means. >> that would be something that we have a couple to a all pages. -- all pages. >> talk about occupant protectioprotection as a system. could you talk about the airbag, how that comes into play in the older occupant or driver, and working with the restraint system? >> before we had airbag switches have dealt, and we broke a lot of chest. the risk from belt alone, especially for elderly occupants is quite high. with the advent of airbags we now have the ability to change the amount of load going through the belt. we can reduce the amount of force by having the airbag come out and take some of the forest of the restraint. and so the risk of injury for a

combined restraint is somewhat in between what it would be foreign airbag alone, district the load completely and has the lowest risk for chest injury. so airbags to work in conjunction with the seatbelt to reduce the risk. more important i think it reduced the risk of head and neck injury. but there are positive force in chest injury protection. >> i think one of the things that's been discussed on the panel and the panel prior is that death from rib fractures often occurs, subsequent to the accident, to 30 days possibly longer than 30 days after the accident. do you feel that these deaths, that only occur from the rib fractures are accurately reflected in the fatalities data? or to what extent do you think you are reflected?

>> if i could just pull up my slides here, give me one second. this is sort of getting to this may be an even bigger issue. so here i'm showing you -- maybe if we can get this slide up. you i'm showing you just some proportion. if you pull out fatal data in the u.s., and look at, say, i'm calling it a young group, it's ask a middle group, age 30 to 45. if you try to compare all descriptive teenager it gets crazy. here i am comparing age 30 to 45 and a group that is aged 75 and older. you see a lot of different things. crash exposure issue. one of them is the delay to death question. so it's about 30% of people over

75 who have died in a car crash died a day or more after that crash, whereas it's all about 10% in the middle age group, and very low in teams. that is somewhat counterintuitive that you think these young robust people hang on and try to live. but no, what they did is they kill them selves quickly in these crashes. massive head injuries and this kind of thing, whereas the older folks don't have those kinds of crashes. i have a couple of examples of some case studies we did where -- i just pulled out some random cases here because they illustrate the point. is is a 39 year old enough, not a teenager, but this is a single vehicle crash with a drunk driver at night, goes headfirst or roof first into a tree. and there's massive intrusion in the roof and the person died in either. of massive head injuries. that's an archetype really of a federal crash, not the kind we study, but typical of fatal

crashes is they tend to be pretty crazy events. then we pulled out some of the older cases. 80 go to the next slide. here's a 75 year-old male with any minor crash, died 16 days later. here's one from an 89 year-old drove slowly through a fence across the yard come hit a house, backed up to hit the house, backed up, drove into the house the third time and then died six days later of the cost not known. we found several cases with heart attack listed by the medical examiner expressly as the cause of death pics of these cases do show up. we see also to cases of sort of moderate cases. one of the things that is very illustrative, if you go to the next slide, this is the driver generation. you see any 65 plus community 45% male, 40% female, 15% are coded as either unknown or pregnant females but probably

not many of them are pregnant female. what that means taking% don't even have the gender coded. this reflects the fact that investigations of elderly driver fatalities are not done very through because it's not apparent that going to die. so up when a young person dies, you know and gets a lot of investigation that they surveyed the scene, they take a lot of photos. when an older person dies there are no pictures, generally. there's no investigation. and, in fact, i've had cases where the police report had been denuded no injury, or minor injury, which later had been widened out and fatal have been checked. so it's not apparent that these guys are going to die in a crash. it's a very good question, what is an elderly fatalities and when should it be included as sort of a caused by the crash. it becomes gray spent as a follow-up question, i guess what he just said, do you think that calls into question the lower fatality rates that were discussed during the first panel today?

>> i haven't thought about how that might be affecting that kind of data. i don't know how pervasive this kind of thing is, how much it affects the database in terms of overall trends. i haven't looked at that. >> then i think as a final question, after market design options to address the needs of older drivers and passengers who are likely under protected by the current designs on the market? >> i have seen things like protectors for cover decisive for belt. typically don't like is because they may interfere with the belt performance, but in general, most of those products, we don't know what their effectiveness is. we just don't test them. we don't think actually they are that effective. the belt ones are the ones we see the most, just recover reasons. just for ease of use to off.

>> some of the aftermarket belt that aim to get the belt off the shoulder actually change the routing of the shoulder belt and caused an increased risk of submarine, sliding under the belt. so i don't like to see those systems at all. we do a lot evaluations with our belt systems to try to get them to get good performance and the dynamic performance. and when you start altering the dynamics of the system you can run into a lot of problems. >> thank you. >> thank you. and i just, for the third panel, for the third table spent good afternoon. i am kelly from iia just to thank you for your presentation. they are rather interesting. we have a few questions. since motor vehicle safety standards, such as to awaken drive designs, do you think any

changes to that standard would help vehicle manufacturers further optimize the health and performance for the older population? >> i would like to say i'm just a research guide. i was at steve answer it. >> currently the standard requires us to test on belt and -- unbelted, and i can drive restraint system design, in particular the airbag design to be very aggressive, or more aggressive press than he needs to be. because we have to protect 50% male, 160-pound occupant in a 30-mile an hour, which is a lot of energy to manage. so that could cause compromises in what we do to the belt system, because it has to work with the airbag. so i guess the answer, the short answer is yes, i think there are

aspects of the regulations that could have an effect upon performance for all occupants ask a, not just elderly occupants. >> thank you. this next question is similar to a question that the other table asked, but a little different. our modern procedure for injury -- for older population, and if not, what else should be done? >> i think modeling will take us a long way. we just need to understand better mature properties of the older folks who certainly show some interesting data relative to muscle versus fat. some of those much or properties are not well-known for fat for this edition of that, or bone changes. so a lot more work has to be done, assure dr. kent will be happy to know that because he can do more work like that, but it is necessary. we are investigating those things, looking at rid of

properties and can't bring properties. it's going to take a row but we just can't do it by skating or by what we think is right. is a lot of literature out there, but it takes detailed analysis of individual tissues to come up with these solutions. >> i guess what it thinks i would like to say about modeling though is the dummy is a model. it's a model of the human also. it's a physical model, and it's named appropriately. because we make a lot of approximations in developing those models. the mathematical models that we have developed, not just for, but the whole industry, there are many different models being developed around the industry. steve mentioned simon which is a model of the brain and skull. these models are much more detailed and the crash dummy can be. the crash dummies is a tool. it's meant to be repeatable and reproducible so that when we write test in about and it's a

runs hs we get the same answer hopefully. and because of that, to make a laboratory tool, many, many compromises have been made. is a good representation and we have done a lot with the dummies as many people in this morning noted, that the number of fatalities have come down. i think a lot of that is the economy in the last three years, and the fact michael c. back from university of michigan have a study on the. got off track, sorry. the fact of the matter is that the computer models, i think, can give us much more detailed answers. the caveat is as steve said, there may propers we don't know and the computer models are only as good as the properties we put in them. so there's compromises everywhere. >> if i could also address that question. i think there's a very substantial impact. i think with glaring deficiency

right there that i think the modeling will be very helpful. i think adding additional properties, but as train to mention, which and that is much more detailed, hopefully with models sort of detailed entry locations. and what we've done is in looking at our very large substantial a very large set of crash cases, we see differences in the location at a specific site of injuries and how they are related to each other. now very different from a young person first and no person. young person, those tens that ribs tend to collapse, or as an older person the ribs break in a different spot which leads to lung lacerations and liver injuries and whatnot. so i think what's necessary is a three-dimensional injury map. all the current databases now are aligned with an specific entry and a score. they don't give you the three-dimensional location. and what you need to see is the

exact location in 3-d space as well as how they relate to each other. and to the location of the force loading on the exterior surface, the body. and all that now is very easily attainable by processing of ct scans. and i believe that's necessary to support modeling. you have to have a target for any sort of test that you have. you have to have a valid argument. so i think that's a very substantial and learn deficiency right now. >> thank you. and one less question from our table. there's a lot of information on cognition. you have any thoughts on polypharmacy effect on bone density for julie and/or frailty? >> as a trauma surgeon i don't laid i am the best, most older person to say. resort is the polypharmacy, the substantial portion of the american population seems to be on multiple drugs at this time. what the interaction of those effects are on osteoporosis in

particular i cannot say. >> thank you. >> okay, thank you very much for those questions. and we'll proceed to the final table. and i think space my name is tom. we have just one question that you can't touch upon order. but are there gender differences in terms of the older drivers biometrics, and one of the policy implications of this difference? one of the things i was thinking about, what i was thinking about was can we talk about in the last section that females tend to be the passengers when there's a male presence in all age groups. are there any implications for protecting those passengers specifically or are there policy implications? >> well, i will start with that. resort is a very substantial gender differences and we know

that we attribute to many of the differences of the patterns to the anatomic difference is that we see between the genders. my personal thing, again speaking from the outside, being one that designed the dummies or designs the dummies for the test devices is that i don't believe there is sufficient gender specificity in the tests. i think would you cut out -- when you love all the injury risks together, you kind of lose a lot about understanding. and so my personal opinion is that does not sufficient gender specificity in the test devices. >> that aside, we still do use small female dummies in both the regulatory and consumer level test. and the site impact as a mcinerney were developing helping to evaluate worldwide, both a midsized and small female based on more recent biomechanical data of, letzig,

fragility of females relative to males. >> i maybe make one quick comment, the front passenger position, i don't have this kind of data, but one thing we been looking at lately is content hot research issue is the rear seat. which sort is your point about not drivers. we do know some things about the receipt come and they do policy applications i think, and what until you hear is the effectiveness, the fatalities that goodness of the receipt as compared to the front seat. so i posit number means that the receipt is safer compared to the front seat. but with the same kind of exposure that it it is meant and a struggle truth and autumn appeal safety has been the receipt is safer, intrinsically safe environment in the front seat. it's only in recent years that this has become untrue, and it's become untrue for older drivers. and so what you see there is up through about age 50, that front

seat has positive effect. to receive has positive effect of this and we get older groups, the receipt becomes negative effect. in other words, the front seat is safer than the receipt for the oldest occupants. there is a working hypothesis on why that is. one of them come if you go to the next slide, is this. illustrated here where there's percent, we see things like load limiters, this data is data dedicate it to go to the current time you would see all of them come 100%. that these technologies, thus enlarging motivated by consumer information and federal compliance tests, which involves dummies in the drivers seat. but there are no such tests involving dummies in never see pics of the receipt sort of, you know, a safe environment. but intrinsically the front has caught up because we been working so hard on it, i think it so that is starting to show itself.

then maybe some advances to be made thereby incorporate some of this technology from the drivers seat into the receipt. and there may be policy issues that can drive some of that. >> i like to weigh in on that one, too. what this graph doesn't show is the driver for the fact that there are pretentious in the front seat. of course, i didn't mean than by the car driver. i met the major factor i guess i should say that. there's always a driver in a vehicle, and one-third of the time there's a passenger and one-tenth of the time somebody in the rear seat. nevertheless, vehicles themselves have become, have been forced to become, for all of our six, more fuel-efficient which makes them typically lighter. also, a lot of the design trends in recent years has been to shorten the front end. and both of these trends making them lighter and more stylish tends to drive the crash pulse.

the crash polls is the reason that we have pretensions and load limiters in a vehicle. the crash is -- the structure of the vehicle is much stiffer now than it used to be. if you were to plot the structure, if you to plot as a function of time in which a be a good thing to do, my guess is you would see that the end cap stiff is also fall the trend as of these technologies are needed and it's time for them to come which is why we put our inflatable belts in the rear seat. >> i just had a very short question that it's going back to train i can when you talk about? your delay to death slidew? committee don't need to bring it up because the question is for dr. wang. when you see your sequence of injury failure that is going on, how long does it typically take? >> that could take in the order of weeks to months.

what happens is, and i think this goes back to one of the issues that dr. kent brought up, the young people, we can to get a very early we'd on them. and he to have enough reserve to get into convalescence. what happens with the older folks is they tend up with a lot of care support. in these days with advances in critical care which have been a very substantial in the last two decades, we are able to keep folks going for weeks, and then afterwards they typically, so it can be months before that pops out. >> so it would be fair for me to say that the delayed death number isn't underreporting? >> yes. and enough away with the database, that i would say that they would be, i would be quite concerned about the. i think if you add on top of that, not just death but the very core long-term outcome, you have to follow that out much longer.

because there will be a much larger portion of the elderly population that failed to return to full function, whereas in the elderly they tend to bounce back and have the recovery function much, much more substantial. >> and just for the record, you are using fars data so that would've been a 30 day window. >> thank you. doctor price, i'm going to keep you busy trying to pull up a couple of slides. dr. kent had a slide that showed head injury and thoracic injury. and one that was going one direction and the other was going the other direction. what i'm trying to understand is, why does head injury passionate if i read this chart correctly -- why does head injury decrease with age but is it because of the operation of the vehicle? >> or values? what's going on here? >> i should've made that point more clearly. the risk of injury to anybody

goes up with aging. so this is not numbers for risk. this is proportionate. so when an injury does happen, it's more frequency in the thorax in an older person did something i should have a risk of injury and had as as well. it's just passionate increases faster. >> thanks. that's exactly what i need. i was having trouble understanding that, and i think when you kind of about the exemplar accident we had a 39 year old female driving into a train, is because they're having these catastrophic i see a drunk driving accidents but we are not seeing that in the older driver, but they have as many head injuries, just the proportion, not si. >> i don't know about numbers, but the risk is higher in the older, in older folks. but their exposure is less because they are driving as much. the total number of head injuries, there's probably more head injuries in the young, but the risk is higher in the old. and the proportion is higher in the young.

proportionally younger people have head injuries more. i think it's also true that older people do not get into the supertype crashes that younger people do. speed. >> thanks. >> is the environment issue which is also important. >> great. and you had another, he had another side, and it was the one that had the category of unknown and pregnancy know. i don't know if there's a gender bias, because last time we had for women, now have the four men. but i'm just confused as to why unknown and pregnant women are in the same category. >> i think my postdoc put them that way. i'm not sure why. [laughter] >> okay. >> but there are some that are coded as -- i think us try to make the point that that is pretty close any case that if you coded as a note or come in both cases you are probably miss. so that is why i kind of combined into show over 10% of

the database is coded incorrectly. >> okay. and dr. ridella, i think we can talk a lot about the dummies types, i would be curious as to what type of dummy, i know you're talking about modeling and you think modeling is a great solution, but there's a reason why we have dummies. and so, we talked about obesity. >> we've talked about fragility or frailty. what do you think is the single most critical area that we are missing in our family of dummies? what would we benefit most but if we're going to go to the effort of putting together a new dummy come what is it we don't do well in our modeling our? >> i think we do well everywhere, and we touched on it, the word that comes to mind is by a fidelity.

that means how lifelike is the dummy, how well does it mimic. not just the injury, when we look at crashes, we try to deduce where was the occupant initially come with it ago. and we try to re-create them in a lab. the dummy does always want to go with the human with. and so part of that is a process of come we don't want to break the dummy because we make it to lifelike it will break over and over again. it's kind of expensive. we get complaints because they don't keep replacing dummy parts, but if we can think of technology to make dummies smarteor biofidelity, the crash forces, and then to have the answer medication that can predict the injury, that's why we are moving into rotational brain injury criteria, multi-point just sent it, so we understand what's happening at the pelvis, more complex lower extremities that and more

lifelike lauric stories which we relate to respectively a project on. those are all great things to move forward with. what comes with it is complexity and the more issues of calibration, repeatability, durability, reproducibility from dummy to dummy that we have to tackle. and we will do that, but it's a process we have to go through. >> it sounds like all dummies need a better buy a fidelity, but is there one kind of prototype human that is not well represented in the dummies. i think that's what i'm trying to understand. when we talk about dummies performing like human beings, what's the dummy that is the heaviest? we look at a d.c., are we able to capture that? >> dr. king would like to weigh in on the. go ahead. >> well, a couple of comments. go to the very last question you asked. we have done some work looking

at a fat jacket for one of the dummies. you know, the rib cage of obese people are quite like the rib cages of anyone else, and so if you get down to the bony structures, they are about the same. there's visceral fat for sure, but the thing that affects, say, is the subcutaneous fat. we can represent that and we have started looking at that. but again he gets into issues of repeatability and robustness and all of that. and so, the point i was going to make is we have a question about resources. to my mind, the resources required to develop a new dummy to get worldwide acceptance of it, and to get people start using it. it has never happened in my lifetime. we got one right around the time i was born, but when we have been working on them ever since. it's very hard and takes a ton of work, and i just don't see that as the best use of resources would be to build yet another dumb. we can work on ways of making

them better. and also i think ways of interpreting what they tell us. things like simon. you know, simon uses a dummy input, to drive them all and give us more information about what human would experience in that exposure. and those kinds of things seem to me to be a better use of the resources come is interpreting the dummies we have rather than trying to build another one. >> okay. i was interested in the backseat, and i'm really glad the last table as the questions and you were able to show slides on the information. if you could pull up that slide that dr. kent used at the backseat information, and i think dr. rouhana, you try to shade a little bit of information in there about one-third of the time to be a passenger, and one-tenth in the backseat. help us to understand the data a little bit more with respect to the benefits that, that's just a front seat passenger, not talking about a driver, just

front seat passenger, the benefits a front seat passenger gets out of having to combine air bag and seat belt versus a backseat passenger, not having an airbag. and so maybe you can talk through your day here again. >> who ever feels like they have something to add here. >> so, this effect in this issue, to sort of start trying to understand this a little bit, we have done things in my back. one come we start looking at the dissipation by body region. why are these injuries happen. and it's the chess, surprised and, in fact, it's the chest even in the young. so that just seems to predominate in the receipt more than does in the front seat. so that if one clue. and then we started looking at restraint performance in the mercy. there are challenges in the rear seat that are unrelated to the lack of an airbag. an airbag, there are other low

pass in a fuzzy that are not in the receipt like a knee bolster. we have had we have quite a bit more flexibility and certainly dr. rouhana can speak to this more that i can probably, but the design of the front seat is much more able to be changed than the design at every seat. the receipt is tied with the chassis of the vehicle. it has huge consequences if you try to change. frequency, a driver's seat, the seat pan is very genius lee designed. it's in explaining important part of the restraint system. the rear seat is difficult to get that same kind of pelvic restraint. so in the receipt testing we've seen, it's been pelvic motion that has been i think the most concern to us because that tends to load the lower portion of the chest and tends to keep the torso reclined. so the receipt poses some challenges, a lot of -- the ones that the dr. goodman, things i

questioned the pelvis. it helps restrained the pelvis. so there are things being done back there. along those lines. so i think, a lot of good news, as i've restraint manufacturer sees as the next market. bases as an area where they can sell technology. so there is quite a bit of work in this area. >> i don't know if the slide is still out there, and i apologize, i'm just not understanding exactly what the data is telling us again i think i particular stuck on this zero to five. i think these age groups, passenger age groups, zero to five are not so front seat. so it's going to be what's going on here. and we were helping the six to eight are not in the front seat and 9012 are not in the front seat. we we understand what the two colors are showing us and whether passengers are spent they're not supposed to be, but they are. there are children in the front seats. so what that is is comparing a relative fatalities get kids in the front seat versus kids in

the receipt. what we see is it's about 50% more effective to be in the receipt for children. but that is true across the age range up until about age 50. it's about 50% safer to be in the receipt and in the front seat. there are kids in the front seat. we encourage parents to put them in the back, but there are still kids in the front. >> where is the airbag go? >> so, in this case, the blue line is representing cases where there is an airbag deploys. the red line is from older vehicles were this not an airbag that deploys in the front seat. and so it's a little bit confusing. it's not the reason i was putting this slide up, but the receipt, the decrease in rear seat effective this is more pronounced if there is an airbag because the airbag provides more benefit to the front seat. so it makes the rear seat seem proportionately less safe just because it makes the front seat more safe. so the effect is bigger if there is an airbag which is why have the blue line. the point is the same.

>> one thing that might help some of the confusion is this was a study done by nhtsa publishing 2005, so that it is more than five years old. it's probably more like 10 years old. and do a lot more kids in a front seat 10 years ago than there are today. >> child passenger safety technician, i just don't like to see any, human you know, data that is showing us kids in the front seat. and think that the airbag, that's a challenge, depending on how their restrained. but what i was curious, dr. rouhana, the belt with the airbag provides same benefit or have you been able to quantify that when you're talking about a combo airbag and seat belt, versus the seat belt that has the integrated airbag in it? >> we have tested, i should that one slide with a standard belt, that stand about tests that we

had an airbag in a. and we reduced the chest deflection over that system. >> we've also tested this with side impact and compared to the inflatable belt, the standard belt by itself and the standard belt is a combo airbag, side air bag. . .