final years of tr's live on c-span's "q and a." listen to landmark supreme court cases. >> in texas, women still are not able to receive abortions from licensed doctors because doctors still fear they will be prosecuted under the statute. >> this week, part two of roe v. wade, argued in 1972, it's still concerned one the most controversial decisions on c-span radio and washington -- c at 90.1, nationwide on channel 132 and c-spanradio.org. >> yesterday senator majority leader mitch mcconnell said he would support a moratorium on

earmarks. they slip into legislation for home state projects. today we talked to congressman jeff flake of arizona, a long time opponent of earmarks for his reaction. this morning's "washington journal" is about 40 minutes. >> host: congressman jeff blake to talk about earmarks. we started out with our viewers talking about their experience with earmarks. how it has impacted them. we have a number of callers that called in and said it's been a good experience for us that we get money that we wouldn't otherwise get. or a little bit hesitate about the idea that republicans in the house and now the senate are going to go forward with a ban. well, i would say that those who are receiving money, federal grants, members of congress want to make sure they get them. they earmark. times we will create an account author money for a certain program and then tell the federal agencies to have competition, basically, and

award the grants based on merits. they will raid the accounts and earmark money. chances are a lot of groups that are receiving money with earmarks could still get them. they would just have to compete for them. >> host: senator inhofe went to the floor yesterday. defender. wanted to show our viewers what he had to say. >> president obama, in present, submits a budget to congress which congress either accepts all or part of, or rejects all or part of. if we reject it, we substitute what the obama requests are with what we think is better for america. the cost is the same. i've often said earmarks stopping doesn't save money. we take what the president would have spent on an item and putting that same money somewhere else. >> host: congressman? >> guest: that's not exactly

how it works. those who defend earmarks are contemporary practice say that unless congress earmarks it, it can't be spend or unless the president propoaing it, it can't be spent. the truth is congress has the power of the purse. we can authorize and appropriate and conduct oversight. what earmarking does is circumvents that hallmark of congress that we've always had. we do very little authorizing, and very little oversight. so we don't have to take what the president says. earmarking is not the only option. we can authorize programs, make sure the agencies spend money on the programs, and then conduct oversight to make sure they are doing as we authorized. so, this notion that earmarking is an expression of congress' power of the purse is simply wrong. and until like 1990 or so, there were very few earmarks. now there are thousands of them.

i don't think you can say that every member of congress prior to 1990 or before the '80s simply wasn't doing their job. they just saw their job a little differently. >> others argue that they take -- earmarks take federal money and tailer to to fit their regional needs. and few research polls shows that this has a positive impact for those that are running for reelection. incumbents, few found right before the election asking people if a candidate has a record of bringing government probablies to money are you more or less likely to vote for them. 50% said yes, 12% said less, and 33% made no difference. >> guest: i think the best test is the market test. look at how much members bragged about their ability to bring home the bacon. very, very few. look at number of appropriators that have lost their seat, those who get more earmarked.

a number lost their seats and often because of scandal that was associated or people simply didn't like the view of what a congressman is supposed to do. >> you are seeking a seat on the appropriations committee. >> yes. >> have you been assured one way or the other. do you know where the votes stand? the republican leaders will vote on this on wednesday? > guest: we have a steering committee. they will make the decision. it looks good right now. and they are very few people now seeking the spot on the appropriations committee. far fewer that used to be the case because it's no longer going to be the favor factory that it was in the past. there's going to be some really tough decisions that are going to be made in terms of cutting spending. and a lot of members, i don't think, have the stomach for that. so it's going to be a different committee that we've seen in the past. >> are you opposed to the likes

of representative jerry lewis, seeking something who has sought out earmarks and now says he'll go with the moratorium, but in the past has not liked them. second is line is congressman rogerrers. do you oppose the idea with somebody with the past history leading the associations committee? >> guest: it's going to be somebody who earmarked in the past. they all have. virtually all of the congress has. no, i think we can work with anyone both congressman lewis and congressman rodgers have said that they fair -- favor the earmark moratorium. both of them seem to think i should have a spot on the committee. i think we can work with everybody on the appropriations

committee. we've been given a charge to make serious cuts. we are prepared to do. >> host: wall street journal editorial says the leader john boehner and the others on the steers committee should elevate george's jack kingston to the spot of chairman of the associations committee. they go on to say they could strengthen his hand by adding yourself and some fiscal hawks to the spending. are you pushing for that as well? >> guest: i want as many fiscal conservatives as mentioned. this is the spear. we have to have people that are ready to do that. jack kingston would be a great chairman. i'd rather not get into the leadership race. i'd rather just ensure that we have a good number of individuals who will make those cuts. >> you said it's looking good for you. do you have an idea of the votes? how does it work? >> guest: i don't know.

we'll choose we know some of the steering committee members already will choose the others this week. and then presumptively, e think after the thanksgiving week, we'll be making decisions on the committee. there could be announcements as the chairman are announced. they would announce certain individuals appointed as well. we just don't know. >> host: waiting for calls. we're continuing our conversation will morning about congressional earmarks. representative jerry lewis who wants to be the appropriates chairman key steps. he says a couple of things --

how would this work? does it go far enough? >> guest: i think all of the steps are necessary. obviously on the emergency spending. it was mentioned by your last guest, we designate emergency items and we know it's money that's going to be spent. it's for the war, con consensus and many items. these omnibus spending bills, that's a lousy way to legislate. it just lends itself to over spending. we've talked about the -- the speaker elect has talked about splitting the bills down and making sure we have up or down votes. that will help. multiyear budgeting will help as well. however we can budget and spent more time in over sight and authoring for the spending.

that's all the much better. >> host: tweet from a viewer. so beyond earmarks if it's such a small percentage what should the republicans be cutting? >> guest: let me mention in terms of earmarks, they are a very small percentage. those who defend the contemporary practice of earmarks, a bunch for every member will often make that point. it's just a small percentage. well, if earmarks are a constitutional expression of our power, then why would we stop at only 1%. earmarks are a big distraction. when we spend all of our time and resources earmarking 1% of the budget, we leave the other 99% to the administration. when we should be conducting oversight on that 99%. so the real crime is not the wasted money. that's big. that's billions of dollars. the worst park of earmarking is we neglect overnight on the rest

of the money. it's important in that way. but if the caller, the tweeter is making a point that we need to cut other areas, including defense, i agree. there is no way as republicans we can be taken seriously. if all we say is we're going to cut nondefense discretionary, that is such a small slice of the pie that you aren't going to make a dent in the deficit or the debt with that. we need to put it all on the table, entitlements in particular. that's what we really got to look at. >> host: are you then concerned about adding to the deficit by letting the bush tax cuts be permanent for everyone, including the wealthy? >> guest: if we want to grow ourselves out of the debt and deficit, we got to have an economy that's functions and is growing. the last thing that you do to a struggling economy is raise taxes. >> host: even if it adds to the deficit? >> guest: well, that's

assuming that tax cuts are static and we know from history that they aren't. particularly when you cut marginal rates, capital gains, you end sometimes with more revenue that you had in the beginning. so i think you've got to be careful treating tax cuts the same as other government spending. the tax cut is simply allowing somebody to keep more of their own money. government spending is something different. >> host: all right. phone calls. dave on the republican line in fresno, california. go ahead. >> caller: yeah, i agree with you on earmarks. they are just a distraction. trust is the main issue. they they it's the economy. i believe we can't even trust them. look at rangel, walks out of the hearing. it's all closed doors. and they are going to sanction him. he ought to be kicked out. gone. obama. look what they did. now this guy that had his feet

is during commercials. trust is the issue. another thing, i think, is we got to do something about these pensions. you know, they say $17 trillion or $14 trillion is going to be our debt. that's not counting our pension debt obligation to public employees, that's not counting social security, we're looking at over $100 trillion in debt. >> host: okay. congressman? >> guest: the caller makes a great point about debt and the fact that the debt that's mentioned, 13, $14 trillion is only a fraction of the obligations that we have for the future over the next 75 years, for example, it's $57 trillion is the estimate. so we've got a lot more to answer for it. and trust is important as well. we republicans, i think we're on probation here back in 2003, for example. we did a prescription drug benefit that added about $10

trillion in unfunded liabilities in the next 75 years. it's tough for us to say the democrats are all to blame. we have none ourselves. i think it's going to take a while for the voters and the taxpayers to trust us again. that's probably a good thing. >> washington, d.c., tom independent line. >> caller: good morning. i'm optimistic hear, hearing the quest republican acknowledging they are on probation. the democrats saying we need to have an honest conversation. i think what's what the country needs. i'm looking forward to seeing the specifics. it's all nice to say, yeah, we are going to cut your taxes. leave more money in your pocket. then you look at a city like colorado springs where they have cut taxes and they can't fund street lights. you know, i'm waiting to see exactly what the impact of these cutting processes will have on the american people. and i also think let's be clear. if you talk about letting the tax cuts expire, we're only talking about another three to

four percent tax on the highest level of income this this country. i don't think that's a lot to ask for to get us out of a crisis. >> all right. let me show our viewers this chart put out by the joint committee on taxation to the callers last point. in blue are the tax cuts that democrats are fighting for. in red is what republicans are fighting for. those that make $1 million and up will get an average tax cut of $97,000. what's your reaction? > guest: well, when you look at those who are paying the highest rate, often it's not simply individuals. it's an sub-s corporation. we are simply asking millionaires or billionaires, you are often asking small businesses to otherwise invest the money to take a further cut. and so i think that it's a -- that's a bit of a simplistic view. so i mean we have spending

problem not a revenue problem. when you look at what we need to do, we need to use more as a model. i never thought i'd be saying this. look to the french and the british and germans and others in terms of spending cuts. they have cut deep and substantially. we're going to have to do the same. >> host: what are specifics? the caller asks for specifics? >> guest: well, i subscribe on one of 15 republicans right now in the house that i believe who have signed on to paul ryan's road map for the future. that has very specific items, for example, entitlements. we've got to over time change the way we calculate benefits, not effecting anyone who is retiring now. tag increases to inflation rather than wage rates, for example. and then also retirement age. it has to be raised over time. we simply have to do that. social security we've got to do

more to let the free market discipline the cost there and that has to involve some form of allowing that is not cutting anybody who's in the program now but for the future making sure that we voucherrize it more. also for this year, we are going to be reauthorizing the farm bill and farm subsidies. that's some $20 billion a year and not only is it subsidies that we shouldn't be paying out, it affects our trade relationships as well and if we want to grow the economy, we have got to export. we can't have the farm bill prohibiting some of that free trade. >> guest: next phone call. alexandria, virginia. go ahead. >> good morning. i thought of listening to our show. what are earmarks? what is the tea party? >> guest: well, somebody must

have been sleeping. it does bring up a good point. i should mention the role of congress is to control the power of the purse. article one power gives us that. we should be able to tell the executive branch we want you to spend specific money for specific purposes. but that should be the congress as a whole or committees as a whole. not individual members saying that i want this pot of money for this company in my district or for this museum in my district or nonprofit. i don't think that was ever envisioned by the founding fathers who are -- it's not been the practice traditionally in congress. it's only a contemporary phenomenon. it's not good for the institution, it's far too much power to the executive because when we focus on one percent we ignore the rest. >> guest: a couple of people here challenging you on tax cuts. the person e-mails in. you said that tax cuts don't mean an increase in the deficit.

sometimes revenues go up. however, revenues always go up unless the economy is shrinking. the issue is that revenues decrease compared to what they would have been. even mitch daniels admitted tax cuts do not pay for themselves. will you do the same? >> guest: not all pay for themselves. in the late '90s, we had a cut in capital gains. on paper, that cut should have been resulted in a $50 billion loss in the treasury over three years. i think the gain was about $150 billion simply because of increased economic activity. and you have that with certain tax cuts. i think if -- if the caller or the writer there is saying that tax cuts don't always pay for themselves, they are right. they don't always. the last thing that you could do is raise taxes on anybody. > host: the republican

argument if you do that, only 2% of small businesses make more than $250,000. he is disporting the truth. >> guest: i don't agree with that. only 2% of businesses make more than $250,000. >> host: small businesses. >> guest: small businesses is not a figure. he maybe classifying small businesses than i do. >> host: what is it? >> guest: i don't know the figure. it's a lot larger than that. >> guest: specifically what entitlements. you look specifically at the road map. we come into balance over a number of years. there are two ways to do that. raise the retirement age, which we will have to over time. we are simply living longer. that makes sense. the rest of the world is doing that as well. also you change the way that you calculate benefits by tagging increases to inflation rather than wage rates. and that's a slower increase.

so that would save significant money. and with medicare, if you voucherrize it or part of it, you are not cutting people off of it or anything else, you are simply allowing the free market to discipline cost a more than it does now. that would save money over time. one republican who is saying we are going to have to cut defense. the notion, last year, for example, during the appropriation process, the one or two appropriation bills that we did among the one or two was defense. and we've failed, or we actually allowed a second engine for the f18 or f35 which is a couple of billion program. that we shouldn't do. simply because it creates jobs in some districts. we can't continue to look at defense as something that is just there to boost our economy. we have to look at as, you know,

do we defend the country or not. we can't continue to spend the kind of money on defense that we are. >> host: back to phone calls. harry on the republican line. good morning. >> caller: good morning. thank you for taking my call. good morning, congressman. a few callers ago kind of stole my thunder as far as the earmarks and the trust factor. i think that a large portion of the united states electorate is looking for trust. temple -- term limits is where you need to go. i'm an unhappy republican, i don't think the democrats or the republican have the middle class in mind in much of anything that you do. i think the republicans are looking at their hides, and i think the democrats are looking at their electorate, and the

middle class gets squeezed. >> guest: you know, the caller, the mention of the trust factor, look at what washington has done, run up trillion of dollars in debt, we have a couple of members of congress in jail right now for dealing under the table, we have things like earmarks that since they lend themselves to ridicule about spending. so i don't blame the caller for the lack of trust. all i can say is we will move ahead and do the best we can. we republicans, i think, recognize that this election was not necessarily because people love us, it's because they weren't satisfied with the direction of the country. and we'll have to do a lot better than we have. >> host: shelly, democratic line in charleston, virginia. >> caller: yes, hello, sir. >> guest: hello. >> caller: i have a comment and a question. are you saying that -- that you

want to get rid of earmarks? >> guest: yes, i am. >> caller: okay. >> guest: the contemporary practice. individual members of congress getting pork for their district. yes. >> caller: okay. if you get rid of earmarks, how does things get done in people's districts? >> guest: right. >> host: how's it done differently? >> guest: well, most of the spending that goes to districts is actually formula funding coming from the federal government or the agencies have a program that we've authorized them to do and they will conduct competition or ask for requests, grant requests from individuals and organizations. that money is dolled out that way. now some members of the congress say we don't like how the terms is used. those faceless bureaucrats, the way they are handing out money. we could do the districts the

way. if we don't like the way that bureaucrats hand out money, we shouldn't allocate the money for them to hand out. we have the power for them in congress to authorize those programs more narrowly or more broadly than we currently are. and that's what we should do instead of saying we don't like how the bureaucrats are handing out money. we're going to run the parallel program where we hand out money directly and compete with the agencies doing it. often times we will authorize an account to be set up and a program to be run by an agency to give out research grants to universities. if our particular university didn't get one of those grants, we step in and earmark it anyway. often a lot of those accounts by the time the agencies get to it, every dollar has been earmarked and so there's no program to hand out. so absent members earmarking it, there would be a process for individuals to receive money under programs. i happen to think a lot of those programs aren't necessary,

aren't the providence of the federal government. we shouldn't be doing some of them. those that should carry forward we should authorize those programs and then make sure that the agencies hand out the money and equitable delay in terms of merit, in terms of competition, rather than us circumventing the process and going and doing it ourselves. members of congress love to cut ribbons. we love to hand out money for a bike path or museum and then be there when it's handed out. members of congress love to have programs named after them. that's kind of like twice cooked pork in my view. if you can get a program for which you receive funding named after yourselves, then you are doing pretty well as a member of congress. it's not good for the institution and it leads to corruption, and it leads to over spending. >> host: charlotte, north carolina, john, independent line. good morning. >> caller: yes, good morning. i want to say, you know, i think

the republicans just don't get it. you just don't get it. you keep saying about we need to look to the europeans and the way they are doing thing. i agree with you on that. you need to look at the france and what they have done with their social security. i think they've -- the community, the people have created a riot, that they went against the government because they are raising the social security age too. so i agree with you. that's exactly, well, yeah, you need to look to france on that. also, you talk about cutting, you know, we need to cut the taxes. i mean this is very simple. simple as 1, 2, 3. if you raise the taxes, you get more. this is coming from a low income person like myself. if it wasn't for obama giving some of these tax break

incentive to lower income so you can create more wealth and income where income tax comes back. if you don't raise the taxes, you don't get enough money back. people depend on that money. >> host: all right. john, i think we got your point. comments? >> guest: i think everyone recognized. 100% tax rate, it will go away. there's some point that you have less if you raise taxes than you would if you lower them. i think everyone recognizes that. the question is where is that point? where's the point where lowering taxes brings in more revenue? i can see that not every tax cut breaks in more revenue. but some do. and particularly when you are in a recession, you shouldn't raise taxes. >> this twitter message from someone who brings us what our previous guest had said. smiling and trying to --

>> host: if you think on any level the elected official is not going to try to get money for his or her state or district, then you are mistaken. >> guest: no, i'm not mistaken. i think they will try. prior to 1990, i think there were a total of just a few hundred earmarks. in all appropriation bills total. by 2006, we had reached 1400. now some members of congress look at that at a point of pride. we have the process. it's no longer just a committee chairman calling an agency said saying i have the project. i see it as awful. i think it's wrong to have a committee chair call an agency and say i spent money this way. at least if it's that way, we have margins. we have thousands of earmarks and hundreds of members of congress making the request. the notion that members of congress know their district better than, you know, some faceless bureaucrat.

i take the point. when you look at the practice, i bring a chart to the floor for virtually every appropriation bill which shows the disproportionate distribution. if you are a committee chair or appropriator, you get sometimes in some bills, 60, or 70% of the dollar value of the earmarks. a small percentage of the body are getting a huge percentage of the earmarks. i don't think anybody can argue because you are a committee chair now you understand your district far better than file members or pure -- bureaucrats. the earmarking is out of hand. yes, they will still try to get money for their district. you shouldn't do it at the cost of having programs that should otherwise be competitive or merit based and say i'm simply going to get the money because i

can. >> host: congressman jeff flake is our quest. we have 10 minutes left. he represents the district. seeking a seat on the appropriations committee. curtis, ark., james on the democratic line. go ahead. caller: i would like to know what type of benefits and salaries you receive. how many years you have to stay in office for you to receive those benefits? host: are you talking about pensions, caller? caller: yes. guest: there is an e-mail that comes around that i get every couple of months that tells members of congress who retire after one term and receive their full salary for the rest of their lives and they do nay >> guest: when you see a

postal employer or anyone else, they have the same benefits of a federal employee. it used to be the case they got benefits, but that's been cut greatly. we have the same packages as any federal employee, really the same as our staff and everyone else. >> host: david, republican line, you're next. >> caller: good morning, mr. flake. i'm interested in your comments on where you think the american people are going to stand. are they going to have the courage if you make the cuts that need to be made? now, we all know that those cuts, if we're going to save money, are going to have to come from social security, medicare, and medicaid. those are the big item, and the military. i'm a retired military man, 30 years in the marines, and i'm concerned that people had the courage and i'll 3w specific in

one area. i had a cost of living allowance and the cost of security, i receive a cost of living allowance. are the american people going to have the courage to forego those costs of livings, those cuts are going to have to be made in those areas, and are they going to say anybody but mine? >> guest: right. the caller makes a great point. i had meetings in my district, and i'm struck often i'm told the whole meeting you have to be fiscally conservative and cut this or that. a few months ago when i was leaving a meeting, someone pulled me aside and said what about the cola on not getting social security. are you paying for that in lieu of a cost of living adjustment we didn't get this year? basically, saying ignore what you heard in the evening and do

that. the caller makes a great point. we don't know if the people are ready, we just know we have to do it. when you look at where greece is now, within six or seven years we'll be there in terms our debt to gdp ratio. i think that congress tends to summon up the courage when we have to right at that fiscal cliff. the problem is we don't know where that fiscal cliff really is. we don't know when between now and when we are where greece is that we have an option for bills and have no takers, for example. we don't know. it's who right now to make these cuts. >> host: a story in the "new york times" where the debt had spread to ireland. >> right. those countries are doing what they have to do. i think we need to follow them.

>> host: next call independent line from new mexico, don, go ahead. you're on the air. >> caller: yes, thank you very much. mr. flick, i want to ask a question, and i want to go on from tr. the question is do you know the effective tax rates for the 50 top earners in the united states? >> guest: the effective tax rates of the 50 top earners? >> caller: yes. >> guest: i assume the top marginal rate south of 40%. >> caller: wrong. you're wrong again. the effective tax rate is 15.6%. those people earn their income on capital gains and dividends. on that, they earn 15%. those people don't even pay into the social security fund because they pay on earned interest. the richest people in this country don't pay social security and they don't pay a

regular tax rate, so when you talk about this skewed tax system, that's an example of how the richest in this country have all of this money, and are they investing in jobs? are they investing in all the things that american want? no. they invest in themselves. >> host: i just want to ask are you talking about hedge fund managers? those people, whatever the profit they make from their bet is taxed as capital gains and not income? >> caller: this is the irs statement, and the irs statement in the irs say the 50 top payers. that could be the hedge fund owners, and they have what they call carried interest, and as you know in carried interest, they only pay 15%. now, there was a bill before congress to move from that carried interest of 15% to real earnings, and here we have an example of paulson who had a

hedge friend called paulson and company, and his company made $37 billion on the subprime crisis, and what happened subsequently to that he had 3.7 billion. he paid 15% on $3.7 billion. republicans were unwilling to tax that carried interest as real earnings. >> host: we got your point. let's get a response. >> guest: the caller makes a point that those individuals, this is money for themselves, and it is not helping the economy apparently. the fact they are paying on capital gains shows that that money is being invested in the economy, and so this notion that if you're making millions of dollars you're just sitting on the money for yourself, and that's not being circulated in the economy. if we know they are paying this,

it's because the money is circulating the economy. it's not a rate as high as individual tax rates, and i don't think anybody is suggesting, and maybe the caller is, we tax capital gains at 39%. i don't think we should. >> host: certain jobs with the hedge fund managers? >> guest: i think you have to -- for people to invest in the economy, we shouldn't care where that money is coming from, as long as it's invested in the economy, and it's very difficult to play class war fair with capital gains and saying we're taking it from individuals who make less than $250 # ,000 a year. we need more investment in the economy, and if can comes from people who are paying at a lower rate because they pay on capital gains, i think we should be grateful the money is going into the economy, and not always looked for ways to punish people

because they have been able to invest more in the economy rather than take it as individual income. >> host: raleigh, north carolina, thomas, democratic line. >> caller: yes. congressman, my question to you is why is it so difficult for the farmers to reach these moneys? i know people who constantly use their farms and have to sell their farms. >> guest: i'm somewhat familiar with that case, and i think that's being dealt with. some of that has been settled, and some is still coming up. the yes nan is -- the gentleman is making the point that individuals are losing their farm and if he's making the point our current

farm bill doesn't have farmers, i take the point. you're right. i don't think our farm subsidy program serves many useful purposes other than inhibiting our ability to trade, and just to talk about the absurdity about it. we subsidize cotton hugely in the country so much so we consider sued by our trading partners saying we subsidize cotton so much, and there was a judgment against us. in order to get brazil to agree to the to pursue the case, we are now subsidizing brazil's cotton to the point of $150 million over a number of years. instead of recognizing we need to cut our own farm subsidize cotton sigh dis, we are sub subsidizing our partners. >> host: caller from florida.

>> caller: good morning. i worked my job for 20 years and lost my job in mai -- may. it was in construction. i've been looking for a job for over two and a half years, i worked for temp agencies that was no money. i have found a seasonal part time job making $7.50 an hour and i make $45 a week compared to my $700 salary. i'm disappointed. the thing frustrating me is a couple things. i would have had a good job in may of last year, but i have bad credit, so the employer didn't hire me because of my bad credit and companies turn me down because of my bad credit, not because they didn't want me.

the thing that's frustrating to me is the amount of products that are now made in china. i think i was watching c-span the other day, and i saw senator, i think from north dakota, talking about the etch-sketch company and how the great retailer of america demand that company close down in ohio and move to china. my mother-in-law gave me $20 and i got a new pair of shoes, and i went to the mall, look for me a pair of shoes, and everything is made in china or india. i said forget it. i'm going to do my best not to by those products. i hope when you go back to work in january, don't get bogged down in repealing obamacare. i beg you, get some jobs here. middle class is gone. >> host: all right. >> caller: thanks to the caller

from florida. i'm from arizona, and we felt the housing crisis substantially. i think the best thing congress can do is try to get the economy back on track, and by saying that, i'm not suggesting that congress create jobs. our job is simply to create an environment in which jobs can be created, and to do that, we have to have a tax and regulatory environment that is conducive to the creation of jobs. with regard to the export of jobs, part of the reason is we have a corporate tax rate that is very high, second highest in the world. it makes it easy for companies to locate elsewhere. that's one the issues we have in congress that we need a good tax and regulatory environment, and that stops, i think, by stopping the overspending because we cannot continue with this debt and deficit or else pretty soon, we'll be paying virtually everything, all the revenue that comes in pays to service the national debt.

>> host: congressman, thank you for talking to oh viewers. -- our viewers. appreciate it. a look at u.s. capitol in washington. the house is working on 20 bills and resolutions, and you can watch that on c-span. charlescharles rangel was found guilty on 13 viemtions and next is the appropriate punishments for rangel and charms rangel represented his harlem district in new york for 40 years and is not expected to resign, but he had to step down last month as chairman of the weighs and means committee.

>> now british prime minister, david cameron, on foreign policy. he described britain as a leading world power and said that tackling the country's

budget deficit would lead to greater british influence in global politics. this is about 40 minutes. ♪ ♪ >> the queen. ♪ ♪ ♪

♪ >> the queen. [inaudible conversations] [inaudible conversations] ♪ ♪ >> prince phillip, the prince of

wales, cornewall, and other members of the royal family. ♪ ♪ >> the royal family. [inaudible conversations] [inaudible conversations]

[inaudible conversations] ♪ ♪ ♪ >> silence for the right honorable, the lord mayor.

[applause] >> my late lord mayor, you're great chancellor, prime minister, mr. speaker, your exlen sighs, my lords, chief commoner, ladies and gentlemen, on behalf of our two sheriffs and their consoles, the lady and i welcome you all to the ball. prime minister, it is a particular pleasure to welcome you and mrs. cameron. thank you for joining us for your first time as prime minister. [applause] we gather here tonight in this remarkable symbol of the city, guild hall, the hall of history, a place of commerce and

cooperation. next year, we will celebrate the 600 anniversary of the present building, the third to stand on this site. guild honors the city's men and women, people of all backgrounds and classes who have dared and dreams, worked and struggled to help provide for their families, and to build a great nation. it is a site of living history in one of the most powerful symbols of our country. we gather here as part of the passage of responsibility from one lord mayor to the next, a prime process that extends back to 1189, and the 683rd time that the articles of this great and ancient office have been exchanged. tonight's dinner is an honor of the late lord mayor. he has left a legacy of contributions, especially through his actions to increase commerce and trade between the

city and other countries. he has also been a champion of philanthropy helping numerous organizations especially through his pitch-perfect initiative. his wife, claire, has been a model lady supporting the lord mayor and so many in her own right. [applause] it is my happy duty to remind this gathering of the late lord mayor's achievement, one of which which was running the london marathon. [laughter] i can faintly say, that is an achievement this lord mayor will not be repeating. [laughter] [applause] on behalf of my wife, barbara, and myself, and behalf of the civic and business committee,

citizens of london, and everyone here, many thanks to the late lord mayor for a job well done. [applause] the late lord mayor often spoke of preparing for the future. one year ago in his speech before you, he asked that we undertake a long term vision for the city mindful that our task is to get the right balance between looking at the problems of the past and finding a way to solve those that we face in the future. i agree. the city must settle for nothing less than the great and sustainable future. we are world leaders in culture, commerce, industry, education, and innovation. we must continue to outtrain and explain our visions for the future to embrace and shape that future, to make this our time of

achievement and progress. our choices now, right now, will drive the city forward, and that is why my theme as lord mayor will be city of the london, city of choice. the keyword is choice. i want the world to choose london. i want investors to look to the city. i want our workers to have choices, and i want those in need to have choices too. we have the best possible opportunity to showcase the city at the down of the 2012 olympics. the world will be watching. london will be on display. about 3 billion people, half the world's population will watch on television or on the internet. the world will see london as never before, and we must make sure the world sees us at our best, creative and organized,

welcoming and tolerant. the world with see a multiculture and a model of progress and decent sigh, social justice and political decorum and see a city of financial stability with an exciting future open for investment, and a city that meets its obligations to those in need. frankly, in the financial markets, the world is already watching, looking to the city of london to leadership and stability, reassurance, and responsibility, transparency in the highest levels. we have just survived the shattering shock of a worldwide recession. it has been difficult. during this tush lance, there's some who predicted a slow, agonizing death for the city claiming that we have been overtaken by our competitors.

these are victories of premature and are also wrong. this is a city that has a strong and steady heart beat. the financial markets are healthy, our workers are among the best in the world, reliable, productive, and well-trained. we have vision ri and dynamic leadership throughout the city. this is a city that is energetic and hard at work 24 hours a day. we know the city continues to provide national and international leadership. it contributes 60 billion pounds each year, 60 billion pounds that pays for schools, roads, and more. in the difficult year of 2009, net exports of u.k. financial services were the second highest covering 50% of the cost of imported goods from abroad, 41 billion pounds. exports will be to our continued

recovery, a recovery depending on trade and investments, and it is a city that will fund this trade and invest. . the city can do all of this and more. we have the right products to meet our present challenges. we lead the world in insurance, sustainable finance, carbon savings, safe derivatives, public and private partnerships, foreign exchange, and more, and prime minister, you see, our great strength in guild hall tonight, the men and women who are the city, who gave the city its life, its birth, and its resilience. together, we can influence the history of our future. for example, we can resurrect places like old fields markets, places of history that can make history again by providing opportunities, jobs, and hope. fields market was once silent,

but now it's a vibrant place where people gather, where trades people make a living, where children play and voices carry. we have made a neighborhood and a community. this is happen anywhere in london. we must dream large and cast aside skepticism. one way to do this is through renewed and better infrastructure. we must do more to maintain and improve our city's infrastructure. that is a perennial challenge. commerce flows into the city and out, through the arches of our roads and roadways, trains a airports. a city is determined by infrastructure, and we must remember that infrastructure pays for itself. one pound spent on construction brings two pounds back into the economy, 92% of which is spent

in the u.k.. infrastructure is more than an investment, but an engine of economic and social change, and prime minister, that is where we are delighted that the government's decision to give the go ahead to cross rail and for the continuing upgrade of the tube. [applause] the city can also lead the world in environmental responsibility. our economic growth, if responsible and ecofriendly, can be a model for the world. we must be vigilant, always ecoconscious, and environmentally aware. if we do this, we will create jobs, good jobs, and in doing so, we help to save our planet. london must be a leader in green technology and in environmentally friendly

practices. this is our chance to be creative, and maybe we can be a bit old fashioned too. i hope that some of you wrote a bike here tonight. [laughter] those two wheels are more than transportation. they are a message and a symbol of our care for the environment. prime minister, we have much to do. we face demanding challenges in a rapidly changing world. the challenges are real, the city must be more attractive for investors. we must create the right conditions for the startup and new enterprises. we must convince global businesses to locate here, and we must find the right balance in regulation. we need to find the right mix of predictability, stability, and competitiveness in taxation, and we have to build a sound, prudent, and constructive

working relationship with brussels and the g20 ensuring that our partners honor their commitment as this country is doing, otherwise the we're losing our competitive edge. as an engineer, we must build solid and lasting bridges in the world. if immigration is to be capped, we have to find a way for the city's international firm to bring in the talent they need. we must not reach a tipping point where the u.k.'s well-established businesses find the perceived or actual risks drive them out. that would be a tragedy for the u.k. and for the world. we have to be aware of those who are left behind in our society. a stronger economy will provide more opportunities for people living on the margin, and i applaud you, prime minister, and the coalition government for your vision of the big society. this is in tune with our

electricity companies that touch the lives of million every year providing support for the young, the old, the disabled, our superbed armed forces and cadets. they play its part in creating sustainable community and supporting those in need. for example, through its chapterble arm in the city bridge trust and by establishing and supporting academies. this is a good record, but is it enough? my challenge to the city is to ask what more we can do. the private sector has an increasingly important role to play especially at this time, and one way to help is through charitable peels like one called bear necessities. [laughter] [applause]

building better lives, yet, i think, i rather like the name. [laughter] you probably saw the large bear in the lord mayor's show. this appeal will principally support two charities supporting disadvantaged youngsters, and people affected by natural disasters around the world. it is one way to help, and for me, charity appeals are a vital part of my work as lord mayor as with the late lord mayor. it is work for us all if we choose to make a difference. this is a time of choice and a time of choosing. choices about our city, our economy, and our environment, e enormous challenges, let us make a powerful positive profound difference in the coming year together. thank you.

[applause] [applause] and now, it gives me great pleasure to invite everybody to rise and drink a toast to her majesty's judges. ministers, sorry. [laughter] her majesty's ministers. [applause]

[inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] ♪ ♪ ♪

♪ >> silence for the prime minister. [applause] >> my lord mayor, my late lord mayor, your grace, lord chancellor, mr. speaker, your excellent sighs, my lord, sheriffs, chief commissioner, ladies and gentlemen, can i first of all, thank you, lord mayor, for that welcome. samantha asked me tonight as we were getting changed and my son was saying why are you once again dressing up as a peguin,

daddy? [laughter] she asked what tonight's dinner would be like. i said i don't know, i have haven't been to one before, but i've seen the plan, and i can tell you you'll be seating next to someone in an even more glamorous outfit than your own. show -- i think she was expecting mary campbell, but instead she got kenneth clark. [laughter] [applause] lord mayor, like me, you are something of a new arrival, i just hope your arrival into office was slightly smoother than mine. [laughter] my abiding memory of those five days in may was the very last day when there was something of a rush to get to buckingham

palace, and after i left having seen her majesty, i was desperately trying to remember the words i wanted to say on the steps of number 10 downing street, but just at that moment, but mobile phone rang, and an ancient relative on the other line said, i've been watching the telly darling, and i wanted to chat. [laughter] now, i've just come back from visiting two of the fastest growing economies in the world, china with average growth of nearly 10% a year for the last three decades, and korea, which in 1960 had a gdp only twice that of disam bee ya -- zambia, but today has a gdp40

times higher. i was in seoul bringing together not only the u.s. and china, but brazil and africa and they provide good vantage points to reflect on the huge changes sweeping our world. the rise of new great powers, the shifting balance of economic power, and the tensions of globalization. this interconnected world, the world of resless -- restless markets so well-represented here in this room tonight is creating huge new opportunities for the countries that are able to seize them, but this very same interconnectedness is creating new and more diverse threats to our security. the device found on a plane at the east midlands airport which we now know was a viable and dangerous bomb originated in the

yemen and was carried to the uae to germany, on to britain, on route to america. today, threats originating in one part of the world become threats in all parts of the world. as you are only aware in the city, the threat from cyberattacks as increased exponentially over the last decade. with the last year alone accounting for more than half of all malicious software threats that have ever been identified. all of this shows how fast our world is changing, how much brit dan's -- britain's interest depends on the interest of others, and why we need to maintain a global foreign policy because our national entererses are affected more than ever by events well beyond our own shores. now, our national interest is easily defined. it is to ensure our future prosperity, and to keep our country safe in the years

ahead. the key question is how do we best advance this national interest with the threats and opportunities are evolving so fast before our eyes? now, there are some who say that britain is embarked on an inevidenceble path of decline, that the rise of new economic powers is the end of britain's influence in the world, that we are on some vast 0-sum game on which we are bound to lose out. i want to take that argument head on. britain remains a great economic power. show me a city in the world with stronger credentials than the city of london. show me another gathering with the same lineup of financial, legal, accounting, communications, and other professional expertise. you know even better than me that britain is a great trading force in the world. whenever i meet foreign leaders, they do not see a britain

shuffling across the world stage. on the contrary. they respect our determination to get our economic house in order so we can remain masters of our nation's destiny. they can see the immense advantages of doing business with britain. we're already ranked first in europe for the ease of doing business, and we intend to become the first in the world. we're cutting our corporation tax to 24%, the lowest in the g7, creating one the most effective corporate tax regimes in the country, cutting the times it takes to create a new business, and cutting the red tape on regulation that has held us back for too long. there is no reason why the rise of new economic powers should lead to a loss of british influence in the world, and neither is there any reason why our military power should be diminished. we are the fourth largest

defense budget in the world, and we rain -- remain one of a few countries with the means to deploy serious military force around the world. on the day after remembrance sunday, i know everyone in this room wants to pay tribute to all of those who have served and continue to serve our country. [applause] in terms of our role in the world, the truth is that many other countries would envy the cards we hold, not only the hard power of our military, but our unique other assets contributing to our political weight in the world, our language, the time zone, world class yiewn verities, the impact around the

world of the bbc and greatest counsel and museums, a civil service and dip 3459ic -- diplomatic service that admire the world over. one in ten of our citizens live permanently overseas reflecting our long tradition of an outward fashioning -- facing nation who is instinct to be self-confident and active beyond our shores is in our dna. we sit at the heart of the world's most powerful institutions from the g8 to the g20, nato, the commonwealth, and the u.n. security counsel. we have a deep and close relationship with america. we are strong and active members of the european union, the gait way to the largest single market. few countries on earth have this powerful combination of assets, and even fewer have the ability to make the best use of them. what i've seen in my first six

months is a britain at the center of all the big discussions. i reject this thesis of decline. i firmly believe this open, network world plays to britain's strengths, but these vast changes in the world do mean that we do constantly have to adapt. let me turn to -- we are to sort out the economy to carry weight in the world. economic weakness at home translates to political weakness abroad. economic strength restores our respect in the world and our national self-confidence. the faster we get our domestic house in order, the more substantial and credible our international impact is going to be. we also have to be more strategic and hard-headed about how we go about advancing our national interests. in recent years, we've made too many commitments without the resources to back them up, and we've failed to think properly

across government about what we were getting ourselves into, and how we would see it through to success. in a rock, there was no plan for winning the peace. in afghanistan, we failed to think through properly the implications of the decisions to deploy into the helmand province in the summer of 2006. as a new government, we should learn the lessons and make changes. i'm not sunlighting that we turn -- i'm not suggesting we turn the foreign policy on its head. as leader of the opposition, i made it clear to foreign leaders, there was a great deal of commonground between the policies of the government and the opposition. we want an active foreign policy that supports democracy and human rights as we have been in arguing for the release and the rights of the burmese people, and it was a fantastic sight over the weekend to see that

wonderful woman freed. [applause] we want a foreign policy vigorous in efforts to address climate change which poses such a threat to humanity and only dealt with by nations coming to the. we will continue to build our special relationship with america. it is not just special, it is crucial because it is based on solid and practical foundations such as our cooperation on defense, counterterrorism, and intelligence, but in other areas where we believe that britain's interests require a change of course, we should lose no time at all in adjusting the national tiller accordingly. i want to highlight three areas this evening. first, we must link our economy up with the fastest froing parts of the world -- growing parts of the world placing our commercial interest

at the heart of foreign policy. second, we need a more hard-headed approach to our national security and apply that to our mission in afghanistan. third, we must focus more of our aid budget on building security and preventing conflict. let me take each in turn. first, a more commercial foreign policy. this is not just about making britain an attractive place to invest. it's about selling britain to the world too. some people think it is somehow grubby to mix money and diplomacy. i say, when it is harder than ever for this country to earn a living, we need to mobilize all of the resources that we can. today, we trade more with the netherlands than with brazil, russia, china, and turkey combined. we are not making nearly enough of the opportunities out there. that's why one the first visits i made was to india, the second

fastestest major growing economy in the world. i've been to turkey that is growing at 11% this year, and just last week i took one of the biggest high powered delegations to china. next year i plan to visit brazil and russia and rebuild relationships with the countries in the gulf. they feel strong links with britain, but felt sidelined in recent years. i'm delighted the majesty the queen visits uae next month and i'll visit next year. this is not just what the ministers or i do. it's about what our ambassadors, dim plo mats, hard working staff, and what they do day in and day out in every country in the world. i have told them every time anyone representing britain meets a foreign counterpart for however short of time, i want them walking into that room armed with a list of things they

are there to deliver for our country. others do this, we should too, and when it comes to the european union, we have shown in recent months how we are constructive and firm partners using our membership of the eu, and i can promise you this, we can stand up at each and every turn for our financial services industry and the city of london. london is europe's financial center, and with this government, i'm determined it will remain so. [applause] >> next, bringing a more strategic approach on defending our national security. we set up for the first time a national security counsel which met on the first day of the government and has met weekly ever since. foreign policy, defense policy,

domestic policy, development policy, all the decision makers, not pursuing desperate missions in different departments, but sitting around a table together asking what is best for britain and working out how to gear up the government machine to deliver it for our national security. our first priority is to set a clear direction for our military and civilian mission in afghanistan. the fact remains that we are still the second largest contributor to the nato led force with 10,000 troops there, most in the most difficult part of the country. we are not there to build a perfect democracy, still less a model society. we are there to help afghans take control of their security and ensure that al-qaeda can never again pose a threat to us from afghan soil, a hard-headed time-limited approach based squirely on the national interests. in august, we transferred

british forces to enable them to concentrate in greater numbers in central helmand where the bulk of the population lives and share with the u.s. forces across the province as a whole. i've said our combat forces will be out of afghanistan by 2015. we also have concluded a truly strategic review of our aspects on security and defense. this was long overdue. it has been 12 years and four wars since the last defense review. we started with a detailed audience of our national security. we took a clear view of the risks we faced, and we set priorities including a new focus on meeting unconventional threats from terrorism and cyberattacks. we looked at the capabilities we need to deal with tomorrow's threats. yes, we made tough choices and had to given the mess we have.

we've ensured that our mag nigh acceptability armed forces have the kits they need for the threats they face whether today in afghanistan or in the world of 2020. we will be one of the few countries able to deploy a fully equipped brigade sized force anywhere in the world. with the joint strike fighter and typhoon, the royal air force has the most capable aircraft money can buy backed by a tanker . they have a new aircraft carrier, new type 45 destroyers, and seven new nuclear powered honda killer submarines, the best in the world, and we have an insurance policy in the age of uncertainty. my determination is britain will have some of the most modern and flexible armed forces in the world, but our security does not depend on our military forces alone, that's why we've also given priority to investment in

our counterterrorism capacity and new programs to prove our resilience against cyberattack and assuring our world leading intelligence agencies are able to maintain their brilliant work in disrupting threats and in keeping our country safe. there's one more area where despite the economic pressures we face, this new government has been determined to hold firm. our commitment to spend .7% of our gdp on aide by 2013. we will meet that target and for good reasons. our aide program like the activities of the myriad of charitable aide organizations literally saves thousands of lives. it helps prevent conflict which is why we doubled the amount of our aide budget that's spent on security programs in countries like pakistan and somalia, and for millions of people, our aide program is the most visible example of britain's global

reach. it is a powerful instrument of our foreign policy and profoundly in our national interests. that being, pursuit of the our national interest has been at the heart of everything i've said this evening. our foreign policy is one of hard-headed internationalism. more commercial in enabling britain to earn its way in the world, more strategic in the focus in meeting the new and emerging threats to our national security, and i'm firmly committed to upholding our values, defending britain's moral authority even in the most difficult of circumstances. above all, our foreign policy is more hard-headed in this respect. it will focus like a laser on defending and advancing britain's national interests. now, that concept of national interest is, of course, as old as our nation itself, and i'm conscious of the many prime ministers who have stood here

before me and set out britain's national interests as they saw it. many watch con -- would have confronted circumstances more perilous than those facing great britain today, but few perhaps would have dealt with a world that is changing so fast from beijing to seoul and washington, leaders must work out what it all means for their countries and where their national interests lie. when some people look at the world today, they are quick to prophesy dark times ahead, difficulties for britain, our foreign policy runs counter to that pessimism. we have the resources, commercial, military, and cultural to remain a major player in the world. we have the relationships with the most established powers and the fastest growing nations that can benefit our economy, and we have the values, national values that sweat slavery from the seas, stood up to fascism and

communism, and help spread human rights around the planet, that will drive us to do good around the world. with these strengths, we can drive prosperity, we can increase our security, we can maintain our integrity. we are choosing ambition, far from shrinking back, britain is reaching out, and far from looking back starry eyed on a past, this country is look forward clear eyed to a great future. thank you. [applause] [applause] some political news for you. on alaska still undecided senate race, senator lisa is holding a lead as election workers prepare to count more write-in ballot.

888 ballots tallied today and yesterday officials said lisa emerges from several days of county with a 1700 vote lead over the nominee. as many as 600 more ballots from oversea and military addresses could be submitted by a wednesday deadline. the state plans to count those on friday. that's from the associated press.

take responsibility to ensure the implementation of the referendum when. the united states has already taken steps to demonstrate the

commitment to improving u.s. sudanese relations. we've changed our policies to agricultural to sudan and supported the creation of the work on ways to ease sudan's national debt consistent with international debt relief practices. as the secretary says amsterdam fulfills we are prepared to do more and if saddam permits to a peaceful resolution take steps to the peace and accountability we are prepared to offer saddam a tough with u.s. sanctions. the secretary just touched down at andrews and this afternoon she will meet with austria and the foreign minister michael. we expect they will talk about eight range of subjects including austria continued contributions to peacekeeping missions. our efforts at stabilization and reform in the balkans and the importance of police trainers to the mission in afghanistan.

this evening the secretary will welcome to washington foreign minister william hague. they saw each other this morning in new york as well, and he will have bilateral with the secretary to mauro here at the department where i expect they will talk about ongoing efforts in afghanistan updating the situation in the middle east, continuing concerns about iran's nuclear program, our mutual efforts regarding iran -- i'm sorry, regarding sudan and preparations for the summit later this week and was then -- and lisbon. >> [inaudible] >> we love with things your the department of state and seeing another one next year. turning to leave russia today we mark with sadness the one-year anniversary of the death of a russian lawyer survey who died of apparent medical neglect in

pre-trial detention it to prison. while we welcome the support of judicial reform and the rule of law we note with regret that no one has been charged in connection with this case despite justice ministry investigation the united states continues to call for the russian authorities to prosecute all responsible for his death and protect the rights of all including those in prison. turning to her guinea obviously we've seen the provisional announcement that names the doctor as the winner of the recent second round of presidential elections. and it is our understanding that rival candidate plans to the result and we encourage and to register the results with the supreme court. we encourage both urged their

supporters to remain calm and allow the court to evaluate any irregularities. and finally, united states remains gravely concerned about iran's continued harassment, detention and imprisonment of human rights defenders. for example, we understand the trial of human rights lawyer is reportedly under way but is proceeding without transparency and due process guarantee under the iranian law. the leaders should know the efforts to silence the iranians to stand up for the rights of their fellow citizens does not go unnoticed. we once again join the international community calling for the immediate release of all political prisoners including those in prison for the defending detainee's or speaking out against human rights abuses and urged iran to afford its citizens those rights that are universal to all people. >> do you have any response,

reaction to senator kyle's statement that he doesn't think that s.t.a.r.t. shouldn't be voted on in the lame-duck session? >> remains president obama's believe that the new s.t.a.r.t. treaties and our national interest. and we believe it should be voted upon in this lame-duck session. we have engaged samet terse for many months over the details of the treaty. we believe would answer all their questions. we have addressed their concerns including senator kyl about ensuring that there is an effective modernization program as a companion to the new s.t.a.r.t. treaty and we will continue our dialogue with the senate, but it is our firm view that the s.t.a.r.t. treaty should be ratified while congress is in session or the senate is in session. >> are you disappointed or surprised at the comment?

>> we've engaged senator kyl and others in good faith and will continue to do so with our message is that the s.t.a.r.t. treaty should be ratified now. >> are there any plans for the secretary or anyone to speak to senator kyl about this or -- >> the secretary had a conversation with senator kyl last week along with vice president biden, and i will defer the white house but i would expect we would have further discussions with senator kyl and others. >> did you understand with the meeting after biden and the secretary that senator kyl might not take the position that he's taking now? >> by all accounts it seems the administration has been a bit sandbagged. he thought senator, would go along and now -- >> we believe we have to address his concerns. we negotiated good faith. we believe we've put forth a kind of package that ensures

that we will have a strong nuclear deterrent going forward, and we will continue these discussions with, you know, all of the 100 senators who will have the opportunity to vote on the treaty. >> are you willing to consider amendments to it? >> well, we have addressed all of the questions senators have had. we've made clear, many have questioned whether the new s.t.a.r.t. treaty in any way inhibits us from developing a missile defense capability. psychiatry gates come secretary clinton, others have assured senators that that is not the case. we believe that this treaty is in our national interest. we will continue these discussions including with senator kyl, and we believe that the end of the day the treaty should be ratified. >> i will ask when you say that you've addressed the question is

it your view that you have addressed them to their satisfaction? >> we will continue to the extent senator kyl still has concerns we will be willing to continue, you know, to engage with him and assure him that we believe that we have satisfactorily answered his questions, address his concerns and put forward a combination of actions that can assure our security will be protected and that the s.t.a.r.t. treaty is definitely in our national interest. >> can you confirm reports the administration might have additional $1.4 billion to help modernize the nuclear arsenal? >> i will be for those kind of details to the white house. >> on the same category, the victor boots to the united states -- >> sort of on the same category? [laughter] [inaudible] >> a lot of people in russia are angry and frustrated at this

decision, some say that this could get in the way of the reset relations between the u.s. and russia. your reaction to that? >> we have -- russia is guided by our mutual national interest, but national interest overlap and we understand on a number of issues, you know, we agree to disagree sometimes, so we have tensions that crop up periodically and we work to manage those. i don't expect that this will have any impact on our relationship -- >> but they say this is the u.s. bullying thailand and that this moves against the law. >> it is fully consistent with both our bilateral treaty obligations with thailand and fully consistent with international law. >> has the case come up at all with the meeting the secure had

with lavrov? >> rest assured -- i can't say whether it came up in that meeting. we are aware of how the russian government feels about this. >> and so they have spoken to you today directly? >> i don't know if they've spoken to us today, but, you know, they have spoken to us on this issue. >> change of subject. they've been waiting for a proposal to discuss the settlement. have you sent them this proposal? spec i missed the first one. >> they've been waiting for the lisbon proposal from the u.s.. >> i'm not going to get into specifics as to where we are. we are trying to encourage both sides to get into negotiations. as the secretary said yesterday, that is unacceptable. we want to get them back to

negotiations. we still believe that an agreement can be reached within the 12 months period the secretary of land back in august, but in order to get to the agreement we have to get them back into negotiations but i'm not going to get a play-by-play figure. >> on the government to blame the palestinian authority for promoting the to the pri minister and netanyahu. >> our efforts are to get both parties back into direct negotiations as soon as possible we are engaged with the israelis. we've been engaged with the palestinians. our message to both is the same, to get back to my direct negotiations, work to the issues and get to a just, fair and equitable settlement and an agreement within 12 months. >> without getting into the

specifics of what is being proposed, is it correct that the israelis had asked for a written proposal? >> i am not going to talk -- >> [inaudible] >> and stand -- i understand -- >> are you prepared to give a piece of paper to outline -- >> we are prepared to do everything we can to create the conditions for both palestinians, the israelis to have confidence to return to direct negotiations. >> including giving the israelis sometimes -- >> i am not going to do a play-by-play -- >> look, the israelis have come out and said they are not willing to vote on this tomorrow because they are waiting for a written proposal. i fail to see how it would affect the negotiations, and you say that is, you're going to consider giving them something in writing. >> we will continue to work with israel to address what it sees as its legitimate process. we will continue to engage with the palestinians and address the

palestinians process. we want to get them back to the negotiations. we are trying to create the conditions to do that. again, as to where we are today, where we might be tomorrow, we have not talked about the substance of this and will not. >> i guess i just don't understand how -- >> whether you are willing to write something down on a piece of paper is and substance -- is not a question about the substance. >> i'm not asking what the words are that are going to be on a piece of paper and might be on a piece of paper. i am just asking if you are willing to give them something written down. >> we will do everything that we can to encourage the parties to get back into the negotiations. >> let me try from a totally different angle. do you think you can do that without [inaudible] [laughter]

>> it's a very good question. >> [inaudible] canceled appearances to talk about -- >> yes, and we apologize for that, although i believe that actually in about a half-hour's type the reason we canceled the to briefings -- first of all, it was because his first briefing would have overlapped with the secretary at -- and her intervention in new york and as we found out at the start of the day the white house is actually doing a call i believe that 2:45, and since the secretaries schedule and the present schedule is significantly overlap, we will defer to our colleagues of the white house. >> for the lisbon summit my question is as your administration heard assurances from turkey that they are going forward with the missile?

>> i will defer to the white house call at 2:45 to go through preparations for lisbon. obviously, you know, missile defense is one of the areas where we have talked within the alliance in anticipation of liz been >> there is a report on u.s. economic and security -- u.s.-china economic and security commission that says on april 8th for a brief period, 15% of the world's internet was routed, rerouted through chinese servers, chinese internet servers and that the .gov web sites were affected by this. have you seen this report and, you know, what's your reaction to it? does the u.s. have an effective silo to this event? >> it's a better question to ask the department of homeland security. >> has there been a dialogue with china on this, in particular are you pressuring in

any way to offer some answers here -- >> let me see what i can find out. i don't -- i'm not up to speed on that. >> [inaudible] for just one second. you said that -- i'm not asking about a piece of paper, don't worry. you said that you still think that you can meet the secretaries timeline of 12 months. but that is a different story than use it yesterday which is -- >> no, i don't know that it was a different story. i thought i said yesterday that our goal remains an agreement in 12 months, and that remains our goal. is there a guarantee of success? there's not. and would ultimately be of to the parties to make the difficult decisions to get to an agreement. but our goal, had we seen some of the coverage overnight, our goal remains 12 months.

>> ten months. >> nine months. [laughter] samir. >> [inaudible] taking charge now instead of senator mitchell and the efforts on israel and the palestinians? >> well, we have the luxury of a very deep, high level bench when it comes to these issues. you know, starting with the president of the united states, we have made a commitment to pursue a comprehensive middle east peace on day to of the administration by naming george mitchell was a special envoy. the president has been deeply engaged. the secretary has been deeply engaged. we have george mitchell and others, so we have assembled an all-star team and we are putting on a full press to get the parties into -- >> [inaudible] [laughter]

>> [inaudible] >> we expect to score major points in the next nine months. [laughter] >> but, you know, obviously the secretary spent several hours with prime minister netanyahu last week and she will be personally and deeply engaged in this. but we update the region today as we speak and others, so you know, there is just it demonstrates how the ongoing commitment to proceed with a comprehensive peace, and it really does require more in one player to get the parties across the finish line. >> what is david doing? >> i can't -- i don't know that the fed has had any specific meetings at this point but he's in the region and i would anticipate he will be in touch

with the parties in the coming days. >> about what? >> about the -- >> [inaudible] >> about the topics under discussion in a variety of formats. >> so who is he going to meet with? >> again, david -- i talked to david this morning and -- too the palestinians or under the impression he is going to meet with them tomorrow; is that correct? >> that is a possibility, yes. >> and what he also had a meeting with the israelis? >> david frequently connects with both sides while he's in the region. but again, as stated has meetings i will leave them out for you paid >> to what end? are you hoping that his meetings will result in the israeli freeze and the palestinians?

is that the goal? >> we want the israelis and the palestinians to return to direct negotiations, and we are engaged with both sides to encourage them to do that. we will continue that engagement, and we will continue that encouragement. >> c2 >> please. [laughter] >> [inaudible] psychiatry powell's criticisms of the president, government policies and pakistan and afghanistan? >> you'll have to help me. i haven't seen -- >> he told one of the main channels yesterday that our support to pakistan is inadequate, he used the word, and also -- and he said that the u.s. should give money to the chief of pakistan's military.

i don't understand why the u.s. should give to the -- >> i'm reluctant to comment on a report that i have not seen. we have significantly expanded our assistance to pakistan. we have continued very robust military and security assistance and we have augmented that with very significant assistance to strengthen pakistan's civilian institutions and help pakistan expand its economy. and we will continue to do everything that we can to help pakistan advance. we think we have a very robust combination of civilians and security assistance to pakistan that is helping pakistan deal with a lottery significant threat that is to pakistan and the united states.

>> should we wait for later in the day because the second is that bin laden is still at large because the u.s. army hasn't caught. >> i'm not sure is there a question there? >> his as it is because we haven't caught him. >> that would be true. [laughter] >> how do you take it? do you know where he is and letting [inaudible] >> we continue our hunter for and interest in capturing mr. bin laden. >> i want to take you to latin america. the question is concerned argentina. the argentine announced is going to negotiate a step with [inaudible] , something that the department of state several times requested the country to do.

i would like to know if you have any comment on that, if you are happy with that -- >> start again. >> the argentina and firemen said once again that it's going to negotiate its status the group of paris. something that the department of state several times requested the country to do, the environment to do, and so i would like to ask you if you have a comment on that -- >> let me take the question. i just not up to speed with where we stand on respect with argentina and paris. >> okay. >> can you talk about a certain case involving a lawyer who's been put on trial in a human rights violation has been released in burma sort of encourage the administration to be a little more outspoken on human rights in iran in addition to other places?

>> well, i don't know that they are connected. we have spoken out about our concerns about civil society and human rights in iran on a number of occasions, particularly coming you know, since last year's elections and the government's heavy-handed response in the aftermath. we have spoken out repeatedly about human-rights in burma and on the case. we speak about human rights and other countries as well. so, it is part of the priority and emphasis that we put on that issue anywhere around the world. >> at the general assembly of new york right now on human rights in iran there is a 38 countries. would you happen to know which country or how many countries initiative that draft resolution? >> i do not. >> [inaudible] >> i'm sorry. charlie. >> i just want to know if you have an update in terms of haiti

[inaudible] yesterday and about what is going on today, but the u.n. forces and people attacking them. >> i don't -- i don't have an update. i think the situation has calmed over night. clearly concerns are on the rise. frustrations are on the rise. we understand that. the number of, you know, cases continues to rise, the number of hospitalizations continues to rise and tragically the number of deaths has crossed over 1,000 because of the cholera outbreak. we continue to work extensively with the government of haiti in the last day. the center for disease control has launched a training program to expand the number of people that can provide significant assistance to the people of haiti and help them understand the steps they can take in terms

of personal hygiene, treatment of water and so forth, which are essential to a resting the cholera outbreak. there's also an aggressive public information campaign to help the people of haiti understand what they need to do and where they can go for assistance, and in the meantime we continue to bring to haiti the kind of simple but effective measures. hygiene kits, soap, washing bins, rehydration kits, the kind of things that can help us help the people of haiti treat the symptoms of this outbreak.

>> [inaudible] clashes between u.n. forces and -- >> i saw that there is obviously an investigation going on to try to determine the source of the outbreak, and as far as i know that investigation is ongoing and has not reached any conclusions. >> have there been a number of clashes with the american troops and the population of western [inaudible] so far the information about [inaudible] i would like to know if you have any specific decisions about the issue that is going to be discussed today in the u.n. security council and also the fact the clashes are raising tensions -- >> sure. and as i recall, the u.n. envoy will be reporting to date to the security council on his recent findings. we are concerned about violent

clashes, but that is also why we continue to support the u.n. process to try to mediate the situation in western sahara. >> [inaudible] against spain instigating the result to the stomach again, we look forward to hearing the envoy's report and we do support the u.n. process. >> okay. >> [inaudible] >> what are you asking about now? [laughter] >> as the administration still think it is important to sign the cgt and the non-proliferation treaty? >> or much less a sign and ratify? >> let me take that question. we support ctbt and dandridge pakistan to sign on to the material cost regime but i will get you a specific --

>> specifically on ctbt in india and non-proliferation treaty which it refuses to sign countries with the position is and what hasn't changed which is you do want them to sign how you can reconcile that with india becoming a permanent member of the u.n. security council. >> okay. well -- we don't see those as being at odds. >> you don't? and you think of india has the same, given the president's interest in the nonproliferation it moving nuclear weapons from the world, you think that india has an equal -- but it's candy should be looking at with japan that is much more [inaudible] >> india has shown itself to be a responsible global stakeholder and the president announce our position on india's membership and the security council and our

support for india is not exclusive of our support for other countries as well. but i will take that. >> it will no longer be the administration policy want them to sign on to these treaties because of the agreement they reach for the nuclear supply. >> we are supportive of the country into a test ban treaty this been a get my last one is there any update on the p5 plus one? >> i checked this morning and they are still waiting for the response. >> the world affairs council of america hosted its national conference in washington, d.c. on global health where we will hear from the director of the national institute of allergy and infectious disease. moderating this panel is brenda wilson former science editor and correspondent. this is about an hour.

[applause] >> this is going to be interesting coming after the last recession to sleep somewhere else and the big question i suppose is going to be on everyone's mind is the ability of the american public to somehow i think beyond their borders think of people who we don't see all the time that we care about. prior to this administration coming we had one of the biggest and the greatest i suppose steps taken towards addressing global health that has happened in years and that is considered one of the maine legacies of president george bush which was his proposal of treatment with hiv. we know that millions of people, we have known for some time

33 million people now are infected with hiv, and president bush, but as a way of counterbalancing our policy and iraq, proposed that we provide it to $15 billion over five years from 2003 and on into the treatment of people with hiv in 15 countries some $25 billion leader you have to imagine at the time this was riposte we were talking about hundreds of millions of dollars going to hiv/aids not much more than that. now we are led to, you know, around to an administration that is proposing 9.6 billion. the main one being hiv and aids under the initiative started by president george bush which is the presidency emergency plan for aids relief.

now is part of an umbrella group of programs called the global health initiative. president obama said he's going to start changing the way we do business. it's clear we are coming up against some notion of the finite, and the question is how we are going to -- the problems have grown even with the funding so the question is going to be how we are going to deal with a supposed problems we haven't began to define when president bush, you know, proposed the presidency emergency plan for aids relief. i'm going to start with dr. anthony fauci who was part of the group who met in the administration of president george bush to create the president's plan for aids relief. what did we learn from that? we are now up to 33 million

people infected with hiv. what are the lessons that have come out of that and can we continue treating people? we are now up to about 4 million people in africa and around the world being treated even though it's understood that 83 times as many need treatment. >> several things were warned by that experience and by the actual implementation of the truly transforming program and that is we shouldn't assume the way some people literally on the week cannot deliver rather complicated health care implementation to people in the developing world, namely getting them to get tested and get drugs used to virtually every single day. so it wasn't only proven concept

but it was actually something that has been implemented very well and the numbers are extraordinary. the program is responsible right now for about 2.5 million close to a million babies saved by the blocking of mother to child transmission. 10 million people who are under care including aids often so it really is one of the truly landmark programs that the united states government has implemented. that's the very good news. the sobering news is that when you deal with such an enormous problem such as this and aids is a classic example of that but as i'm sure you will hear about malaria and tuberculosis and others is that solution to the problem is just not treating people. you've got to treat the people who are infected, but if you

look at the totality of people in the low and middle-income countries, 30 to 40% of the people who need therapy is getting which means 60 to 70% of those who need it or not. for every one person that we put on therapy, two or three people get newly infected, so if you just do simple math the number of new infections are out the capability of not only initiating therapy but even sustaining the therapy. it's economically not feasible. we need to try as best as we can. what we really learn as we have to prevent hiv infection. that's the thing we need to do. we have biologically proven the prevention raising from the distribution to the mother and child transmission to circumcision to a variety of things. that's the good news. the sobering news of that is

only 24-cent of the people who would benefit from those modalities have access to them so lessons we've learned is when you deal with a disease like that, prevention is a major part for any to do. and also you've got to get the countries themselves involved in making these things part of the run program and i think that's what the global health initiative is trying to do not only by having a larger umbrella that falls apart and maternal health and child health, etc., but making it a part of the countries have an investment in the health of their citizens as opposed to the united states and other developed countries coming in and continually taking care of them so amazing amount as unaccomplished to some important lessons that have been learned. i will stop there because i'm sure we will have questions

about that i will try to make this not just of money, and we will come back to this question of whether by changing the approach and strengthening the health systems in these countries whether in fact you can do these things more effectively with the resources you have, the limited resources that you have, but before we go into that, as i noted in the beginning, we started out talking about 300 million or so a decade ago and now we are up to about 25 billion with this administration proposing 40 billion over i guess it's actually 3 billion with all of the programs. then you've got a whole bunch of groups and other folks involved here that have the bill and melinda gates foundation, you know, and a lot of actors coming in. the u.s. is the largest contributor, but it contributes 40% but then there are all the

others and you've got people seeing what we really need is not $40 billion, which is the total amount of contributions right now we need about twice that amount. you've got lots of different people with handouts are one thing or another and i don't want to say handles, that's probably not a fair description and i will leave that to laurie to put it in perspective for us. japan, the united kingdom, along with the bill and melinda gates. what if they asked of all of the players and what can we expect them to? the u.s. is not doing this alone, let's put it that way. >> one of the things we know from our own experience is that health costs money. you can have all the good will in the world but unless there is cash to purchase the necessities cleaning up water supplies and the starting hills to prevent

malaria infection you can't accomplish very much with just good intentions and albert schweitzer zeal. the good news is that in 1998 and 2008, the total pile of cash out there what we call global health increase exponentially. it went from somewhere in the ballpark depending on whose numbers you are using, but in four to $500 million. that is everything we call health from clean water supplies all the way up to pills being handed out and training doctors and all sorts of things and we are now well into the ballpark of 45 to 50 billion if you include egullet in the original number. the biggest driver of that increase is in the united states government and if you combine

private and public giving from the united states to the whole pot of global health, we are by far the biggest donor in the scale of 60 to 70% of the cash that's out there for what we call global health. so this puts us in a difficult moment in the rest of the discussions that you've heard today. general odierno said you cannot succeed in this division of iraq or implication of what he was say in where we are going with afghanistan if you can't increase the level of the civilian engagement in what we are dealing with foreign assistance. that means you need a strong u.s. agency for international development, a strong global health initiative and strong account to put it in budget terms. but we are in a different world now as the election and we are

in for a different world from the one in which tony fauci played a pivotal role in the creation, the conceptualization of this thing we call pepfar, that was the post 9/11 world in which there was an awakening among christians at the very grassroots level across the united states for the need to engage us christians in improving the health and the lives of people outside of the united states and so you have literally from grass-roots churches a kind of movement in the united states supported president bush's announcement. i think tony was one of a handful that knew what he was going to say when he stood up at the union address and announced by the way i'm going to throw billions of dollars of the hiv/aids epidemic. and now, where we are, look at

the constant nudging the u.s. government is giving to the rest of the donor community to step up to the plate and collectively at least combine all of them to match what we give, just to accomplish that we would have a hell of a pot to fight for global health and look at where we are now. first of all we have an enormous wealth gap that has occurred that was already in the process of altering before the 2008 financial crisis. just here in the united states in 2005 the bottom 50% of our population earned 12% of the wealth of our country while the top 10% earned 21%. but according to the 2009 census that got much worse off 3.4% and the top 41.5%. that sort of a widening of the gap of wealth and shrinking of the real income of middle class is not a unique american

problem. in fact the most extraordinary gap occurred in the u.k. with a 600% increase in wealth for the top 1% of the u.k. population over the same time period. and what this has meant is that our own middle class is shrinking as experiencing tremendous financial pressure and is in a less altruistic and generous mood at this moment. and this is going to get challenge going forward pushing in the g20 and various other places for cash dedicated to global health or frankly food policy, water policy, any of these mccaul transnational threats. in addition, we are shy americans as individuals collectively are shy. 4.6 trillion for our personal retirement. so if it looks sad now, it's

really going to look bad in about five to ten years in a full baby boom generation marches off into the retirement or whatever they marched off into and health care is the most not but the inflating sector not just in the united states but all over the world in terms of cost so that in the overall health care costs have inflated 7.8% roughly each year and a single-payer economy such as the democracies of western europe it inflated 16% between 2008 and 2010. so they are feeling the pinch on the home front that is an additional pension that's going to constrain the sense of generosity. we have a currency war going on but it's essentially involves countries trying to devalue their personal labor force is more than the other guy in order

to attract industrial investors. this doesn't bode well for middle class is in a bear and the liquidity crisis with roughly somewhere between five to 10% of the trillion dollar global wealth locked up. not out there the moment in the general circulation. so, when you put all this together, what it means is that we have less cash in circulation. we have a shrinking middle class in most of the wealthy countries. the wealth has really shifted to the top 0.1% wealthiest and most large economies in the world and we are shifting from a g8 weld two ag 20, and here comes the big catch. most of the big g20 countries are actually still recipients, not donors for global health. china is a major recipient of funds from the global fight for aids, tuberculosis and malaria

india is a major country. brazil was still a recipient country. so when the latest g20 summit happened to weeks ago if i got my memory right, two or three come as of three -- south korea tried to push for -- self korea tried to push for a real discussion of the donor rule of the key 20 and the rest of the g20 nations beside the original g8 set off the agenda. we are talking currency, we are talking trade and market policy and when you get locked down into the arguments about how to deal with global health governments and the intersection between the government and donations to support such things as all those people, the four million-plus that we have successfully gotten on the antiretroviral treatment but need to stay on for the rest of their lives you cannot stop the

polls from flowing. when we look at the big picture that the level of the g20 in the emerging market countries it all ends up being we are not talking in the same conversation as you. we are talking about trade policy, about technology transfer, who controls and whether or not the next pandemic we get vaccines or it stays in the ritual. so we don't really have a collective conversation where we are talking on the same plane when we say global health among the potential donor states except the original traditional wealthy nations. and the original traditional wealthy nations are feeling a lot less generous today than they did four years ago. >> a good place to segue towards you i noticed on pbs you had spoken about the generosity of

the american people. willing to be generous as dickensian fact that their contribution to the global health for a country or in fact effective, and i think an important point that might get missed by some of the g20 countries is the link between prosperity, productivity, and with malaria you are talking about 450 million people. many of them children. the children die of the illness but the adults, it doesn't make for a very vigorous work force. so i guess the question is against the scenario painted by laurie do you believe the legacy by president bush will protect the new dimensions for men in congress at this point? >> that's a good question,

brenda, because everybody is asking it. we have set tremendous expectations in the world today. with the success of the programs and i would refer back to what lowry said. there is one of the major shifts that have allowed us and collective multilateral c2 the increase and resources and what we are facing now while this is quite dramatic and causing a lot of questions we need to remind ourselves we have been at a place like this before and so the question is what do we do, and we don't know yet because the dollars and economics will become a bit clearer over the next several months and at that point we have to look at the reality of congress appropriates and look at our national commitment and priorities and make appropriate adjustments.

you referenced the generosity of the american people. lori mentioned that in a number of comments and i feel that is a trait we have in our dna as citizens of this great country and if i can get personal for a second, i have come to that conclusion based on a number of things. i grew up in asia. my parents were missionaries. much had to do with medical missions and in many of the countries today, 50 to 60% of health deliverable system through ngo, the private sector and along with that investment comes a lot of passion and personal sacrifice and that's going to continue. that is marginal when you talk about the billions of dollars needed to sustain programs, but it still exists and then there's

the private sector and it is an extremely committed and involved. but we speak for malaria specifically. it's been an inclusive community, internationally as well as u.s. where we've seen a the sports fema nothing but net. we have billions of dollars for the net but we have advocated in front of the american people the significance of engaging on a chronic international problem that we call malaria. we of a major contributions, motivating and driven by the chambers, the u.n. malaria envoy would mobilize private citizens as well as the foundations and work with government and then there is the donation to the global fund, the world bank, the program and then our own.

so as we look to the future and we look to the commitment that we have communicated to the most endemic country of sub-saharan africa, i think the challenge for us now is the budget realities become clear and we are quick to have to make adjustments because we have made significant progress over the last four years and many of the countries and malaria. the challenge we have and malaria are much different than what the hiv and aids community have. we have proven effective intervention. our program, called my ppp program, private public partnership in which we have significant ppp partnerships so i called my prevention, prevention, prevention program because three of the four interventions are all about preventing people from getting

malaria so there's a significant investment of the front. as we have seen the rate to drop as much as 50 or 60% in some countries and all cost job mortality dropped by 30% in seven countries based on the two data points the result to be to celebrate and the amount of money we get we have to rally the forces, court of the wagon and do everything we can to sustain the progress we have made with our multilateral partners as well as the national government and look to sustaining so that when the dollar figure changes we can continue to scale up the same capacity moving forward. >> you said at one point that we've been here before. and there was a time back when

john f. kennedy was president of the united states when the u.s. congress voted to try and eradicate malaria, and the american people set out to get rid of malaria, not to send the united states. that we had done. the whole world, and it was out that time ddt was brand-new and there were no more resistant insects and [inaudible] was brand new and there were no resistant to recite cities both work just tremendously and we got out there and all over the world the campaign was full and the countries that lived with malaria for sentries suddenly with almost malaria free, jakarta to a state of malaria and congress said we gave you a deadline and you haven't finished yet so the money is cut

off, and malaria sword everywhere and one of the things that sort with it was ddt and resistance. so the lesson might take to that which i think is really where we need all of you on our side is this if i can use that sort of rallying cry is this surgeon global health interest concern and funding is an infant stage. the army is poured out a lot of the programs are just still making the state's finding their way, trying to develop the right relationships with post government, trying to balance where does the ngo fit in and the face based group said in and so forth just as things are starting to work we will pull the plug because we are looking elsewhere, something else to do with our money. >> not just talk about aids tuberculosis and malaria.

most people in the country's doherty of the same thing so the question is how do we do it and with less force is i guess. >> we each all three of us have diluted to it in one way or another. a couple of years ago in a journal i'm not so sure people in this room would called nature, medicine i wrote an article that was a commentary on the success of the programs that we had with malaria and hiv/aids and to some extent tuberculosis and the point that i made in the commentary is what lowry and tim have been saying and the catch word is sustainable. health is there. you don't fix health. you have to keep with it because people keep getting sick and

disease continues to emerge, so the answer to your question is that how we deal with it is putting more money in but putting it in a way that it becomes sustainable with in the country that we are dealing with and make health a part of the national strategy of the country's then you are working with. it's no more -- psychiatry clinton gave a wonderful speech a few weeks ago where she was talking about getting rid of the word and talk about partnership and development, and that's really held as a part of that. it is a fundamental part of that, and we were talking about this panel that was here before that was talking about the political event in foreign policy. health is one of the most important components of the

foreign diplomacy. so, i think this is all a big part of the big picture. so the way to do it is to take an approach that is not just going to be doing something on the short term. here is the congress gives a five-year appropriation and that's it. it can't be that way. and almost an indefinite commitment and not a commitment of giving that the commitment of building sustainability. >> is interesting i referenced president obama's speech to the millennium demint in new york and september and he specifically said we should not think of development as charity, which i think if we do we think of it as something that we give, i think what is felt is a few -- i would be curious to know how building health systems, how did you build systems and places that for so long have depended

upon assistance and can you make these trade-offs with countries to get them to do this? >> we can do it but we have to have cooperation from the country. we can train people but they have to have an environment in their own country where it is an attraction for them to stay in their country as opposed to treating people who then go off to other countries because you train them and we can't fix the economic system in the country or the attitude of the country about how much of the total gross national product they are going to put into health. and that is really part of the millennium goal. that is really a part of that is to deal with countries who are taking seriously their own contributions to what's going on in their own country. so its not going to be easy, brenda, it's not easy because some of the countries that have the greatest means have

leadership that don't see it that way and it's presumptuous to think that we are going to go in and change the culture in countries but we have to at least try to help train the people. >> at morrill -- admiral bremmer. people were talking about the defense diplomacy and development is essentially. i think a lot of people think that in the past it's sort of gotten it wrong and so much of our resources and so much of the emphasis was on the military, and so the people bringing aid and cared for in uniform and might cover their impressionable the u.s. is doing and why it's doing. how do you link to the diplomacy on that? ..

it's a core component of diplomacy. and we can talk about that all evening. i think the defense department does understand their role and their mission. and they have been mobilized successfully over the last number of years to do tremendous work because of the capacity and disaster relief situation but the earthquake, tsunami. i think there's an awareness, though, by the defense department do what they do is not long-term development.

but sophistication that they sophistication that they understand it's the government parallel to the whole of government approach effective development. and again, one more thing, underneath the global health initiative, the principle that we see outlines in addition to the focal point on women's health, leveraging the interagency process, which includes looking for innovation, leveraging resources, but focusing in on what tony said, it has to be owned by the country of so that owners some of the players look at one basic common plan by which we engage and can leverage what the country kind of fire with the other members. so i'm optimistic that the playing field that's coming together in a clear way, even though the finances may be finer.

>> but his irony of the moment were in. as i said, the global health and development in a linkage between the two and sufficient funding to do something meaningful is a relatively new phenomenon. we just get to the point where we have the sort of perfect alignment of an administration, a leadership of the house, bitter soup in the senate, all agree that they had to be more transparent. there had to be a strategy to four instances. but it had to be linked in some way with the sense of a smart form return and development. and now, that leadership on the house side is out. we accuse of the gop leadership would feel about all of this. and kerry luker joined by partisan efforts, never really got beyond the level. so we don't know where all that's going. one of things again we also took away from general odierno's talk about which was was such an

inspiring conversation earlier today, was that you're not going to win over the court for good governance or working out differences between tribes, ethnic groups, political interests of various kinds in iraq or afghanistan is the only american presence is a combat presence. and he also used the phrase, a whole of government. the whole of government approach in afghanistan, hillary clinton has said over and over again, starts recognizing that and ask any woman has several orders of mac to come a greater probability of dying in childbirth than the american one. there's very few women here i do worry that they would die in childbirth. if you are in kabul or out in the rural areas, it would be a very real concern every time you got pregnant.

well what does it mean to u.s. interests and u.s. foreign policy is more and more women in afghanistan recognize that because the program brought by the global health initiative from the united states, fewer than are dying in childbirth. in more of their newborns are likely to live to their fifth birthday. what does that kind of engagement need? and i've been going to the health system and so on. but it always goes to what are we trying to do for foreign policy? and my degree, for so long, think of these issues -- i noticed how much of the room has left. we are to had all the hard stuff. >> it's a question. i'm going to pitch it to the audience after this, but i'd like to ask each of you to answer the question, why should,

particularly in the current economic climate, why should, you know, we continue to grab at the very small percentage to begin with? for all of the count 150. so why should americans not, you know, let this drop in why should they continue to invest in development? >> well -- >> in global health care. through the release two reasons, probably for. i'll give you two. one that i used to work on people got interested in global health and the causality of what we do and that is pure humanitarian human beings we should feel a moral responsibility is possible to help take care of people. i think as human beings in general and particularly in america, that is still with america for a very, very long

time. that's one reason. the other reason that we live in a global community and we are all interconnected economically, politically, from the security standpoint. and a healthy world is a world that will be economically viable and we depend on different countries back and forth. we know that. that's an economic discussion that could go on and on. but also from a security standpoint. i would venture that if afghanistan were not as core a country as it has been from the standpoint of hope alone, it's one of the most unhealthy countries in the world. i'm not so sure that we would have all qaeda being able to just go in there and roam freely if that was a strong, healthy nation. so it's everything from humanitarian to economic interest to a security. >> all just go another level if you'll you'll just add on to what tony said, all of which of course i agree with. as long as folks in gaza and the

west bank have children contract measles in israel goes decades without ever seen a case of active life measles inside israel, you're not going to have warmth between those two places. if the odds of a palestinian child, living to age 10 are exponentially lower than the odds of an israeli child living to age 10, you're not going to reconcile the differences between the two places. expand not globally. we have, you know, we have this clarion call a year and a half ago when h. one-on-one flying flu emerged in u.s. and then explosively in mexico. unfortunately it was a relatively benign virus, not anything akin to the 1918 horror of the full length. but everything that we had dirties warned that would have been in a pandemic that would

aggravate tensions between nations and misunderstanding between nations really did happen. overwhelmingly, the very slow and eventually available vaccine cost treated in the wealthy countries. overwhelmingly the only effect of drug, tamil flu, concentrated stockpiles in the wealthy countries. and overwhelmingly, every single thing in the tool shed that could address the pandemic was far more available and a very rich country than anywhere else. in fact, by the 10 most vaccines comply for africa reached africa, the epidemic was over. so what that is said to the rest of the world is to know what, why should we partner with you on anything? because when the really big one comes, you're going to walk away from us. you're going to hoard everything. you're only going to take care of your own. if we can't demonstrate we think

the health and survival of a baby boy in beirut is as valuable as a baby boy in los angeles, were never going to have an equal conversation. >> health is the right thing to do. and tony said the programs of the u.s. government invests in. they were best as a life-saving mechanism and i were saying it's building capacity and sustainment. in addition to health and the united states government is spending part of the presidential initiatives in the future. so in addition to house, we have nutrition and food to move towards this whole development commitments. i'll jump back to what tony said earlier. in the millennium, you hear a lot of chatter about it, but getting back to malaria, we address six, which is reduction in infections. we address the maternal health issue and child survival. but healthy communities and kids

in school. so we touch and education. in malawi, a mother, making less than 1 dollar a day spent 30% of her disposal income on antimalarial drugs. as poverty and action. if we can eliminate that from her expression or income care, that will help her that day in that moment. and so that sends drivers to millennium development goal poverty alleviation. while we do excellent work in-house, while we are saving lives, the united states government can actually show impact and show the data sufficiently with the good return on investment. and it drives us back to the ultimate goal of poverty alleviation, community development, which is what we're all speaking and hope for. >> if there are questions, we certainly can start here.

>> can you hear me? by patricia prosky from the western mass council, world affairs. i know it's not a very economical -- economic consideration or militarily important country, but for purely humanitarian reasons, shouldn't we be doing more about haiti, which is a country in our own hemisphere? i am very concerned about the recent outbreak of cholera in the fact that what i read about, that we had hoped initially and then we pulled back. and what i would like to know from you folks, is there any kind of ongoing help in our own hemisphere for countries especially like katie who have

nothing really to offer to us economically, militarily, but from a humanitarian point of view, thank you. >> haiti and last, frank, captain mendez said and i co-authored a piece saying the national weather service is forecasting six major tropical storm events but the caribbean with a reasonable odds at lease one would slam haiti. didn't we need to immediately come as a matter of urgency for the survival of the people of port-au-prince, build some structures that could withstand storm and flood conditions to which the people living in tents could flee? adults in early winning a radar system which we didn't have four distinct local weather detection, build an emergency alert system with warning and

training of the populace, so they knew where to run. and now, hurricanes hit haiti and none of that is in place. people are literally holding little pieces of plastic over their head while the rain and wind are pouring down upon them. and we saw similarly with cholera, it's axiomatic as he going to a farmer globalized, which is good news, humanitarian and peacekeeping response to the world, that the humanitarian responders and peacekeepers themselves can become vehicles for microbial hitchhikers from all over the world. if you're moving u.n. soldiers in congo one week and the next week naipaul and alexi thomas and the red cross workers are the same and the msf are the same, you have the potential for every single one of them to be a disease carrier. we know that cholera was introduced from outside. if they do naturally arise spontaneously out of the water

of haiti. and it doesn't really matter. i don't want to blame anybody for that introduction, but i think that our inability to respond very effectively and very rapidly once it did emerge may keep a very localized is disappointed. >> i think the initial response and perhaps the doctor could address this isn't what people are severely injures and facing major trauma. that must be an initial concern. the question of why we have not been able to rebuild or get around to doing the bulldozers didn't get there till october. i know this is not particularly helpful -- it is an offense. >> it isn't fundamentally help. it is the problems who are neighbors about doing something about getting not country to be

self sustainable. if you look at some of the heroes of the health areas in haiti, people like he'll hop, paul, who spent so many years there, it is clear that you can accomplish an extraordinary amount with relatively little investment. it is nice that you're putting billions of billions of dollars in their. so the answer to your question, the shorter answer is we should be doing more. >> because there are hemisphere. and for humanitarian. >> i think humanitarian reasons also. and also because of the whole issue with cholera. you know, if you look at the colorado map, the belt of cholera, cholera occurs in regions. so do think it's going to stay, as laura said, in haiti, when chu introduced into regions and people go back and forth to different countries, or being

presumptuous and naïve to think that it's guaranteed it's going to die up there. they likely will and i hope it will, but it may not. >> in fact, just historically, cholera outbreaks in the united states were united states were unrelated to the slave trade and the movements into the caribbean and back up again. so we constantly had cholera were introduced into our waters, especially in new york city. sometimes devastating results. >> i appreciate your interest in haiti. just to address what are we doing right now with the storm and the cholera outbreak? we go to the u.s.a. today website and we see there are 20 members in the response team there right now. and there's a significant aggressive amount of work going on in conjunction with that help organizations, cdc and usaid. the just for the immediate update, i would invite you to go

to the usaid website and that will give at least today readout. >> thank you. >> next question. i'm sorry, over there. >> my question is on hiv in sub-saharan africa. uncheck why more from the tennessee world affairs council. and my question is, what funding for the u.s. government and the ngos and other government is available for prevention right now in sub-saharan africa for hiv? and how much funding would it take to have a preventable, sustainable come for federal programs for hiv in sub-saharan africa? >> well, what was put together the original program, 20% of the total amount was in therapy and the rest and care. between 20 and 30% in prevention. what would it take? and bashes the tablet program. their other components of prevention. it really would require access

to the modalities of prevention that we know work. and that's the point i made that is so frustrating. even under the best of circumstances, when you have hoped infrastructures that don't allow any more than 20% of the population, who would clearly benefit from a proven prevention modalities don't have access to it. that's a very serious problem right there. it was the whole issue with all three of four of us were talking about about building sustainable health systems. because if you don't have a health system, you're not going to get anybody into the system to be able to counsel them or give them the care about what they need to do to prevent. that's the structural, functional answer. there's also another answer that when you're dealing with a transmitted disease, and culture in which you had flagrant and

egregious disenfranchisement of women in which they really don't have the human rights tribunal to protect themselves in a society that really demeans women. that's become very difficult. and we have made friends in africa thumbnail the time and a smile to my live. you don't want a guy like me going to africa saying you have to treat your women better. what you have to have is the leadership in the african countries realize that they have to turn around centuries of cultural issues, which have notl to protect them selves. that's one of the really important stumbling blocks in prevention. >> and even in this country has contributed to a research in certain communities, gay

communities with hiv. we haven't managed to get it under control and make her bench and effective here. i think the administration has focused come and see. we have time for two more questions. >> i want to shift to another topic. as i recall with h1n1, we did not have enough vaccine even for here. and it got even to the whole complex of vaccine production in which countries are going to do it and how much lead time do you have in knowing exactly what a virus or dealing with and then distribution. as i wondered if you would address that part of the problem. >> well, the problem with not having enough vaccine for influenza is that we have -- the root cause of that really is that we as a nation and the world have not taken seasonal influenza very seriously. we say well, i have the flu,

whatever. and that we think about a pandemic can you get nervous. but influenza is a serious issue. it kills at an average of 36 billion americans a year with 200,000 excess popularization. but we just take it in stride. the incentive to make a vaccine in a way that you can quickly ramp it up and get it in a matter of a couple of months. and i'll take it one step further. the incentive to make a universal vaccine, that you don't need to change from season to season, that you're given once every several years to protect not only against strains, the strains actually changed dramatically as a pandemic strains. we haven't had that incentive on the part of industry are on the part of our leadership to encourage industry to do that. the good news about the threat of the age by then one bird flu and the reality, as laura said,

of the relatively mild h1n1 is that it got everybody all exercised about, my goodness, are we really doing with antiquated ways to make vaccines, growing at 10 mpeg or will do one better. luke wrote in a cell. no, with molecular biological techniques that we should be able to get the virus sequence and immediately start making a set of having a month delay. so what is happening now is that the federal government, to their credit, is now sharing the risk with industry by doing things like helping with the advanced development production. the federal government has financed a plan of novartis in north carolina to go from a dazed to sell based. for making extraordinary investment in trying to develop molecular-based flu vaccines and ultimately a pandemic for

universal flu vaccine but essentially covers everything. so we're really way behind. the jumpstart we're seeing now because we all got frightened by the threat of the pandemic, ever looks to 1918. my god, we can't have another 1918. so i think it's going to change. but unfortunately it took several decades of really mediocre responses to influenza. >> thank you very much. >> hi, marty long from connecticut. we've had rankings of countries over the last two days in the u.s. is not in the top cocytus one is a thank you for putting us at the top of the list for giving around the world. we did not have a think one category where we were number one in the last two days. as a thank you for that. that's a good feeling. my question is i think part of that is because, you know, we

trick or treat boxes and we have rallies and we have telethons that would raise a lot of money on the air and i think we support our government is doing the same around the world. how do we get the emerging market countries that have huge savings to do the same? and you know, they love to call finish, so can they do rallies? today do that? i don't think you can do with the government. it has to be a populist, you know, topic that makes the government give more money so that we maintain our number one status. but i'd like to see china number two. >> is a great question. this goes to what i was talking about in the early part of this discussion, the shift from the g8 to the g20 world and how we talk about the priorities of global health? and for that matter, food and

agricultural policy climate issues, all of that in the shifting political landscape. it's actually interestingly what is slamming the successfully emerging market countries is the sudden surge in chronic diseases that are typically seen in the wealthy world. so suddenly their experience in an obesity explosion, diabetes associated with it. more and more their population is living long enough to develop serious cancers. cardiovascular diseases, stroke. and every one of them has a minister of finance that sitting down during the demographics of the long forecasters say my goodness, if we don't do something, we're going to be drugs trying to do with all the end-stage disease burden down the road. so what we see now is an increased level of concern in china, in brazil, and mexico, in south africa and so one, that is

in part spurred by the sudden anxiety about the chronic disease and aging population. it doesn't get to the fact that so many countries, south africa being a prime example, after experiencing both at the same time. they transition to the chronic disease burden by the still have this enormous infectious disease burden that is akin to what we were going through perhaps 150 years ago in the united states. that is where we have a logjam is in a continuing commitment from the global donor population and the g20 countries generally to that remaining infectious burden. just to put a data point on something that the admiral said. since 2007, the amount of money put into fight malaria globally has increased 166%. that's an astounding figure.

and what that means is people in parts of the world that still he had nothing to do except except malaria as part of life, now actually have tools enhanced to save their lives, to get infected and prevents infection altogether. but those same people, as brenda said about an hour ago here, will eventually than die of cardiac arrest or cancer or lord knows what because they don't have any health service for that at all. so i guess i would say the big momentum is to try and sustain and even increase the commitment to conquer these old burdens of infectious disease about the same time revving up for this demographic explosion that's going to have most of the countries of the world in the next 20 years that will be aging and chronic disease, perfect

storm. >> one with folks of emerging economies in growing economies in the growing middle class, which should also have an active citizenry, which would begin to demand this administration has said that it's going to link and support even to the second tier are middle income countries are going to link assistance here from the u.s. to governance, you know, to democracy. and one vote, the efforts are supported by the current congress and will bring about some change. and that's all we have time for. [applause] >> a very big thank you to our panel on this very critical topic in u.s. foreign policy. thank you very much. i hope we've achieved our goal, our object is that engagg