assistant commandant. i watch it for the 24 months i was ahead of requirements of requirements to nhs came to the inescapable conclusion, we just couldn't afford it. it doesn't mean we don't need a capability. so back to the expeditionary nature. america needs the capability to be offshore, and offshore option, and be able to come both from the air in the 20 twos and helicopters and it was to come to service with the marines. people talk about forcible entry and the kind of get, the kind you get stuck on that and ago i don't know whether we will ever do a forcible entry operations again. lunches can be a sense of magnitude. when the marines surrounded the town of falluja in iraq, we had five infantry battalions on the edges of that town.

before the marines entered in falluja is a different place today, and you know that. in fact, there isn't anybody here that can tell me the last time you saw the name of falluja in a newspaper. so it turned out to be good news. but five attacks. what what we're really talking about is having our nation a superpower have the ability to put six battalions of marines ashore in amphibious vehicles, and then it's a pretty modest investment for a nation that has global reach and its international responsibilities. so we need a vehicle that can come out of the ship and swim ashore, and then operate on land as -- as a fighting kind of a vehicle. you kind of giddy to for there. you get seaborne transportation, you get the ability to maneuver on the seat. so we need that.

and then the last thing is the f-35. our nation has 22 capital ships. what am i talking about? i'm talking about 11 carriers and 11 large deck navy ships like the v-22 launched off of. if we don't have those, right now we're flying carriers. those carriers will run out of service light around 2022, 2024. if we don't have the ability to put a fifth generation airplane on those large ships, then when it's all said and done our nation will have 11 capital ships that they can send around the world to do the nations bidding instead of 20. i think it transcends the marine corps is mission. it's important for the united states of america to the fifth generation capability on 22

capital ships instead of 11. >> and you feel that program is starting to do a bit better? >> i do. i track it, you know, i guess ran january, i've been watching it and i watch it go through, and i said we are reclaiming ownership of the f-35b program. i think i used the public statement nobody beat me up for it, but i said you're looking at the program manager of the f-35b. now i am not. i understand the rules. but i make player coach. i am like bill russell of the celtics. and there's nothing that happens on that program right now for that model that i don't see in my office, i've got a set of metrics i'm watching every single day. you can't put a pound of weight on that airplane that i don't know about. and we are treading. we are making business decisions at the headquarters marine corps. one last point. congress doesn't give the

program manager money. congress give the united states marine corps the money. and i take that responsibility. so when the plane is doing well. it ahead of schedule right now. land, vertical landings, test points achieved. the engineering fixes for the three our four major things have been designed, putting them in over the next couple of months. i'm optimistic. >> two more quick questions on the budget and i would go to the crowd. one is on the issue of military pay, pensions and a ton of us. it was interesting as secretary gates' speech on tuesday at aei which he built as his last major policy siege, the great repute, respected, experienced secretary of defense didn't give us some speak for the history books about where we stand, vis-à-vis the rise of china and islamic extremism and to wars versus the rewards versus one more. it came down to pay and pensions and tricare as almost his

victory set of issues for his send off. maybe that's the most he could say about where we are in the budget review right now which is not exactly something he expected to months ago to be. the main thing he was coping with on his last days in the building. but nontheless, it was sort of striking that he basically said we are going to have to rethink to some extent the military retirement system, the military tricare system and the premium structure which, of course, is very favorable to servicemembers. and i think most americans would believe and support the idea the military compensation should be a very robust, especially any time of war, for those deployed. but would you ask ago secretary gates thoughts? and we are going to begin to approach $400 billion in savings that are going to have to rethink in fundamental ways our compensation in personnel policy. >> i absolutely -- these are different times. i think in the marine corps for 41 years and i've seen it and

and flow. i've seen the budget cycle go up and down. i'm probably more concerned now than i ever have been before. and i think that's probably -- the service chiefs, all of us, this has caught our attention. probably it's exacerbated because we are at war. we got 20,000 marines on the ground in afghanistan, another 12,000 deployed on ships around the world. and the army is admittedly more, the navy has a bunch and so does the air force. while we are, we have this friction that is building, we are currently fairly heavily engaged in some pretty important parts of the world. and the vision though is the budget is going to go down. and so, it has caught our attention. and so it doesn't surprise me that the secretaries, his last

public address our major speech talked about that. so i do think, we are looking right now among ourselves, how could we be more efficient, how could we be more frugal? we are returning to the brink or back to its frugal roots, as the penny pinches of the department of defense. and in part of that though is you can't just come from programs. nor did you can't just say okay, which is going to cancel all these programs because five years from now or 10 years from now, when we will be at the next part of the world history, we will be dealing with, you know, decades old equipment that are outdated and worn out. so it can't just come from programs. we are paying about 60% of the marine corps budget, those in manpower. 60%. it's about another 25% goes to operations and maintenance. so if you can to do the math,

i'm down to about, you know, a small below 20% to buy new equipment, and to put money out the research and development. so, i think the personnel peace, the bill has to be reduced, it is a sensitive topic. and here's another point of friction. we are doing that while we have these forces engaged, and we're asking a lot of them, it's an all volunteer force, so i think there's a balance there. we don't know where this is -- you know, kind of new into this, taking a look at the entitlements peace. but i think we ought to be glad to look at it. we get into the what did i signed up for, what was it when i joined, you know, you enter that arena.

but you think it's time for a healthy look at what, where all this money is going because it's going, it's increasing. the entitlements piece is increasing at our personal costs are increasing. i remember we testified, the service chiefs testified i think in march, march or april, and we supported it, the idea of just adding $5 a month tricare addition to your costs. and it was purely -- it was a for active duty. and it wasn't for those retirees that are truly retired. it was for the retirees who are actually still in the war. where you spent 20 years in the marine corps and you get another job and you're working. all we ask or is just raised the try to bring and buy another $5. it hasn't happened yet. i would say that's pretty modest, since we haven't adjusted tricare premiums since

the '90s. so i do think, i think, and how far, where, what will it end up with, i can't tell you, mike, but i to as a service chiefs i'm sensitive to that, but i think we have to look at it. >> one last question and then we'll go to the crowd. this may be the hardest one to enter because you found a way to answer all my questions so far, so you are allowed at least one invocation of that's not what i can talk about right now. but is there a range of marine corps in strength numbers, that you now decided have to be considered as options? in other words, i know you have a plan for what the marine corps should look like once we get to the spirit of intensive engagement in afghanistan, and you worked very hard on that and he was no doubt be the plan we would stick with. but i'm assuming that everybody service is being asked to rethink infrastructure in the course of this $400 billion drill. and is there a range of numbers that you can tell us, sort of under act consideration for

marine corps active duty? >> there's really not come and i will take the reason why. we spent all last fall with secretary gates in september, told the marine corps, and i was just about to become the commandants lies about a month away. he told the commandants then, but he gave it to me, he said you shepard this. we spent all -- he said build a force that is post-afghanistan. build a force that understand you are 202000, we grew the marine corps from 179,000, to help ease some of the 12 and the turnaround. so think about when you think about when you come out of afghanistan and billy force now that meets the department of defense's demands and all these requirements that we talked about earlier. and he said, i want you to be able, i want you today, i want you to build a force to kind of

focuses on what we call the center of the range of military operations, those day to day kind of crisis response to. i'm not just talking about handing out in marty's any humanitarian assistance, but we do that as well. but also that kind of range of those operations that are at the second and then take risk what he said was at the height and. in other words, it doesn't mean you're not going to go to some major war, but don't build a force that is designed purely for the. build a force that is designed for this but have the capability to do that. we put our best minds to this. and there's a lot of analysis behind that. to build a force that is going to come down to 186,800. it's a better marine corps that we have today. it's a more capable marine corps in many ways that we have today even though it is a smaller number. we have incorporated the lessons learned a 10 years of combat. and yet there's a host of things that i won't go into because of

time, i'm very comfortable that the rigor has been put in that number, mike. haven't started dialing the forest and yet because secretary gates said don't do it into we come out of afghanistan. but we have a plan and we're continuing to refresh that plan. so it would be pretty premature to take the marine corps and say, okay, that was then, this is now, give me another plan. the truth of the matter is we put a lot of effort into this thing, and they can show just about anybody what the value added of the forces. so i'm not prepared to fall off that debt because we haven't started going down through a jet. we need -- if we had to start down that path and see what ago and been a just there. >> let's open it up. please wait for a microphone, and identify yourself. start with peter here in the front.

>> thank you for joining us. i wanted to go back to the question mike asked about the f-35. you talked about the experience of watching it essentially go through almost like a death spiral, it got into expected to meet the needs. what are the lessons that you drew from that experience? and how you applying those lessons to the current f-35 broke them, but then secondly, to the potential replacement amphibious assault, what do you draw from that and how are we applying them in many ways, another way of parching ago, are the sums that can be applied and those that we learned a lesson but it doesn't apply in terms of a different set of program? >> i tell you what, i've been in this job i think i'm in my eighth month now and times gone by pretty fast. i've learned a lot of lessons, but i tell you what.

the acquisition peace of the major programs is a lesson that has just been, i mean, i've learned that lesson now. i'm not saying i am done learning but it's in here. quickly. here's my sense of this thing. i think, you know, and i would just take on the acquisition. there's probably acquisition folks out here who will take me to task, but we have over the years, as we have taken our acquisition cycle and we trained folks and we have them certified and then we lay out programs, we lay out a milestone chart and which is that a couple of times since i was a young brigadier general. ..

i think the services have abrogated their responsibility to the acquisition community as it relates to bringing new equipment in. what do i mean by that? i made the point earlier. i said congress doesn't give the f-35 manager, he doesn't give them the money. he gives it to the service chiefs and congress expects the service chiefs to be good stewards of that money. we turn around and we go, i'm not worthy, i'm not qualified to manage this thing. i'm not even qualified to provide oversight. so you take this money,

acquisition community, and professionals, then you come back and tell me how i'm doing. meanwhile we go off and focus on other things like iraq and afghanistan and all the things around the world. all of sudden we turn back and we go, well, we owe another $4.3 billion. how did that happen? in the case of an efv, we're entering our second and a half decade, the program went $4.5 million a vehicle to somewhere between 17 to $18 million a vehicle. the program costs grew whatever it was up to $13 billion. you go, how did that happen? i think service chiefs need to reclaim ownership of these major programs. these really expensive ones. we need to have oversight. that's what, that's where i am on the f-35b. coming into it a little bit late. if you talk to folks that

understand development programs, the very best things the services can do very early on in the concept development phase and when you're really kind of developing this thing is to be engaged because there are tradeoffs that the, that the service who is going to use this vehicle and buy this capability will need to trade off as they, as costs become reality. engineering challenges, if you want this vehicle to go 15 knots in the water, it will cost you this much more but if you're willing to have the vehicle go 12 noerts, you can -- knots, and i'm making this, you can save a significant amount. so the services ought to be involved in that. well, 15 knots is what i want. you go away and tell me how much that costs and be shocked at the cost. back to the efv, back to the amphibious combat vehicle. we have right now, a really systemic approach to using the best engineering mind an

production mind across this nation. we know how much it's going to cost. if you want to go extra three knots we tell you precisely how big the motor will have to be in that thing which is function of space inside the hull of the amphibious cargo vehicle or combat vehicle. we can tell you precisely how much the gun will cost if you want a different caliber. what we're doing right now we're defining the requirement today. working very faithfully on this thing in fact we're probably within about 60 days of having this thing really, and guess who's making those decisions? it's senior leadership of the marine corps. i mean the very senior leadership of the marine corps sitting across the table with the engineers and systems engineers folks, taking lessons learned from efv and going, okay, what are the trades so we know now we can actually build a vehicle. we've got some idea,

reasonably, well how quick, how much it's going to cost. the other thing i'd say is that we have to accelerate production of these test articles and get, you know how long it took the sr-71 blackbird from the time it was, yeah, from the time it was being drawn on graph paper, to the time it first flew? i think it was 18 months. 18 months. that was in the '60s. this is 20 levin. you're going to tell me, here's what the acquisition guys said. when we were going to cancel the efv, they came to one of my premier three-stars who kind of manages this is effort for me and they said, okay, we're going to go for an alternative vehicle, general amos. i said, that's exactly right. it will be 2024 before it will do initial operational

capability. i'm not making that up. i wanted to pick the heaviest thing up in my office and throw it at them. i mean, think about that. so what are the lessons learned? how are they going to apply? let's be engaged right up front. let's do trades, requirements, trades so we can realistically have an idea what this thing is going to cost and let's get the acquisition cycle, maybe not quite as aggressive as the mrap was. we did the mrap in a leer, ladies and gentlemen. it saved lives, untold amount of lives but maybe not quite but it was pretty rudimentary thing. steel box, very v-shaped hull, drivetrain and shock absorbers and guns on top and seats in it. this will be a little more sophisticated than that. you can take the lessons learned of the mrap acquisition to push the acquisition cycle faster so we can come out the other end with a product that is

affordable. everything, the longer it takes, the more expensive it becomes. that is the lesson learned. f-35 i think we're coming into it a little bit late. those requirements were all derived 1998, 1999. i was in the pentagon as deputy of aviation. it was all powerpoint and so we're farther down the road on that but that's why the marine corps has come back in and engaged right now on what are the requirements on that airplane? what's acceptable? so we're looking at right now. i think early engagement as lesson learned. you can accelerate the timeline on acquisition. service chiefs need to reclaim ownership of major production, those major programs. and, one other point i forgot. i really think we can do a whole lot better. okay? >> start working back a little bit about six rows back on the aisle. >> anthony izaki, education news. general amos, do you have

any reaction to the proposals set forth by senators levine, mccain to merge the air station and the air force base in okinawa? >> i do have a couple reactions to it and i think they're favorable. first of all i think we've got a good plan that our nation and the japanese agreed to in 2005 and 2006. i have flown in and out of the air station many times and i flown, been lived on okinawa as a portion of my life as a marine so i'm reasonably familiar with that. i think in good faith the marine corps needs to, needs to find another location for the, you know, the airplanes, what we call marine aircraft group 36. rote toe wing airplanes that are in there and the reason for that, for those of you

who aren't familiar with it, it is a great little air station. it is wonderful to fly out of and satisfies all our needs but some of the airfields around the united states of america has been encroached. building, everything, construction, apartments, schools, businesses, have encroached all around the airfield's perimeter and i think it's in the best interest of the marine corps and i think it is in the best interest of our nation and japan to find another location for kadena. we completely support that. another thing you didn't ask about it, there is significant amount of land south of there. you get center of the island and going south and the agreement of course is to give that land back. we have some logistics facilities down there and, areas down on the port of naha. the plan is to give that back to the people of

okinawa as soon as we reasonably can. so i think the plan is sound and i support the movement of the airfield. i think it is's in the best interests of all of us to be able to do that. the dilemma of course where does that, where does that capability go? and that's what our nations are working on right now at the very senior level. >> two further back. >> good morning, gentlemen. midshipman benic. university of southern california. i'm here on usc on wmds and nuclear proliferation. >> speak up a little bit for me. >> yes, sir. is that better, sir? in the wake of usama bin laden's death, many media outlets that report a drone strike is what killed him. as the first commandant from the marine corps from the aviation community wonder

where you see the role of marine aviation going specifically with uavs and the marine corps shadow tactical system coming into play in both afghanistan and other conflicts there? >> make sure i have got your question right. first avery eight tore command did, aviator. commandant. i'm just a marine. what do i see the role of marine aviation in the future? was that your question? >> shadow tactical system. what was the last part of that? >> shadow tactical system. >> uavs. >> i think it is interesting when we crossed the border in 2003 i was a wing commander on the ground and we had about 435 airplanes and probably about 60 of those were forerunner of shadowy was the pioneer and boy, i'll tell you what. i had limited experience at unmanned aerial systems and i quickly fell in love with them. i mean i had, we were able

to use these things and i think all of us, thank all the service, even our nation has come to understand the real value of an umanned aerial system. so i think as you now, pioneer was replaced with the shadowy is an army program. so we're all in cahoots with the army on this. very effective. we have them on the ground. to tell you how effective they are, we, we had two squardrons of uavs, of pioneers. we now have, we now have built almost four squardrons of these things with this force structure review. so we are doubling the size of the unmanned aerial system capability in the marine corps. i'm a fan of it. i think it's got a future. i could see down the road where, you know, these capabilities on unmanned aerial systems have are growing almost exponentially. the ability to move information around a battlefield, the ability to see things, and be able to

relay that information real-time down to forces on the ground, the ability to deliver precision munitions, i see a time in the future where we're probably do some medevacs with unmanned aerial system. i'm a big fan what we call the cargo uav. it is now called, cargo uas. where we can deliver logistics supplies around a battlefield, especially 2:00 in the morning when it is dark and scary and pilots get nervous. a uav doesn't care. launches out and flies out and delivers ammunition and water and that kind of, food. so i'm a big fan of it. i think there's a huge future in it for all the services. as a marine aviator i'm not threatened by it at all. there is always going to be the requirement to have somebody with a brain making decisions on, on things on the ground but i'm a big fan

of, and i hope that answers your question. >> if i could follow up quickly on that, general and i apologize to people that keep waiting but is it, this is not meant to be a critique of the f-35b program. but we've seen the f-35 program stay at about 2500 airplanes through a period, uavs, uases have become much more effective in general. you were talking about some of the cargo responsibilities much uases which are not related to the f-35 mission. but is it possible in this budget drill the services realisticly and reasonably be asked to rethink the 2500 number without going to the f-35 specifically? are we building too many manned tactical airplanes even as we're doing much more with unmanned tactical system? >> no question we're doing a lot more with umanned systems. i think there is a, there is a piece of the future that the unmanned system owns. but i can't tell you right now how much, mike.

i mean, can't tell you is the 2500 minus 300 systems? is it 2500 plus unmanned systems? we're just right now, we've got four airplanes delivered to us. we're about to take our fifth one at end of this one. air force has one. navy as four or five. too premature to say. we need the airplane in production and see how it will do and also technology is going to advance. i think that's a decision that doesn't need to be made right now. that could be a decision that could be delayed out there 10 years as much. you think about how long it takes to produce 2500 airplanes. takes a long time. we're going to be building airplanes and delivering them out to "20/20" five and 2030. so i don't think it is a decision we need to make right now. capabilities are going to increase significantly between now and then. we have to stay where we are and let's just get the airplane built and see where

we go with technology in the future. >> next question please. here in about the 7th row. young lady on the end. >> hi, i'm claire perk with the university of southern california. you talked about the reasons for optimism earlier such as increasing in infrastructure, district government leadership and increase in education. i was wondering if you could shed some light on the potential challenges that we're still facing in afghanistan and more importantly why these reasons for optimism that you listed earlier might or might not have a sort of snowballing effect to address these challenges or how they might spill over to offset these issues? >> first of all, i think the education piece, i want to make sure i answer your question for you. i think the education piece is critical especially in the country like afghanistan which as i recall has an 85%

illiteracy rate. education is important in the marine corps and we don't have an 85% illiteracy rate for everybody in here so i don't want to everybody to think we do. it's critical for security. it's critical for any maturing organization like us or any maturing country like afghanistan. so i'm very optimistic, i'm very hopeful that the education, i think education is key to what's going on. i know there is an effort underway in afghanistan right now to train the 85% of, large percentage of which are policemen, soldiers, mechanics, teach them, even language up to first grade. so i'm, i am very optimistic about that. i think it's, i think it's an important part of the future of that country. but since i'm not answering your question. did i miss something?

>> additional part of the question or he answered it pretty well? >> i guess if you could talk about the potential challenges that we're still facing in afghanistan and maybe why education or other important things like that would offset those challenges i guess? >> i think, i'll tell you what. here's, we're going to go to fundamental kind of counter insure againsy and helping -- insurgency and helping people reclaim their country. this is find kind of fundamental blocking and tackling. first of all there has to be the will of the people, not matter if they will have whole sale change or but a matter if they like to have peace. if they want to have some of the most fundamental things they take for granted when you drive up here around dupont circle and move around washington, d.c. i have freedom of movement. i'm not going to be threatened. and in that country some of the most basic freedoms of

being able to take your goods out of your small garden that you grow and put them in the market and sell them, i mean that's, that is significant. can you imagine that in the united states of america, things that we take so much for granted? that's what they want. they would like the ability to put their children in school. so the key to all this, is, is a, is strong leadership. remember it's a tribal system so it's not like, we can't view it the way we view ourselves in the united states of america. it's a strong tribal system. the tribal chiefs have a lot to say. the elders, and it's even different than it was in iraq with the chics. the elders have a lot to say about what's important to that town, that village. i will tell you while we were there, one of the, one of the tribal chiefs said,

and i'm not telling you where it is and this is not unanimous across afghanistan. so i don't want everybody to walk out of here and say this doesn't count anymore in afghanistan. one of the tribal elders in a very rural area of afghanistan, in a part in the marine zone in helmand province said, i don't care about electricity. i would just like to have freshwater and i would like to be able to take the stuff that we grow, my villagers grow, i like to be able to take it to a market and sell it. now that is pretty significant. i mean that's pretty visceral. so i think back to your issue, back to your question, i think a strong, local government with responsible leaders and the ability to provide security. and what is that? that's the police force, a credible police force, that's honest, that has the best interests of the, of the local community at heart.

and then a credible military that should something happen, that they will step in and reinforce the police or they will step in and do the bidding of the nation. that's pretty simple. to me that's the fundamental basics of counterinsurgency and it is not nation-building. we're not trying but i'm saying that's what's important for afghanistan. and i'll tell you what. from what i saw and what i think, you know, michael can speak for himself, there are those leaders that are there. they're in the villages like nawa. they're in villages like lashkar and villages like delara m&m arja. imagine that. a year ago, marja was on the lips of everybody in this room and now, and for the most part, you're visiting with us and we were in marja, unless you're visiting with

us you probably can't remember the last headline you saw in a newspaper anywhere in washington, d.c. that had the name marjah on it. yet a year ago it was on the tips of our tongue. marjah has a series of governors and police chiefs and army and they're doing a credible job. so if they can do that, at that fundamental level, and we can help train them to do that, the united states can ease out which is exactly the plan and they can build schools and they can build wells. we help them dig wells and that kind of stuff that is the fundamental. one last point on this thing and just forgive me for, what is the key that what is it they really want? one of the governors, district governors i was with at christmastime, he's a great, great courageous man and he said, sir, i

would like to have my market opened again. i'd like to have freshwater. now we're in the middle of this little village and here's this, what we might call a pretty nasty-looking, very shallow creek kind of flowing through it with water that probably nobody in this room would drink out of. he said, i would like to have freshwater. he said, you know what else? i would like to have some kind of medical care. i don't necessarily have to have an ob/gyn. i don't necessarily have to have a pediatrician or thoracic surgeon but i'd like to have some medical care because i just put two of my women in the back of a pickup truck that were about eight months and 29 days pregnant and they were having problems in their pregnancy. put them in the back of a pickup truck to drive them to lashkar and they died in route. he just wants to have a nurse that is pretty

visceral. that is what those little villages want. mike, you care to comment, what you saw or anything? >> i will say just two brief things you told it very well in terms of what is to be accomplished and still what is to be done. two encouraging little factoids or statistics that some people may be interested to hear. as you all know governance at the civilian level in afghanistan has been a challenge and certainly in the south but i was encouraged to see that in the last 12 to 15 months the number of afghans populating the key government positions at the district level in helmand has roughly doubled from 30% to 60% of the estimated requirement. that is not by any means adequate and it doesn't mean any one of the 60% is competent but it was still an encouraging number. another thing i heard that was encouraging and it has been said publicly before so i'm not too hesitant to say it, district governors in afghanistan are able to travel by roads to meetings. previously they never would because they could go by helicopter because they were

afraid of encountering a roadside bomb or check point governed by taliban. that is one indication of headway. obviously still a long ways to go. let's go over here and then we'll go to the back of the room and jason will be after this gentleman here. >> hi, general. my name is andy gordon. i'm with the office of senator richard j. lugar. the senator as of late voiced concerns the cost of financial and human capital is outweighing interest or vital need in afghanistan. i wonder what is your response to that perspective and how the marine corps is vital to securing those interests or those needs? >> you know, i'm not, truly i'm not qualified to, the answer to cost and human capital and money outweighed our national interest. i can't answer that question. that's for the very most

senior leadership of our country to answer. i'll just tell you that, there's been a fairly healthy price paid. we paid a pretty healthy price in iraq. i think if you use iraq as a little bit of a model, we lost 851, move your head that way. we lost 851 marines killed in action in iraq and, just about 9,000 wounded. various kind of wounds. that's a pretty healthy price. but if you look at iraq right now and look at the anbar province and you, i mean i keep going back and i say, when's the last time anybody saw anything in the paper about fallujah or ramadi or, any of these places that were in the headlines of our daily newspapers? so you ask yourself the question, was it worth it and hasn't been a commander on the ground, haven't lost my marines, haven't put a lot of

heart-felt time in there and answer for me is yes, absolutely it is yes. so i transition that to afghanistan. if i take that same concept and that same, that's why i look and say i'm very encouraged. i am. i tell you look in the eyes of these young marines and, they want to, they want to finish the job. and i don't mean finish the job like in a bad way, like, you know, vengance way. i mean in a good way. when you have got a young 19-year-old marine and he is excited because the guy just opened up the bakery in marjah and now serving that wonderful afghan flat bread -- by the way that guy had gotten run out two years earlier by the taliban. that young lance corporal that is 19 from akron, ohio, is excited about that, they want to finish. that's what i mean by finish the mission. they want to change the iraqi or afghan army and help train the afghan national police, they want to provide security. they want to finish the

mission. so i can't answer about your initial question. i just want to give you a sense for what the marines are feeling. >> jason, in the far back. jason has got the gold tie. he is standing near the door. we'll work up. >> thanks for the directions, mike. jason campbell with rand. general amos, over the last few months there's been a fairly well-publicized of increase in number of representatives from civilian agencies in the government. however there's been other reports that due to security concerns many of these newly-arrived civilians aren't able to get out to the field as much as hoped. looking specifically at our rc southwest, can you speak to the impact the civilian surge has had on area of operations? >> jason, i would be happy to. everything we've done certainly in the last 10 years has been evolutionary. we're not the same, we don't look at things the same at the department of defense as we did prior to 9/11. and i suspect that a lot of

our inner agency partners don't view things the same way as they did prior to 9/11 either. i mean who would have thought that we would have, that we would actually be hiring people in the civilian agencies now and part of their contract way i understand it when you sign on you are deployable and can go to some of these thorny places around the world and some of these places are at times very, very dangerous. so we've changed and, my sense is that we're absolutely, we're absolutely headed in the right direction. we spent some time during the evening, in fact on a couple of occasions with provisional reconstruction team in the helmand province which is headed up by a brit and he is doing a terrific job by the way. i mean the guy is a hero. and his staff is coming together. the state department fleshing that out.

you know, there's others that need to be a part of that and they're coming in. is it slower than we like? yeah. but is the, is the, vector heading in the right direction? yes. i'd argue that, this part of this evolutionary learning process is, we're going to have to hire specific kind of people at the front end to be willing to go out with the skillsets, to be willing to go out and do some of the really hard things that our nation is probably going to expect of our civilian part of the solution. the other thing, piece i will say on there, jason is that not only is it heading in the right direction but it has to head to the right direction. i mean it's imperative. one of the other lessons we learned, we talk about the whole of government, people use that phrase, like it's a bumper sticker but it really is the truth. we're in it together. the marine corps has, i

don't have, in my and my generals have no business thinking that we're going to go someplace all by ourselves, flying the marine corps flag, playing from the halls of montezuma and we're going to stake out our claim and that's it. i'll be happy to be in complete support of some inneragency effort someplace else around the world and we're supporting them, we're providing the capabilities and security and the ability to be able to do the nation's bidding. we're all in this together. so it's not where it should be but it's heading in the right direction and i'm encouraged. >> another question from the back. the young woman with the red hair, about four, yeah, there you go. >> morning general amos. a few months ago secretary stacly how he would like to reorganization of the department of navy along real lines instead of program lines. some of the ones he

mentioned. litora warfare and nifca which seemed to do a lot what the marine corps is doing and established peo-lcs. i was wondering if any of the marine corps acquisitions programs look like they will be rolled up in that effort and reorganized under kind of different acquisition structures? or if you see that, affecting the way marines do business? another quick question i had for you, do you see the marine corps taking an interest in u-class at all in the future? >> mostly about which programs will come under new acquisition framework or strategy by, if i heard you correctly. and then the last, i'm sorry, the acoustics weren't great. the u-class particularly was how she -- >> do you see the marine corps taking an interest at all in u-class in the future or looking modifying it either way so it can launch off an amphibious ship

instead of a carrier? >> okay. so when we started the first part of your question dealt with the acquisition of kind of a new acquisition framework? is that, and how do i --, what was the question out of that piece of it, mike? >> summarize very quickly and put a point on that part of the question. >> okay. stackly talked about organizing acquisition by capabilities instead of programs. specifically he's mentioned nifca, naval integrated fire control and littoral warfare. i wonder any marine cops acquisitions get rolled up in those new structures or whether you think it will affect marine corps capabilities? >> i don't know of personally any, if there's an effort underway to change the acquisition program to talk about, kind of lump things under capabilities i'm unaware of that.

i'm not saying it's a bad idea but i haven't put any thought to it. when i spoke earlier i was talking about primarily how woe take what we have and make it better. i wasn't necessarily lumping it uncapabilities. so i can't answer that. and i heard u-class back there and i think you're talking about the navy's carrier variant of their thing? i think that's a tremendous effort. i think, go back to the uas question we had earlier. i mean there's an example of taking technology and the requirement and actually bringing it aboard, something like a nimitz-class carrier. that's pretty significant. yet to be seen. the airplane's flying right now. yet to be seen how it will turn out but we're optimistic. i don't know of any effort right now trying to pull all that together under different sets of capabilities and acquisition world. >> time for one last question. are you waiting, sir?

over here, yes, please. last question. wrap up. >> hello, gentleman. i'm james fredrickson from the university of edinborough. concerns previous answers with a question to budget difficulties you mentioned an emphasis on strategy first. that aims, goals and priorities must guide production in a risk assessment. my question how that risk assessment is actually going to take place? for instance, is there more emphasis on capability in afghanistan right now or more emphasis in the desire to shape the marine corps afghan began? >> that's a very good question. my sense is, when we start talking about budget items and you start thinking about, you know, the fiscal pressures we're probably talking post-afghanistan. i don't think there's anybody, and let me just speak for myself. if you were to look at the written guidance i put out the day of a i became the

commandant, i have, there is a bunch in there but i have four priorities. and my number one priority is to, everything that is required to guaranty success in afghanistan for our deployed forces. that's my number one priority. and my promise to the marines on the ground and families back home and those marines in training i will spend whatever money's required, i will take whatever personal capital is required, in other words, people, i'll take whatever expenditures is required with regards to training our forces and equiping our forces, all of that, i'll do all of that, even at the expense of the rest of the marine corps, to guaranty success in afghanistan. now, you heard me talk earlier that it is not winning or losing and success is a sense of well-being how we're doing. that's what i mean by that. afghanistan is my number one priority and, and i know as i sit at, on the joint chiefs it is absolutely a

top priority for our nation and certainly our service chiefs. so i don't think, i don't see that changing. until such time as the withdrawal plan is executed and america comes out of afghanistan and our allies. you know, our uk brothers and sisters and everybody else. i don't think that is going to change. i think what we're talking about is the risk in the future. in other words, we're out there in 13, 14, 15, 16, 17, probably the next decade and you could make a case that if you're going to look out over the next decade you probably out to look out over the next two decade because when you start buying equipment and procuring stuff it takes a long time to buy it. and takes all the things we talked about over the last hour. so my sense is the risk will be, will be addressed in what the world, what the department of defense is going to do for our nation in a post-afghanistan

environment. doesn't mean it is not going to apply prior to that but i think if you take a look at the bulk of the effort, it will be towards strategy for the world beyond afghanistan. and then, what can we do, what's required, what can we do. what is it we can't do. at risk, how do we mitigate it. >> please join me in thanking the commandant. [applause] >> the u.s. house begins debate this afternoon on raising the $14.3 trillion federal debt ceiling by $2.4 trillion. it will need a 2/3 majority to pass because of the way the legislation is being considered.

that debate begins at about 4:45 eastern time. live over on c-span. this afternoon a house panel looks at autism cases in other countries and how children can get medical care in developing nations. live coverage of that house foreign affairs subcommittee hearing begins at 2:00 eastern here on c-span2. at the same time, live on c-span3, a house energy subcommittee holds a hearing on security of the u.s. electric grid. threats to the power infrastructure, possible weaknesses in the system and how to defend the grid from cyber attackss.

>> now republican presidential candidate newt gingrich at a see coast republican women's breakfast in new hampshire. the former house speaker talks about the 2012 presidential campaign, health care, tax reform and immigration. this was his first visit to the state since announcing he was running for president. from the portsmouth country club in new hampshire, this is a little over an hour. >> the republican presidential candidate campaigns are beginning to take form and building excitement. in less than eight months, new hampshire will hold its first in the nation presidential primary. helping -- which candidate has the best chance to beat barack obama. and end the era of big government and big spending. the citizens of new hampshire take this leading role seriously. new hampshire people tend to be well-versed on the issues facing the nation and how

these issues impact their personal lives. they critically evaluate their potential leaders in numerous local events. we can certainly account for that. they take measure of each person, not based on the biases of various news outlets and pundits but based on personal interactions and observations. we're very fortunate to have such an opportunity today. we're especially honored to have one of our party's most experienced and qualified candidates, the former u.s. speaker of the house of representatives, newt gingrich. speaker gingrich's history evidences a life committed to public service. perhaps no one knows better his way around congress. newt has been a representative, a minority leader, and the 58th speaker

of the house. he heralded the revolution in the 1990s ending four decades of democratic rule in the house. he coauthored the contract with america, and congress balanced nation's budget in the 1990s. his resume' of pre and postcongressional life is extensive and impressive. it includes being a college professor, forming a network of successful business and not-for-profit groups. writing numerous books and producing many award-winning documentary films and working as a political consultant and commentator for many news networks. let's welcome a true american leader, newt gingrich. [applause]

>> thank you all very much. thank you corrine, for that introduction. i am delighted to be here and i want to talk to you about what i believe will be the most important election of your lifetime. a decisive moment of choice for america. but to do that, i want to ask you two questions that i think will help explain why i'm running. how many of you believe that america is seriously in the wrong direction? okay? how many of you agree that getting washington, forcing washington to change to the right direction will be an enormous fight?

you just explained why i'm running. you see, -- [applause] i thought about this a long time, talked with my family about it a long time. i didn't run when i might have in 2000 or in 1996, or in 2008 and today the catastrophe facing this country is so enormous that as a citizen, a grandfather, who wants his two grandchildren who are nine and 11, to live in the freest, safest and most prosperous country in the world, i really felt compelled to become a candidate. because i think there are three characteristics with we need in a successful candidate for 2012. the first is, it has to be somebody who can articulate

our values and our policies so clearly and so decisively that the country will glad that the crossroads we're at has a, from my perspective left and a right that are fundamentally different. it has to do it so well that in october of 2012 our candidate has to be able to debate barack obama and decisively clarify for the country how big the choice is and how bad the last four years have been. . .

>> the first great entitlement reform was welfare, two out of three people went back to work or went to school. the most successful entitlement reform in your lifetime. i also chaired in 1996 the medicare reform task force, and we saved medicare at a time when people thought it was going to go broke. we passed the first tax cut in 16 years, including the largest capital gains tax cut in american history. the result was that unemployment went from 5.8% when i was elected to below 4% shortly after i left. finally, having reformed an entitlement, having cut taxes to create economic growth, having reduced the unemployment rate which also, by the way, not only meant less money on medicaid,

less money on food stamps, less money on unemployment, it meant more money coming in because more people were paying taxes because they had jobs. as a result of all that, the policies we initiated led to four straight years of a balanced budget, and we paid off $405 billion in debt. now, the problems are bigger today, and we'll need even bigger solutions, but i think i can at least offer you a track record of having successfully managed a very large scale change, and that was with a liberal democrat in the white house. so i can assure you, if you have president gingrich, speaker boehner and majority leader mcconnell, you'll be amazed how much we get done. [applause] but in order to get that done, we have to run a campaign next year that is so decisive where the choice is so clear that we pick up at least a dozen u.s. senate seats and another 30 or 40 house seats so we enter

january of 2013 with the momentum and the energy and the drive to truly govern. this is not about electing a caretaker to preside over the obama disaster, this is about defeating obama and fundamentally replacing many of the institutions of the left. in the first six to nine months of 2013. third, because the challenges are so large, we need solutions that are equally large. and what i've done for the last 12 years since i left office is i've worked at the center for health transformation, at the american enterprise institute, at the hoover institution, at the national defense university, at the defense policy board and a variety of health agencies. i've worked as an adviser thinking through the scale of change we need. and i think i can offer americans a fundamental choice. on the one hand, you have the most effective food stamp president in american history. [laughter] on the other hand, i'd like to be the best paycheck president in american history. [applause]

on the one hand, you have a man who goes to brazil and praises the brazilians for drilling offshore. i'd like to be an american president who implements an american energy policy keeping the money in the united states and creating jobs in america. [applause] on the one hand, you have in obama somebody who says we would like to be your best customer to the brazilians. [laughter] that's exactly wrong. the president of the united states should not go around the world as a purchasing agent for foreign countries. president of the united states should go around the world as a salesman for american products and american companies to create american jobs. i would like the brazilians to be our best customers. [applause] you have today a president of the united states who cannot control the american border but

lectures the israelis on their border. [laughter] first of all, i believe the israelis have every right of self-defense against terrorism, and i have no intention of lecturing the israelis on how to survive in a region where there are people who want to kill them every morning. [applause] and second, i want you to know that as a historian i am absolutely convinced that we have every right to and every ability to control our own border if we have the will and the determination. and my goal would be by january 1, 2014, to have 100% control of the american border and the slight hyperbole, but to give you a sense of scale, if that required that we took half the bureaucrats in the department of homeland security and moved them to texas, new mexico and arizona -- [laughter] i am prepared to insure that no one will be able to say in a

gingrich administration we didn't control the border. and the president's speech in el paso was a disgracefully dishonest campaign speech was to attempt to fundamentally mislead the american people, and i wish president obama would for a few months quit being candidate and try to tell the truth about the challenges america faces. [applause] this campaign will focus on three areas; economics which includes jobs, health care, the deficit, all the things people are concerned about; the nature of america, i believe in american exceptionalism, i believe president obama has a totally different vision of america. i think this is the central defining election of whether the declaration and the institution still matters, and i think that's a fundamental choice for america. and, third, national and homeland security. now, let me talk just very

briefly about american exceptionalism, then i want to talk about economics because they actually are directly related. we are the most extraordinary country in american history, in human history. the reason is simple. it's not because we're personally extraordinary, it's not because we're bigger, smarter, more powerful. it's because we're the only society in history whose founding political document, the declaration of independence, starts by saying we hold these truths to be self-evident. very important concept. founding fathers weren't developing a philosophy, they weren't developing an ideology, they were trying to understand the truth about human nature and the truth about how people can operate and govern themselves. and so they were digging very deeply into the very nature of being human. they said we're all created equal, something which the recent obamacare waivers for pelosi and reid fundamentally deny to every american.

every american should have a waiver from obamacare from now until january 1, 2014. nobody should get a waiver, or everybody should get a waiver, but picking and choosing is a fundamental violation of the declaration of independence. [applause] it goes on to say we are endowed by our creator. this is the crux of the american system. we're endowed by our creator with certain unalienable rights. now, what does that mean? it means that power comes from god to each one of you personally. you are personally sovereign. you loan power to the state. the state never loans power to you. and obama believes in the european model. washington decides, we obey. we believe in the american model which is the power, ultimately, rests with the citizen which is why the constitution begins, we

the people. it doesn't say we, the judges, it doesn't say we, the bureaucrats, it doesn't say we, the politicians. doesn't even say we, the news media. [laughter] it says we, the people. and that has huge implications. it means that as the republican nominee i will have a contract with america, it will have seven bills, one of the seven bills will be a tenth amendment enforcement act to take the constitution and return power to the states, to the people thereof and move it back out of washington. [cheers and applause] so obamacare is a fundamental violation of the basic rights of the declaration of independence and should be repealed in its entirety in the first 30 days of the new republican president and a new republican senate period. then we can go back and start

over, but we should repeal every single page of obamacare in the first 30 days of the gingrich presidency. [applause] now, the rights we're endowed with include life, liberty, and the pursuit of happiness. two parts to the pursuit of happiness. first of all, happiness in that anal meant wisdom and virtue -- age meant wisdom and virtue. not he donism and acquisition. [laughter] the founding fathers all believed that a wise people could remain free, and a foolish people would end up in a dictatorship. second, they don't guarantee happiness. they guarantee the right to pursue happiness. there is no provision -- this is a fundamental debate with obama -- there is no provision for a federal department of happiness. [laughter] there's no provision for happiness stamps for the underhappy.

[laughter] there's no provision for a right to sue if you're unhappy. and if you told the founding fathers that a politician would be so arrogant that they would walk in this room and say i'm going to take from the overly happy and redistribute to the underly happy -- [laughter] they would have said to you that is corrupt, it is a dictatorship, and it is a fundamental violation of america. now, it was the pursuit of happiness that led to welfare reform. because people concluded that, in fact, giving people money for doing nothing crippled them. it taught them dependency. it weakened their ability to stand up and pursue happiness. it taught their children a terrible role model. so when we reformed welfare, 92% of the country agreed including 88% of the people on welfare, and the result was two out of every three people on welfare went to work or went to school. their incomes improved, their

lives improved, their future improved. now, let me apply this principle straight out of the declaration of independence to unemployment compensation. it is fundamentally wrong and destructive to give people money for doing nothing nor 99 -- for 99 weeks. and what we should do is replace the current system with an up employment system that -- unemployment system that says for the first four weeks we'll help you buy time to get a better job. to get any money after the fourth week, you must sign up for a training program with a business so that we are paying you to do something to improve the human capital of the united states, and we, the people, are getting something for the money we are giving you, but we are not going to give people money for doing nothing. [applause] last year we gave away $140 billion in unemployment dollars at the state and federal level

combined, $140 billion invested in worker training. that would make us one of the most competitive countries in the world. the germans pay 50% more for manufacturing and labor, and they have the lowest unemployment rate in 19 years because their government favors manufacturing, they retrained their workers to remain productive, and their government goes overseas to sell german goods. now, put that aside, and let's turn to economics and health care in the context of american exceptionalism. first of all, america only works when americans are working. the current economic policy is a disaster. this is the longest period of unemployment since the great depression. in every recession since world war ii, we would right now be in the second year of a recovery. and yet the obama policies, i can't get the white house to understand, this is a very simple phrase: job-killing policies kill jobs. [laughter]

and this administration in regulation, in the tax policy, in psychological attitude is the opposite of reagan. reagan came in at the end of the carter years, we had 22% interest rates, 13% inpoliceinf, and we were sliding into the deepest recession until the obama recession. at that period reagan arrived. he had, basically, four goals: an american energy program, tax cuts, deregulation and praising entrepreneurs and business people, particularly small business people who got up every day and went to work. so reagan wanted to make people feel good about creating jobs. obama wants to attack people for creating jobs. reagan wanted to say it is terrific if you're successful in the america. obama says you shouldn't be that success. let me take away your money. i mean, there's a fundamental disjoint psychologically where obama's consistently on the side of a european socialist model which, by the way n europe has

led to a disaster. so in january we had 45% african-american teenage unemployment. that's a disaster for this country. we want every american to get a job. our goal should be let's get back down to 4% which ought to be the natural unemployment rate, and at 4% we'd take a huge step towards balancing the budget because we'd have millions of people leave food stamps, medicaid, unemployment, go back to work and be paying taxes. no single step will move you towards a balanced budget faster than a full employment economy. you can't solve 27% of our homes being worth less than their mortgages until you get jobs. people have to be earning money to raise the price of houses. and washington keeps trying to find a solution without solving things. it's not possible. so creating jobs is our first goal. and the first step there is an american energy plan, because if we had $500 billion a year staying home, we'd be vastly better off. so i am for drilling.

i am for using oil. i am for using gas. i am for using coal. i am for biofuels. i am for an appropriate, safe, effective nuclear program. i'm also for wind and solar where appropriate. but the fact is if you use all of our energy resources, we have more energy than any other country in the world. despite years of the government opposing drilling for oil, we're the third largest oil prusiner the world after saudi arabia and -- producer in the world after saudi arabia and russia. and that's with the government opposing it. [laughter] second, we need a totally bold, new tax program. i'm going to outline five steps. they will be very controversial, and i look forward to the controversy. because i believe we can create enormous economic growth, and i believe if you take the obama tax policy of $2 trillion in increased taxes plus the obamacare increased taxes versus the gingrich plan to reduce taxes, i think the economy gets to be dramatically bigger very

fast. under the gingrich plan. and so i want to argue over whether you want a big economy with everybody at work or a small economy with a huge deficit with everybody on food stamps. because that's -- those are the two futures we're faced with. i would do five things on taxes. first, i would freeze and make permanent the current tax rate so there would be no increase in taxes in 2013 because it is wrong to raise taxes in a recession. second, i would abolish the capital gains tax, and we would have zero capital gains tax. we have a worldwide market. the morning we abolish the capital gains tax, cash would be transferred into the u.s. at an enormous rate in order to invest here, and you would create many, many new jobs, many new factories, many new companies because we'd be the best place in the world to invest. and if you think people can't figure this stuff out, the new york stock exchange is now in

amsterdam. forty american companies have now moved to amsterdam because our tax code is so destructive. i mean, just think again. obama drives companies away, i want to bring companies here. fundamental difference in approach. third, we should go to 100% expensing for all new equipment whether you're a farmer, a factory, a doctor, a hospital, a business. if you buy new equipment, you should write it off in if one year. and the goal is very direct. we want american workers to have the most modern equipment in the world so they are the most productive workers in the world so we can compete with china, india, germany or anybody because our workers can, in fact, be more productive than theirs if we have a tax policy which favors them. fourth, we should take the highest corporate tax rate in the world, 35%, at which level general electric pays zero. because at 35% it's worth their while to hire 375 tax lawyers to find every loophole.

let me try -- i'm looking forward to debating liberals on this because the gingrich tax plan which is a 12% corporate tax rate will actually get more money out of general electric than the liberals' tax plan. because at 12% they'll fire half the lawyers and write a check. [laughter] [applause] finally, we should permanently abolish the death tax. the death tax is a fundamentally immoral tax which says you can work hard all your life, do everything correct all your life, save all your life, and some politician can take half the money away from you. there is no justification for a politician taking money away from people when they die, no one should have to visit the undertaker and the irs the same week. and we should abolish the tax permanently. [applause]

let me just talk briefly about two more components. part of what reagan did was deregulation. and then i want to talk about a project you all can participate in. on deregulation, first, i would abolish sarbanes-oxley which is a destructive bill which particularly hurts small and medium-sized companies and has produced no useful information. i would also abolish the dodd-frank bill from last year which is a disaster for the banking and finance industry and further cripple job creation in the united states. i would fundamentally replace the environmental protection agency which has become an anti-jobs, anti-local control, ideological set of radicals trying to impose their views on america, and i would create an environmental solutions agency which uses science and technology, incentives, innovation and entrepreneurs to solve the problems, and it would be instructed to cooperate with

local communities to apply common sense to have both a good economy and a good environment, but not to impose from washington a set of rules written by radicals. [applause] finally, on deregulation i would create a 21st century food and drug administration which was assigned the task of collaborating from the scientific laboratory all the way through to the patient to maximize the speed with which we bring new solutions to save lives and a 21st century fda will save lives, increase independence and living, lower the cost of health care, create american jobs, all of which are the right thing to do. you cannot get it done today because the food and drug administration's become so bureaucratic and so hostile to developing new ideas and new

approaches. and so once again this kind of change changes the whole underlying pattern. last thing i want to mention to you is we have -- and then i look forward to taking your questions. we have a project that we'll have up on our web site which is newt.org, and i'd be thrilled if any of you would like to sign up. obviously, i'd be very, very grateful. and since it's my first name, it's reasonably easy to remember. [laughter] we're going to have a project called on the first day. and everybody gets to participate, everybody gets to submit what they are interested in. here's how it's going to work. on inauguration, january 20th, after the inaugural address i'll take an hour, go to a room where c-span will cover it and any other tv that wants to, and i will sign between 50 and 200 executive orders, decisively changing the direction of government within hours of being sworn in. now, we don't know what most of them are yet.

that's why this is going to be an open process, and you get to look around and think about what you wish we'd do. but the promise is this: we'll take in ideas all of this year and for the first nine months, ten months of next year. i'm sorry, nine months of next year. on october 1st, during the election, we will post all of the executive orders so that they can be part of the final debate of the campaign, so people can understand here's where obama is, and here's where newt would be. now, i can tell you what the first four executive orders are because those four we have, we've thought through. the rest have to be developed, and you're going to be invite inside a couple weeks to come and help us. the first executive order will abolish all of the white house czars as of that moment. [cheers and applause] the second executive order will

reinstate ronald reagan's mexico city policy that no taxpayer money will be used to pay for abortions overseas. [applause] the third exdave order -- executive order -- excuse me -- the third executive order will reinstate george w. bush's policy of enforcing the conscious provision that no doctor, no nurse, no pharmacist, no hospital can be compelled to undertake a procedure which is against their religious beliefs. [applause] and the fourth executive order will direct the state department to accept the capital as designated by the host country and to place the united states 'em bass si in the capital -- embassy the capital. the only country it supplies to in the world is israel because the u.s. state department has

refused to move our embassy from tel aviv to jerusalem. you can be the most corrupt, most destructive dictator on the planet, and we accept your capital. but if you are the only stable democracy with the rule of law in the middle east, we humiliate you every morning by insisting that our embassy stay in if tel aviv. this will be changed with the fourth executive order as of that date and, frankly, i hope we can find somebody as strong as john bolton to be secretary of state to decide that we're going to fundamentally overhaul the state department and fundamentally get a state department which wants to implement american foreign policy on american terms, not represent the world to us, but represent us to the world. [applause] so that gives you kind of an overview. i want your help, i need your help. i need lots and lots of grassroots support. i'll be back often and be glad to answer questions. why don't we now, if we can, i

guess if you come to the microphone here, anybody who wants to can ask any question you want. we'll start with all of the citizens, and at the very end we'll let the news media come up and ask questions. so anybody like to ask a question? [laughter] >> i would like to ask, where do you think george soros fits in this administration? >> where do i think soros fits in this administration? >> yeah. >> i think he's an enormous influence on it. i can't tell you in detail. but if you read the book, "the argument," he outlines clearly how big a role soros play inside in organizing the left-wing interest groups that wants to defame george w. bush and then wanted to find a left-wing candidate for president. thank you. [applause]

>> good morning, mr. speaker. i'm kate pratt, and i'm one of the three rockingham county commissioners in this county. such a big part of our job is managing about $6 million in health insurance costs for our employees, another million and a half dollars in health care costs for the prisoners in our county jail, and this doesn't even get to the costs of worker's comp, disability and the rest of it. i've been very frustrated and disappointed that in all the discourse from obamacare to, unfortunately, the ryan plan there's little or no discussion about getting on top of the actual cost of health care. it's all about who's going to pay for it and, frankly, in my opinion, rearranging the deck compares on the titanic -- the deck chairs on the titanic. i've been following for years

your work on health care transformation among other things, and i wonder if you have just a few comments this morning on the subject of the actual cost, control of the cost of the health care we all need. >> that's a great question, and you're exactly right. [applause] i got involved, when i stepped down as speaker, i decided, i spent about a year and a half studying science and technology just to sort of get my head clear and to get back into understanding intellectually what was developing. and then i thought i would focus on two big areas; health and national defense. and i concluded after a while that health is about ten times more complicated than national security. so it was so big and so complicated, i knew i could personally never master it. it was too much. so we actually created an entire center for health transformation which you can see at health transformation.net, and we've been developing ideas there for about nine years. and i started with a very basic

premise that there are two fundamental things wrong with the current system. the first is that it tends to deal with acute care, so people talk about health care when, in fact, you ought to talk about health and health care. because if -- and i learned this from necessarily -- nestly's which is the largest food company in the world, and i was talking about patient-centered care, and they stopped me. and they said that's exactly wrong. you want to catch people before they're a patient. and they said there are three things that change patient status; attitude, activity and nutrition. so the fist thing i say -- first thing i say because you have several different groups you're trying to deal with. i would say for your employees, i would design a health-centered insurance program and in the worst case, i would insure separately from the insurance companies if they won't work with you, and then reinsure the

cost for extra higher things. but i would start with their attitude. there's a company in green bay, wisconsin, which is a food company with about 6,000 employees, $4.2 billion a year. and the center people could get you this information. but they have a program where there are four levels of insurance costs. and if you do an annual checkup and you quit smoking and you exercise and you take care of your diabetes or whatever your condition is, you get the least expensive. and you work your way up to where if you refuse to do anything to take care of yourself, you pay the most. this is the opposite of liberalism because it i implies -- it implies responsibility, not victimhood. so i would start with that. second, you should contract for cash. you go out and talk to doctors in your community and say if we just paid you on the spot, no red tape, no time value money, no hanging around, and we audited you after the payment, what would you charge us?

prices drop dramatically. i have a good friend who's a reconstructive surgeon which is what plastic surgeons prefer to call themselves. [laughter] he's a really good friend. and he said to me the other day about half of his patients are cash, and about half of his patients are insurance. he said there has been no increase in price for his cash payment patients since 1993. because they call everybody in his town to get a price before they come in. now, you can't do that for a stroke, you can't do that for a car wreck, but you can do it for -- i'll give another example. you should reward people if they go to a minute clinic, and you should charge them extra if they unnecessarily go to an emergency room. [applause] and by the way, it should be scandalous in medicaid the number of people who abuse emergency rooms which is the most expensive way to get care. so there are practical steps you

can take that can dramatically reduce the cost of care. and i'm sure the folks at the center would love to work with you on that project. yes, sir. >> thank you, mr. speaker. i'm representative ken weiler. there is no society that is as heavily burdened as ours by the costs of litigation. it's not just in the medical field, but everything we do is burdened by excessive defensive things and so on. what can we do about all this litigation and all the costs that the rest of us pay for those parasites, the lawyers? [cheers and applause] >> well, let me just say, first of all, i think civilization does require some lawyers. [laughter] remember, remember, in shakespeare when he says first we kill the lawyers, that was the guy who wanted to establish a dick dictatorship. [laughter] it wasn't meant as an anti-lawyer comment, it was meant as an end of the rule of

law comment. however, it's one thing to have the rule of law where you need rulers, it's another to have the exploitation and abuse of law which is what we have right now. to give you an example, jackson health in gallup working with the center for health transformation did a study of doctors and said to doctors across the country, what percent of your medical practice and your friends' medical practice is defensive medicine? their estimate was that defensive medicine, unnecessarily done in order to defend a lawsuit, now costs $800 billion a year. so even if you assume it's off by half, $400 billion a year in be absolutely unnecessary tests, procedures, etc. just to have the paperwork in case you go to court. so here's the challenge. i have good friends in texas who spent seven years and beat the trial lawyers and passed litigation reform. dr. john gill in dallas is one of them. and it was a big project. they actually wrote litigation

reform into the texas constitution because they did not trust the texas supreme court which is made up of lawyers. [laughter] and so they had 4,000 doctors a year moving into texas. they now have doctors in areas that hadn't had a doctor in 20 years. and i was in oklahoma recently, 18,000 doctors altogether have moved into texas. i was in oklahoma about a year ago, and they said to me we now have the worst of all worlds. our doctors are moving into texas, and the texas trial lawyers are moving into oklahoma. [laughter] just as a good example, though, of why i always tell people i am not running for you to send me to the oval office and go home. no one person can change these things. i am running to recruit millions of people to join in a long, hard effort.

because particularly in the senate, i think we could pass litigation reform in the house. but particularly in the senate, the trial lawyers have a number of republicans who are also favorable to them and it takes a huge grassroots movement to convince those lawyers that maybe, you know, maybe you're not going to get reelected if you don't vote for litigation reform. but i think this is one of the three or four things we most have to do in order to be successful, and you put your finger on it. [applause] >> mr. speaker, i have a related question. i know you've been divorced, so you're familiar with the family court system. my question is related to parental rights and family values issues. family courts generally allow loving fathers only a few days a month with their children. this is not only harmful to children because it's so important to have both parents in their lives, but it's also a terrible civil rights violation when the government dictates how much time a father or mother can spend with his or her children.

what are your thoughts on family court reform? >> i'm actually in favor of fathers having rights, and i've been approached by a number of fathers' rights groups because the laws grew up over a period and have a largely female bias and i think are not right and, second, they're not economically right. we live in an age that's very different than 50 years ago. as you know, i was divorced. i'm very close to my two daughters and to our grandchildren. and that required a conscious effort with my ex-wife to work together to make sure that the children weren't the victims of our problems. and i think it's very important that we have a much greater sensitivity, that both sides, both parents, both have rights and have responsibilities. and just as we should insist that the male pay their fair share of raising the children, we should also insist that there be some opportunity for the children to truly know who their fathers are. [applause] >> hi, mr. speaker.

i'm tim breen, a business owner from hampton, new hampshire, and i had a couple questions for you. i'm really concern with the the debt. i think it's 25% of the taxes goes to the interest on the debt. that really has me concerned. i'm sure you as well. and also, would you be in favor of raising the debt ceiling which is something that is an event today? and very good speech, thank you. >> well, those are great questions. look, my first principle would be that you want to set as your goal balancing the budget, paying off a large part of the debt and buying back the $3 trillion in bonds that the chinese are holding. so that's a strategic goal. when we set out to do it in 1995, we thought it would take seven years. in that particular period, it actually took three. and we turned the corner and balanced the budget within three years. now, given the scale of the mess that obama's going to leave, i can't promise you you can do it in the three, but you could make enormous progress in the first year or two if you're serious about balancing the budget.

and that should be our first goal. on the debt ceiling, i think speaker john boehner -- [applause] on the debt ceiling, i think speaker john boehner had a very good idea. think of it as a rheostat, not an on/off switch. for every dollar of spending cut the president will accept, he gets a dollar of debt ceiling increase. it means he'll be back in three months for another debt ceiling increase at which point he gets an increase for every dollar that he accepts in spending cuts. but there are no circumstances where we should be bluffed by obama and the media into with giving them a blank check of additional borrowing power without fundamentally changing the spending power in the united states. and senator marco rubio had it right, it would be a disaster -- it's a bigger disaster for this country down the road for us to give them a blank check debt ceiling than it is to have a confrontation this summer and refuse to raise the debt ceiling until they're prepared to bear some financial responsibility for the united states.

[applause] yes, ma'am. >> mr. speaker, thank you for being here. i'm wendy jones. i'm not only an activist, but business owner. i'm also a nurse. so while there's lots of parts of obamacare that are not very good, what i'd really like us to talk about is not just insurance, but may we talk about health care? and i don't often hear that at the national level. two things that are, that are positive that occurred, one was up to 27 years of age you're able to go under your parents' health insurance if you didn't have health insurance elsewhere. i wish you would look at that versus just getting rid of all of obamacare. the second piece that was important is parity in health care, that means oral, mental and physical health care is very important. community health centers, of which i participate, work at, deliver $3 of care for every $1

spent. so as we have this discussion, i hope we'll look at health care and look at our needy that really do need that parity, not just the dollars. thank you. >> sure. those are both really good questions. let me start by explaining my view about obamacare. i think out of a 2800-page bill there are probably 200 pretty good pages. but i distrust the washington staff so deeply that i would never let them partially repeal the bill. because you have no idea at 3:00 in the morning what they're going to slip into it. and so i would say repeal the whole bill and then start hearings, and there are pieces that are worth looking at, and we ought to look at it. and i think there are things, frankly, there are other ways of solving some of these things that are even more powerful that should be looked at as ways of solving these things. so my only goal is -- i carry around a slogan that i think is

the most important governing slogan of the next 20 years. it's a little bold, it's a little on the edge, but i'm going to use it to explain this health problem. it's two plus two equals four. [laughter] now, we got this because we made a movie about pope john paul ii going to poland in 1979 called nine days that changed the world. and -- which, by the way, i'm proud to tell all of you was just recognized by the vatican as one of the three best documentaries on john paul ii. when we got there, we found out he'd started this big fight with the soviet empire, and for ten years the polish people were constantly in turmoil. they were dealing with a dick dictatorship, so they made signs. we have an original solidarity sign in polish which says two plus two must always equal four. what they were saying was that this is a truth, that governments can't lie about this. because you'd know they were stupid.

and if a government comes in and says two plus two equals five, you'd go, that's really dumb. so one of my goals for the women's organization is very simple. when you can make these signs on their own -- they're not very hard. [laughter] go around your neighborhood and show this to your neighbors. if they agree, get 'em to register to vote. [laughter] [applause] if they disagree, they're probably liberals and leave them alone. [laughter] now, let me come back just for a second to the second part of wendy's question. i co-chaired with bob kerrey the alzheimer's study group, i worked for a long time on mental health issues. my mother had bipolar disease, for example, so we have a family experience of this that's very real. i believe in something beyond parity. i believe in inclusion.

i believe that in the future when you go see a doctor, they're going to worry about three characteristics; your -- or four characteristics; your spiritual life, your social life, your mental life and your physical life. and they all relate. and you have to understand, to understand -- women who are in group are three times more likely to survive breast cancer than women who are isolated. so, therefore, if you have a breast cancer patient, one of the first things you should find out is what are their social relationships? women who exercise together and have social relations in a program called silver sneakers are 62% less likely to have depression medication. because they are 62% less likely to be depressed. because they have friends, and they're doing something, and they're not isolated, they're not alone. women have a very high requirement for social relationships. men have a very high requirement for beer and television. [laughter]

they're fundamentally different organizing principles. [laughter] so, but on a serious level, i think we have to -- from medical school on, reframe how we approach humans. humans who have a belief in a higher being live longer, are happier and have fewer diseases. there's a reason that the alcoholics anonymous 12-step program, the first step is recognize you have a problem, the second step is recognize there's a higher being. we once had a federal official say, you know, we could finance that except for that second step. [laughter] and they said, could you come up with an 11-step program? and the answer was, we think you misunderstand how big the second step is. [laughter] so i am very much with you on including all of those characteristics in what should be a serious health approach. i also believe you made a key point here. we have been trapped into this insurance-focused mentality when, in fact, community centers and other devices may deliver better care at dramatically lower cost, and you may want -- we may after obamacare's

repealed think about very creative, new local solutions that have a multiplicity of organizational structures and don't fit a one sides fits all washington -- one size fits all washington mandate. yes, ma'am. >> speaker gingrich, my name is representative pamela tucker, and i'm here from greenland, this is my hometown. and i would like to understand your thoughts on a national right to work and our federal laws regarding labor relations. as you know, new hampshire right now would like to become the 23rd state that has right to work. thank youment -- thank you. >> i have to say, by the way, for our viewers on c-span that when i learned earlier today that i was going to greenland -- [laughter] i double checked. [laughter] but they can, in fact, visit new hampshire and be in greenland. [laughter] or berlin or a variety of other cities. [laughter] although i don't think the wall's in berlin, not to my

knowledge. first of all, i hope that this is a state matter, you have to decide it yourself. my bias is in favor of right to work states, and we have seen a continuous growth, for example. there are a lot of american auto factories in right to work states. they may have foreign brands, but they're american factories, and they're creating jobs in america. this national labor relation board decision that boeing could not open a factory in south carolina because it was moving from a closed state to a right to work state is such a threat to the entire american system that i am urging the house republicans to zero out the national labor relations board -- [applause] the two key people on that board are both interim appointments. the president nominated somebody so radical that even when the democrats had a huge majority in the senate, they couldn't get

him confirmed, and he gave them an interim appointment. he's a genuine radical, totally anti-business. they then hired a general counsel who's also not confirmed, and the general counsel decided that he would block boeing which wants to create 8,000 jobs in south carolina. think about this. we're in the middle of a deep recession. boeing is the largest exporter in the united states. they want to build the dreamliner in south carolina to export, and the obama administration is blocking 8,000 jobs, and it wonders why the recession's going on. so i think we should actively and aggressively say that the national labor relations board if they're going to break the law -- which is clearly what they're doing. by the way, for those of you who think boeing made an inappropriate decision, the president's current chief of staff, bill daley, was on the board and voted to build the factory. this is how bad this is. and so i think it's very important that we, that we bring the nlrb, the national labor relations board, under control.

but i also think you're going to see a continued trend towards right to work states because the fact is, unfortunately, unionism instead of being a pro-change, pro-productivity, pro-competition movement, unionism has been a very rigid conflict with management movement which has made it harder for us to compete in the world market. now, that's not true of the craft unions. there are a number of them that have big training programs, very serious efforts. but unfortunately, many of the public bureaucracy unions have been anti-work and anti-productivity. yes, sir. >> hi, mr. speaker. i'm steve mckenzie, i'm also from greenland, and, um, first of all, i'd like to say it's nice to have the old newt back. [laughter] and that so when you win the election, but the country doesn't think straight and we don't have a clear majority in either house, can you get all

these things done? >> well, i, i can't imagine winning the election without having a clear majority in both houses. i mean, we will run an election that is so vividly clear that there is a left-hand approach that kills jobs, kills american energy, weakens the country, fails to control the border, puts us deeper in if debt and risks the future, and there is a right-hand road that creates jobs, creates american energy, controls the border and gives us a fundamentally better future. we're either going to win this argument d which we will, in which ace we're going -- case we're going to have a landslide election -- or we're going to lose. but i can't imagine a place where we don't pick up additional house and senate seats if i win. if we lose the argument and don't pick up the house and senate, we won't win the presidency. that's why winning the argument is so important. margaret thatcher used to always say first you win the argument, then you win the vote. i believe president obama is

giving us the finest opportunity to set up an argument to replace the left in 80 years. and i believe we should take advantage of the opportunity he is giving us to paint two futures for america, to win the argument over those two futures, and as a consequence to win what i think will be a historic majority. [applause] >> mr. gingrich, my question for you is, so, how do you intend to beat mr. obama, a man who has the potential to amass millions, possibly billions of dollars as we sit here today? and he has the media behind him? how are you going to beat that? >> by pelling the -- telling the truth. that's why two plus two equals four matters. [laughter] i believe he can outspend us by about four or five to one and still lose. if you go back to 2006, every republican senator who lost spent more money than the

democrats. if you look at california, jerry brown was outspent, i think, three to one. and the fact is in the end, particularly running for president, it comes down to people you see in your living room every night. it's people who you hear from them, you don't hear from their consultants, their advertising. that matters in primaries. in the general election, if you have a message that's real and people know that's real, all that will do -- i believe it is impossible for the president to try to turn all of america into a chicago machine. i believe it is impossible for him to raise enough money to convince the american people that reality isn't real, that their principles aren't their principles and that they should reelect somebody who has failed in performance and who is a radical in the policy and philosophy. i don't think there's enough money in this country to be like that. if we have a candidate, this is the key thing, i mean, the great victory of reagan over carter, reagan beat carter, reagan carried more states against carter than fdr carried against

herbert hoover in 1-9d 32. and the reason was reagan had spent years getting to a very clear message. and the american people looked up, reagan had a good line. hard times then, not as bad as this, but hard times. and reagan campaigned saying, you know, a recession is when your brother-in-law's unemployed. a depression is when you're unemployed. a recovery's when carter's unemployed. [laughter] now, you might imagine as an historian that that phrase may come up with one name change sometime next year. laugh and i think we'll take one more question, and then we're going to let the news media ask a couple questions. >> thank you so much for being here. my name is judy, and i live in new hampshire, and i have just received my medicare card through the mail, so i've become very interested in medicare, and i was wondering how you would tweak paul ryan's plan.

>> that's a good question. and let me start by saying to show you how i think despicable is the right word the democrat mediscare campaign is, showing a cartoon of ryan pushing a grandmother off a cliff, i think every american should condemn campaigns designed to frighten senior citizens that are totally false. there's something disgusting about it. [applause] i was yesterday at a medical center, and a man walked up who works at the center, and he said my 85-year-old grandfather knew you were coming and asked me to ask you if his social security and his medicare were going to be taken away from him. because he's genuinely frightened. now, the president of the united

states ought to tell every single part of his party to quit doing this stuff. i mean, it is truly remarkable that the president of the united states would do this. this is the third time in my lifetime we've had a mediscare campaign. the first was against reagan, and when the country figured out it was a lie, they beat carter by a landslide. the second was in 1996 against us, and when the country figured out it was a lie, they made us the first reelected republicans since 1928. by next fall we're going -- we will win this thing decisively was seniors -- because seniors will begin to realize, remember, the obama budget just went down 97-0 in the senate. so you say to them, what's your solution for medicare? the answer is attack paul ryan. so how are you going to fix medicare? attack paul ryan. so what are you going to do to make sure that medicare doesn't go bankrupt? attack paul ryan. i mean, there's something pathetic about the great

national party with control of the senate, control of the white house having nothing -- you know, franklin roosevelt said we have nothing to fear but fear itself? the democrats are now reduced to having nothing but fear, and it's really sad. i will tell you, i believe -- and i say this having studied it for years -- i believe we can offer a better medicare program with improvements that are real that are based on choice. we could allow those seniors who want to to have a health savings account, make it universeally available if you want it. if you don't want it, don't get it. we could allow those seniors who want to to have a right of private contracting. so you can go find your doctor without worrying about the washington bureaucrats' rules. if you want to. there are a number of things we can do that are voluntary choice. you know, the government doesn't say you have to go to walmart on tuesdays. somehow walmart convinces you on their own. [laughter] and the challenge to conservatives is we can start from the base of what paul ryan has proposed, we can go out and listen to the american people, we can develop better solutions,

and we can absolutely save medicare. i'll just close with one last example. we did a book two years ago whose title was deliberately simple in hopes that washington would notice it. it's called "stop paying the crooks." it's at the center for health transformation. and we showed that the federal government is such a bad manager of your money that in medicare and medicaid they pay between 70 and 120 billion dollars a year to crooks. now, if you wanted to save medicare, the first and easiest place would be to bring in american express, visa, mastercard and ibm, all of whom have volunteered to come in the. because they don't pay crooks very much. you are 330 times, 33,000%, more likely to pay a crook in medicare and medicaid than you are at american american express. and so i believe you can apply common sense ways of improving the system that every senior will applaud, every doctor will

applaud, and the only people who will be screaming are liberals who are dedicated to bureaucrats running your life. and their answer is rationing. and nobody should kid themselves. the obama model is to ration care for you by an unknown bureaucrat who's never met you, has no idea who you are setting objective, abstract rules that may or may not have any impact on your life. and i think that is a terrible alternative. and when seniors understand those are the two alternatives, they're overwhelmingly going to prefer one which gives them choices, not one which rations their care from washington d.c. so -- [applause] for just a couple minutes, any reporters who want to ask questions, we want to give the reporters an opportunity if they'd like to. >> just one quick thing, mr. speaker. i'm a selectman here in town. i'd like to welcome you to greenland, new hampshire. and i want to thank you for speaking with us and answering our questions. it's an honor. >> thank you very much. glad to be here.

[applause] yes, ma'am. >> hey there, mr. speaker. thanks for doing this. good to see you. i wonder if you could talk about the challenges you think you have when you look at the field that's out there of gop contenders, when you look at the map, iowa, new hampshire, south carolina, what are your challenges in getting out of the primary? >> well, my challenges are all communication. i don't think about the very fine people who are running. i think about the american people. if i can get out a message of dramatic, bold change, and if i can get out a program that people believe actually will get america back on track, i'll win the nomination. if i can't get that message out clearly, i won't win, and i shouldn't win. so my goal is this, frankly, not to focus on any of my good friends who are running, and a number of these people i know very well and i mr. respect. my goal is to focus on a conversation that says here's what it's going to take to make america healthy again, here's what it's going to take to bring energy in america, create jobs.

if people decide that my solutions and policies are better and my ability to articulate is better, i'll be the nominee. but it's not against one of our republican contenders, it's a conversation with the american people. >> great. thank you. [applause] >> thank you. >> hi, mr. speaker. >> hi. >> last night vice president -- sorry, i'm a little short. vice president joe biden said democrats are on track to bounce back, and americans don't like the, quote, unvarnished agenda of the republican party. what's your reaction to that? >> anybody asked joe how he felt about every democrat in the senate voting no on the president's budget? [laughter] i mean, if a bounceback is a 97-0 vote -- this would be typical of biden who probably didn't notice it. [laughter] [applause] thank you all very much.

[applause] .. >> speech autism occurs in all racial, ethnic and socioeconomic groups but on average affects 4 to 5 times more boys than girls. i actually became involved and immediately concerned with autism back in 1982 when i

visited with dr. david holmes the founder of eden institute now edin autism institute and i'm very glad that dr. tom mccool will tell us how eden is using its 36 years of experience to improve autism service programs around the globe. i became deeply involved and even more so in 1998 when a family of my congressional district bobby and billy gallagher told me about a perceived prevalence of autism in a township. i requested the centers for disease control and the agency for toxic substance that it was indeed to be much higher than was generally to believe to be the prevalence. as a direct consequence of the bringing study and the cdc

admission that there were no recent prevalent studies in the united states with which to make a comparison, i introduced legislation to authorize grants for autism and pervasive developmental disabilities surveillance into established centers of excellence in autism and pervasive developmental disabilities epidemiology. this legislation, the autism statistics surveillance research and epidemiology act or assure was introduced in 1999 was incorporated into title 1 of the children's health act of 2000, which also established the centers for excellence in autism, research in nih and created the interagency autism coordinating committee. to continue to monitor implementation of these new federal implementation programs i established in 2001 along with my colleague mike toil the congressional autism caucus to raise awareness of autism and provide a forum for advocacy

within congress. the combating autism act of 2006 reauthorized the autism programs created by the children's health act but also expanded the act calling for research into possible environmental causes of autism and creating and, quote, autism education, early detection and intervention program to improve early screening diagnosis, interventions and treatment for asd's. just last week, i introduced along with mike a package of free comprehensive autism bills the combating autism act of 005 which will ensure continuation of the important federal autism programs for education, early detection, surveillance and search of the national asd act makes the hhs secretary the head of the national autism effort and ties budget authority to the strategic plan for autism

research. and the asd act or h.r. 2007 which establishes grant programs to provide important research and services for children transitional youth and adults and establishes training programs for service providers. i would note to my colleagues on a trip to lagos, on human trafficking while there i met with a man, a parent of an autistic child. he is the executive director of the public/private partnership resource center and his wife dr. doris is the executive director of the oig health foundation and autism center. they told me of the large numbers of nigerian children suffering with autism and the lack of government or other supports. as a result of my discussions with the family, i introduced on

february '08 the global autism assistance act which directs the administrative and u.s. agency for international development to establish and to administer a health and education grant program to support activities by nongovernmental organizations and other service providers focused on autism in developing countries and also establishes a teach the teachers program to train health and education professors working with autistic children in developing countries. i will be reintroducing this legislation later this week. while this is a first of its kind hearing, i plan on scheduling additional hearings on this escalating health crisis and on the global autism assistance act when we introduce it later in the week. i would note that the progress that has been made in recent years and increasing awareness and particularly of some of the more developed countries in improving services and treatment

for autism, however, i would note at the same time that we must take seriously the world autism organization's assessment that in every part of the world, the situation we're dealing with autism remains inadequate, even in those countries with considerable experience and understanding of autism because the systems that have been established are being completely swamped by the number of people in desperate need of support. there are a wide range of autism prevalence figures between countries and individual studies. in the united states cdc estimates that close to 1% of the population is affected by an asd. autism speaks, the nation's largest autism science and advocacy organization describes a scientific consensus that 1% of the world's population or some 67 million people, i repeat an estimated 67 million people are affected with some form of

asd. according to the world health organization, i'll include their testimony and hopefully at a later date they will testify as well but in their submission they note that, quote, tens of millions in africa are affected by autism. tens of millions. in that context autism is a developmental disability pandemic. it is largely underrecognized, underappreciated in its impact and underresourced. caring for individuals with autism often takes as we all know a very high physical, emotional and economic toll on families and other caregivers. more severe forms of autism multitime over the require care in countries autism can overwhen he will their families as their lives become consumed with the considerable challenges of identifying appropriate biomedical and psychosocial treatments, and other needed

support systems for their autistic child or children and eventually for as autistic adult. in less developed countries, the situation is even more desperate. very often there are no resources outside of the family to help. and rather than a diagnosis of developmental disorder, the child and the family may face cultural stigma and discrimination pushing the family and the child further into isolation and desperation. we all know that early interventions are effective in improving the functionality of the child and that the positive outcomes from early interventions can last throughout the life of the individual but very few children in africa, for example, as well as other developing countries have access to such interventions. even in more economically developed nations there are large disparities in the quality of care. concerted actions are required to overcome the global

challenges to effectively address autism and other developmental disabilities. we need to continue to help increase awareness of autism at all levels. and in all countries who advocate for the inclusions of developmental disabilities in national and state health policies to increase the availability of quality services across a continuum of care and across the life span and to continue to support scientific research that will lead to more effective treatment and one day to effective strategies or prevention. the benefits of international collaborations and corporations are multidirectional. in fact, i'm looking forward to learn about northern ireland's autism act of 2011 from arlene cassidy, ceo of autism northern ireland. i'm pleased we will have miss cassidy join us today and she will be speaking to us very shortly. i and other congressional

cochair mike doyle signed the memorandum of understanding with the northern ireland assembly to share information, support common interests regarding autism. in addition to tom mccool and arlene cassidy testifying here today will be brigitte kobeman founder of the foundation of africa and andy shih, who's the vice president of scientific affairs for autism speaks. we're all looking forward to hearing the valuable perspectives that each of our witnesses bring to this discussion. and although they are not here today, i would like to recognize the autism society, who will testify at a later hearing for their invaluable work in advocating on behalf of individuals with autism both within the united states and in the international community. i've been informed that tom payne, who's our ranking member who is en route and who will be here to a half hour to an hour.

i guess he ran into some delays at the airport but he will be here and we'll be joined by some other members as the hearing progresses. i'd like to ask our distinguished witnesses to come to the witness table and i will begin with their introductions at this point. we'll begin with mr. andy shih, who's the vice president for scientific affairs at autism speaks. he's -- autism speaks as i think many people know is the nation's largest science and advocacy organizations dedicated to funding research into the causes, prevention, treatments and cure for autism, increasing awareness of autism spectrum disorders and advocating for the needs of individuals and their families. mr. shih works closely with members of autism speaks board, scientific committee, senior staff and voluntary -- of volunteer leadership to develop and implement the organization's research program. he oversees -- he focuses on

things that include genetics, environmental sciences and epidemiology. and he also leads autism speaks international scientific development efforts including global autism public health initiative and international advocacy effort that intergrates awareness research and then scientific development. i note parenthetically in 2005 and 2006 when the reauthorization was very much in limbo, whether or not it would actually occur, autism speaks moved heaven and earth to make sure that legislation was enacted and i congratulate you on your extraordinary advocacy, senator santorum's bill that did become law and passed both the house and senate, obviously -- it was a great credit to your organization as to how well you helped to bring that about. so i congratulate you on that. we will then hear from ms. arlene cassidy who's the ceo of northern ireland's autism charity known as autism ni. she specializes in autism spectrum disorders for 20 years

and has provided the research service development and strategic lead for autism ni or northern ireland the in the development of an internationally acclaimed early intervention program for autism including a catalog of academic research and published journal articles. she's led the charity as an accredited training agency as well as an effective agent for social change through a community development and partnership ethos which she has provided the foundation for the charity's family support services and an effective -- political lobby for a dedicated northern northern ireland autism act which was signed into law in northern ireland. we will then hear from ms. brigitte kobeman, who moved to the united states over a decade ago. in 2004, brigitte's daughter had

an autism spectrum disorder and they moved to where their son can receive appropriate treatment for his choice. back in maryland brigitte founded the not-for-profit autism community for africa in 2008 to create a platform to share her experience and help african families in need by providing them with information and resources. brigitte also represented her country and was voted miss congeal -- congeniality. and then we will hear from mr. tom mccool who is president and ceo of eden autism services, a new jersey-based nonprofit organization that works to improve the lives of children and adults with autism and their families.

eden provides a specific variety of needs throughout the life span. mr. mccool is the founder commissioner on the national accreditation of special education services and founding member and current vice chair of the national association of residential providers of adults with autism. he served on the medical investigation of neurodevelopmental disorders institute advisory board. he's currently a member of the autism society of america and is serving as treasurer of the national association of private special education centers. he's also the chairman of the board of autism services group. i don't know where he gets the time. mr. shih? >> thank you, congressman smith, and members of the subcommittee for this opportunity to share with the autism speaks and goals of autism. i'm andy shih i'm part of autism

including research and gifkz in terms of sciences and epidemiology as well as an international scientific development environment. i'm a biologist by training and i have the honor and pleasure of serving in the austin community for a decade. as congressman smith mentioned, it's scientific basis 67 million people for about 1% of the world's population is affected with some form of asc. a prevalence higher than aids and cancer and diabetes combined. though there's no medical ker four autism treatment can work if diagnosis is early. the recognition for need of better screening for treatment has led groups is such as the american academy of pediatrics command the screening for all children between 18 and 21 months years of age. the success -- the success is improving care both in north america and europe also makes it

clear that these approaches can be adapted and extended to countries around the world. unfortunately, today, in most of the world, dinosed intervention is more aspiration than legality a major barrier to improving the health and well-being individual in the family is a lack of expertise and capacity to diagnose the disorder and to deliver appropriate intervention. with our expert and capacities it improves the quality of life for individual asc and their families from being out of touch. in many countries there's little awareness and simply no often service providers. as a result, affected children and family do not receive proper care. and support. an opportunity for better outcome and improved quality of life for the families are lost. to address this global public health challenge in 2008, autism speaks a public health initiative. an ambitious advocacy effort to provide support to other countries in order to enhance public professional awareness of autism and to increase capacity

to enable early detection intervention as well as research. the core value of a sense of urgency, scientific excellence and families touched by autism, public health initiative or gap provides technical expertise and support to our partners to help realize their vision of progress. to collaborate broadly and incluesively with stakeholders of all levels, clinicians and science as well as parents and families because we recognize the development and implementation of meaningful and sustainable program solutions required local leadership and ownership. strategies and content are continually informed by the latest research in clinical dissemination and science. in addition, the experience we gain in data we collected from gap programs would help us advance and refine autism science and inform service and agency development. indeed, benefit from the gap-related activities are expected to be reciprocal with greater international collaboration and there will be

new insights into a success c causes including environmental factors, social cultural influences and diagnosis and treatment, education, and service development. interests that will help affect individual families the world over including those in the united states. autism speaks currently support gap-related countries in 26 countries and six continents and these collaboration are already yielding impressive returns for our community both here and abroad. we have a country like brazil, mexico, qatar have their own established their own collaboration with u.s. scientists. they are supporting governments like albania and ireland with the international health policies and program. as an initially ngo partner of the w.h.o. and working with geneva and health minister industries in the south of europe and southeast asia to develop a regional health networks to develop awareness and training. autism speaks and w.h.o. are

collaborating bangladesh collaboration office and the ministry of health, to host an international conference this july -- this july in dakar. to bring together like-minded scientists together for several countries to explore regional coordination collaboration. finally, the recently published first ever prevalence in south korea reported two prevalence of 2.6% with many previous cases found in the mainstream schools. in addition to the potential implication for environmental science research the difference between case methodology using the korean study and the one used by cdc to determine cdc by our statistics and if we are underin the autism. the prevalence in other public

health data and their policy and service development is not available in most of the world. however, our recent estimate over 90% of autism research conducted on about 10% of the global community. and supporting gab related activities like korean opportunities worldwide it's to help bridge the knowledge gap in foreign policy and development and hence evidence-based and as a result narrow the service gap. in south africa, for example, we found a prevalent study where aids is an epidemic. with public health statistics and explore a compromised means system on brain development. simultaneously we're working with stakeholders from that country including government officials to develop consistent community priorities having upcoming programs and discussions with public agencies and it's worth noting that one of the recurring themes we've encountered with health officials and low resource countries in those in africa is

how best to prioritize autism with so many life-threatening diseases and conditions such as aids, malaria and malnutrition compete for public health resources. while we understand that perspective, we believe that such a public health policy-making is overly simplistic. as child mortality increases, simple math predicts an increase of the disability. so instead of seeing mortality and development disorder like autism as two distinct public health challenges it should be tackled as part of the same problem. autism speaks and our partners around the world believe that by addressing autism-related disorders now south africa and the other developing countries can get ahead of the curve, help maximize outcomes for individual families and limit long-term costs to society. in conclusion, the daily challenges are familiar to any individuals of families in this country struggling with autism spectrum disorders. by sharing our experience,

expertise and translating and adapting best practices into health solutions we believe we can make a difference in communities with less know how and resources. just as important, we can also learn valuable lessons from these collaborations that can help improve the quality of life to our families here. but we need help. our work at w.h.o. has a power of collaboration in the salary and progress and speed and delivery to answers to our families. we welcome suggestions, and recommendation about how perhaps we can work with other government agencies further our global effort. thank you. >> thank you very much for your testimony and again, thank you for the fine work that autism speaks does not just here in the u.s. but here around the world. i'd like to now invite arlene cassidy who's the ceo of autism northern ireland, if she could provide us with her testimony. apparently, audio part of this

has not come through. i would note she is speaking to us from our -- the u.s. counselor's office in belfast. >> thank you. >> thank you for being here. >> please let me begin by thanking chairman smith, ranking member payne and the members of the opportunity to appear before you this evening. i hope that by the end of this evidence, the subcommittee will look beyond the relatively short history, 20 years of the autism movement in our small country and recognize the huge steps taken over the last four years to address the issue of inequality, the legacy of neglect regarding service planning and funding that is our experience. in my written evidence which was submitted last week, i referenced in some detail the impact that they had of stunting the growth of economic growth in northern ireland.

those decades of that particular civil conflict coincided with the birth and spread of the global autism movement but that wave of autism awareness and knowledge passed us by. the progress regarding post-conflict reconstruction of northern ireland, therefore, has been a barometer of the fortunes of autism. in the 1990s, knowledge about autism swept and was absorbed by families on the nonprofit sector but government ownership was absent. the subsequent decade has witnessed the fledgling efforts of various government departments to plan strategy for autism alongside the establishment of the northern ireland assembly. the question is are we going in the right direction, and yes, this can be viewed as progress until one considers that planning has been limited to single government departments such as health, planning has not built on the developments of the 1990s. instead, the more proactive government role has resulted in

existing services being deconstructed and innovative local research ignored causing delay as new untried models are in place. also planning and liaison is more disconnected between the statutory sector and the nonprofit sector than ever before. the funding priority overall is still very low. funding allocations are based upon an data placement of asd within the learning disability budget the result asd services are funded by money taken from the learning disability budget feeding back into the lack of services for people with asd with an i.q. score of 70-plus. the campaign for the northern -- for the autism act ni 2011 began in the homes -- began in homes across northern ireland as families increasingly voiced their frustration about how the lack of dialog and planning across government's departments was seriously impacting on their lives as support across the

various life transitions was challenging for individuals with autism failed and failed again. the campaign for the autism act began in the hearts and minds of parent activists. increasingly aware that the core of all the flawed planning and absent funding was a fundamental inequality. asd was not recognized or clearly defined in disability-legislation in the united kingdom. resulting in all the decisions regarding service and benefit entitlement that are based upon disability legislation being open to interpretation, rejection and inconsistency. this campaign united families a nonprofit sector and public representatives at a period in our political history when the art of lobbying political institutions was in its infancy and lobby agencies were nonexistent. a democratic lobby of the people have been created so we made an impression and we had to -- because the status quo was

against us, few public servants understood the need for change and, therefore, they opposed it. the campaign gained momentum in 2006 encouraged by developments in wales where the welsh assembly government to unite the public and nonprofit sectors in planning for asd across government departments. within the u.k. and across the world, the call for national strategies and legislative social change was getting stronger. the creation of the celtic nations autism partnership and the 2007 delegation to washington, d.c. to meet with the cochairs of the autism caucus was part of that movement. it was no accident, therefore, that the autism act is rooted in the realities of our society. it is unique to our situation and in the aspirations of the families here. yet, it is an example of one mechanism that is available to many societies in addressing

fundamental human rights and the inequalities when the state is resistant about its legislation. there's little doubt that the changes brought by the northern ireland about the definition of disability will reverberate across the other jurisdictions within the u.k. and the republic of ireland. if the autism act northern ireland initiates legislative change beyond its own jurisdiction, what a complement to the journey we have traveled. the next steps at home are crucial. as the northern ireland agrees the implementations for the autism act we must ensure that the lessons of the past are well learned and that families living with autism are not disenfranchised again. there has never been a budget or cost center for autism across government departments because -- well, a budget for a condition that doesn't exist in northern ireland and when there's no data there's no

problem. this will be the greatest challenge, finding the budget, quantifying the need. the autism act is our hope. above all, it is evidence that we have citizens with autism who can no longer be ignored. thank you. >> ms. cassidy, thank you so much. if you could hang on for a few moments, perhaps to answer some questions, we will go now to -- and i want to again thank you for the work that you've done with the all-party caucus which works so closely with our own caucus here. the more we collaborate, hear best practices and learn from your new autism act of northern ireland, 2011, the better. we could all borrow best practices and hopefully put them into law and policies so thank you so very much. i'd like to now ask ms. kobeman if you would now proceed. >> thank you, congressman smith,

and members of the subcommittee for the opportunity to share with you my experience in dealing with autism in africa. my name is brigitte kobeman, founder of the autism community of africa and a mother of a child with autism. in 2007, after being invited on the voice of america television to talk about autism in africa, i was contacted by a young lady from nigeria. she was asking for help because she recognized the symptoms of autism that i had talked about on the show. and she was convinced that her brother has autism. but she was more alarmed by the treatment that he was receiving. he was tied on a tree and beaten with a stick to chase the evil out of him. and a lady contacted me because

the lady was on the verge of depression. with the cultural stigma labeling her daughter as a bad omen, and the constant challenge and lack of sleep in raising her daughter, the mother end up in the mental institution. another concerned sister from atlanta, georgia, contacted me because her sister in ethiopia was exhausted. her der was looking for something, anything that could help her deal with her daughter's autism condition. we can say with caution that through the years the awareness for diseases like hiv/aids, malaria, and malnutrition has reached a great deal of maturity in africa and around the world compared to others. the minister of health in an african country which i will not name for privacy once told me, what is autism anyway? what is malaria? everyone knows malaria.

my point exactly. everybody knows malaria. not to minimize this issue in any way, but what do we do after children are feeling better from malaria? malnutrition, or receive treatment for aids but still have autism. in africa, children with autism are a burden of most families and society due to the lack of awareness, education, and proper treatment. they need to be given the necessary tools to care for themselves. autism can be treated. my son is a living proof. he was unverbal until the age of 4. after receiving his diagnose. my husband as the congressman said earlier. that avenue battle that people with autism faces. it was hard, frustrating and

sometimes brutal but we had to keep going because we knew our failure as parents was not an option. vine was lucky enough to be born in the united states of america where he's able to get the treatment that he needs. the infrastructure are there so we as his parents have no excuse to fail him. today, at 11 years old, even though he's a little different from his peers, vinnie is self-sufficient and he's in mainstream school. he's doing well according to his iep and his education plan. sometimes during our conversations, he gives me the magic phrase, mom, you just don't understand. and to have the attitude to go with it and i smile and thank god for living in this great country but my joy is bittersweet because i think of all the children and families in africa and i shed a tear. the children in africa are not so lucky. they have nothing to help them,

doctors don't have the equipment necessary to dealing with the problem and there is no follow-up program. as of now, a few ngos in countries like nigeria, cameroon, south africa, ghana are struggling to take on the challenge. these ngo were created mostly by parents who were frustrated by the lack of infrastructure to help their children. but they are faced with a variety of challenges, lack of funds, lack of support from the government, fear from family to shield the evil child with autism, et cetera. the mother told me once, if i show my son to you, what are you going to do for him? and this is the reality on the field. these kids are hidden. they are afraid to show their children with autism because they know there's nothing that can be done for them. they think that they should just expose themselves and the child, they think that they will just expose the child for nothing. they do not have any hope.

they do not seem protected. and i think that the local government by collaborative with ngo and families will have those who bring them a sense of security. throughout my work and experience with aca i have the experience to work with many families with autism and decision-makers in the united states and around the world. one of the main obstacles i observed with regards to the african continent is the lack of political will. for any program to be successful, leadership and ownership is required among other things. but the majority of the leaders and stakeholder on the local level in africa are either misinformed or just not interested in the subject. again, to think of the minister of health ask me the question, what is autism anyway? just imagine the level of knowledge among the population.

one of the great challenges is poverty. many families do not have the means to see a doctor, let alone care for a child with special needs. and for those who can afford it, well, there are no resources. hence, the importance of autism awareness campaign in africa as well as care. thank you. >> thank you so very much. we're joined by our distinguished gentlelady from new york. >> thank you, mr. chairman. and thank you for holding this hearing on an issue that has significant global health implications. autism can be difficult to diagnose and even harder to understand especially those who have any specially acquaintance with the disease or disorder. autism is no respecter of all limitations. regardless of whom it affects autism is a heavy burden for families who have a child with

autism. but there is hope. modern medicine has seen the development of new treatments for autistic children. early intervention is key. autism no longer has to be a barrier to the future successes and fulfillment of those affected by autism. with the increasing prevalence of reported cases of autism, this hearing is indeed timely. and i'm glad we will have additional hearings on this topic. thank you, mr. chairman. and i yield back. thank you. >> thank you very much. i'd like to now yield to whom it may concern to mr. mccool. >> congressman smith, thank you for inviting me to participate in this dialog by the global aspects of autism. as you mentioned eden autism services started in princeton, new jersey, 36 years ago. and during that time, our organization has gained a great deal of knowledge and experience in addressing the needs of children, adults and families impacted by autism. all of us in the autism

community recognize that there's a lot to be done and each of us has a role to play. in its short history autism speaks has been able to significantly increase awareness of autism and its impact on families. they've also been extremely successful in raising funds to support its awareness activities and also support autism research projects. in recent months, autism speaks has begun to focus on the plight of adults with autism. particularly, looking at the broad range of residential, and employment programs needed to support this growing population. the autism society, another one of our partners, has a long history of bringing family members and professionals together nationally and through their local chapters. they annually present successful program models and that can benefit a broad range of needs for children and adults with

autism. the autism society financially supports training programs for teachers and direct care professionals working in the field of autism. eden has not yet had the opportunity to work with the autism community of africa, however, several eden professionals have visited africa to work with families dealing with autism. eden provided family and staff training and the eden curriculum. the role eden autism services plays in this arena is the direct -- is the direct service delivery component. that interaction between a person with autism and those teachers, family members and other professionals that follow a proscribed scientifically based treatment methodology. eden does this in its schools and adult residential and employment programs and works with other direct service providers across the country to duplicate this treatment

wherever needed. there are two basic components to this process. the first component is the treatment model. in 2009, the national autism center issued its national standards report that emphasized the importance of evidence-based practices and the need to ensure that research-based treatments are given the priority over those that have not yet been proven effective or those that research has shown to be ineffective or worse. the second component is the autism-specific curriculum. the teaching content that promotes the acquisition of knowledge and skills that support the person with autism i-ability to function in society. eden has developed an autism-specific curriculum that is used in both public and private schools across the united states and several other countries. eden autism services in the thousands of direct service

providers across the country provide that intensely personal interaction between teacher and student using treatment models and lesson plans to decrease and eliminate appropriate behaviors and increase the capacity for children and adults with autism to live as productive citizens in society. eden has acquired expertise in teacher training, family training and direct care training using applied behavior analysis in addressing problems behaviors exhibited by children and adults with autism. we've developed a curriculum that contains hundreds of specific lessons that can be used effectively by teachers, family members and direct care staff. our goal is to share the knowledge and experience eden autism services and many other direct service providers have developed to improve the quality of life of children, adults, and families impacted by autism,

wherever they are. the information is available. the technology is available. and our hope is that we will be able to find a way to share this knowledge and bring help to those children, adults and families impacted by autism in other countries where such help does not exist. and the one thing i wanted to mention that we have gotten involved in most recently that has significantly enabled us to directly impact more children with autism and it's a social networking network called edweb. and edweb builds communities where different types of educators or different educators can directly connect with one another so eden has hosted the autism community on edweb. and it is a way for teachers who are working directly in

classrooms with children with autism to connect with one another and deal with very specific issues and an email people ask goes out to everyone on the network and a question is asked how to deal with a specific issue and immediate response is taken. and edweb is available. it's on the internet. it's something that could be very valuable beyond the borders of our country. so we're looking forward to working with our partners. and to take the knowledge that we already have and find ways to get that knowledge and experience to those who really need it. thank you. >> thank you very much for your testimony. and for the great work eden has done for all these decades, at least for this member and i know many other lawmakers including our governor, eden has been transformational for us in helping us to understand this

devastating disability. so thank you so much for the great work you've done. let me just begin the questioning. i'll start with mr. shih, if i could. you spoke of the global autism public health initiative, which you began in 2008. i know that w.h.o. began a six-country pilot program in 2008 as well and i'm wondering what kind of collaboration your organization is having with the world health organization? and if you could, what are the biggest challenges -- you know, we just heard from ms. kobeman when she and others speak to other ministers -- and i raised this with other health ministers any chance i get, the knowledge base is so rudimentary but it

seems as if and you, i think, offered a very clear way forward that we need to see this as the other side of the coin in mitigating the child mortality as that improves obviously this will exacerbate and get worse unless we address it. so if you could speak to the global health initiative, the global autism public health initiative, maybe elaborate on that for us, if you would, and also in your answer if you might speak to where are we now in terms of getting to the root cause of what is triggering autism. i know it's always controversial. i'll never forget in 1998 when i first imposed the brick study some very well meaning person from the centers of disease control got up in my face literally and put her finger in front of my face and said -- when i mentioned vaccinations as a possible maybe

multivaccinations thimersol people were concerned about and maybe still are and i was told not to go there. and i'm a very strong advocate of vaccinations. i was the sponsor of the amendment that doubled the amount for the child survival fund in the early 1980s. i was in el salvador when they immunized upwards of 200,000 kids against polio, diphtheria and pertussis and other diseases but there should not be a collateral of doses where a little body cannot metabolize that. so if you could perhaps speak to that as well. >> thank you, mr. chairman. first, to address your question by the global public health initiative. we are an official partner with the w.h.o. their mandate is a little broader than autism speaks.

their focus is on the child mental health and disability including autism. and we see our relationship as one where the community has gotten together with the international agencies and health agencies to address the tremendous public health challenge that was hiv infection. and as a result, even though the focus is on hiv or aids by these groups, i think it can be argued that they have benefited the diseases and research services overall globally and we see a similar kind of relationship of the w.h.o. to the health priorities. so the six pilot programs that you had mentioned that the w.h.o. recently launched, we are in discussion about where we can be helpful. we are part of a discussion, ongoing -- at the institute of medicine, the new york science board talking about how we address mental health and

disability development needs in sub-sahara africa. my expectation is that activities with these pilot project would be launched in the next six to nine months and our expectations would at least be part of those efforts. indeed, the bigger challenge, i think, in addition to capacity and expertise is really is awareness. as ms. kobeman mentioned, at the country leadership level often with you run into individual ministers and highly placed officials who knows nothing about autism. and that makes the challenge of helping the families even more difficult. what autism speaks does on a yearly basis now is that around the time the united nations general assembly, we organize an awareness event for the first spouses of the world's leader to bring them in and show them a

little bit what we know about what's happening in autism worldwide and we ask for the help. this year actually we're going to be working with w.h.o. so that in addition to bringing -- engaging the first spouses around the world but also bring in the ministers of health in these countries so that there would be a more immediate connection from the good will by the leadership and the public health officials of that country so we're optimistic that going forward we'll be able to bring higher level awareness to public health official, education officials as well as leadership from around the world. it is actually very exciting time for autism. i think over the past four or five years, there has been a tremendous amount of advances made in terms of understanding the causes of autism. i think it's always been and it remains the case that autism is like diabetes. cardiovascular disease.

it's a complex disorder that involves genetic predisposition as well as environmental factors. in recent years we have learned a lot more about genetic architecture autism and we understand where the problems are, where in the biological system that goes wrong that results in autism. and that has given us is foundation in which we can explore both development and new interventions as well as environmental factors, interactions. so we have now started partner with industries as well as other federal agency including the nih to look more deeply in the causes of autism. what can we do is turn this knowledge into meaningful applications and solutions for individuals and the family affected by this disorder. we're also working with -- with industry as well as public agencies to take best practices and to disseminate them broadly. because we do know things that behavioral intervention as a result of the diagnosis do work

and do help many individuals of families affected by autism. the challenge has been to disseminate these best practices in every corner of this country as well as the world. >> as a follow-up, you mentioned working with nih, i've met with dr. shaw twice, the head of the u.s. agency for international development and stressed with him the importance, i think, of usaid with its multiple missions in overseas and especially in africa to initiate an autism initiative within the department. and i'm wondering have you had collaborations with them and same way with dr. friedan, internationally with cdc. are they also looking to dedicate and prioritize autism at those two agencies? >> sure. i think global health is a priority and we're fortunate to be able to work with mental

health and human development, for instance, in this area. cdc similarly has an interest and often globally in international research network that autism speaks is a network that's actually codeveloped with the cdc and with research from 30-plus countries. i think that usaid and other agencies is certainly some, you know -- we will welcome the opportunity to work with them. we'll have a prousaid and understandably at that point. autism is not one of their priorities. but we certainly look forward to revisiting that opportunity and to work with agency. our sense is that from our travels and conversation with stakeholders around the world, it's a highly respectable agency and their work has had tremendous impact on the population around the world and we would love to be a part of that. >> you were very diplomatic and say it's not among the priorities at usaid. is it even on their agenda.

>> i think so but i think it's a matter of prioritization. yes. >> you mentioned south korea, 2.6%, which seems extremely high. is there any -- is it better prevalent studies or is there something that may be triggering autism among south korean children? >> right. i don't think we have a simple answer at the moment. i think the study has sort of set the stage for more elaborate study in including at the environmental study but a creative study that's more comprehensive than being used here in the cdc. the korean investigators went into the general schools, the mainstream school trying to identify children who might have been missed. and shockingly, stunningly while they look at the -- just the special schools as we do here, the prevalence is about the same, about .8, .9% but the mainstream school, there was

almost 2% of kids that had not been previously detected and served by the community. so i think the lessons here from our perspective is that we should think about using perhaps a more robust methodology so we can get a more accurate reflection of what's going on. >> okay. please. >> i yield. >> thank you, mr. chairman. well, i want to follow up on the question regarding the methodology. it sounds to me like our message goes into schools and not in the general population of children in schools. is there anything else that's different between how we conduct our research? >> i think that's the main difference, right? i think what we're encouraging people to do now is try to do case finding in a comprehensive manner the way we have done in south korea. because i think -- when i often think about the korean study is

not necessarily of high prevalence of south korea, even though that is very important, i think about the individuals and families who are -- who have not been officially diagnosed who may be struggling through schools, try to deal with all the issues that they're dealing with little assistance at this point. i think as a society, as a community are in a position to do something about that. we have the resources. we have the means which we have defined them at this point. >> thank you. >> i'll return to our distinguished gentlelady from new york. just a few more questions if we could. ms. kobeman, you mentioned the cultural stigma labeling that daughter as a bad omen. i would note parenthetically i would recently in nairobi and met with some nurosurgeons who are working on treating children who have hydrosephallic conditions and in one case i was told in uganda children who develop water on the brain or

this terrible and lethal unless -- there's an condition a hydrosephallic condition are often seen as a bad omen or something along those lines. and i'm wondering who can be done to dispel that very dangerous myth which leads to these children being ostracized. when i was in lagos when i was on that trip, he said that some of the children in nigeria are just put aside and they are allowed to die because they're thought to be contaminated or possessed or some terrible condition rather than a physical developmental disorder that with the right interventions could be greatly helped, if you could. >> yes. that's why we are trying our level to take home the awareness. the most important part is letting people know what's going on. that the children are not bad

omens. so communication is the key and the way to communicate in africa -- most countries in africa is using the media, you know, tv, radio, and even having social walkers go in from school to school of villages and villages and having forum. and they know this person is coming from this government health department talking to the village and they will come to a public place and the person will talk to them. so it's organizing a small group of leaders that can go to these places, family, and villages and talk to them and say, it's okay to come out. you do not need to hide your child. and your child is not a bad omen. in my case, the lady went to see my mom when i went on tv and i was talking about it. she was she went to her

19-year-old daughter hiding her out and she said because of your daughter i can bring her out and i'm not afraid to show my daughter. communication is the key, you know, at tv, radio, and anything like that. >> you were at a work autism conference in south africa in 2006. could you -- was that issue addressed particularly for the sub-sahara and african context and could you just elaborate on the buy-in. were there health ministers there? was there a robust participation? was it what you expected? >> no, it was not, actually. it was a little disappointing. we did have -- it was part of the world autism congress who did have people but i think from about 53 countries were represented. and one of the things that we tried to look at was what was available in that part of south africa. we didn't go through the entire

country. and we found that many of the children were leaving or were being taken from the home to get the proper educational programming because they couldn't get served and the families were resistant to recognizing that this autism was something that could be -- that could be treated in a positive way. so we actually visited a school, a nearby school, that had about 100, or 150 children who were basic or educated out of the home because of this issue. >> i know that eden is involved in singapore, developing curriculum, philippines, canada, israel, south africa. could you, you know, tell us what is eden doing? >> yeah, these are very specific-focused activities where we're contacted by

someone, often -- we have groups that travel through the u.s. to look at model autism programs. and will visit in eden among the programs that they look at. what we found is that they -- they really look at the behavioral interventions as the priority for autism. and so applied behavior analysis is something that is demonstrated effective and people want to learn how to be trained and to train direct care workers and families. what we found they are so focused on the behavior, that they fail to bring content into the equation. and so in many cases they're not teaching specific skills.

they can observe classrooms and teacher interactions anywhere in the world. and has done so. and so she can actually watch the behavior, consult with the teacher or the family and sitting in new jersey and really provide that kind of support to anyone anywhere in the world. ..

>> we are told that the autism resource organization has shut down during the crisis. again, kids are put on hold while political problems are

deteriorating to violence. if you can speak to the setbacks, and there needs to be a separate focus on what do we do in conflict areas? there needs to be awareness of the special needs of that of an autistic child do not go away with political turmoil. >> yeah, thank you. well, starting with the 500% increase, i think that ties in together. i think that reflected a catch up. you know, no doubt a collection had taken place, and then all of the sudden one of our government departments decided to do some data collection with school age children so there was a captivated add vens with school age children, and a number of

years later they kept on that data collection. that's really all we have to go on, and i really know that in 2002 even when the original report was done, they talked about an autism wave traveling through the school system in northern ireland. they knew there was the tip of the iceberg going on here, but i would attribute it to really the way it happened worldwide. exactly the same issues as you picked up on. it's about increasing awareness, expertise, and identifying and diagnosing the condition. i do believe there's a lot of questions to be asked about environmental factors, so we're just with everyone. i don't think there's anything particular to northern ireland except for the fact that there was until there was no baseline

information gathered, and there was the baseline data gathered of school age children in ireland, and then a number of years later when the same exercise was carried out, they figure they came up with almost 5,000 children. soda that collection has been issued, and in northern ireland various services are starting to collect some data, but the data is nontransfer issue and particular to that service of child health or education, and the departments have not been exchanging the information, and that's one of the really, you know, good things about the legislation that's come about because within that legislation, there is a requirement for all government departments to agree,

to communicate over data that they are collecting and to develop a common language so that they can plan within single departments and across departments. i would be extremely humble with regard to our legislation. we are tremendously excited about it because we come from such a low baseline, and we believe we have addressed a core difficulty, and that is the whole inequality issue. it was one of those, you know, your -- eureka moments we had realizing the legislation was out of date. i know in england they upped their disability legislation and created the english equality act, others involved in the u.k. did not, and northern ire

ireland, we looked at it initially, probably first, discovered the legislation was out of date, that it didn't make alliances for the interpretation of autism within the definition of disability, and therefore, that needed to be changed so that is one of the things that's really exciting about the new legislation as well. in short, i suppose the new legislation for us is really recognizing autism for the first time within disability legislation and protects citizens with autism and gives them a voice and gives them a position. the other thing that came about was the legislation was the need for a cross departmental approach to autism and a government approach to autism, and with our particular, we have particular challenges with the mandated correlated system in

northern ireland in the assembly where various ministers are in place from various political parties, and their policies may or may not agree, so, you know, policies and individuals bump into each other from time to time, so it was quite something to get uniform agreement, so i think this legislation to my knowledge is the first northern ireland legislation that requires our government ministers to work together on an issue, and that issue being autism, so that's another first, if i'm correct, that's another first for this legislation. as in the legislation, it requires data, but it also requires the government to fund the first autism awareness campaign, and i agree absolutely with your previous speakers. i think one of the greatest challenges for autism in the world is knowledge. ignorance is the greatest

enemy. arrogance too, and, you know, i think with the situation in northern ireland, it comes back to your third point, the particular conflict situations. i think parents are paramount. this legislation would have never come about in northern ireland if it hadn't been for the non-profit sector, you know, and working with parents on the issue of parent empowerment and to make their voices known because they were basically disenfranchised citizens and now they developed a voice, and they were able to lobby their local public representatives and get their voices heard in the northern ireland assembly, and there was uniform support for this legislation across the parties, so that was very

encouraging to see, but i think it was given the troubles that we have had in northern ireland, it was fantastic to see the bill become law, and, you know, the members were congratulating other members across the aisle for their role in bringing this legislation about, so i think i would end by saying that parents are paramount. i do take the point -- you know, we had about the society, and, you know, in a part of africa going to disbond in a time of extreme conflict. that actually happened in northern ireland because in 1970s there was an autism charity, and they fractured as well, and it wasn't until, you know, it was 20 years later that in 1990, the charity that i work

for was formed by parents again, and that time, the timing was right, and, you know, that was in 1990, and that was, you know, people's minds were turning to can this go on forever and looking to maybe towards cease fires which came a few years later, but, you know, certainly, you know, and the legislation in northern ireland, the parentings and the links they had with local politicians, they brought local politicians to family events so the politicians could see what it was and what they were coping with. you know, and the home situations, some very challenging children and adults, and gradually -- this took ten years, this legislation, a lot happened in the last four years, but we've been working on this with local parents and

politicians for the last ten years. i hope that helps. >> thank you very much, and i'll remind our colleagues and audience that she is in our consulate's office in northern ireland and most appreciative of her leadership and time in joining us today. congresswoman burkel. >> thank you. i want to go back to your previous testimony with regards to the research that cdc is doing, and you mentioned we should be more comprehensive. we talked about what venues we go into. can you expand on that in a perfect world what you consider comprehensive research? >> i think in an ideal world the data that we use to estimate prevalence of autism in the united states should come from multiple sources in addition to special schools and physician

records. there probably should be some effort to screen the general school population. not all of them of course, but do it in a representative fashion just so that we can be sure that we're not missing any childrens that perhaps of the condition are actually in the mainstream school and try to deal with all the challenges that they are facing with little or no assistance at this point. >> thank you, and then in a previous statement as well, you mentioned u.s.-aid and that you didn't feel this was a priority in that they have other priorities. as we see the incidence of child mortality decreasing, of course, it seems like we are going to begin to see an increase in disabilities, so can you -- do those two pieces have to be separate from each other? can we address mortality and then look at disabilities

including autism jointly? >> yes, i think that's been an ideal situation. i mean, our perspective is they are interrelated and that we have heard from advocate friends and they would like to have survival ability without disability, and that's our ultimate aim m i think that makes a lot of sense, you know? it's an idea of not just being able to survive a disorder and disease as a child, but to be able to go on and realize your full potential as an adult. that's more difficult when you have to deal with disabilities. i think we can get ahead of the curve and line it up with policies and not only address mortality issue, but look into the future. what do you do with children with disabilities and as time goes on? it helps us in terms of not only in the context of public health,

but development in general for the country and our ability to address, you know, public health in a global health issue like autism, and other diseases. >> thank you dr. shih. you mentioned in your testimony about voice of america being able to go on to that radio and talk about autism. have you been back with voice of america speaking and beyond that, how have you found the media? are they a good partner in getting the word out? has the media been helpful, and if not, could you maybe talk to us about how that would look if they were going to become a partner in this. >> voice of america -- they invited me, as a matter of fact, last april i was there, april 2 was autism awareness day. i was there, and they've been

very helpful in passing the information around because the audiences in africa, and i get a lot of feedback from africa seeing me on voice of america. i've been back on voice of america, and i hope in the future they will keep inviting me, and we can have a close partnership. as far as where i've been on tv, they saw -- i'm going to use the word ignore rapt about the subject, but they don't know how to handle it. i think when you address these types of issues when it comes to health, it's always important in africa when you have the approval of the minister of health or somebody in that department so when you go on tv and you -- the journalist of who is inviting you knows that you are working in the department of

health. they give you enough time and a platform and everything you need to talk about your subject, but when you come as an organization, they are an organization talking about so many things that sometimes they don't give you enough time and in the communication is not very strong. i think by talking to the stake holder and the responsible parties that they will have enough time and the platform with the tv and the radio, and they will be more, you know acceptable. >> yeah, thank you. as not really a follow-up, but another question. as a mother of a child with autism, can you tell us what tools have been most helpful to you in dealing with his disability? >> it's been very hard, and we try it all. we try supplemental vitamins and

everything, but what has worked with us which is a little bit controversial is -- each child has its own situation, and one -- whatever works of one child might not work of the other, and in the case of vinny, it was so hard we were wrestling our child to take the medication. i was crying all the time. i said there's got to be a better way. the doctor said put it in apple sauce. after awhile that tastes like medication. the child doesn't want to take it. eventually we come across the homoppatty who helped him. that worked for us. as a matter of fact, this lady is working with children in africa. if we find a way to bring these children with her, and she deal

with them to see them, watch the children through a videotape, and then she has a questionnaire. there's a ware for her to -- there's a way for her to walk to the children. it's cheaper and more affordable and in africa, everything cheap is good; right? that's what she's doing right now. we started with a couple chirp to see how it goes among other treatment we're doing, but we have our challenges like, for example, the -- we have to take a break and things like that, but it's working, and eventually the parents said the chirp are more calm and quiet. that's one way, and of course you have your treatment and regular nutrition medication and everything that we have over there. there's a pharmacy where they can get their medication to hope them cope with it. >> thank you. mr. mccool, in your testimony, and you talked about the e-web

and the program, you talked about 900 educators being involved in it. is this just for educators and those involved in education, or is it more comprehensive than that? >> it is more comprehensive. it has communities for different segments. eden established the autism community as part of the e-web. the people i was referring to, i think we have about 1200 teachers that signed up and network with each other dealing with specific autism-related educational issues. >> are you aware of any other programs similar to this, similar to ed-web. >> no, i think facebook and twitter and all those have been used by various people around the country, but we wound that this is so focus that it really helps people make a direct connection rather than having to

go through a lot of, you know, other systems that you have to sort of navigate through with facebook and twitter and linkdin. there's a community of librarians who deal with school issues and there's a community for special education administrators so you're communicating on very specific meaningful topics, and it's one-to-one once you sign up. >> excuse me. thank you very much. i yield back, mr. chairman. thank you. >> thank you. mr. marino. >> thank you, chairman smith. i apologize for being late. some constituents kept me longer than i anticipated. thank you for calling this hearing because it's critical. excuse me. i have two children with special needs, and i'm going to just pose a little scenario to the

panel and ask if each one of you coiled respond to my question starting with mr. mccool. my son has been -- it's been suggested by a couple of physicians that he has a very mild form of autism, asperger, but there's other physicians who say, no, they're off the mark. how well defined are we and how in tune are we with diagnosis today of autism and the elements of autism. do you understand my question? >> yes. >> please. >> autism is a diagnose where there's no medical test or blood test, so it's done by observation and sort of looking at the different categories. obviously, autism impacts that part of the brain that impacts speech and other communication behavior, those kinds of

things. it doesn't impact iq, so i think obviously the expansion of the definition to include aspergers has impacted the numbers. i think what we see is if someone is diagnosed or suspected after having aspergers, the thing to do is to really look at their communication and is their communication system in tact? is it appropriate? that seems to be the most singular indicator, and because children, especially young chirp, have different levels of development and so you don't really want to characterize someone or give them a label until you are pretty sure they're going to have it. if they are suspected to have aspergers at an early age, would

you treat them differently now suspecting that and not saying they actually have autism? we basically -- or to say treat the person normally, let's see what happens. generally, when we get to the point where it impacts their behavior or socialization skills, then that's a bigger indicator than just language development. >> please. >> i think there's a lot more that need to be done as far as diagnosis is concerned. my experience -- the experience i had with my child up to 4 years old, he was not speaking, and the nutrition said it's because i speak french, not to worry. this is here in america, not to say anything bad was done, but he lived here, and up to 4 years old, he couldn't tell me, and

the physician i had went to canada on vacation, and the doctor there saw him because he was accompanying his cousin who just had a cold. the doctor just did the cold medication to his cousin and spent 45 minutes on my son and diagnosed him and faxed me the progress nose sis° prognosis. there's a lot more that needs to be done even though in the united states we are so far ahead compared to africa, but there's a lot that needs to be done. in my case, they had to do a brain map to know exactly what vinny's problem is and when we did that, the doctor said he was smart with a high iq, and i shouldn't worry about the intelligence part, but the society part, having him live with everybody. spend your asset on that department, and that's what owe did. if you don't know that, you are all over the place trying to help them when it's expensive.

you waste money to treat him on the wrong direction, so that's going to help us. the brain map help us a lot and where to put our efforts. as far as diagnosis is concerned, i'm grateful for what we have, but in africa, there's nothing. >> okay. doctor? >> as mr. mccool mentioned, diagnosis is largely behavioral these days and there's a tremendous amount among the population, and i think a well-regarded researcher from the science school of medicine said that when we met one child with autism, he met one child with autism. it's difficult to generalize beyond the social deficits. saying that, there's these instruments, psychological instruments used and so the

ability to discriminate an individual on the spectrum from individuals who are not is robust at this point. i think the question you ask about aspergers and all these subcat garys of autism are used to differentiate, you know, people who are perhaps verbal or nonverbal, disability versus those who are not, but i think those definitions are falling away as we learn more about autism. i think at this point, the new addition of the sm5, the bible for diagnosis, they will do away with all the subcategories and just one disorder, so all the things previously talked about, high functioning and low functions aspergers and so on is all part of one diagnosis. this is consistent with evidence we have so far. you know, we have individual -- we're not appreciating the individual who are nonverbal

have very rich upper life, very robust intelligence, but they don't have the faculty to express themselves well, whereas there's people who have, you know, average or above average faculties, but have tremendous amount of issues, you know, intellectual disabilities as well as social interactions, and certainly these categories, these labels you put on children doesn't always predict an outcome. there are many individuals who seem to be very challenged in early parts of life, but come out having productive lives, where others don't make as much improvement. as we learn more about autism, i think the more we appreciate really it is a very broad spectrum of disorders and that siewfn what we say now as autism as one disorder, just talking

about cancer, there's a big collection of disorders, but there's individual types of cancer that require different treatment approaches. >> thank you, i yield my time. >> i'll ask a final couple questions. mr. mccool, in your testimony, you talked about the teaching students with autism effective strategies for grades k-5 and effective strategies for 6-12. one of the things we've all come to a better understanding is that unlike other disabilities, mental, emotional, whether it be that autism is in a league of its own, a category, a teaching where unless the teachers are very specifically trained, it is very difficult to meet the challenges, and i'm wondering, you know, in her testimony, she said that there are three

primary problems, lack of awareness, lack of education, lack of availability of proper treatments. in the united states where we grapple with this for several years, we still have not trained the teachers in a way that's dealing with the problem and the challenge that we face. i'm wondering if the teaching youth can increasingly be exported to africa and exported either via the web or training seminars or bringing people to princeton, the eden institute, or similar institutions so there's a teacher initiative to meet this challenge? >> absolutely. that certainly is the model that we're advocating. with webinars, they can be live so they can be interactive. they can be rebroadcast later so people can look at them. i think one of the biggest issues with autism training is back to the certification. most teacher education programs

do not have the specific autism certification track. california has passed legislation that has defined specific certification in autism that requires both instruction and course work and a practicum and that process has begun. a lot of the courses are available online so people can get them. the motivation for this is obviously to be a better teacher, but also there's inventives built into pay increases for people who achieve higher levels of certification. i'm not aware of any other states right now that have that same process in place. we are working with newman university in pennsylvania looking to establish a similar

process in pennsylvania even though there's no state law that defines it, but building on what california has done looking at the same course work, the same kinds of things. what people look at in terms of autism certification is a national certification, board certified behavior analysts, and this is a very rigorous training program. the ma majority of people believe if you get the certification that you have acquired skills that make you proficient in dealing and teaching children and adults with autism, and it's, again, very rigorous. you have to take coursework and do about 1500 hours in a year of practicum under the supervision of another cbva. we use that model. we have them at eden, and we look at them to train the aba

therapists. there is no real certification for an aba therapist, people who work in residential or employment programs, but the teacher certification for autism right now is just something that's emerging more and more. colleges and universities recognize the need for it, and there are, you know, several proposals out there. cane university in normings just established one as well, so i think it's not a normal -- it's so behaviorally intensive that regular college coursework doesn't really equip people to be effective aba therapists. >> thank you. let me -- [inaudible] >> i would just add to thatment i think that's one the major challenges to identify, to train professionals to really meet the needs, and i think in less on

the mystic moments you wonder if you with train enough people to meet all the needs out there. fortunely, in recent years there's research done where people are training non-specialist as therapists in taking care of children, and that includes parents. there's been several really well-designed studies published that demonstrate non-specialist parents, one working with an expert can actually faithfully deliver intervention at home for their children, and we see this essay as a possibility in terms of our international development because, number one, it empowers the parents and every parent knows their child the best and knows their needs, and you give them the tool set to better manage behavior, develop, and learn the way they need to learn, and the second thing is that you can even do these kind of training via the internet. this is learning technology.

again, there's been recent publication demonstrating that. there's no difference when you train professionals via the net versus the in-person setting. you get the same expertise comes out of your class and providing tools for the family. there's reason for hope. >> thank you. again, dr. shih, you mentioned in your testimony, and it's worth quoting again, 67 million people or 1% of the world's population is affected with some form of asd, it's higher than aids, diabetes, and cancer combined. directer of the mental health world health organization in his -- this is part of the record -- says tens of millions of people are estimated to be affected in after africa only. you talked about the numbers in south korea being higher. when we study it, it's the tip

of the iceberg phenomena where it's worse than we thought. i'm wondering again, and i asked this earlier, but i ask you with emphasis because i have raised it at the u.s. agency for international development, this needs to be made a priority, and i hope it becomes one in the global health initiative because we have a, you know, pandemics are reserved for infectious diseases, but with quotes around it, it is a pandemic largely unrecognized, and it's about time and our hope is with the hearing to begin with vigor and a fresh set of eyes to make this a global effort with our tax dollars which heretofore has not been the case. i say that in the late 1990s when i introduced the assure act, cdc was spending $287,000

per year for five successive years. that doesn't buy a desk. that doesn't buy anything of value, and then they got into it, and obviously as a result of the legislation. we're now spending $22.1 million. regards to nih, we were spending $10 #.5 million. now we're spending in 2010, $160 million, so, you know, when we chronical, prioritize, the money will follow, and hopefully the good work that that money buys will make a difference in the lives of people, and i do have one final question. i read a book called "dancing with max" with emily colson. i invited her up, and she talked to the members of the autism caucus, and here was a case, and perhaps, mr. mccool, you want to speak to this as well.

we are still focused on early intervention and what do we do with the young people, help them have a productive life and help the suffering of the heroic parents faced with severely autistic children, a very, very challenging life, and i'm wondering with the aging out issue in the book, emily tells the story of how her husband left by the time max was 9, she had had it, but then through the grace of god and it really was through prayer and a lot of help of people around her, she got through it, and now max is approaching adulthood, and the important renne min that goes along with formal schooling goes away, and she made an appeal to congress, and i know autism speaks has been making this appeal very robustly autism society and mr. mccool, you are a part of it, and making that as well. what do we do now with the young

adults to ensure that their lives and the quality of life does not diminish? i'm wondering if you can speak to that. obviously there's international implications as well as domestic ones for those children. anyone want to touch on that? >> sure. one thing i learned about talking with the stake holders around the world is the concerns of the parents what they want for their children is all the same; right? the best possible life for them and so on, and so the idea of being able to help them to achieve those objectives i think is very worthwhile. you know, the idea that the individuals and families can benefit from awareness and research and delivery is really not a very ambitious goal. i think it's actually within the reach of most societies. i think it's been talked about in this particular committee

meeting, you know, i think it takes political will. it takes understanding and knowledge, awareness of the issues, and it also takes understanding that you don't really need to invest a tremendous amount of money to make a difference; right? so that oftentimes the quality of life issue can be robustly addressed with the right investments, strategic investment of resources and expert assistance, so i think it is really important for this committee to help the global community to think about what are the possible solutions? what can we do? we're not looking for charity, per se, but empowerment and the ability to help them to help themselves. >> i just want to say something about the training, you know, and tie it up with this. what i want to say is i hear all these numbers that you are

talking about, and i have just -- i go, oh my. in after africa, it doesn't take much to do a lot. just an example -- in 2009, i sent a thousand dollars to autism. with that thousand dollars, they were able to have two volunteers, french aba professionals that gave their time, that were not paid for what they were doing, but we were able to put them in a hotel, little things like that. within a week, they trained few teachers and a few care givers. now, this is not a lot, but it's a small step that can be taken and add up to that little by little every so often, six months or a year, you can have a good team of people, you know, with some tools to help. it's always hard when you want to have something on the bigger level and add, you know, come

with all these big strengths, but start small, create centers, you know small centers. they don't have to be very sophisticated, but where they can go and get information and where the communication can come from. i just want to add that. >> well, i think we have to remember that until 1975, children with disabilities were not entitled to a free, appropriate education, and so a lot of the strides we see with early intervention services and with education are because of that legislation. it has put some teeth into the law, so when children graduate from that educational system and become difficults with disabilities, particularly adults with autism, that same level of support is not available, and, in fact, many times the huge investment that's been made with behavioral therapies, speech therapy, occupational therapy disappears,

the effectiveness of that disappears as the child becomes an adult and cannot be sustained, so we recognize that all of the children diagnosed with autism now will be adults with autism in the future, and we have to look at housing. we have to look at support for them. we have to look at employment for them, and right now i think a lot of strides are made to sort of look at the kinds of employment, the kind of jobs that align skills that people with autism have. i know years ago when bittersweet farms was started as a model program, it fell out of favor because it was seen as an isolationist program or segregated program putting people on the farm. what i see today is a growing number of farm programs, and obviously, it's the model in ireland with an agriculture culture, but even in our

country, the farming, small farms are coming back, they are employing people with autism who enjoy that kind of work. it's very repetitive, it's the kind of work that aligns skills with certain people with autism and the duties and responsibilities of the employment, so i think our challenge is to look at how, with the resources that we have, children age out of school so there's a population constantly leaving childhood and entering childhood, but the adult program, adults with autism are living normal life spans, and so right at eden at this point, we have group homes and apartment programs, residential programs, and some of those guys have gotten up to their 60s, and we're looking at what is that next step? what kind of support can we provide them? i think the model that we had

with the education and the children's act in 1975 really set an example of what can be done to help adults with dates and particularly autism as we go forward. the numbers are big, and we have to look at various streams of funding that can help provide that support, and enable them to be productive in working to help support themselves. >> the ranking member of the subcommittee. >> thank you very much, and thank you for prolonging the hearing so i could at least get here in time. i think it was -- i thought he was in the senate filibustering, but i appreciate that, having the opportunity to be here. i had a long standing engagement which i was up able to alter, but let me take the indulgence of the committee for a brief

opening statement. it maybe past tense now because you testified, but we looked at your testimony, and i'm aware of what each of you had to say, but i certainly began my statement by thanking chairman smith and certainly let me recognize his longstanding leadership on this issue both domestically and globally. i would also welcome our esteemed witnesses today and look forward as the testimony that you've given and my staff heard and that we looked at earlier on autism globally and how proposed interventions would coexist and complement our efforts to prevent africa's leading disease killer, mainly hiv and other diseases, as we had the answers already, but issues and impacts like this and so many others are left unintended to.

autism identified by impairments in communication and social interaction is identified in early childhood around the age of 3. imagine the news that one's child as you must have experienced faces the challenges of autism and the devastation of hearing that this has beset your young child. fortunately here in the united states and in other developed countries, progress has been made and our efforts to detect and treat those with the disorders, however, we still have a long way to go as you mentioned in your testimony -- [inaudible] i never would have said it so

nicely, kobenan, but you testified as you had to leave this region of the country and as you leave washington dc and this environment in west virginia that we have the most appropriate attention given and resources, but you chose to move to arizona because you knew that they were better services and so we can just imagine how in a developing country where many, many, many needs are that autism certainly is an issue that seems to be and mental health in general, tends to be put on the back burner rather than the diseases we hear so much about. in the u.s., the private

resources available to impact families to better cope with the disease, but sadly the same support structures in developing worlds do not exist in low and middle income countries due to lack of funding and a lack of understanding of the diagnosis of the disorder. there's populations battling mental dates in if other countries furthering combating health, communities, and government. the united nations have taken important steps to ensure equal rights of those with disabilities including in 1981 the declaration of the united nations for the international year of disabled persons and established the united nations decade for disabled persons in 1973-1992. the u.n. then expanded the universal declaration of human rights to include people with

disabilities, some 35 years after the declaration was adopted, and the united nations reaffirmed equal rights with people with disabilities particularly the convention of the rights of people with dates and declaredded on april 2, world autism awareness day, and so many times there is, and actually, they really moved forward in addressing the problems with the framework for action to meet basic learning needs which calls on governments to pay special attention to the learning needs of the disabled and take steps to provide equal access to education for every category of disabled persons as an integral part of the educational system, concept for equal education for disabled people endorsed by several countries through the ratification of numerous agreements and so although we do

hear criticism of the united nations, i think that many issues would have gone unspoken throughout the world if it were not for the united nations going back 40 years ago, recognizing that countries, especially in lower and middle income countries, would not raise the issue of disabled when they had so many other basic issues like clean water or malaria so i do commend them for that. there are certainly, as i mentioned a lot of private resources available for impacted families to better cope here in the united states with the disease, support, sadly though, the same support structure in other worlds does not exist due to inadequate funding and a lack of understand og or diagnosis of the disorder.

often there's the pop pew ligs neglected further compounding the burden of poverty and weak health systems on families, communities, and governments. the united nations have taken the important steps, however, the right to educate remains unattained for many autistic children in a developed world. while the united nation's actions are commendable, others fail to address the needs of their autistic population. in middle and low-income countries, there's only one child psychiatrist for every 4 million people. that's unbelievable. i look forward to what you have said and has been recorded, looking at low cost interventions, given their limited state budgets and overburdened in public health systems which developing countries can apply and to better deal with the issues of

autism within their borders. we know that there have been a number of several journal of international association on special education founded chirp with autism in africa do not share the same behavioral signs as the western counterparts which was interesting, such as rocking back and forth. it seems geographic and environmental differences impact the way the disorder manifests itself which makes it even more difficult because it's not going to be one kind of a treatment covers all, and it's -- the -- i look forward to how we might be able to work along with the fact that there are different signs. furthermore, we know from the haiti earthquake and other examples that in crisis situations, those with dates are often inadequately cared for.

we know that this is a big problem, and so i once again would like to join with the chairman in certainly thanking you for your appearance here and also that -- for your interest. i have a quick question or to since i almost exhausted my five minutes. i don't know how to tell time. there appears to be limited information about the prevalence of autism worldwide especially in africa. what do you know about it in a nutshell about how widespread this disorder is in the world and in particular in africa, and what are the greatest challenges in conducting autism prevalence studies abroad, so if any of you want to take a stab at that. >> sure. so the challenges of conducting prevalence study in africa is actually similar to elsewhere.

it's about informing the community, informing the stake holders so they understand what you are trying to do and they work with you. when you have community buy-in, you generate the highest quality data, and the greater challenge i think for working in the territory in africa is actually the second act. to do a study in the community is one thing, but trying to figure out what you're going to do with individuals in a study is something completely different and requires a commitment not only to the vines and families, but also a commitment to change community, society, and governments, and that kind of work takes a long time. it takes a lot of resources. it takes a lot of focus, but at the same time that kind of policy change will be meaningful only if you have real solutions

on the ground, the idea you want to support, nurture, and grow solutions that are working for families on the ground so going through any low developing country, you have to really approach it from a top-down as well as a bottom-up perspective. you need the top-down so the solution is developed from the bottom-up is sustainable and integrated as a meaningful solution in the national public health system in longer term. >> i said with a minute to go, and i'll say it again. one of the basic, basic challenge that we have, that i came across is centers. you know, you can have a program to teach teachers, to educate stakeholders, and all of that, but once the whole team is gone, whether it's in the united states, you teach the peach and they leave, where do they go for

more information? everybody has a house. they need a house that's the center. it doesn't have to be sophisticated, but that's the major challenge. once they have the little centers, they can go there, get information, and if anybody has any questions, they can go there, have a small staff member that works part time and just walk there to educate people and to have a place to go. that's the first step. >> would you think the church community or other organizations in africa could be a center if there's an educational campaign to educate the religious community and simply ask their parsonage or some part of the building could be used for that? >> yeah, that's a great point. indeed, that can be a solution, and when i said center, it doesn't have to be a building. it can be those things too. for example, the ex-wife of the

ambassador of liberia and, you know, get them to be involved, and she got involved. her solution was to talk to one of her church pastors and see if he can give her part of the building, and indeed, within a year, she was able to do that, and she told me that the center actually was created, so that's a very good suggestion too. >> we might even go further and ask our u.s. department of state if as u.s.-aid as they move forward on this that we might prod them on this issue and suggest to them their ambassadors and they all have projects that they can fund, little stipend they could do, and they don't need that, but ambassadors' wives could have the women perhaps of the country and encourage them to have a meeting and then encourage the

african community to therefore approach the high remark ky of the church. i think as you mentioned, we don't need a lot of money, just have to use the resources, and everybody needs a home, you're absolutely right. because i was late and have taken enough time, i yield back and will ask no other questions. thank you very much. >> thank you, mr. chairman. just as a brief follow-up, mrs. kobenan, you mentioned your son and the brain mapping that was done, and it really seemed to shed light on what his strengths were and difficults would be. can you expand on that? >> it's an ekg that they put a lot of -- how you call this -- electrodes on his head, and then he has to stay still, and they do a map.

they kind of read the activity on his brain over a period of time. it's very expensive. we had it in arizona, but it's so helpful. i wouldn't suggest that for every family if they have to come up with the money out of their own pocket because this cost us $3500, and if they can have the insurance, some kind of help, that would be very helpful because it really tells you right from the start whether you should plan on putting your child in the facility where he will be 24/7 taken care of by people, or if he can take care of himself when he grows up. you can start investing money for a good facility for him or invest your money into activities for him to help himself. that gives you a road map right from the start, and we were lucky enough to come across a

doctor who did that. >> anyone have anything to add to that? dr. shih? is it not covered by insurance? >> not at all. >> it's an egg? >> an ekg. >> i think it is the egg. >> egg? hoe. >> it's similar for other brain functions. thank you very much. i yield back, mr. chairman. >> mr. marino? >> i'd like to thank -- would the witnesses like to add anything further? i would like to thank -- ms. cassidy, thank you for your testimony from ireland. this captures why we are so concerned. he noted in the testimony as child mortality decreases, simple math predicts an increase in the number of children with

developmental disabilities. instead of seeing autism as two distinct public health challenges, but should be tackled as parts of the same problem. he says -- you said a few moments ago, autism speaks to our partners around the world and by addressing autism and related disorders now, south africa and other developingies get ahead of the curve and maximize outcomes for individuals and families and minimize long term costs to society. we have a pandemic with autism. hopefully, we can launch and do much more with the global health initiative and all the other related efforts at the u.n., at the countries specific level to mitigate this devastating developmental disorder. i thank you, and the hearing is adjourned. ..

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>> the u.s. house begins debate this afternoon fundraising a $14.3 trillion federal debt ceiling.

>> now a discussion on journalism in the digital age. we begin with remarks a "washington post" reporter bob woodward. he is joined by journalists representing russia, pakistan and al-jazeera. it's about an hour and a half.

>> welcome and good afternoon. i'm suzanne nossell, deputy assistant secretary the state. i work for the united states the united states department of state, a proud sponsor of world press freedom day. it's almost 40 years of woodward to find the balance of power between the press and the state breaking a story that would lead to the resignation of a u.s. president. his dogged fearlessness and unimpeachable credibility has set a standard that is help show the world that press freedom is an essential part of even the best system of checks and balances in a modern democracy. his work has also demonstrated threats of freedom of the press come not just from thugs in russia or dictators across africa, but even from the quarters of the white house. we all know his storied career and a tangible way he shaped the history of press freedom.

but bob has also transformed lives. i had the honor of millions because one of those lives is my husband, david greenberg. david's first job out of college was working as assistant to bob on his agenda which chronicled the clinton administration's economic policy. together they interviewed witnesses, plowed through files and shifted to all of it in an office upstairs in bob's home. you don't have to look hard to see bob's influence on david's life and career. david has written a book about richard nixon and his now hard at work on a history of political and presidential spin. but he's only one of the thousands of journalists worldwide has been inspired and shaped by bob woodward. in an age when blog post, tweets and opinion journalism, bob's work is a constantly monitor of the indispensable value of in depth meticulous reporting and information gathering. his steady stream of headline grabbing, page turning account of the most challenging episodes of american governance to

policymaking are testament that whether it's first break, online, on air, in print or any bound volume, the most compelling insights that shape our discourse are the products of hard work, careful thought, and viewpoints weight and assessed. obsoletes book on the war in afghanistan which dominated the chatter and the state department for weeks is just another example of how his unique brand of access, in depth reporting an in depth report could change the conversation. in an era of continuous messaging and spin, bob woodward has set the standard as an arbiter of what can be believed, what should the question, who is deciding, and what lies beneath the most complex and contested policymaking. last night we heard the breathtaking announcement that osama bin laden had been killed, but there's still a lot we don't know about the story. and if we're lucky in the coming months and years, bob woodward will let us on in.

for these reasons we couldn't fathom a more appropriate person to lead off this critical discussion on how press freedom is being threatened, tested and transformed by technology. it's my great honor to introduce bob woodward. [applause] >> thank you. it's nice to be here. is this picking up? great. they said i'm supposed to talk to one in minutes. i'm going to talk less than 15. and sheila has promised to give me the hook and stand up. i just want to make a few random observations about the media and the press and what's going on, and then the context of the truly astonishing story of the killing of osama bin laden. the handbook that was handed out for this gathering said the

following. digital media tools have fundamentally changed the nature of reporting and the meaning of transparency. know. [laughter] i disagree. i disagree strongly. i think that the digital media tools have supplemented in a very significant way how we do our job. is handbook also says citizens now have instant access to the source material. reporters use in their story. no. not so. it is just not the case. some of the information, and again, there's more in better data, but it is just not so that there has been a total revelation, or total revolution in the way we do the reporting business. and i want to take an example.

"the new york times" last year when they started publishing the diplomatic cables that they got from wikileaks, in a note to readers november 28 of last year, the editor says that there's an important public interest illuminating the goals, successes, compromises and frustrations of american diplomacy, in a way that other accounts cannot match. no. not the case. then there's the note went on in rather astonishing form saying, and i would agree with "the new york times," i thought they did a masterful job in sorting through the wikileaks material and presenting it. i think it's important. i think it adds a dimension of understanding, but like people

in government or business, sometimes people in the media take a success and overstate it, and this is in the note to readers that ran in "the new york times," the more important reason to publish these articles about these documents is that the cables held the unvarnished story of how the government makes its biggest decisions, the decisions that cost the country most heavily in lives and money. no. that's not the case. if you look at the wikileaks documents, they are middle classification documents. in many cases the ambassador meeting with the head of state is sending its secret cables think this is what the head of state said, this is my interpretation, all valid, important news, but if you understand the white house,

which i attempt to do, you realize those documents do not get to the white house, that they have very little standing in the white house, that the white house has its own intelligence channels, it gets information that is much more heavily documented and authentic. and the kind of raw information that is in top secret or codeword documents that the wikileaks people, at this point, got. the fact is i think we are not in a world of radical journalistic change. that we still have to rely on human sources, the best sources, documents can hold contemporaneous notes but human sources, people who are

witnesses and participants in fees, the biggest decisions, the decisions that cost the country most heavily in lies come in money. sometimes those are in documents but you really need for human sources. and i want to tell a story about what i think the problem has been in the business of journalism and free press, going back decades, and it still exists. and this was several, a good number of years ago. my wife and i were watching a panel in colorado, one of these conferences on aging. now, because i am now 68, it iss a subject that interests me a whole lot. really interested in aging. and on the panel they had physicians and psychologists,

and real experts. and james watson, the codiscoverer of dna. and everyone talked about aging, except watson. and after about an hour, in a situation like this, the power of silence, here's the guide who won the nobel prize inconceivably knows a great deal about this, saying nothing. finally, the moderator said, doctor watson, what do you think? what's the best way to deal with aging? and he looked up and he said, the best and only way to deal with aging is stay away from old people ear. [laughter] -- away from old people. very good advice. after the panel they handled out the sheets, kind of a self

scoring about your lifestyle. and you would answer the questions and how often do you exercise, how often do you eat red meat, have you ever smoked? personal questions. and it was quite extensive, and you would then get points, or not get points for certain answers. and at the end you a total it all up and it would tell you how many years you had to live. now, this is something -- i wish i'd copied of his to hand out. it's an interesting exercise. elsa and i were sitting behind dr. henry kissinger, who was the secretary of state, social security adviser for president nixon and ford. and being believers in the free press, we got out and looked

what dr. kissinger was doing. and he was, i tell you, this mattered to him. this was a big deal. and he answered all the questions, and then got down and total it all up, and it turned out he died eight years ago. [laughter] not happy. not happy at all. and so, what did kissinger do? he reached into his diplomatic tool bag and opened shuttle diplomacy with a question. he got out his a racer and restored. well, it turned out he hadn't eaten red meat since 1949. it turned out he exercise several times a day. turns out all of these things, and he rescored it all. and at the end it turned out

after the re- scoring that he had eight years to live the. now, that's what we fight in journalism everywhere in the world, the rescoring that takes place by people in government, particularly in business, in the media, in working on my last book, "obama's wars," i know i would interview people sometimes hours or days after an event, and then six months ago you wouldn't revisit the decision point, and they would say oh, yeah, my view was the following. you know, four hours after the meeting you said this, rescoring. everyone is trying to rescored history and reality. that is what we are fighting against. it is inherent in the white

house, whether democrats or republicans. everywhere in the world there is the rescoring of history by people who make the decisions. the journalists have to come in with a method that will provide a more authentic version of what occurred. the key, you know, i love the internet, all of the information that we get from the new digital access and tools. it's about going to human beings and getting beyond a story. one is working on the fourth bush book, there was a general who would not talk to me. and i sent e-mails, phone messages, intermediaries, radio silence. wouldn't talk. so i found that when he lived, and what's the best time of night to stop in on a general without an appointment? does anyone have an idea?

8:15 because they haven't gone to bed and, alasdair george w. bush. [laughter] they had eaten -- the evening is still kind of young, so i knocked on the door. the general opens the door and looks at me and says you, are you still doing this shit? [laughter] didn't care for the characterization of what i do. but there was a moment there of -- and i didn't kind of do anything, kind of stand there, it was obvious. i needed information, needed his cooperation, and he kind of looked at me and that is either going to get the door slammed in my face and finally after a few seconds, he kind of, come on

and. and three hours later i loved with answers to the questions. questions are not the answers -- are not on the internet, are not in social media. they are in the experiences of firsthand witnesses. now, what's going on in the convulsion in the middle east, and north africa may be the 9/11 the world. it's something we've got to figure out. the government has to figure out. the media has to figure out. they are is truly the beginning of the emergence of the civil society in many of these countries. a public consciousness and a public conscience. we are learning that people discover that benign dictatorships are often not that benign, if benign at all.

the movement, the collective movements, if you look at al-jazeera you see where they do one of their split screens, two or four screens, same slogans. the same ideas are being expressed to in countries that are not collected. connected anyway. how do you report all of this, what's the challenge? one of the challenges is the traditional elite's don't matter as much. you're going to have to find the people, the opposition, the renegades, if you will, in these countries. the digital media tools are key, but the best answers are going to come from human beings. but as an example of using the new digital media tools, i've got a google map of pakistan.

and this is where obama, obama ordered the killing of osama bin laden. it's i guess about 30 files -- 35 miles north of islamabad. about the same distance as tarbela, which is where it turns out the pakistanis keep many of their nuclear weapons. it is a sacred, well protected area. it is about 15 or 20 miles from where osama bin laden was living. and you look at this map and you ask the question, wasn't anybody curious? didn't anybody go up route in 35, labeled here on the google map and say where is this, what is this house here that is different and more secure and more hidden? and you just look at the

geography of this, and you realize that pakistanis have an immense, and then it's about to enter for. last point is, what should we worry about as journalists as we attempt to find out what's going on. and my answer to the question is, secret government. that the secrecy of government -- this is what nixon tried in watergate, in all these administration all over the world, the government, too much unnecessary. secrecy, whoever said it got it right. democracy is dying darkness, and if we lose the means and the capacity to really find out if those of us in the business of journalism don't have the methods and the luck and persistence to really get the

story, we're going to miss out. because the real story is not on the internet. it is in often the secret records of government, and the secret memories of those who participate in making these decisions. thanks. [applause] >> thank you. my name is sheila macvicar. i'm your moderator this afternoon for our panel discussion on reporting sources and information in a digital world. joining bob woodward, huma yusuf was it an award-winning columnist and investigative reporter in pakistan, and is currently a pakistan scholar at the woodrow wilson international center. among other things, her weekly column folks is most often on terrorism, security, foreign policy and international

relations but you can imagine she's been having a very busy day today so we are very glad that she is with us. she's also done a lot of reporting. we'll talk a look at later on and that's about the problems faced by bloggers including the kinds of legal penalties, lawsuits and other kinds of difficulties bloggers are facing. abderrahim foukara is the bureau chief here in washington for al-jazeera. is live to washington now for more than 10 years pick in addition to managing the al-jazeera team he hosts a weekly political and show which talks to newsmakers, and current cultural topics here. >> like bob. >> and elena milashina is an investigative journalist for novaya gazeta. his work to expose outright falsehood of them. in 2000 i she was awarded the human rights award for

extraordinary activism. in 10 years you said six of your colleagues at novaya have been killed. >> yeah. >> six killed. >> yeah, exactly. >> and those are fellow reporters journalists? >> they were journalists at my newspaper who were killed. >> and many more of your sources and fellow activists have also been killed. >> many more civil activists, and other journalists were threatened, were beaten clearly. the latest probably the world knows about the correspondent from russian newspaper who was beaten. and a lot of people actually also were. that's the way how putin treats people, not only journalists but those who actually try to tell

the truth. so, a lot of bloggers right now in russia who are trying to do journalism work, trying to deal with corruption our democracy, they are afraid for their lives because it's very easy to find them, or even to kill him. kill them. and in a long time, i know few cases when actually killers were punished. >> you heard bob stories of going to the generals home at 8:15 at night hoping that you would be in a receptive mood for conversation. could you imagine doing that and you were, going to the home of a russian general at night looking for information? >> well, -- >> i bet you have to. maybe they're on his the tenets or majors. >> well, you know, the first big story of my career was probably you know, in 2000 there was a

threat with submarine, with 180 sailors on it. and i was getting it for several years. and i knocked on the door of many generals and admirals, russians, who helped make him who the interviews. and it was at night time for them because i asked right questions, and then we -- hard questions for them. the main thing of the story was, they never tried to take people who stayed alive on the subway. and they were lying at the beginning. and i would say, well, 10 years, like 11 years ago the russians

was not like it is now. but even now, i doubt that bloggers can ask russians which professional journalists ask. >> we also invite your questions. there's a microphone down you. please feel free to come down and join the discussion. we hope you will do. huma come into work in pakistan, you've reported off and on national security matters. we were talking before about an instance where they've been executions carried out by pakistani special forces. is that a story -- and that's not a one off. that is something that is covered in the past, but is extremely difficult to report. how would you able to report it in this instance, and what made a different? >> what made the difference was citizens. because pakistan journalism work in constraint about it. can't say anything about the pakistan army. they can't say anything about terrorist, militant organizations. they are working under the

threat of their life. what happened with this instead, was that an anonymous video clip started circulate on the internet which showed the soldiers doing there. and what happened was we still don't know what the source of that video was. but the job of the professional journalist became just to verify that that video was genuine and had not been doctored or stage any matter, who were the generals showed him a bigger. without that initial spark, we would not be able to talk about an incident like that even though they knew it was going on in pakistan but you don't critique the pakistan army. if you want to stay alive. >> take me to the process of due diligence. how did you verify? did you literally do a facial recognition on the settlements because i'm an editor as well so i was not a reporter. what they went out to do is they try their best to try and activate, identify -- the first piece was trying to figure out

whether the video came from to get all sorts of hackers to try to find ip addresses and things to locate the sources added the. when we were unable to do that, we sort of play the name game of who posted it, who retreated it. we came pretty close. it helped a set of location. and from there, and several news organizations were working on the story at the same time. so it became almost and collective intelligence. we still don't know. we were able to look at things like what weapons were the people caring and who have access to those weapons come and appointed directly to the pakistan army. journalist ended up analyzing things like what language the people were speaking, the terrain, what is suggested, the victims have this book. it ended up being more of a textual analysis. by no means a refined process. the pakistan army doesn't clamp down or provide counter evidence

to show it is fake, it becomes the spark of really interesting discussion. >> bad company the argument there is really no substitute for shoe leather, and for personal contact. where there is ample shoe leather even if there's cyber variety. >> right, but some courageous general or major or somebody who had access to that video put it out, and it was a human being who did that. it wasn't technology. it wasn't an accident that it was put out, right? >> these new media technologies are tools that people can use. you need to have the eyes of the story if you're a citizen journalist, or you need to be, you need to want to have that piece of information circulate. this becomes convenient tools. i don't think technology has any determination.

>> but in this case obviously was important. but my thought and listen to both of these accounts is how much more guts it takes for you people who work in your countries when you know when you are leaving an interview, when you're getting into this area, where they don't want you to touch that you are going to be killed. when i left the generals house in the case i'm talking about, i knew that i could go get in my car. i didn't have to run. i didn't have to hide. we have the luxury of a genuine free press, and if they kill the reporter in this country, the mob has done this a couple of times and so forth and there was talk during the nixon era of assassinating jack anderson who is a columnist, but they didn't. and so it is with a lot of gratitude and a lot of admiration for that i salute you

operating in your country. because what we do is a cakewalk. >> absolutely. [applause] >> abderrahim, as you look at al-jazeera, particularly during the egyptian uprising, there came a moment when al-jazeera was shut down. you're broadcasting license, you're right to broadcast from egypt was revoked and you were essentially remade to go dark. what kind of challenges did that does and how did you get around them? >> i mean, it goes the ivies channel that we are coming for our audience principally before we recovery for the rest of the world. the major story that's going to have serious ramifications, not just for each of but for the entire region. and, therefore, you stop dead in your tracks was covering that story because you have been kicked out of the country by the

government, or because they have destroyed your infrastructure, whatever kind or shape the infrastructure may be. to do that, you obviously not only giving up your right to report on that story that you are putting the credibility of this nation on the line for people would say they found the story right in the middle of the. but lucky for us, in a place like egypt, we have invested for over a decade in egypt in terms of the infrastructure, in terms of understand the country, in terms of understanding the political regime and its instincts. so when the decision came to start al-jazeera and others, it wasn't just al-jazeera, harassing al-jazeera and other news outlets from the region and outside the region, we had a system in place. and somehow we've managed to dodge the secret police and keep

some of our reporters there, in hiding but they kept doing their job. and we kept getting the voice. we kept getting the picture of one kind or another. but we relied on egyptians and ordinary egyptians who are in tahrir square and alexandria and other cities in egypt. not want to provide background information but sometimes to provide the image, the picture. picture ultimately that carried today, youtube played played a huge spot bringing this story for us out of egypt. and as bob said, you could have at al-jazeera on the one hand and you could have had youtube and facebook not connected together, maybe things would not have happened the way they did, but the fact that we were able to marry conventional television with social media on that scale in a place like egypt was obviously fundamental in bringing that story to the outside world. >> what do you say to those who

refer to what happened in egypt as the facebook revolution? >> i actually find that outrageous. i really do. because it really demeans the sacrifices that people in egypt, and throughout the region, have been making for decades. i mean, in the case of egypt, there were people who were in prison, who were tortured, who died. they were later movements who were harassed, given a hard time. they were all sorts of different players, who played out in the revolution eventually in egypt. and, therefore, to say this is the facebook revolution, or this is the twitter revolution, i think that's rather a flippant and silly description. not to take away from the role that social media played india peoples in the middle is, but i

think pinning down to facebook and say it's the facebook -- what about the man who set himself on fire in tunisia? what about the egyptian guy who was killed by the police, for no apparent reason at all? and that -- there were so many different acts that contribute to that. there was a general atmosphere in the region, the region was strife to see what has been happening for the last few weeks happened. i would even add one more thing. which not a lot of people in the middle east agree with, and it is the role of the u.s. administration. because bush went to the iraqis in 2003, and in the eyes of a lot of people 2003 iraq was a total fiasco. obama took over, and he seemed to have renounced the freedom agenda of the bush administration.

at least in public. but we all know that the obama administration continues to work with civil society that bob referred to earlier. and it's that contact with civil society that provided one of the engines of what has happened. civil society has played a very important role, not just in his book. >> i think that's true. here's the question. was the next bounce of what's going on in north africa and the middle east? there was this expectation, well, now everything is free in egypt, that there is this wave of revolution that's unstoppable. and i remember, i hate to go back so far, about 30 years ago -- this was 1981 -- being invited by the journalists association polling which was under the thumb of the soviet union at the time.

and going there, and he took me around to factories that you could just feel the solidarity movement, and they took the movie, watergate coverage that karl and i did, all of the presidents men and they showed in downtown warsaw. people were hanging from the balcony. this was a subversive act, and i came back and drafted an article saying freedom has come to poland, and you know, here we are, and a very wise editor said, well, let's wait and see. six weeks later the general clampdown with martial law and it was six to eight years before poland became really free. and i remember the editor coming around after finally the fall of

what happened in eastern europe and the soviet union said that peace was accurate. it was just eight or nine years too early. [laughter] >> but remarkably, that editor would remember. >> and i remembered, and i took him to lunch because he kept me from publishing this story that would've been premature. and the problem here in all of these countries have where did it go? >> i mean, the answer to where did it go take me to the second component here that want to take issue with of the facebook revolution. because it seems to me that revolution in a broader sense, let's take the french revolution, for example. it wasn't just about changing a regime. it was about three us in a whole mentality, a whole culture. and it went through ups and downs, trials and tribulations for at least 10 years. that's how we got this wonderful thing that people in the middle east are fighting for now,

respect for human rights, for example. and so, when you say revolution in the middle east, i would like to use a metaphor from the kitchen, not because i'm hungry but i think i feel that it does the trick. you have a microwave and you have an oven. and you throw food into the microwave and it cooks quickly. you throw turmoil in the middle east through facebook and youtube and whatever, and something quick happens. the president of tunisia goes in 23 days or 18 days. mubarak goes in 18 days, or the other way around. you are talking about something much more protracted than that. you're talking about cooking by of them. and i think the middle east is only now beginning to think about it in places like tunisia and egypt because libya is still in -- it's not even in the

microwave yet, nor is it so you. but in places like tunisia and egypt, people are beginning to think about, okay, now we have changed the political regime. what next? how do we go about that, affecting that total transformation of society and culture and the economy, and how do we rethink our relationship with the international monetary system and political system. >> just a reminder, we really do want to have your questions. if you could make your ways -- make your way downstairs to the microphone. we would be delighted. thank you. please come on over here to the microphone. >> please, can ask you to tell us who you are. >> i had a research foundation. and i've actually figure out -- if you just google wisdom on

google you'll see i 4000 pages of it. [laughter] i have two books, but my question to everybody here is, can you teach a pig table manners? sir, i want to ask you. >> what's the question? >> i think this is a metaphorical question. >> metaphorical question. can you teach a pig table manners because i think for purposes of -- >> let me ask another question. suppose you have rats. can you expect old quality? >> what you're saying is it depends -- the question you're asking is it depends on the base in mature you begin with. what can you make? >> yes. the main thing is corruption, whether freedom of the press, anything. if a person's mind, i quantify the mind also. minus two, minus one plus one and plus do. if they mind is minus two, can

you expect a minus two to behave plus to? it can be done. the only solution is most intelligence education is a subject. >> thank you. i think the question here is a legitimate question. and the question is about the quality of information. and about knowing what it is that you're dealing with. and in a situation where you have a lot of sources, you may be operating blind. we've talked about one example where that is true. huma, how -- and you talked also about al-jazeera's need to sift through huge amounts of materials. we've heard other examples during the course of world press freedom today discussions today. how do you find that gold and all of that stuff that is out there? how do you know that you're not being led down a path by someone who is deliberately seeking to manipulate you. we've heard stories about governments are spending

millions on cyber -- how do you know when you're sitting in a position of editorial authority at al-jazeera, or anyplace else, operating at distance that what you got is the real think? >> the rule of thumb initially you don't. we were talking about this before the panel started. you have a live broadcast. you get somebody calling you and saying that they are a member of the opposition to the government in that country, for example, and they want a particular area of the country. let's say, that is under the authority of the rebels. let's make libya, for example. you have absolutely no way of verifying that what the caller is saying is true. but in the case of, let's say, the case that you mention, in pakistan, you get this video.