>> to your point about, you know, kind of cutting through the clutter of information and misinformation. >> see this program and its entirety president video c-span library. live to where general john allen is providing an update on current operations in afghanistan. it day coming days after troops were killed as their helicopter was shot down by insurgents. >> general allen assumed command approximately three weeks ago. he commands a multinational coalition of troops drawn from 48 troop contributing nations and joins us today from his headquarters in kabul to provide an update on current operations. the general will have some

opening comments to make, and then he'll take your questions. with that, sir, i'll turn things over to you. >> thanks, dave. ladies and gentlemen of the pentagon press corp., thank you for taking the time today to discuss our efforts in afghanistan. as you know last friday night we lath 30 americans when the a shinook helicopter went down and we are deeply saddened by the loss of these americans. they represented the best of america. we honor their duty and ultimate sacrifice, and we offer our eternal gratitude for their commitment to the defense the american people and our great nation. this was a trajics incident in a great military campaign, but a singular incident in a broader conflict in which we're making

considerable strides and progress. to be sure, we face challenges ahead. there will be tough fights in the days to come. however, as president obama noted in his june address, we are on a part towards achieving our goals in afghanistan, and we will face the obstacles ahead with a steadfast determination to prevail. to that end, at approximately mid eight on 8 august, coalition forces killed the taliban insurgents responsible for this attack against the helicopter. this action was a continuation of the original mission to dismantle the district of the wardak province, but we must and will continue to pursue the enemy. all around afghanistan, taliban is losing territory, leadership, weapons and supplies, public support, and across afghanistan, more and more insurgents are

losing resolve, and the will to fight, and they face relentless pressure from coalition and increasingly afghan forces. the progress in afghanistan is visible. last month, we began the process of transitioning security responsibility to afghan government and afghan forces. our military is working hand-in-hand with our civilian partners to secure gains made by strengthening the afghan government and by advancing economic opportunity. we're committed to working with and strengthening our afghan partners because we know that only they can get the security of their country. the afghan forces made immense strides in their professionalization and effectiveness. increasingly they are out in front securing territory, safeguarding populations, and when necessary, fighting and die for their great country and fellow countrymen. we lost eight brave afghans in this crash and pay tribute to

their service and sacrifice. i met troops all across the four corners of afghanistan. i say with certainty our servicemen and women remain steadfast to the mission. we know why we are here and what's at stake. our troops are on the battlefield committed to succeed. they have my full and complete support and the support of a full nation that stands squarely behind them. again, thank you, and with that, i'll take your questions. >> before we get going, the general has a limited schedule. i ask you each to hold to one question to get through this. >> general, with the associated press. i was wondering if you could tell us about the investigation. i know it's just beginning so you have no answers yet. can you tell us what your key questions are that you pose for the general to answer in his inquiry and what particular

information you might be looking for. >> the investigation, as you are correct, is just beginning. we should see it begin very shortly here. it is the standard questions that we would ask in any investigation of this nature. what was the cause of the crash, and what lessons can be learned as a result of that cause, and ultimately, hopefully feeding back into the process of evaluation for our missions to improve them however we can. the investigation, again, is just beginning. we anticipate it will take some time, and, of course, we look forward to the results of that investigation. >> general allen, you say the taliban is responsible for the attack. can you be specific, sir? was this an air strike? ground action? who exactly did you kill? did you kill the person who

fired the round? did you kill th taliban heard you were going after? how do you know you killed these people and who did you kill. briefly, how concerned are you that special operations were put at risk in one place? the seals coming in, the rangers on the ground, was that a good idea? >> well, across afghanistan that night, there were multiple missions very similar to this one. our special operators are operating in afghanistan on a regular basis, multiple missions every single night. this was one of many occurring in afghanistan that night. as any of these missions do, they generate intelligence, and the intelligence that had been generated to this point led us to believe that there was an enemy network in the wardak province, and the purpose of the

mission was to go after the leadership of that network. as this mission unfolded, we saw some significant success occurring on the objective itself, but there were elements escaping. in their court to depart the objective, we had a force to contain that element from getting out, and, of course, in the process of that, the aircraft was struck by an rpg and crashed. again, this was one mission that occurred that night of many. that same number of missions occurred last night as tonight, and it will continue to occur, and in the context of our sperption operations and nightly special missions, these will continue unabated. with respect to the enemy specifically, all of these operations generate intelligence, and the intelligence that was generated both from activity on the objective, but also the activity of those who sought to flee from

the objective gave us significant certainty of who they were. we tracked them as we would in the aftermath of any operation, and we dealt with them with a kinetic strike, and in the gaff math of that, we achieved certainty they were, in fact, killed in that strike. >> yes? >> general, from national journal. following one part of barbara's question. are you comfortable committing this many special operators, seals, to a mission where it was not u.s. troops on the ground in imminent danger, but containing people from escaping the battlefield. are you confident and comfortable that that decision was correct and justified? >> well, off the decisions that are made are made based on the unfolding mission, and, in fact, that was a decision that was made at that particular moment.

i'm comfortable that was the right decision to be made at that time. >> hi, general allen, cbc news. back to the taliban fighters you killed early monday morning specifically responsible for the shoot down of the chinook. how many did you kill and did it include the leader you were initially going after? can you give us the scope of both the initial fire fight they were involved in on friday night that the chinook down on the way to and how many you ended up killing in the ensuing search? >> let me make a couple comments. there are a number of issues i won't get into specific detail about because the investigation remains openly to be accomplished, but i also won't go into the operational details associated with it. what i'll tell you is on the

original objective, we were pursuing a taliban leader. we anticipated that we would encounter not just the leader, but probably some of his followers as well, and some of them actually got off the objective. we were able ultimately to determine, as we will continue with respect to that network, where those elements ultimately ended up in the aftermath of the strike on the original objective, and then one night running their location, we were able to deliver ordnance on that position and kill them as well. >> general allen, the washington post. you said earlier that the taliban is losing across afghanistan, losing the resolve and will to fight, yet in the last six weeks, there's been a number of pretty major victories

from their perspectives and the tragic incident on saturday involving the chinook, attacking the hotel, and the president's brother in kandahar was killed. what basis do you say they are losing begin the type of violent attacks? >> well, the intent ultimately of the serge beginning in the middle of july of 10 and continues on was to create the opportunity for us to roll back the momentum. we have done that significantly across the country, and particularly in the south. we've achieved significant security gains in the helmand province and kandahar, and not only we stopped the momentum, but rolled it back. as a consequence of that, we've seen improvement in governance,

the development of economic opportunity, and it's not uncommon in an inser jen sigh when insurgents are losing ground to resort to significant attacks. while we've seen their ability to invoke violence and have enemy attacks, we've seen the number come down and expect those areas where they get high profile payoff, and that, in fact, is what you're seeing here with those particular attacks. what's not necessarily apparent every single day is with respect to the establishment of afghan local police units, in villages and towns across afghanistan, these villages that seek to embrace afghan local police in the village stability operations program are mobilizing their communities for their own security. that's not widely understood. it's also not widely covered,

but that's a great example of where the taliban are losing ground and losing influence because they can no longer get inside the population of these areas. another area we are succeeding is in the area of reintegration. that program is an afghan program we support as necessary. it's a relatively new program, and across afghanistan, we're beginning to see the taliban foot soldiers ultimately come forward and seek to rejoin society and become a member of their villages, and to date, we have reintegrated the afghan population of more than 2300 and there's about 3,000 success of security operations in the south and in the east, and ultimately in a program that has been well-structured by the afghans with our support, and we anticipate more success in that regard as well, so it's a function of security operations. it's a function of the

establishment of afghan local police. it's a function of the establishment of credible governance, economic opportunity. it's an indicator that they are losing by numbers that are coming forward ultimately and joining back into society through reintegration. we are not declaring victory certainly. we realize there's long days ahead and pretty heavy lifts, but there are indicators that lead us to believe that we are moving clearly in the direction of achieving our goals. >> general, npr -- you talked about the surge troops, and i wanted to ask you, as you know all the troops, some 30,000, will all be pulled out of afghanistan next year well before the end of the fighting season, and i'm wondering if you can tell us what impact you think that will have as you talk about the path on achieving our goals in afghanistan. do you plan on rewriting your campaign plan, shifting u.s.

troops to the east earlier than anticipateed? >> thanks, tom. it's important to understand that the surge will occur -- the surge reduction, the movement of troops back to the united states will occur in two phases. as the president indicated in his speech, 10,000 will depart by the end of this calendar year, and then another 23,000 will depart in september. we're already well into the planning for the first portion. we are adapting our campaign plan and that adaptation includes the shifting of certain resources in areas where we believe we have enduring security gains. the afghan national security forces beginning to come on the field in extensive numbers. by the time our additional 23,000 traps come out by the

september of next year, we'll have seen on the order of some 70,000 national afghan security forces come on to the field. it's a tradeoff in terms of the afghans who are joining us in the battle space with the forces that are coming down. the question was are we going to change our campaign. we're constant lee evalwaiting and reevaluating the campaign to adapt it to the environment and are able to focus resources necessary to accomplish our objectives. as you correctly pointed out, we will probably -- the east probably sometime after the new year. we continue to work hard in the south through the remainder of this fighting season into the fall. we'll fight all winter. we're attempt to disrupt the enemy safe havens throughout the winter, the opportunity for him to rest and refit, and then in the spring and summer, we'll

continue to disrupt the enemy and spend a particular amount of attention in the east. the time for those decisions remain to be determined. i'm working very closely with my staff, doing staff analysis now, and i'll be making those decisions probably in the near future. >> from cbs -- just to be precise -- did you eventually kill the specific taliban leader that you were after in the original operation, and you seem to be saying it was an air strike, but you don't quite say it was an air strike. was it an air strike which you used to get him? >> two separate questions. the first is did we get the leader that we were going after in the initial operation? no, we did not. we'll continue to pursue that network. as i said, we continue to develop the intelligence. we'll continue to exploit that target. we will remain in pursuit.

the other individual that we were able to develop as targets as a direct result of the intelligence that became available as a result of this operation, we did, in fact, locate them with certainty, and we did strike them with an air strike. >> sir, jennifer with fox news. was it a breach of standard operating procedure to put one unit on one helicopter, and were you short of helicopter assets that night? also, in the initial fight, how many taliban were involved and how many were escaping when that unit was called in? >> i won't get into the details associated with how we assign units to its battlefield transportation and tactical mobility, so i won't get into the details associated with that. in terms of the number on the objective, again, an operational detail i'd rather not discuss with you here.

we did determine there was a certain number off the objective, and ultimately, when we struck the target for the follow-on strike for this operation, that number was less than 10. >> general, michael evans from the lone ton times here. i'm told one field is roughly equivalent in terms of combat value, six englishmen. the death of 22 seals is equal to a company of regular troops. is it true while you are in the process of drawing conventional forces from afghanistan, you will increasingly have to turn to these sort of guys to carry out quick agents or rescue operations or follow-up operations, and that therefore, they will be in perhaps more danger of this sort of strike action, the taliban will get wise to this?

>> counterterrorism operations occur within the larger context of the counter insurgency campaign in which we're dealing. you are correct as our surface area decreases in afghanistan, the role of counterterrorism operations and in particular these kinds of specific missions will become prominent. it's not the sole mechanism by achieving battlefield decision, but it will certainly play a role. with that as an anticipated outcome, we will pursue special operations on a regular basis both now and for the foreseeable future and it's an adjunct and component of the larger unsurgeon sigh campaign. >> general, was it a mistake to use ch-47 in this kind of operation, and is that -- using

that kind of asset in this kind of operation something that you are either not going to do in the future or what's your thinking on that? >> we've run more than a couple thousand of these night operations over the last year, and this is the only occasion where this has occurred, so we routinely use in airplane. it's an important mean for our tactical mobility, and so the fact that we lost this aircraft is not a decision point as to whether we're using this aircraft in the future. it's not uncommon at all to use this aircraft on our special missions. >> richard fisk of war report. can you say, sir, what kind of aircraft carried out the air strike last weekend? was it a drone, manned aircraft or --

[inaudible] >> f-16s. >> sir, i was told that you were briefed, read the united nation report that came out on civilian casualties, and what's your reaction to the apache helicopters responsible for the air strikes and while air strikes were up, the apaches were responsible for the air strikes. >> i'm sorry, i did not catch that question as all. it was garbles. >> i'll do it here. the question was about the report last month regarding civilian casualties and one of the conclusions about apaches being the largest contributor of civilian casualties in air

operations, and your thoughts on that. >> well, first any civilian casualty is a casualty that we mourn. i've been very clear with the commands since i've been here that we'll do all we can to adhere to the tactical directive, the driving directive, to adhere to the directives associated with the escalation of force, to ensure that on those occasions where we have to apply force, we do so with every possible measure taken to avoid civilian casualties, and to that, there have been occasions where we've delivered air ordinates that inflicted civilian casualties. when that occurs, we seek to learn from that. we are careful about the application of force in that regard and i'll end where i started. any occasion with civilian

casualty, we're very introspective and learn from that with the intent of not repeating it. >> jim michaels, usa today -- you mentioned progress with reintegration and afghan local police. i'm wondering if there's also any progress that you see with regard to the talks between the government of afghanistan and taliban leadership. >> jim, i'm not involved in that between the governance, and so while we do have significant involvement in the process of reintegration, we are not involved in the term reconciliation, at least at my level. >> can you give us the sense and support that mature taliban and al-qaeda leaders have across the

border, and has it come down or increased over the last several months after the killing of osama bin laden? >> again, i have difficulty with that question. dave, can you help me with that, please. >> since the death of bin laden, your assessment of the level of supportal tban and al -- taliban and al-qaeda from across the border. >> we've not seen any real discernible outcome that the death of osama bin laden had direct impacts on the battlefield of afghanistan. certainly there's rhetoric among the taliban in some places that they are conscious about the death of osama bin laden, but that's not a new cause for the taliban nor increased the numbers that we have seen in

cross-border operations or inside afghanistan, so at this juncture, i would say if there will be an effect of the killing of osama bin laden, it has not been felt on the ground inside afghanistan. >> thanks. general tom from the new york times, thank you for your time this morning. can you help us understand the decision to deploy one of your one forces on this mission, when o call comes in for reaction force, a commander has many assets. the mission to send a tear one force to do this, was it because the value of the target, just close and fastest, and is this something the investigation will look at. thank you. >> again, tom, as you're probably aware these missions have a number of packages associated with them, and i won't get into the details of how and why we ultimately make a

particular decision on any particular mission, but this force was actually part of the mission, and so with that, i'll end that response. >> larry? >> general, a press release sent out just as you began talking to us saying the man you killed aside from the shooter was someone named mullah mohbullah, a taliban leader. was he not the target you were going for the on the night of august 6, and if he was not, who was? >> i won't tell you -- i would prefer not to discuss the operational details of who we were going for, but you have the name of the leader we ultimately dealt with. >> sir, it also says while it's not been determined if enemy fire was the sole reason for

that helicopter crash, it took fire from several insurgent locations on its oi approach. what weapons were fired at the helicopter and whether you know it was hit from those weapons other than the rpg people said is the likely cause of its crash. >> small arms primarily were the weapons we encountered that night. we don't know with any certainty what hit the aircraft. that's the purpose of the investigation to ultimately assess it was an rpg and also assess whether small arms fire contributed to the crash of this aircraft, and so that will come out in the investigation. >> all right. we are out of time, so back to you general allen, for your closing remarks.

>> ladies and gentlemen, i want to thank you for your time today. we will always remember the families of the fallen, and we'll continue to build on the tremendous progress made to date in afghanistan, and we're determined in our mission, and ladies and gentlemen, we will prevail. thank you very much for your time today. >> thank you, sir. [inaudible conversations] [inaudible conversations] [inaudible conversations]

[inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] >> some live coverage to tell you about on c-span.

>> seen as a testing ground for presidential hopeful, republicans candidates are gathering in iowa for state fair festivities. >> june of this year marked the 30th anniversary of the start of the hiv/aids epidemic in the

u.s., and earlier this summer the health and human services department started a discussion on the early start of the disease, the growth over the years, and what the future might hold. including in the event are remarks by kathleen sebelius. it's 90 minutes. [inaudible conversations] >> good morning, everyone. thank you so much for joining us here today. i'm richard sorian, and it's a joy and pleasure to welcome you here today. we have a full program, so i'll just enter deuced assistant, howard koh who will begin the program. thank you very much. >> thank you so much, mr. sorian, and welcome, everybody. it's great to you see here. i am secretary for health, and we are thrilled you are joining us for this important

congressmen ration of 30 years of leadership in the fight against hiv/aids. today, we honor the lives of those we have lost, whose life journeys are literally stitched into these quilts you see around us. today we honor the dedication and persistence of advocates here and around the nation who have ushered in a new era of action on behalf of the country. today, we on hoer the continue -- honor the continued commitment of public and health officials, that's everyone here, who are advancing vital work, prevention, awareness, and treem not just here in the country, but indeed around the world. most important of all today, today, reflect on stories over the past 30 years because this epidemic has touched all of us. you don't have to be infected to be affected by hiv/aids.

i remember so clearly that 30 years ago this month, i was the medical chief resident at boston city hospital, a young physician trying to help patients, and i remember so clearly studying that first wave of scientific reports on hiv trying to come prehenned what seems to be unexrensble condition. i'll never forget the stigma that vowndz the patients we struggled to care for or the courage of people across the country who stepped forward and tried to make a difference in the face of this new threat. since then, we all know how the virus literally exposed the fault lines of our society, and now 30 years later, ironically, we have a new generation that has arisen that has little to no knowledge of those early dark days. today, we share stories, not

only of past fear and confusion, but also of tremendous caring, passion, compassion, and leadership. today, you will hear the perspectives and the stories of the secretary and many other leaders in this room. you will hear tremendous stories of scientific advances and progress, and we want to celebrate with you, your commitment and the unvailing of a new generation of leaders who care deeply about these issues and share with you passion and compassion understanding that the word "passion" means to suffer, and the word "compassion" means to suffer with. it's so critical that we share these stories today to build our community. there's a wonderful saying that a sorrow shared is half the sorrow, and a joy shared is twice the joy. that's why we are holding this important meeting today and work

closely with you as we try to put this epidemic in our past. of course; we are delighted by the commitment of the administration led by the president. many of us were there at the white house last july when he unvailed the national hiv/aids strategy. it's a pleasure to work with jeff crowley here in the audience today to make this rally come alive. thank you to all of you for implementing this strategy. i'm honored to be a part of that effort as assistant secretary on behalf of the secretary. i want to acknowledge the contributions of our office of hiv/aids policy, the work of aids.gov led by michelle gomez and want to recognize ron, is he here? stand up and get a round of applause here, ron. thank you.

[applause] so in closing, we note that the history of hiv/aids began some 30 years ago in an era of i'llness, fear, and death, we hope with this anniversary we mark a new chapter that is marked more by hope and promise for the future. we need each of you now to do more than ever before to deliver your healing touch, enrich education, advance research, promote prevention, and advocate for the vulnerable. we made so much progress in the past 30 years. we look forward to the say that together with you, and can say that this devastating disease is part of our past and not our future. thank you very, very much. [applause] >> i'm actually delighted now to introduce a tremendous community

leader, ms. dazon dixon diallo, of sister love incorporated, a prominent women's support organization based in the southeast. she is a woman with tremendous passion and come pages, and i want to thank dazon dixon diallo for joining us hear today. thank you. [applause] >> wow, thank you so much, dr. koh, and thank you all for being here, and for being here. debbie thomas, janet, martin delaney, novella dougly, arthur ash, so many hundreds of thousands of others are also

glad for you being and being here. in the summer of 1981, i was a 16-year-old rising senior at peach county high school. that's how we say it. [laughter] in fort madison, georgia, one of those places where it took longer to get the word of this strange new deadly illness that we soon came to know as aids. by 1985, i was a college sophomore in atlanta, but working and advocating for women's reproductive rights. in that same year thanks to rock hudson's disclose sure, another longer story, i was volunteering at the local aid organization. since that time, i founded and co-founded several organizations including sister love which will be 22 years old next month. i've planned and participated in demonstrations with act up to

the treatment action campaign, worked with community planning for prevention and treatment and care, i've buried more friends and colleagues than most of my college classmates will ever bury before they become seniors. i married and divorced a man who loved me, but not enough. i have fore gone spending summers and holidays with family to sit with sick clients or write another grant or attend another meeting. i met and worked with so many amazing, smart, dedicated, and giving souls, and i have a community, that's yal, that really understands and identifies with me in my passion with this disease and its impacts on families, individuals, communities, and even nations. i dream of a future where there's no hiv or aids, and to keep working to bring that future into my present because

that's what all those people for whom the end of this pandemic comes too late. i have learned that love really does conquer all, even when we don't know it, see it, or feel it. now, you know, we've been in this for a long time, and i swear i thought back in the mid-80s that by this time in my life, i would be running a bed and brunch on a beach writing notary public-fiction erotica. [laughter] i think that's still in my future. [laughter] we have still come a long way. despite how far we've come with, you know, creating evidence-based strategies, with having life saving, quality of live giving, treatments, and a network of social service providers and educators and

supporters and peer leaders and finally having a national strategy and plan to get behind and work with regardless of some of the challenges put to that plan. we still have a long way to go. where i live and work in the south, no, the deep south which is may more than a geographic location. stigma still exists, and i'm still waiting for my more than magic campaign. y'all got that one? discrimination has not yet been eradicated, and people living with hiv and aids are still at risk of criminalization, disclosure of status is a risky endeavor for family, employment, and dignity. while the strategy might not be a perfect tool, it is the tool we have to work with. we're also having to keep the fight and defending the prioritization of hiv/aids. that's why i'm still here. even though i know i'm in the

business to put myself out of business, i'm not here to go out of business, and given the fact that we have thousands of people on the aid-out list, half of whom are in georgia and florida, the news today in "usa today" says we are not catching people early enough to keep them alive longer. we still have a lot to do which means you yet cannot rest. you still must find inspiration and energy and still must call the names and remember on them as your own soul guides and lift up the importance and meaningful importance of people living with hiv. i'm reminded that from the beginning of this epidemic, community has always, always been in the forefront. we've been in the front of science. we've been in the front of policy. we've been in the front of

social, cultural attitudes and ideas. we've effected change in every sector. we have galvanized systems, but it seems to me in the last couple years, at least where i live and work, some, it's a be careful what you ask for thing where community has now fallen a little bit behind the science and policy. policy is in front of us. that doesn't necessarily mean we're going to solve all these problems with just science and just with policy. i want to hear -- i'm here to remind you that while science, research, and policy might be the body of the end of the epidemic, the community, civil society, civil service, people living with hiv are its soul. body and soul, we work it. we work it together. we work it as one.

i'm going to be here until the end of this thing, and i'm just going to continue to wake up every day, call on our collective ancestry of people no longer here as a result of hiv and aids and do the good work that we need to do together. thank you. [applause] now, it is my absolute pleasure and distinct honor to introduce a woman who may not need an introduction, but you're going to get one anyway. two years as secretary in health and human services, secretary kathleen sebelius has been a champion for improving our health care system and fighting the hiv/aids epidemic. in fact, she's combined these fights to make clear that comprehensive health care for

all americans must include people living with hiv and aids, and as a person who has fought for reproductive justice since the age of 17, i personally thank her to fight for reproductive health and family planning services for youth and women across this great nation. ladies and gentlemen, comrades, secretary sebelius. [applause] >> well, i want to start by thanking dazon for not only that kind introduction, but for mother amazing moshing over year -- amazing work over years, and she is tireless leadership in the fight against hiv/aids and everybody day through her work and her example gives hope and courage to some of the most vulnerable women and families

around the world, so let's thank her again please for being with us today. [applause] i also want to thank dr. koh, howard koh, who as the assistant secretary of health, has tackled a number of issues and has taken leadership roles in a number of areas, but i can tell you his experience and passion has inspiredded him to be particularly focused on our continued battle, our national strategic plan, our efforts on hiv and aids, and thank you, howard, for continuing that battle. you're going to hear from some remarkable health leaders who have been generous enough today to share their personal stories with us. i'm struck by looking at this audience that we have an interesting combination of

health expertise in this room. some of you have been in this battle from day one and know well the history we're going to talk about. others were not alive when this story first began, so some of this is important history for you to understand and know about, but today we're here to remember those we've lost to the pandemic and honor those who continue to fight against the virus and fight for a cure. we're here to mark the gains made over the last three decades and look ahead with hope and purpose at the next steps we have to take in this fight of the battle. the story of the first 30 years has been one of great commitment, discovery, and collaboration, but it's also a story of great uncertainty and terrible loss. more than 600,000 americans have died long before they should have.

600,000, and these quilt squares represent just a few of those souls. worldwide, more than 30 million people are living with hiv today including 2.5 million children. it can be easy to focus on all the data, the dollars, the scientific milestones that we so often use to measure our progress, and they are important, but we can't ever forget the story of hiv/aids is one of countless individual human lives. now, there's so many in this room today who never thought this disease would still be with us three decades later, and as i said earlier, there's some of you here who were not alive when this epidemic began, and just think about that. a generation of people who have never lived in a world without this virus being present. in this age of advanced treatments when hiv is no longer a death sentence for many, it

can be easy to forget how scarry those early years were. when it was first discovered, no one knew how the disease was spread, and we didn't know what caused the disease. what we did know is it almost certainly meant death. when advocates compared the early years to living in a war zone, you were never sure when the next bomb would drop, and with that uncertainty came a lot of fear, and with the fear came enormous prejudice. children, like ryan white, were turned away from their schools because they were hiv positive. tenants were locked out of their apartments and forced to live on the streets. workers were fired from the job they had for decades. sons and daughters in hospital beds were abandoned by their families and loved ones, and treem was hard to come by unless you qualified for medicaid or could keep a job that provided

insurance, and the treatments that we had were not very effective, and not as effective as anyone would have wished. our national government was frankly very slow to act, and so it was community organizations springing up on street corners, around the country, the soul that dazon just talked about that meant people's -- met people's needs, educated how to protect themselves, to battle discrimination, and got this nation's attention, and they taught us most poignantly that silence equals death. now, many of you know this story because you lived it, and you went on to build strong coalitions that included government and community-based groups, employers, health professionals, and individuals with aids coming together with the sense of urgency to develop better approaches for treating and reducing the spread of the disease. no single narrative can do

justice to our journey over the last three decades. there are up stead a -- instead a million individual stories sewn together for a shared hope for progress. science must keep moving forward. prevention must reach even further and be even more effective, and all people living with hiv and aids must have better access to treatment and care they need whether they live in washington, d.c. or in a village outside of nairobi. overtime, in some instances a relative short time, scientists took what was once a mystery and began to uncover answers, the answers that not only worked in a lab, but also saved livings, and thanks to the i think newty of doctors like center of

disease prevention, health and food administration, and our own hrsa, new effective therapies and treatments and tools for prevention came online. today, there's more than 30 licensed drugs that are widely available in the developed world and have begun to transform hiv into a chronic disease adding years to people's lives, but we know that progress is not enough, and it's why president obama made the fight against hiv at home and around the world a top priority for his administration including the first ever development of a national aids strategy that's providing direction and focus to our efforts. the battle is not over. as long as this threatens the life of people here and around the globe, the struggle continues, and so on this day in this place, we need to remember the words of mother jones who told us to pray for the dead and

fight like hell for the living. that's what we're going to do. thank you, and now i'd like to turn things back over to richard, and you'll hear from some of our terrific leaders. [applause] >> thank you, madam secretary, and thank you for joining us. the secretary is now going on an event to promote healthy child care for children. she's fighting on every level. we appreciate her taking time. let me welcome you again to the great hall. we call this the great hall, but until today, i never thought of it as great. i wish we could keep the quilt panels forever because this is life. this is what this is all about, and so take a moment when you can to just look at the quilt panels and remember these people and all the people that were

close to you. an author and survivor taught us whoever survives the test, whatever it may be, must tell the story, and that's in part why we are here today. when hiv started in 1981, i was 23 years old. i was in my first job, and i was a journalist here in washington writing about health care policy. who knew. i wrote some of the earlier news stories about a disease that didn't have a name or didn't have a decent name for a period of time, and i never thought that 30 years later i would still be working in some or part of my life on this epidemic, not just working, but living through 30 years with so many people,

and i'm glad. i'm glad that i am not because the epidemic has lasted this long, but because it's changed my life the way i'm sure it's changed the lives of everybody in this room for the worse, but also for the better, so one of the things we need to do is remember and not forget, and as the secretary reminded us, there is a generation of people who have grown up in this world never knowing a day without hiv in our lives, and there'll be generations to come, and we need to make sure today, but also when the epidemic is over, they remember where we came from. we have a short video before the rest of our speakers join us, and i hope you find this to be both informative and enriching. i think they're going to cue that up.

>> june 5 #th, 1981, the cdc published a mortality weekly report describing cases of a rare pneumonia in healthy gay men. >> it was from those reports that the great epidemic of aids begin to mushroom, and we were in the midst of it before we knew it. >> i didn't know what it was, but i made a decision in the summer of 1981 that i was going to change my career, start bringing into the hospital and start studying these unusual situations of gay men who had the strange disease. >> when the pattern went from gay men to injecting drug users and then people with hemophilia, there could only really be a

unifying hypothesis, a viral agent transmitted through a variety of means. >> once we got the virus in our hands namely in 1984 and 1985, then we began to study in earnest some of the events. >> by the time the virus was discovered, there were more than 5,000 people in the united states infected with it and millions worldwide. >> we saw, really ended up following in the aids clinic about 25,000 patients with hiv. the average person we would see would have four or five infections and then succumb. >> aids was and is a public health problem, but one with many political assets. >> the community's response was a mix of insider and outsider tactics. sitting with policymakers finding the best solution, but at the same time, street atavism, a ash activism and

street demonstrations. .. >> in 1987 the aids memorial quilt was displayed on the national mall. the following year dr. coop's message, understanding aids, was mailed to every household in america. in 1990 ryan white died at the

age of 18, and congress passed the ryan white care act providing access to treatment for uninsured people with hiv/aids. >> because of the hiv virus that i have attained, i will have to retire -- >> the following year basketball star magic johnson held a press conference that changed the way many people thought about hiv/aids. the early '90s were marked with progress despite some setbacks. in 1994 an nih trial found azt was shown to prevent transition from mother to infant in childbirth, a huge advance in managing infection. however, aids remained a leading cause of death for african-americans. >> 25% of folks impacted by hiv in 1986, and yet the response in black communities and the

delivery of services at that time, primarily prevention and awareness to black communities were disproportionately low. >> by 2002 about half the people living with hiv worldwide were women. >> for women to recognize the risk especially for heterosexual african-american women and latinas in the u.s., i think risk awareness is still a very, very, very, very big challenge. >> as the epidemic entered its third decade, the focus turned global. in 2003 president bush announced the president's emergency program for aids relief or pep far, providing billions of dollars to fight and treat hiv/aids in countries around the world. >> pepfar has been, really, the most remarkable program. we are now at 3.2 million people on antiretroviral treatment, all of whom would have died. i think it's a remarkable contribution that the american people should feel very proud of. now it's part of president

obama's broader global health issue, so it's taken even bigger impact now because it's been linked to other global health problems. >> today we're releasing our national hiv/aids strategy. [applause] >> announced in 2010, president obama's national hiv/aids strategy was aimed at preventing infections, expanding access to care and reducing disparities. >> i think that we are in a period of time where we have to tools in the aids epidemic today and across the globe, and that's critically important, and it's exciting. ♪ [applause] >> wow. thirty years in five minutes. think i got a few more gray hairs. and several of the people who were kind enough to participate and give us their, their memories and their thoughts are here today, and i want to thank them as well.

the word hero is overused, so i'll try not to use it too often. i'll just say our next speaker is a hero of mine and a leader throughout this epidemic. let me introduce tony fauci. [applause] >> thank you very much, richard. it really is an honor and a privilege to be here this morning to commemorate this extraordinary time in our history. um, 30 years of hiv/aids, um, looking around the room i don't know whether it's true or not, but i may be the only person here who has spent his entire professional career in the department of health & human services. [laughter] for a very long time. so it's really good to be here with you in this building.

i just want to take a couple of minutes to share with you the kinds of reflections that those of us who were there from the very first day had when we saw the unfolding of this historic and extraordinarily tragic event, the emergence and the evolution of the beginning of this hiv/aids pandemic. as i often say when i talk to people about subjects like this and similar subjects, it is really quite true that when you're living through or beginning to live through a historic event, you don't really appreciate that it's historic until you actually reflect back on it. it's sort of a quirk about history. you don't say, wow, i woke up today, this happened, it's going to be historic. but it really has been a historic event that has brought out in many respects the best and the worst in people

throughout the world. but having been through it from the beginning, i can say now that the ultimate experience is one that has brought out some of the finest qualities of mankind. you saw this clip -- in the clip there i remember very clearly there are things that you remember and know exactly where you were. i was sitting in my office at the national institute t of health in bethesda doing my job of working on basic and clinical research when this mmwr that you saw on the screen landed on my desk. june 5, 1981. and i remember reading it, what a curiosity. five men from los angeles, curiously all gay, otherwise well with a disease that i knew very well is -- as an infectious disease physician is only seen in people with suppressed immune

systems. i thought it would go away, and then one month later on the fourth of july, 1981, a similar mmwr landed on my desk now reporting 26 men -- again, curiously all gay men -- now from l.a., terrorist and new york city. not only with pneumonia, but also sarcoma. and i remember for the first time in my medical career i got goose bumps because i knew this was something new and something horrible. but i never in my wildest dreams would have imagined what would unfold for us in this country and throughout the world. i'm very proud to have been in this organization, in the department of health & human services and at the nih during those early years when we were struggling from both a scientific and public health standpoint about how we were going to address this pandemic.

i refer to it as the dark years of my professional career because unless you've done it, it is difficult to describe what it's like to have people come in who are suffering and dying, and you don't have an idea or a clue about what is going on with them. you suspect it's an infection, epidemiology tells you it's sexually transmitted. also later on injection drug use. but yet you don't know what to do with the patients except palliative care. and it was over the period of those three decades with support from so many groups here in the department, through the department at nih, through multiple administrations and multiple turnovers of congress that we had the resources to put into effect a scientific research both basic and clinical attack on this pandemic to the point where we now, 30 years into it, have the capability of

really putting an end to the aids epidemic. there are certainly scientific gaps, we still don't have a vaccine. there are implementation gaps, we still have not been able to get penetration into communities, voluntary testing, linking to care and treatment of individuals which we know now treatment can serve as prevention. so there are really many, many challenges ahead. it's both humbling, but also energizing to realize that we've come a very, very long way. but in the same breath as we realize that and the same thought that we assimilate that, it is clear that we have a very long way to go. so although we are now three decades, entering into our fourth decade of this pandemic, i would hope that a day like today where we come together and remember the experiences we have

that we reconfirm and recommit ourselves to the important tasks ahead. because as i've said very often, we as a global society are going to be judged as much as the advances that were made over the previous 30 years, we're going to be judged even more by what we do in the coming years because we now have the opportunity from both a domestic and a global standpoint to put an end to this pandemic. and i can tell you all in this room that i will do everything i can to stay in this fight as long as i can and, hopefully, one of these days i'm going to come down to this great auditorium and talk to you about not the challenges of the future, but a commemoration of something in the past that is now over. thank you. [applause]

>> thank you, tony. one of the things that, um, dr. fauci's remarks reminded me of, it's become fashionable again lately to use public employees as punching bags to talk about bureaucrats and about government people needing to work harder and all that. we have to remember that, you know, many of -- not all, but many of the scientists and the public health professionals and the caregivers and others that were working on this epidemic from the beginning worked here at this department in various parts of it, worked in other parts of the government, worked in state government. so there are a lot of public service heros that continue to do that work every day, and we need to remember that they're scientists, they're physicians, they're public health professionals, but they're also our colleagues. so thank you for that. i first met daniel montoya when

he came to washington for, i think, his first job here in d.c., and we work withed together over at the white house office of national aids policy, did some traveling around the country to visit programs and really find out what was going on on the ground. of course, daniel knows better than most anyone i know, and he has been an advocate and an outspoken leader on this epidemic for a number of years and now serves as the deputy executive director at the national minority aids council, one of our leading advocacy organizations. daniel will share his thoughts. thank you, daniel. [applause] >> thank you, richard, and good morning to everyone. i'd certainly like to also thank the department of health and be human services for hosting today's symposium. it's really important to take a moment to reflect, and 30 years is that moment to reflect. this administration has demonstrated a laudable

commitment to fighting this epidemic and will be a critical ally as we enter the fourth decade of the struggle. i'd also like to thank my distinguished panelists, some of whom i worked with and for. um, i'm extremely honored to be in the presence of such amazing advocates, allies and trailblazers. many of you are in the audience. as richard said, currently i serve as deputy executive director for the national minority aids council, and i started that opportunity this past year in january. i'd like to recognize the staff of the national minority aids council, especially its executive director paul who allowed me the opportunity to come back into this role to be able to advocate more directly. the national minority aids council represents a coalition of 3,000 faith-based and community-based organizations as well as aids service organizations advocating and delivering hiv and aids services in communities of chlorination wide. since 1987, we've advocated

through campaigns, public policy education programs, national conferences, research programs, capacity-building, technical assistance and treatment and trainings and digital and electronic resource materials. like so many gay men of my generation, i got involved in aids advocacy because of the epidemic's impact on me directly. i was diagnosed with hiv 24 years ago, and i make the point to say diagnosed instead of living with because for years after aids was first discovered, there was no test for the virus. i finally got the courage and tested for it in 1987 but had no idea how long i had been positive before that because up until that point we had already been practicing safe sex and using condoms which was really spearheaded a lot by, um, the community. luckily, i have responded well to treatment and have lived a relatively healthy life.

however, many of my friends, family members and loved ones were not so lucky. after being diagnosed i reevaluated my priorities, abandoning a job that i had really looked for and longed for in terms of working on wall street to come back to texas and work for changement -- change. and while i haven't looked back, i do look back in terms of remembering why it is that i continue to fight this fight for all those people that i sat at their bedside who were dying and for the promises that i made to them to continue this fight. i think it's important to note some aspects that i think have happened over the 30 years that are significant. um, because there has been significant progress over the last few decades. and i also must take time to really thank some of the trailblazers i mentioned earlier in the gay community and organizations like act up, the gay men's health crisis, project inform and several others. because of them, the public was forced to address the growing

epidemic. and as a result of the support of the nation's medical community, today infection rates have dropped from a peak of 130,000 a year in the 1980s. unfortunately, the annual rate has held steady at 56,000. our nation's prevention efforts seem to have hit a wall. and while there may be many reasons for this including adequate funding, lack of evidence, sexual prevention programs is an issue that we need attention on. the continued disproportion of the impact of the virus on the minority community itself also poses additional prevention challenges. in the african-american community where infection rates are seven times as high as caucasians, the problems of the virus makes each sexual encounter considerably riskier. this is why identifying effective evidence-based prevention tools is so critical. thirty years into the epidemic,

it is naive to assume that everyone will use condoms 100% of the time. whatever the reasons for an individual's failure to use condoms which could be lack of intimacy, condom fatigue or simply the occasional poor decision, it's critical we expand our approach to prevention without judgment. if a white man or woman have unprotected sex once, his or her chance of contracting the virus is significantly lower than two gay black men. as long as disparities and infections persist, those of us in the prevention community will face an uphill battle. but this is where science has provided some potential breakthroughs. the promise of pre and post exposure could prevent transmission. recent studies point to treatment as prevention offer

possibly the best hope for a practical approach to expanding prevention efforts. a study released just last month that reviewed discordant couples found that early and sustained treatment with antiretroviral medications reduced the risk of transmitting the virus to your partner by as much as 96%. for minority communities facing significantly higher prevalence, this is a hugely promising development. assuming that we could get everyone diagnosed with hiv on early drug therapy, this could significantly reduce the risk of transmission with each sexual encounter even in groups with highest viral burden like gay black men. the critical point in that last statement is whether we can insure that all people living with hiv can get on drug therapy. currently, more than 200,000 living with hiv in the united states are unaware of their status. any effort to enroll all those with hiv into antiretroviral

therapy would require a renewed push around testing. it would also require avenues to insure that people can access care once they are diagnosed. current programs are simply inadequate. medicaid, for example, requires at least currently that a person be disabled by aids before they can access treatment to the program, and most recently we were really satisfied to see that new guidelines were released to states on waivers which we think will be helpful to building a bridge to the effort in 2014 when medicaid will become that opportunity. ryan white faces shortcomings in funding. these programs provide medications to low income individuals not eligible for programs like medicaid and like was said earlier, there are states in the south that are incredibly impacted. and those states in the south are really communities of color

that are being impacted. currently, and states -- 13 states have introduced wait lists while 17 others have introduced cost containment methods like capped enrollment there is some great hope, and that was, i think, referenced in the video that you all saw earlier and some of the fact that we've been participating early on, and it comes about through the importance of health care reform and the national strategy. the passage of health care reform and the release of the strategy will go far in addressing these challenges. health care reform will improve access to care by preventing insurance companies from dropping enrollees when they are diagnosed with hiv. it will also keep private insurance companies from denying coverage based on an hiv diagnosis for from capping treatment. health care reform will also expand medicaid eligibility eliminating the requirement that a person -- the national strategy aims to decrease

infections and expand access to care and minimize health disparities. one of the ways it aims to achieve these goals is by focusing resources on those communities where the impact of the epidemic is most severe, namely minority communities. in other words, it calls for funding to follow the epidemic. this will go far in addressing the prevention challenges posed by the dispoo no more questions mate -- disproportionate -- while we must be careful that we do not abandon one community's health for another. for example, while the asian and pacific islander community has the lowest infection rate of any racial and ethnic group in america, it is also the only group with infections that are actually on the rise. if we based our reallocation on funds solely on the virus' burden in the community, we could risk worsening the epidemic in others. this is why the need for continued prevention funding is so important. while programs like prep and the

use of treatment as prevention hold senate promise, we -- significant promise, we must insure funding of traditional programs. any additional weapons in our prevention arsenal are only effective in concert with safer sex practice and regular condom use. in the today's political climate, efforts to reduce the deficit have occasionally put funding in jeopardy. to the credit of this administration, it has continued to push for sustained prevention funding. but efforts in congress to cut family planning funding including funding for planned parenthood could have a devastating effect on our nation's fight against this epidemic. instead of cutting these programs, it is critical to note that each infection that is prevented saves over 350,000 in lifetime medical costs, much of which falls on the taxpayer. in fact, preventing all 56,000 annual infections for just one year could save as much as 20 million in lifetime medical costs.

if you multiply that figure out over the period of a decade and you are looking at potentially savings in the hundreds of billions of dollars. prevention is an investment, and it is something we must really work towards. it is not just an investment in the citizens of this country, it is an investment in our economic security. and finally, i think, the most important thing i could say as one who's been living with hiv in the advances of treatment over 24 years is that i'm able to be standing here and doing this work and advocating for the needs of people living with hiv and aids. but there isal benefit that i know of that is really important to me that i've been able to participate in, and that is in being able to be around and see my parents get old and take care of them in their twilight years as they've been taking care of me when i was dealing with this when i turned 23, and they were there as my support. and for that and for the science

and for all of the work that's been going on, that's been the greatest gift, i think, for people living with hiv and aids, that we can actually be there for others to do the work, including our own families, to take care of them in their own twi lightening years. thank you very much. [applause] >> thank you, daniel. thank you so much. you know, it's easy for us to focus in on the domestic epidemic. it is, you know, so devastating and continues as we've talked about. but one of the most important things i think we've done in this country is look outward at the pandemic, and is as the video talked about a little bit, the pepfar program that president bush launched is one of the most amazing public health initiatives, particularly global health initiatives in our time. markdybul was at the president's

side really getting that program going, and we owe him a debt of gratitude. and he is now the distinguished scholar at georgetown university, inaugural global health fellow at the george w. bush institute, and he's joining us today to talk about the global pandemic. thank you. [applause] >> good morning, everyone. i'd like to begin by thanking secretary sebelius and dr. koh for hosting us here and keeping a spotlight on hiv/aids which is so important as many things are going around and many other important issues on everyone's plate. it's also good to be back here at hhs. i served in the uniform public health services for 14 years, so it's good to be home. leadership starts with humility and service, and nowhere is that more important than the global hiv/aids epidemic and how the american people are responding globally. the opportunity to serve is often a series of accidents, and my own life the first accident was in the mid '80s reading

the cover story in "newsweek" about global hiv/aids. and like tony, there was something just inside of me that told me i should leave the academic career i was pursuing in the humanities and pursue hiv/aids. the second accident was tony. tony was, i was very fortunate that he picked me up and shepherded me and mentored me in his laboratory. and then as president bush turned to him and a small team to develop pepfar, tony was kind enough to include me in that process. and then president bush launched, as was said, the largest national health initiative in history for a single disease. the first global aids coordinator, and i was fortunate enough in another accident to be there as he moved on and to be named coordinator. now, president bush's leadership was sorely needed. it's difficult to remember looking back given how far we've come that just two years before

pepfar was launched we had almost no global leadership and, in fact, treatment for hiv-positive patients and hiv-positive people on a global effort was blocked at the united nations as a millennium development goal. and it was blocked as a millennium development goal on very pernicious arguments, arguments that africans were uneducated and poor and, therefore, could not do something as complicated as treatment despite having the science there. that slander was compounded by something that was being promulgated that africans were so promiscuous, there was nothing that could be done to turn the epidemic around. we now know from science that africans actually have fewer sexual partners than americans do over the course of a lifetime. and in the context of that general we can't to this or the africans can't do this, president bush and the american people stepped up and said, yes, they can. we actually believe in that saying in the last

administration too. [laughter] i knew the truth, and tony knew the truth that that was a slander and untrue because we were doing work in africa with heros like peter and alex who were actually delivering antiretroviral therapy already. and we knew that what they needed was support. and that comes back to leadership being about humility and service and understanding that africans actually cannot only solve their problems, but are among the most talented and dedicated and innovative people. and if you support them and give them a chance, they will solve their problems. and that's precisely what they did with pepfar. pepfar was not about americans doing, pepfar was about americans supporting africans from the village level to the statehouses to solve their hiv problem, and that's why tens of millions of people had their lives lifted up and saved. president obama is continuing this theme and is carrying the torch.

his accra speech was fully on point to say that africans must lead and will lead and americans will support. and president obama's global health initiative, in our view, is a natural evolution of what was begun in the bush administration, not a break. and, in fact, so much so that the bush institute is focused on very similar efforts and working with the obama administration and his extraordinary team of people in this development and global health, many of you in this room among them as well from across the government at the white house, the state department, usaid, here at hhs, the peace corps and department of defense. now, pepfar came at a unique moment in history where the science gave us the opportunity to support people for prevention, treatment and care in combination which is what pepfar was all about. people focused on the treatment, but that wasn't the only issue there. and the science was there. and as president bush said at the time that if we had the science, it was a moral

imperative for us not to let people die. we are now at a similar crossroads on prevention. while we could do some combination prevention when i was in office, we had behavior change including condoms where we could have a combination approach, as we were ending our term in office male circumcision came on the stage reducing infection by 50-60%. we now have treatment as prevention as daniel and tony pointed out. we hope for preexposure prophylaxis, and we hope it'll be more effective for others including young women, hopefully, in africa. we have a microbe side passenger side that's coming on stage, we now have the science that will allow us to drive this epidemic into the ground. and just as we have the science with treatment and we could have done as many people said, here are all the reasons for implementation and financially we can't do it, we said this is why we can do it. we now have the opportunity not only to say here are the

problems and challenges with combination prevention and using science, here are the problems financially, here are the problems on implementation. we have the opportunity to grasp this moment in history again and say this is why we can do it, and this is how we will do it. and how we will do it is by supporting africans who, if we support them, will solve this problem. they will figure out how to do it. what we need to do is support them. and so as pepfar grasps a moment in history, we are very hopeful that we will now grasp that moment in history to drive this epidemic into the ground through prevention, care and treatment. for an hiv-free generation. and all of us on this stage who have been privileged to serve and privileged to have the opportunity and humility to serve look forward to supporting all of you and future generations of leaders as you tackle this problem, as you own this problem supporting africans to solve their problems. thankthank you. [applause]

>> thank you, mark. i had the pleasure to work with helene gayle when i was here last in the mid '90s, and she was at the centers for disease control and prevention. and i got to see leadership at work. really advancing prevention and advancing a real frontal assault on infections in this country. she is now the president and ceo of care usa, and she also serves as the chair of the president's advisory council on hiv/aids. dr. gayle? [applause] >> thank you so much, richard. and, um, as always when you're the last speaker, many people have already made some of your points, so i'm going to try to be relatively brief so that we can start the panel. before i start i'd also like to thank secretary sebelius and assistant secretary koh for having us here and for the

leadership that they continue to show not only for hiv, but health around the country. and i had the opportunity to work with both of them in my role with the president's aids advisory council and really just so appreciate the support we get from them, christopher bates who's there, and i really want to thank jeff crowley who was my kind of partner in crime this all of this who heads the white house aids office. and, you know, so there are a lot of people i could call out, but just to say how thankful and how privileged i am to be back here again as many of the people on this stage have already said. i spent 20 years as a commissioned officer at the centers for disease control and a few other assignments, and so this was, this building is home for me, and be it's great to be coming home like this. i also will say i have to mark

this day, this is the first day, first time i've ever heard tony fauci be called an accident. [laughter] but i'll remember that. [laughter] a good accident. so richard kind of just asked me to say a little bit about my past and more from a personal perspective. and so i'll do that. and, you know, when hiv was first, um, discovered before it was hiv when the first cases of aids were reported, i was doing my pediatric residency not very far from here at the children's hospital and, clearly, pediatric aids and hiv was not on the radar screen. so, you know, i finished my pediatric training without ever really having heard much about hiv or having had much experience with aids, um, other than to read about it as a medical professional. i then went on to the centers for disease control because i wanted to have some experience

in public health and thought i was going to stay there for two years but ended up staying for 20. but, you know, when i first went and you had this opportunity to choose your different assignments, i thought about hiv because i thought this was an interesting, fascinating, new issue. and everybody, almost everybody told me to stay away from it because they said, you know, this is a kind of strange political disease and, by the way, you know, it's not going to be very serious, and it's, you know, in if a couple years we'll have figured out a cure and treatment and, you know, why don't you go spend your time on something that's a real public health challenge. obviously, i didn't take that advice, and, um, you know, soon although for the first couple years i did something else, but i soon got drawn to work on hiv and aids. and by that time i think we were all beginning to realize that this was going to be the defining not only public health

issue of our time, but in many ways the defining human and humanitarian issue of our time as i think several of the speakers have mentioned. and for me hiv, i often say i didn't choose hiv, hiv chose me because it was fascinating scientifically, but it also had social imperatives that i thout were very, um, that called to me. and i've always been a person who was very, very involved as an activist, really wanting to work on social change issues. and so hiv which does not on one hand does not discriminate, on the other hand is not randomly distributed, and we know that in many ways hiv does, um, show us the fault lines in our societies whether it's in the this country -- in this country and the disproportionate impact it has on people of color, people

who inject drugs, gay men or whether it's around the world where it has its biggest impact on those living in extreme poverty and par wily -- particularly on women who have no ability often to negotiate, um, safer sex within the context of their lives and their relationships. so, you know, we know that -- so for me hiv was a calling in many ways as many people here have said. and, you know, i'll just end by saying for me as others have said, um, i marked my life by many of the chapters in this epidemic whether it was, um, when we first started talking about the disproportionate impact on communities of color, heterosexual spread, perry natal transmission, the global epidemic. i've also marked by life by aids

conferences. and every year there's a different flavor in the environment in the conference. often times that has to do with whether the discoveries are, um, limited or whether they're very hopeful like the vancouver conference in 1996 where, um, combination therapy was first rolled out. so, you know, i think we've all come to mark our lives, and luckily, we're marking our lives less by the number of people who are dying in our lives who we love and more by the advances that people have already talked about. and i think that's what's hopeful about this epidemic. and the other part that i always find hopeful is there are people like the people on this stage and people in the audience and others who are part of a caring community. and i think all of us can say that as a result of working on hiv our lives are richer than they would have been before. we're more human in many ways than we ever were before, we're more equal and think about society in a more equal way than

we might have before. and so, you know, while this has been a horrendous epidemic and has affected people in around the globe in horrendous ways, i think it's also helped to form a more human approach to life, to health and to medicine in ways that i think we will never turn back from. so those are just my few comments. i look forward to the panel. has -- [applause] >> thank you, dr. gayle. before we start the discussion, and we also have a mic up front here, and i'm going to ask people to, um, come forward and ask their own questions, i just want to thank all the people -- and i can't name them because i won't remember all the names -- who worked so hard to put this together. it's been a couple of months of very hard work, and most of them are in the back not taking up seats because that's the way they are. they're terrific colleagues, and i want to, please, join me in thanking them for the work that

they've done. [applause] and this is my oprah moment. [laughter] so i'm going to ask a couple of questions just to get the conversation started. but really, folks, if you can come up, um, if you have a question or a comment, please, please feel very free to do so. um, i'm going to ask two questions. one, first, is what makes you the most optimistic about the epidemic as it stands today? what gives you the most hope? >> well, there are several things, richard. one of them is that over the last couple of years it's clear that we have already within our grasp the scientifically proven capabilities of really, as i say, getting our arms around this pandemic this sense of turning around the dynamics of the epidemic so that instead of seeing this, we're really going to be starting seeing this.

and be it really has to do with what i mentioned, what mark and others mentioned is the issue of combination, prevention modalities. there have been in the past understandable but not appropriate tension between treatment and prevention, and we know now that treatment is prevention. and in addition to the things that we know work, circumcision works even better than we thought it did in the beginning, we clearly know that under certain circumstances preexposure prophylaxis works, interventions such as topical microbicides, if you put all those things together right now, we need to implement things in a way that we get the best bang for the buck. so i'm, i'm enthusiastic and optimistic that before there were so many scientific gaps that even if we were able to

implement them, we wouldn't have the tools to do that. our tool kit is getting more full and more full. and it's really up to us to implement that now boast domestically and internationally. so i feel good about that. >> any other panelists want to add on that? >> i mean, i would agree with that. i guess i would flip it around a little bit and, um, you know, what am i most pessimistic about because i totally agree that i think we have now more than ever an opportunity to with all the tools that we have both for prevention as well as for treatment, you know, but i think we also have the potential for taking our eye off the ball and not continuing to keep the resources that are necessary to really go, you know, that next and hopefully sooner or later last mile. and so i think, um, it is easy

to get too optimistic and to take the heat off, and i think that's, you know, there are lots of other issues. you know, we have a huge economic crisis on our hands still, you know, there's a lot going on. but i think we just cannot for the 30 years that we have poured into this and the people's lives who have been lost, we cannot blow this opportunity to put these tools to use and make sure that they get used by those who need them most. and that's going to, you know, that's going to take a lot of political will. >> i'd add two things that make me very optimisticment the first is the number of people from the villages, and this is true whether it's in the united states or africa. the people on the ground in the communities, in the health clinics, in the hospitals that have, are there to do the work

and the creativity and innovation. and if we just support them, they will actually figure it out. they have for the last five years, in africa seven years, and they have in the united states for the last 30 years. if we support them, they will figure it out. the second thing that makes me incredibly optimistic though i share helene's concerns is the history of bipartisanship on these issues. and in a city where we have a lot of partisan concerns, hiv/aids, global and domestic, has traditionally been areas of common ground although there are difficult policy issues, we've always worked through them. so we have a real opportunity for using that bipartisanship. and some of that grows from the fact that even in financially difficult times there are very few programs where you can show a direct line from a dollar invested to a life saved whether that's in the united states or in africa. and as we move into health in general, that is true. not just in hiv/aids and certainly globally with the global health initiative and integration which we did some

this bush administration and this administration and the natural evolution is carrying on. we can make the arguments in a way, and there is a sense in the united states that we are even in if our most difficult financial times, we are part of a global community, and we care about our brothers and sisters in the world. that we are not a self-centered nation for the most part. we are not self-centered individuals. and that was demonstrated clearly in the early days of hiv/aids here, and it's been demonstrated globally. so i'm very optimistic that we can, if we're careful and do it well and do it right, achieve what we need to achieve and grasp this moment in history. >> richard -- [inaudible conversations] >> so, richard, i have first to say that i absolutely share the same hopes and concerns, and i have two more. and one is particularly every single day that another person who has been diagnosed or has been living with hiv is able to lift their head in dignity and come out, disclose, share what their concerns are, share what

their experiences are and bring others along with them means that we're going to continue to link arm in arm with people who are experiencing the brunt of this epidemic with folks who are looking for all of the solutions to the end of it. they give me hope every single day. p.m. 'em. .. >> understanding that anyone could agree that health is a human right, that hiv will eventually be integrated into

the much larger frame work in a much larger effort to be sure health is treated in dignity and everybody has access to it, and hiv is not this exceptional issue that's only reserved for a certain number of people. that's one where the hope lies when we realize the perspective and put the resources to responding to that, that we're going to see the een -- end a lot sooner. >> to underscore, it's people who will make the difference. i think more importantly, i think, it's the younger generation, you know, there's so many trail blazers back in my day, but many people in this audience and many people who i work with now who were not around when the epidemic started and are now taking up the mantle, not living with hiv, but fighting for those, people i fought for all my life, and i think that's the biggest hope for me because i think no matter what, you know, if we have to continue fighting this as long

as we have to fight this, we've got a new generation that's really taking up that mantle, and that i think gives us the most hope. >> just want to remind folks if they would like to ask a question, just come to the microphone, and if you want to address it to one of the panelists, let us know. otherwise, we'll all take it. >> thank you, and more -- i'm -- [inaudible] nearly 20 years ago, i didn't know i would be working at hhs, but i am now, and i have two special heros here today, dr. vochi, my son, and my son, justin goforth. let me connect the dots and you'll see we're part of the story you're telling today. there was a time i thought 20 years ago where i thought my son would be a piece of that quilt.

it is because dr. fauci was his first doctor, and he was part of the experimental treatment at nih, that he is lives today, that he is in this audience. justin, do you want to stand up? [applause] justin, dr. fauci, has gone on to saving many as you have. he is in the medical field at whitman locker treating individuals with hiv/aids. during those days of his treatment in nh hospital, i was mother to many young men who their partners rejected them, who their parents did not know, and i thank you all very much for the tremendous, tremendous work you have done, and

especially for my wonderful son. [applause] >> good morning, everyone. i'm the deputy editor of posh magazine and living with aids -- hiv, thankfully not aids yet. as a person living with hiv, i've been hopeful for the cure. i have been waiting 30 years. i hear a lot of good news, and i'd like to hear how hopeful each of you are about the cure. >> very. [laughter] [applause] >> how much of a chance do we have for a cure in the near term? >> well, when you talk about a cure, there are a couple of ways at looking at a cure. there's a true e eradication of all the virus in the body so when you discontinue therapy ring there's nothing there to

rebound. that would be a true microbilogical eradication cure. right now, we are in the stage of scientific discovery to even determine if that's feasible, and we are encouraging by requests for application and putting funding into different streams to get people to think of inno slative -- innovative ways to do that because the drugs we have are spectacular in suppressing the replication of the virus, but doesn't rid of the virus that hides in the reservoirs. another cure is to get the virus small enough by means of boosting the body's immune response or another mechanism yet to be determined, that you could stop therapy and the virus won't rebound back, so that would be what we call a functional cure.

to be honest with you, i don't know lounge that's going to take because we're still in the phase of what we call discovery of mechanisms of how we can do that as opposed to implementing. we know we can stop the replication of the virus. we'll get better drugs. we have great drugs now, but it really is still a scientific challenge about whether or not we're going to be able to really cure, so that's really the honest answer. we're going to try really hard to do that, so hang in there, and maybe you will be one the ones that gets that medication to get that out of your reservoir. >> thank you. >> i also want to add a couple things, and that is that one of the greatest opportunities we have in front of us are the structural interventions out there including the affordable care act and the national strategy. if i can allow myself to redefine the definition of cure, one of the goals of the

strategies on reducing infections, access to care, we know the science is there in terms of treatment and prevention, and there are opportunities to really work it really eliminating the virus as much as possible to get to a different type of cure in the sense that we could really have communities really not worry about hiv as they have been in the past, and so i think there's ways to look at this from the stand point of not just the science, but also sort of what are the policies, sort of opportunities in front of us to actually allow us to get to that point. >> thank you. >> good morning, and thank you to each of you for all that you've done individually and collectively. the ethnic coalition and health alliance -- knowing one size does not fit all, what in each

of your professional judgment, each can answer, needs to be done to address the epidemic in blacks and in hispanics as the hardest to reach, and more at miffing than harder -- risk than harder to reach. >> i'll start from a community perspective. when i, in my earlier comments, i facetiously said i believe in the magic. it's not facetious at all. i'm dead serious in our community, our leadership, the leadership that not just the hiv/aids leadership that many of us look to and work with, but our community's leadership, our civil rights leader, our faith leaders, our political leaders, our education leaders -- when those folks are celebrities, you know, the people our youth listens to, and then go and get the information, advice, and

treatment from our medical and our social service providers, that when our whole community embraces this epidemic and responds to it very much in the same way they'll respond to when, you know, one tv show is taken off that they are interested in or when one pastor has to settle a lawsuit because of some salacious stuff he's involved in, and they are all up in arms about that -- when we begin to get on television and demand what is right for us, with us, by us, then that's what we're going to see a trickling down and a trickling off of the exchange of hiv, the transmission, the incident, and also the lack of services that are available to us in our communities. we're going to be able to address that, but without the proper leadership and a community that will embrace that leadership's ideas and implementation of the programs and policies that we need for

ourselves, and then we're going to stay way behind this this epidemic. once we actually embrace it and recognize that this is an emergency, it is an urgency, and that we don't look to black folk in africa to be the only ones who are coming together and solving african problems with african solutions. it's going to be black and brown people using black and brown solutions solving the problems in this country, and until then, we're still looking for someone else to come and save us, and it's never going to work. >> maybe i'll add a couple -- [applause] a couple more pointsment i mean, i do think as greater access to treatment and we know the impact that treatment has on prevention, you know, i think all the the things we've talked about with greater access to the tools that are available and to the extent that the community

gets the access and demands access as dazon said, you know, i think that will be helpful, but i also think not only is it important that there is leadership coming out and claiming this is an issue, but also the willingness to talk about the issues that are related to hiv. you know, you cannot talk about hiv in the african-american community without talking about homosexuality, and we don't want to talk about homosexuality and pretend it exists. young african-american and his panic gay men are the ones who are disproportionally at risk. we have to talk about what's happening to women and why women aren't in the situation where they feel they can negotiate safer sex and that means talking

to young girls about sex. we got to be willing to talk about the issues that are related to it and talk about them openly and honestly, and we're not willing to, and until we are, you know, remember back in the day when we would say, you know, talk about the risk groups for hiv and aids, and we would say gay or black as if there weren't gay black people, and so i think we got to be open and honest in the dialogue, and until we do that, until we are willing to talk openly and honestly about sex and sexuality in the african-american and the community, then it's -- because we've had the leaders getting up there and talking, but, you know, they have not been willing to say the words. >> there are also a scientific and medical response to that question also, or is only just

social? >> well, i think there is, you know, i think there's a science and medical in the sense that, you know, these are the same communities that are disproportionally impacted by other diseases that have poor health services, poor access to health information, so it's no surprise, you know, kind of on the medical and health side that the same disperties would be the case for hiv, but i think beyond that, there's these other issues as well. >> thank you. >> we've got time for one last question. >> hi, i think i was introduced earlier. [laughter] my question's really about stigma and how it relates to especially the values of prevention. we are really excited about becoming a demonstration site for preapproval access, and i'm really excited about now that there are world class leaders talking about treatment as prevention, but treatment as

prevention and prep and test all come with their own unique stigma that comes from providers as well as patients, community, and so on. risk compensation issues where providers say we should not go down that road because it's a free-for-all, and everybody's not going to stop using condoms and there's solid research the more you engage people in care, the less risk they actually take along with getting on treatment as prevention, and i appreciate your statement about homosexuality because we use the word "stigma" so much and have for 30 years that we sometimes forget that what means, and the majority of that is homojphobia, so how do we deal with prevention and find leadership

to address homophobia to break down the barriers? my job is to figure out how to break down those barriers, and there's a list of barriers this long, and i can map almost every one of them back to stigma, so i just wanted to see what your thoughts were about treatment is prevention and the stigma related to that. >> i think that one of the biggest opportunities that people have and that can do in terms of stigma is to, and it's one of my former bosses, president clinton said, if you are gay, come out. it's tremendous in terms of letting someone know you are gay. it is not easy to do, but it has an impact on what people view on what being gay is. it's the same thing living with hiv and aids. it takes courage, but it's important to come out about your

status because you have to work to educate others about the fact that it is still there, and so there are important things that i think can help in that site, but it takes a lot of courage and a burden in some respects because it really impacts those who are probably the ones stigmatized the most. >> you know, when i was off site, i was asked questions that annoyed me, but the one that annoyed me the most is why is there so much stigma in africa as if we don't have any here. [laughter] you know, we all up here remember, and looking around a good chunk of the add yuns some don't remember, but in the early days of hiv/aids, the incredible stigma associated with hiv/aids. as a medical student at va, people would not touch hiv positive patients.

literally not touch them. we had to sue them to operate on hiv positive people. parents disowned people, partners disowned people. the misinformation about how you got it was so bad the white house security people were wearing gloves. the stigma here was remarkable. we got through a lot of it, but not all of it, and you're living proof and congratulations, and thank you for what you're doing to serve through your life's story. we got through a lot of it, but not all of it, and just as in africa, they are a little bit behind because they started later, are working through the issues, but they are complicated and difficult. to me, the solution comes back to what we talked about -- go back to the people in the community and ask them, talk with them about how they would get over the stigma of preexpoture local access. talk to them of getting over the stigma of treatment as prevention. what are they hearing? it's remarkable where we make

these big proclamations globally or nationally, but on a community what they hear and their experience is completely different than what we just spent a bunch of money on. going into the community and finding out first, again, they will figure out their problems. it's not easy. this is a journey, but we can do it and know we can because look where we were 25 years ago. if we keep moving on that pallet -- pathway and continue, we'll work to solve the problems. >> the question for stigma to me especially talking about homophobia is not only centered for homosexuality's sake, and that is if we draw back the lens, the real stigma is on human sexuality, just to be sexual is a stigmatizing issue. we saw a lot of that this week.

[laughter] i mean, you know, it's so funny and sad at the same time that -- and i talk to safe leaders about this all the time. you talk about god and the gifts, you know, of faith and the gifts that god gives us, and all these tools, well, why else would he give us sex as a means to get here if it wasn't a gift? in order to get life from anything from the plant to the human, that something has to engage, and to be able to normalize that conversation in such a way that there's no stigma around sex and sexuality that we all know we have to engage in it if we're going to procrete or just enjoy ourselves, destress, stay around to tomorrow, we're going to have to get some at some point. [laughter] am i wrong? [laughter] i mean, you know, celibacy is a

choice. it is not natural. [laughter] i want us to be real clear about that because in all seriousness, young women who are sexually active are stigmatized. teenagers who are sexually active are not only stigmatized, but discriminated against in the age of abstinence only. gay black men who are sexually active are stigmatized. men who are -- might have proclivity to having sex with more than person because of the socialization of moo noelmy are stigmatized. people having sex at 85 and 90 are stigmatized. the rights and recognition of same-sex relationships and marriages are not given the rights and the equal access and the equal respect that opposite

sex or heterosexual relationships are given. sex is the stigma. until i can talk about my sexual positions, preferences, orientations the same way i talk about what color lipstick i'm going to wear today or which high heels i need to put on today or what earwax i got coming outs of my ears, in the it's the same part of the same conversation, then it's going to continue and continue and continue. >> well, i think i got to make that the last word. [laughter] [applause] thank you. [applause] thanks to our panelists. thanks to our audience. thanks for your commitment. have a really great day. [applause] [inaudible conversations]

s

>> ralph nader and the center for the study of responsive law hosted a debate on whether there should be a tax on stocks, bonds, and derivatives. you'll hear from a supporter and another opponent of the tax. this is organized by mr. nader entitled dates taboos. >> second of the series on dates on generally taboo subjects in both legislative and mass media arenas. the topic today is variously called the wall street trading tax, the securities transaction excise tax or the financial transaction tax. taboos exist in all cultures, and our society's ripe with them. it's remarkable with all the current preoccupation of the major political parties and their governmental

representatives with deficits and debts, spending and revenue, a major form of public revenue from financial transactions is hardly on the screen of their consideration. it was not always so. until 1966, our country did have a transfer tax of 0.2% of all transfers of stocks. it reached that level in 1962 under roosevelt to boost financial recovery and job growth after the great depression. after scene of this accident, discussion of the tax went cold, though as trading volumes skyrocketed here and abroad, there was considerable discussions in foreign countries and some adoption of financial transaction taxes there. my experience in speaking around the country about what is essentially a sales tax on the

buying and selling of financial instruments is that people once it's brought to their attention sometimes make a comparison with the sales taxes they pay when they buy furniture, clothing, hardware, services, and sometimes even food. why they ask, do they have to pay a 6%-8% sales tax on necessities of life, yet wall street traders no matter how much they buy, pay zero on tax. by imposing the tax by a handful of members in congress now, they are been ignored by the leadership and committee chairs and the president and thus can be considered dormant ignored by the mass media as well. last month, the fast growing california nurses association and its affiliates in other states have adopted the "wall street tax for main street" as a

major initiative that started with a rally opposite the new york stock exchange. the wall street traders looked out on the ralliers with curiosity, but appears they were not amused at all. discussion of a financial transaction tax can radiate in many directions. it can be elaborated with endless variations and steeped in infinite dimension. today's debaters and moderators are so knowledgeable about this subject that they will be able to identify and clarify the points they wish to make or prod others to do so in understandable language. nonetheless, the subject is not simple especially with it is contested. the audience and the national audience reached by the presence of c-span and other media here may need their better concentration on the details as they think about the more

general principles of fairness and equity in our tax laws. once the debaters make their presentations and responses, the moderators will expand the discussion. the debates will be given the opportunity to question each other followed by written questions from the audience which include over 30 students visiting from other countries, and if you're going to write your question down on the card, please write very, very legendly and try to print if you can. the debate will close with final comments by the debaters. now to introduce the participants and the moderators. for the affirmative in favor of a securities transaction tax is professor robert pollin from the economics university of massachusetts inamherst rmt he

centers on low wage workers in the u.s. and all over the world. the financial analysis of clean markets and a clean energy economy in the u.s.. his books include measure of fairness, the economics of living wage, and minimum wages in the united states and unemployment targeted economic program for kenya and similar one for south south africa. wrote contours of dissent, u.s. economic fractures and the language of global austerity, and the book of which he is an acknowledged expert on the living wage, billing a fair economy. more recently, he co-authored the widely debates study green recovery, the economic benefits of investing in clean energy, and also another book called

green prosperity, exploring the economic benefits of broad investments and building clean energy economy in the united states. he's currently consulting with the u.s. department of energy and the international labor organization. he has in the past worked with the joint economic committee of the u.s. congress and as a member of the capital formation subcouncil of the u.s. competitiveness policy council. in the negative, opposed to a financial transaction tax, is professor james angel at georgetown university. coming from the california institute of technology earning his bs degree, he got a ph.d. at university california berkeley in finance and mba from hair vade business school. i might add that professor

robert pollin got his degree of research in new york city. professor ape jell was a train engineer for pacific gas and electric working on regulatory issues. he is an author of many books and often quoted in major press on financial issues. he is a visiting -- he served as a visiting academic fellow and residence at the national association securities dealers and visited over 50 stock exchanges all over the world, even was adviser to the shanghai stock exchange, and he now is on the nasdaq economic advisory bull and member of the otc bulletin board advisory committee own serves on boards

of directors of the direct edge stock exchange. we have two moderators who also have a particular point of view, and i thought it would be good to have a knowledgeable moderator even though one is against and one is for rather than have a not knowledgeable moderator and allow the debate to sag a bit. opposed to the transaction tax, but moderating half of the time here is gus sauter, a member of the advisory board, but in his day job, he is the chief investment officer of vanguard, and he's responsible for the oversight of about $1 trillion managed by the vanguard fixed

income and quantitative equity groups. got an mba from the university of chicago in finance. he is past member of the equity markets committees of the investment company institute, and he also has served on the trading committee of the securities industry association, securities industry and financial markets association and the aimr tax execution tax force. you can see all the participants are very much into the details of this subject. in favor of the transaction tax on financial transactions, dean baker is a widely quoted economist here in down getting his ph.d. in economics from the university of michigan. he is presently co-director for the center of economic policy

research in washington, d.c.. he has his own programs on the internet. his blog, beat the press, features comments on economic reporting, and his analysis appeared in many major publications including the "atlantic monthly," the "washington post," and the "london times". wrote several books, one called taking economics seriously, an attempt to clarify the principles of economics and as he put it, to take away the ideological blinders off of basic economic principles. he's the author of false profits, recoverying from the bubble economy. one of the earliest economists to predict the housing bubble

collapse. he walked the walk selling his house and rented an apartment here in washington, d.c. before the collapse. he also predicted the market meltdown. he is the author of a book that needled the other side called the conservative nanny state, how the wealthy use the government to get rich and get richer as well as the book that he co-authored called social security, the phony crisis. he has also author of getting prices right, the debate over the consumer price index. he's worked as a consul at that particular time to the world -- consultant to the world bank, joint economic group of congress, and the union advisory counsel.

we'll start now with the debaters, and we'll leave moderator dean, dean baker. >> okay, maybe you should both get up here. okay, thanks, ralph, and thanks everyone for coming here. i don't know if we have a coin flip or a random assessment, but bob will start out with a briefcase arguing for a financial transactions tax and jim having the same amount of time arguing in the opposite direction. bob, are you ready to go? >> well, yeah. thank you, ralph, for organizing this. we were talking before the event we had done one of these about a year and a half ago and this was like the holly frazier fight. wait for the second one for those of you who are boxes fans. i'll speed over some of this. the idea of a financial

transaction tax is a small fee paid on every financial transaction. for example, if you set a tax on stock trading at one-half of 1%, and you could divide that among buyers and sellers, so it's one quarter of 1%. if you have a $100 trade, each trader pays 25 cents. now, dean and i have actually worked with a tax -- financial transaction tax at that level for stocks, and then we scaledded the values, and we can get into details later if you want for bonds and all derivative markets including options and future swaps. what we calculated is you could raise about $175 billion in today's financial market per year assuming that you cut trading by 50% in plausibly high

level of trading. now ring we may be off a little bit with the calculation, but the basic numbers are there, and i'll give you evidence on that in a little bit. $175 billion would be enough to fully cover the entire deficits of all the states that are now facing austerity budgets today, fully cover for fiscal 2012 so that rather than hearing news stories about cutting teacher's pay, nurses' pay, cutting health care, shutting down the state of minnesota, and maybe shutting down the united states, we could talking about expanding opportunities and services, and on top of that, we could fully pay for and still have $90 billion left over to expand investments in, for example, the green economy, strengthening small businesses, and job creation.

now, as ralph said, the tax is equivalent to a sales tax or a gambling tax in this city of dc. the sales tax here is 6% so if you spend $100 here in washington, if you go to home depot and do something useful like buy caulking e quipment to retrofit your windows, you would pay $6 tax. if i buy $100 in stocks tomorrow, i pay no tax, zero. if i go gamble on wall street or las vegas, i pay 6.75, the owner of the casino. the tax can be used for two distinct purposes like raising revenue like i described or reduce the size of the markets. now, the beauty of the tax is that if you are in the market to

buy and hold -- if you have a long term perspective, the tax is negligentble. if you by $100 in stock and hold for a year, you pay 25 cents in the way i describedded the tax. if you buy $100 in stock and turn it over every week, you pay $12.50. this tax does become onerous if your strategy is to keep trading all the time. now, you can design a tax, make it higher or lower according to whether your primary purpose is to raise revenue or to discourage speculation of the you can also try to hit a sweet spot between the two. the tax is flexible in that sense. now, why are we talking about the tax now owner ralph nader had the idea to organize it? as a result of the financial crisis in 2008 and 2009 which

left the economy in the most severe recession and still have not gotten out of it, i just heard the new unemployment statistics, 9.2% for the narrow measures and include underemployed, it's about 16%, and that's about 25 million people. 25 million people sounds like a number, but imagine the entire population, the biggest ten cities of the united states, new york, los angeles, chicago, houston, phoenix, san diego, and dallas -- imagine all the people, that's less than 25 million people. that's how many people in the country are underemployed. in addition, we know about the massive bailouts to the financial markets who created the mess in the first place. >> [inaudible] >> okay. the international monetary fund

estimated after the money, the banks have paid back considerable portion, there's still about $500 billion that has been unpaid. now, i don't have much time for this initial statement, so i'll just make a couple of quick points. the crisis that we've experienced is no aberration in terms of financial markets that are unregulated having created multiple crisis over the last generation tied to the deregulation of the financial markets. other countries are running financial transaction taxes. the u.k. has a financial transaction tax now. roughly it's in the way i described it. japan operated with a tax until 1989 and raised about 4% of all their revenue. okay.

and -- okay. i'll stop there, and we'll come back. >> okay. thanks, bob. and now professor angel will tell you why he's right. >> or not. >> or not. >> thank you to everybodying everybody for being here. who is in the audience? how many of you have a mutual fund or a retirement account? okay. how many of you have a mortgage, car loan, credit card, other financial product? how many of you have a bank account? okay. i see that almost everybody in the room here is a consumer of financial products. you're the people who are going to get hit by this ill-proposed tax, and -- but, this is a tax proposal. let's ask ourselves what do we want from a tax system? now, if you look at topes on

public finance, there's always a section on how you evaluate tax alternatives. first of all, you want a tax that's going to raise revenue. i mean, that makes sense, but you also want one that's easy to administer that does not impose enormous compliance burdens on the government to try to collect it and the people you are trying to collect it from. you also want one that minimizes the economic distortions that a tax causes. in other words, when you tax something, people try to avoid the tax in some way or stop doing whatever you're taxing, and you want to avoid distorting the economy. furthermore, you want something that's fair where people are, you know, paying their appropriate share of the tax burden, you know, where the pain is distributed appropriately to the people who should bear the

pain, and we can always debate on that because everybody always wants somebody else to have the pain, and there are other goals as well. some people want to use the tax system to redistribute wealth. some people want to suppress undesired activity like smoking or taxes on tobacco. sometimes you just want to punish people we don't like, or just make other people pay, okay? this is, you know, what some of the goals of taxation are all about, and when you look at this proposed tax, what you see is that it fails in virtually every one of those dimensions. you know, it's not a free lunch raising hundreds of billions of dollars. what it will end up doing is not hitting wall street. it's not going to get the people who brought about the financial crisis. they are not the people who do the most trading. turns out, the people who do the most trading actually are some of the most beneficial players

in the markets. they are not, you know, speculators causing excess volatility. no. when you study financial markets and actually look at the people doing most of the trading, most of them are doing very small tech technical things through small profits and doing things that help you and many, so the problem is, you know, this tax misses its target. it doesn't really get the back tax. what it does is it's passed right on through you and me, and that's one of the reasons why i don't like the tax. the, you know, there's plenty of other problems with the tax. you know, we used to have a professional transaction tax much, much smaller than the one being talked about here. the one talked about here is roughly ten times larger than what we got rid of in 1965 and 20,000 times larger than the current fcc tax, and let's look

back at the lessons of history. back in 1995, congress looked at the old tax, and in an overwhelming bipartisan vote, they said this kind of taxation is a bad idea. they were not in a big tax cutting mood either. if you reread the congressional debate, the congressmen were well aware of the impending funding needs of the vietnam war, but they lookedded at the tax saying it's a bad idea. when you look at other countries with such a tax like sweden, they put it in, and all the financial activity went offshore and didn't get the money they thought they were going to get. they got rid of the tax. this is a bad idea that we got rid of before, and even though each generation is, you know, should think about taxation, there are plenty of better ways to raise needed government rev new. >> one minute. >> so, the -- when you talk

about reducing speculation, again, the people who trade the most are not speculators, and if you look back in the past when transaction costs were higher and we had these taxes, there's plenty of speculation. if you look in our recent history, where did we see the worst speculation? in the housing industry where transaction costs are enormous. typically, when you buy or sell a house, the cost of doing that is up 10% the value of the house. did that stop people from speculating? no. the speculators are not going to be stopped by attacks of a quarter or half a percent. what you're going to do is you're going to get rid of all the beneficial trading that make things work more smoothly, so the transaction tax is a bad idea. it misses its target. it won't raise the revenue they say it's going to raise, and it's not going to punish the people they want to puppish.

all it's going to do is mess up the good things that the financial markets do for the economy. thank you. >> gus will lead a round of questioning back and forth. >> oh, i'm sorry. >> someone here has the scoop. >> bob goes first summarizing for two minutes. i read ahead. >> okay, some responses. jim said it won't raise hundreds of billions of dollars, but we have evidence that it does. we have the evidence from the tax in the u.k. that's operating right now that's raising about the equivalent of $40 billion in the united states only taxing stock. the taxes are easy to design and

administer. the recent paper on the issue acknowledged this point. economic distortions. i want to cite quick numbers here. from the decade 1970-79, every productive dollar of investment by non-financial courses, there's a $1.30 of trading. for every dollar of productive investment, there's $4 of trading. the year before the financial crest in 2007, so we had a jump from $1 to $4. goes what it was in 2007? for every dollar of investment, there's $36 of trading. we went roughly one to one to 36 to 1. that's just the stock market, so trading, what jim is talking about, huge turnover in trading has overwhelmed the financial markets and not contributed at all to any productive increase

in activity the the rate of growth of productive investment is lower of the decades in the 2000 than it was in the 197 #s. -- 1970s. congress said it was a bad idea. congress also said deregulating financial markets was a great idea. remember that? that was both democrats and republicans. we got rid of a regulatory system that was working reasonablebly well and ended up with two decades of financial crisis culminating in the 2008-2009 case. >> jim, two minutes. >> yeah, you mentioned the u.k. tax. i think that's a classic example of how not to do a tax, and, yes, it does raise revenue, but simple and easy to administer? i downloaded off the internet, the compliance manual for the u.k. tax. it's 320 pages of dense fine

print. it is not what i call a simple or easy to administer tax, and you know what? it exempts most of the financial professionals. the folks in the u.k. are not dumb. they realize that finance is a big industry there, so it basically is all designed to tax the end user, the end investors, people like you, the people with retirement savings in a retirement plan. you're the folks who end up paying a tax like this. if you want a u.k.-style tax, you are not screwing wall street. what you're doing is screwing the consumer. i would say the u.k. tax is a really bad example of it, and by the way, the proposals have been put forth in the u.s. congress look nothing like the u.k. tax. >> okay. >> well, i'd like to thank ralph nader for sponsoring this

presentation and thank you for coming and welcome to the debate. as a level set, i come from the mutual fund industry, and there was confusion initially when the tax was described that perhaps mutual funds were expect from this. investors do not pay a tax, but 90 million investors in mutual funds would be indirectly paying a rather substantial tax. if applied in 2008, it would have been about $35 billion worth of tax that individual investors would have paid through their mutual funds. there's three stated objectives of the proposed bill. first is to tax wall street. second is to curve financial market speculation, and the third is to raise revenue. i'd like to tease out each one of these issues as some of them have been described already.

first, i want to start off with is this a tax on wall street? who does pay this tax? is it investors, or is it the stockbroker, is it wall street? if it is wall street partly if it's levied against them partly, is there reason to expect they are not going to pass their costs through? bob, you want to take that first in >> the tax, like any tax, has ramifications beyond the immediate payment. now, the actual payment of the tax, for example, as jim mentioned, there is a tax already. there is a securities transaction tax administered to finance the securities and exchange commission, and the actual payment of the tax is done by the exchanges. now, the exchanges then pass the payment back to the brokers, and the brokers, you know, may

incorporate into the fees they pay that they charge their clients. there's passthrough, of course there's passthrough. we can say there's passthrough when there's a financial transaction tax than if the dealers, the brokers might charge it back to their clients who then might put it into their business expenses, but, you know, that's also true with any other kind of tax. i mean, like we say, paying a 6% sales tack at home depot or mcdonalds, they are calculating the tax rate and may pass it to you or absorb it. the immediate point though is who is actually paying for the tax? it's the people doing financial transactions. that is mostly, lee, there's small scale investors, a lot of them, but mostly, who is trading on wall street? where is the big money?

it's wealthy individuals, big companies, and pensions. well pensions are middle class people and so on. that's true, but the biggest holdest of pensions are also the wealthiest people. the immediate payment of the tax falls dispore new york citily as it should on the people operating big time in financial markets. do we know how much the passthrough will be? you don't have evidence on that, and either do i. thank you. >> jim, would you like to address this? >> sure. the people who do the most trading are the people who make the markets work, and, yeah, that is the basic misunderstanding of the proponents of the tax, so i'm going to get technical here to describe who is doing the most trading. these are people generally who have computers programmed to look at the crisis of different

related instruments. we call that arbitrage. when it's out of line, they buy something cheap that sells expensive and pushes it back to where it should be. i buy an exchange traded fund, an etf, which is a basket of stocks. it's the vanguard and my standard recommendation for everybody. [laughter] okay. it represents the whole u.s. target. i don't have to think of what is good and bad. it's the whole market. now, that trades on an exchange like any other stock, and it represents every stock in the country more or less. now, there are people out there, they have their computers programmed. they look at the price of that vti, and they look at the price of the stocks that go into it, and when they get out of line, they buy the cheap thing pushing

up its price, sells expensive to push the price down and hope to make a half penny a share profit on that. when i buy vti for my retirement account, the price reflects the stocks that go into it. that's a good hinge. the arbitrage going in and out trying to make money on the differences of prices making sure i get the fair price for the thing i'm buying for my retirement plan, and -- >> done. >> to be continued. >> i'll ask another questions. if investors are going to pay this tax to some extent, it not larger, how big is the tax? we know it's 2 2.5% -- >> he just said 50. >> on both sides. >> 25 for each side. >> if the direct tax to

investors of.25% and the average mutual fund turns over 100% a year. that means the mutual fund loses .25 on performance. the proposers of this bill indicated they thought transaction costs would increase back up to the levels they were 20-30 years ago. that's an increase of about 1%, so another increase of costs for the mutual fund on 100% turnover is another 1%. jim, can you discuss what you think the cost might be? >> sure. that investors expect a certain level of return. what's going to happen is if you raise transaction costs up to where they were 20 years ago by 1% and figure the average mutual fund turns over their portfolio about once a year, the people who investing on our behalf trying to make the right decisions for us, so that's 1% a

year, so if you think about it, you know, 1% a year come poppedded over 20-30 years to retirement ring that's basically 20%-30% of your retirement savings going to this tax so it actually is a big hit when you compound it over time, so it's going to hit long term up vesters, mom and pop investors, people in mutual funds or if you've got a pension plan, you know, an old defined benefit plan, it's going to affect the returns to those plans. >> bob this -- >> well, first of all, the tax we propose is 1.25 on stocks, and we then scale it down for other assets including bonds, swaps, options, and futures, and our work on this is fairly common, so it's not actually an

accurate situation that he made because the entire port foe low -- portfolio is not just stocks, so the number is much smaller than jim just described, but be that as it may, the notion there's costs that people will not have as much money because they pay their tax is obvious that there's nothing to debate around that, but by the same token, again, why should we pay a sales tax? you know, if i go to home depot, i would rather spend $106 things on stuff i want rather than on what i don't want. it's a 6% tax, not a 0.25% tax. we have to compare apples to apples here. >> okay. thank you, bob. i would note that if the fund itself is going to incur taxes

of about one and a quarter percent through transaction costs higher or through the direct imposition of the tax, a saver or investor -- using mutual funds as an example because that's where america saves, 90 million savers. if they saved at 9% -- sorry, if earning 9% on their equity investments and reduce by 1.25% down to 7.75%. seven years later it's worth 30% less than it would have been without that tax. it is a game changer for millions of americans who are saving for retirement. bob, what are your thoughts on that? is this still a small tax? >> well, okay. the point is that your assumption is that financial markets operate first timely on their own -- efficiently on their own and all this is an efficient proposal

with an insufficient process. >> i never said that. >> i said assumption. the fact is our society, our economy has just paid a gigantic cost because we operate hugely inefficient financial markets. the process that we're describing, the short term trading does not create any social benefit. i mean, the notion of people sitting around and trying to guess an hour ahead of everyone else and having experts to tell you what you should be doing two hours ahead of everyone else does not enhance the long-term productivity of the economy. moreover, the kinds of things we are deprived of doing because we don't have revenue coming in -- for example, that we're having to cut education budgets, having to cut health care budgets, talking about breaking pension funds for state workers throughout the country, that the state of minnesota is out of

cash -- these are the kinds of tradeoffs one has to think about. a tax is a tax. it does impose costs on the people who pay the tax, but this tax is disproportionally on the people who are better off. it engages with the activities of wall street and only sets them at a level comparable to what one sees when you buy anything. in fact, it's not comparable, but it much smaller tax. the tax does have to be scaled relative to existing transaction costs. i agree on that point. in fact, a lot of research we've done is to try to understand how to do that and to set the tax at a level consistent with transaction costs, and that's what we've done in this paper, and that's why, as i said, the tax rate should be lower for bonds. it should be lower for options futures swaps. >> time.

thank you, bob. jim? >> you raised the issue of we pay sale taxes, so why shouldn't we pay taxes on transactions? well, in general, we have several simpt levels of taxes. you know, we tend to tax wementd with things like property taxes. we tax profits with income taxes, and we tax consumption with things like sales taxes. now, we don't have a federal sales tax for one thing, and i kind of like that, but, you know, the argument for consumption taxes is that basically you want people to produce more, consume less. now, trading is actually an intermediate good. you know, it's not like we wake up in the morning and say, wow, you know, i'm going to consume five stock trades today because i get a joy of moving electrons around. maybe some people do, but i don't. once again what he's missing the target because most of that high

frequency trading is actually the most beneficial trading around. these are people who support the ecosystem. now, you might say how can it be the case somebody's buying one second and selling the next is doing a service? well, as i said, i'm a long term investor buying it once and been in mying the for decades, i hope, and guess what? the person i'm buying it from is probably one of those real short term traders who makes sure that the gap between the buy and the sell price is really small because at any time in a market, there are people trying to buy, just like ebay, and there's a person trying to sell. what the high speed traders do is go in between and narrow the gap so it's now razor thin. if you put on a tax thousand

times higher than current transaction time, you drive a wedge between the buy and sell price, and every time -- >> time. >> okay. to be continued. >> i'd like to turn to a topic that has been discussed already is speculation. the second goal of the regulation is to curve speculation, and i'd like to first talk about what speculation is. speculation is taking a non-trivial amount of risk, typical than higher ordinary risk to make it higher than an ordinary rate of return, and jim described something where people trade, high frequency traders buy and then turn around and sell to make a fraction of a cent. is that speculation? really two great examples of speculation is speculation in the housing market through 2007 and speculation in the target in 1999. i'd like to ask will a transaction tax actually curve

true speculation? jim, you want to take that first? >> no, because again the people doing the most trading are not speculators. these are people taking very small trades for a very short period of period of times -- periods of time and doing things to help the market. let's eliminate all bacteria on the planet. that's what i think i hear here. now, oh, trading is evil? no. yeah, sure, there's speak litters out there, but they are not doing the trading. most of the trading, you know, is done by the beneficial players on the market. if you eliminate all bacteria on the planet, you e limb nate those that ferment cheese and beer and bread as opposed to, you know, as well as getting rid of the ones that cause disease, so we need to make sure that we are not missing the target which

you are. you're missing the target. most trading is done by people who do things that help long term traders, people like me and gus here. he has low turnover in his funds, and yet his -- when he goes to trade, the fact there's an ecosystem of people out there willing to trade with him at a good price means it's a lot easier and cheaper for him to trade, so, you know, a transaction tax, you know, is not going to really detour the speculators because they're in it for the kill. you know, a quarter percent or half a percent do not stop them. look in the days of transaction costs being high, you still had speculators. what the cost has done is help create that ecosystem of people who make trading work better, and people who make sure that the price of my, you know, when i go to buy that exchange traded fund, it's proposer lee --

properly price the. when gus buys stocks for his customers, that the gap between the buy and sell price is really small. that is a beneficial activity. >> okay, thanks, jim, bob, do you have a comment? >> i'm not clear as to why we assume that increasing the level of trading on stocks alone and, again, stock trading is actually a small proportion of overall trading, but just thinking simply about stocks, increasing at 36-fold relative to productive investments. the thing that strives the economy forward creating jobs and innovation is productive investment in equipment, machines, computers, so increasing the level of trading 36 fold relative to the 197 # 0s, i don't understand why that has been such a great benefit to

the economy. i don't see any evidence. in fact, the evidence is it has led to excess of focus on these exact -- these short term differences which i see as actually a net loss to society because we're wasting a lot of time on trying to exploit these tiny differences as opposed to achieving some long term benefit to the economy, and we talk a lot about the vanguard fun, and there's a quote from john bogle, the founder of the vanguard fund, and maybe at some point your colleague. here's what he says about the transaction tax. i support a tax on securities transactions primarily as a way to delay the ram pant speculation creating havoc in our financial markets, but also for its revenue raising potential in this time of staggering government deficits, that's the founder of the van jr. guard mutual fund that you

two have been referring to. >> well, thank you, bob. [laughter] he was your boss? >> i worked with jack for more than a decade until he retired, continued to have contact with him, and there are number of things that we don't agree on. >> apparently. [laughter] >> i'll leave it at that. if this transaction cost is going to definitely take return away from investors in the form of the direct tax that investors will pay and also in the form of higher transaction cost, what's the impact of raising capital? businesses need to raise capital in order to build their businesses, in order to hire more people. what's the impact on the cost of capital? bob? >> yeah, cost of capital, again, let's not think in technical terms so much. we're talking about interest rate taxes and so forth on businesses that want to invest or consider investing. at one level, of course, it