>> how receptive is the department of education to that? smack their budgets are limited as well, we have challenges to fund our public education system. i can tell you that that is a part where the state and the school district is really trying to make this better for children. but it is very challenging to provide the kind of care that these children need day in and day out at school. they also need wraparound services with someone who is there to deal with their emotional outbursts, to deal with other things. it is very challenging. >> i am sure it is. doctor, may ask you another question. total budget for the fiscal year

>> we do a lot with the resources that we have, but we can always do more with more. >> given the requested increase i grant you congress is supposed to do the budget and appropriations so there's always a disconnect between what the request is and what the actual dollars r, but it almost seems out of come out of kilter. is it because you're not asking for enough? frank loves to give money. so he will do it. he will write the check himself. i've seen him do it. this committee when he was chairman. >> there is a disconnect between the level of funding for the traumatic brain injury and all of the many things that were the hrsa does and i masking as we go through this that's something we might spend a little time and

attention to see if there is places where the other funds could be freed up in other areas and delivered to this pressing need. thanks, mr. chairman, for the indulgence. i will yield back. >> the chair thanks the gentleman. the of the members have stepped out so we will begin a round number two of questioning. dr. struckman, the geode just found that nih, the dod beach lacked comprehensive research funded by the other agencies. raised concerns about the potential for the unnecessary duplication and urged the agencies to find ways to coordinate their efforts. how is research that is conducted by the va coordinated among the agencies? >> i would reiterate that both

be dod are members of the newly established coordinating council and we will have our second meeting at the end of this week but specifically if partnered with the dod in building the central federal agency the brain injury research database that will allow access to the researchers among the multitude of research done by both agencies this is important because that helps us establish better classification systems come better diagnostic criteria for the mild tbi, predictive markers for the dementia and a host of other activities that can only be achieved through that type of collaboration. the federal interagency dramatic bring injury research and the setting is going to be a real

facilitator. >> so you're working to improve access to the databases and electronic information on the funded research for triet hauer the state's working with returning service members or veterans and power to states coordinate the services with the veterans organizations crux >> the states have had an interesting opportunity over the last several years. the veterans administration actually established a program in conjunction with the department of health and human services that is called consumer direct at home and community-based veterans services, and was modeled after a program that was done in a number of states in which individuals were given an individual budget and then allowed to decide how to use the

money to meet their specific needs, so the states have gotten involved and it is a slow process but it's taking off, and getting involved in understanding that the returning service people once they have had the care and go through the acute rehabilitation phase they then need a sort of stepped down they are not ready to just go back into their communities and live, they need an environment, a threat to the environment, not as intense as intense physical rehab is, but something that is more a day to day living the kind of getting adjusted program and so i think we are making headway with that because before to be perfectly blunt in most states the department of defense was placing individuals and long-term care facilities and nursing homes so we are getting away from that. also the states are reaching out

to their veterans administration agencies to network with them and become involved with them and to open up the doors to the states now have to offer in terms of helping out. many times veterans employees are just not aware of the brain injury programs and frankly because this has become the signature injury of the war. this is the first time people started looking at these other programs that were dealing with people who had acquired their brain injuries in a different way other than combat. thank you. you described becerra fer tbi patience. what are the factors that caused this variability and also, i only have so much time to describe the difference in the rehabilitation of children's verse is adults. >> yes, sir, the first part of your question is what accounts for the variability begins with a lack of understanding of the

condition itself. as i mentioned earlier in the general medical community and in the paper community there isn't a good understanding of the narrow physiological and an atomic principles of the plasticity as a recovery mechanism for a brain injury it used to be fought with you see and six months is what you get what we do in the environment by creating appropriately structured demand deprograms existing salt to take over the function or induces growth in the brain for the new the philip mant of structures to take on the functions with the proper knowledge and the medical community and the paying community that underlies this but it's treated as though it is a broken bone, a broken bone takes six months to yield. we get six months or so in the rehabilitation for the brain appropriate.

we also have the rehabilitation policy of insurance plans the was designed for muscular skeletal rehabilitation decades ago when it first came to being. it hasn't more often to coverings of rehabilitation needs that we now see what surviving fund neurological injuries sri spend a great deal of money to keep a personal life and no money to give quality-of-life after word and the injustice is we actually have the ability to do it so we are simply withholding becerra calling it something other than medical treatment and constraining it in policy by either license restriction or by benefit restriction one or growth. idle hours. the second part of the question the difference between children and adults. it's euphemistically said that children are not little adults.

dr. winston touched on that nicely when she indicated that the path of the physiology of a child's brain is substantially altered with an injury and differs substantially from adults. one of the areas that we have to really investigate has to do with the onset of the lifelong process sees that a rise from the changes in the brain matter logically and once altered it's difficult to know if these changes actually refers to normal or not. there's great suspicion for example in pediatric injury that to the abnormalities contribute to a failure of the system to further mature appropriately. as a consequence, we have to call into question their role of even in the injury much more obvious brain injury in conditions that might lead to dyslexia, difficulties with

reading, writing, math and so on that we have bundled under the learning disabilities as an example, and further as we see the difference in children and we have medication differences confirm a local logical the interventions that are not effective with children and of course we have the real social dilemma of how we treat these children difficult to amass the menacing will environment to take them out of the cultural surroundings, schools etc., so because of the vagaries of net of the rehabilitation coverage of the schools to end up being a the defacto rehabilitation setting. they have stepped up and try to address the problem, but the medical rehabilitation of children really ought to be left to medical professionals.

>> the chair thinks the gentleman and yields five minutes for opening questions. >> i want to ask dr. winston, she described how the majority of researchers focused on the traumatic brain injury in adults and the scientific foundation for pediatric brain injury is limited. you mentioned the need for a focused research investment to inform the products, programs and policies that would prevent and reduce the severity among children. it's -- it seems, you know, you believe there's an important role for the other federal agencies and congress to upon the existing research on the pediatric brain injury. can you share your perspective on the specific pediatric research question that could be further or should be further explored? >> thank you for much for asking that question. i think that we need to build up our scientific foundation so that we can improve and be more efficient in how we deliver our care. i'd like to think about it in

five categories. first, to present, to improve the prevention strategy, we need to understand who, what, where, when, how and why of the pediatric injury and using by mechanics, behavioral science, epidemiology and the like. we need to improve our methods for studying, diagnosing and fall when the course of tbi, by zero markers are also important. we also need to conduct work to know what works and what doesn't. how to improve therapies that are currently done, how to deliver in the best way possible. we need to know how to get state of the art to the field, to the front line for the safety products, but you markers and therapeutics high and we must not forget to train our next generation to be our scientists of pediatrics injuries.

there's the two resources to call the committee attention to the would be able to give you more complete answers, trying to be brief here. the first is an exciting initiatives that i was part of, actually both i was part of the would be released by the cbc i think next month and it's a national action plan for the injury prevention it provides the steps in the research data, education, health systems command occasion to prevent child entry from occurring for the strategies of the national state and local level. the national institute of the development is interested in child injury and i applaud the leadership for their interest in this. the society for the advancement of the violence and injury research under the direction of the president, dr. frederick vara tasked his experts in the

field and eliminated the next steps of child injury research and i recommend you get ahold of that else well, so from a personal perspective there's a range, wide range of what we need to do and we shut what. >> let me ask -- running out of time but dr. ashley, in your testimony i'm struck by the continued need for people with traumatic brain injury and you stated for those americans that experience moderate to severe traumatic brain injury extends beyond the hospitalization to the ongoing extensively out it's the disease accelerative process. can you elaborate on the serious brain injury is the lifelong conditions i know you mentioned that if you talk of a little more. >> the difficulty we see of course is anything and everything a human being does is

mediated by the rain. so in the brain is injured the potential for the impact of any and every organ system in the body and its function exists that the most recent level in the brinza was injured and you have 100 billion of them that begins the new road to digit narrative process at the end part we are not sure which exists. in fact, a few hours after you see the infantry process eisel ramadi initiated and wonder of all individuals late in life will see the same process these we initiated suite change of the biochemistry works, the brain functions in various degrees of by you energetic crisis following the brain injury almost indefinitely what happens is it creates tremendous stress within the system that triggers a number of the generous

policies so we begin to consider the life on diseases we've known a lifelong as parkinson's multiple sclerosis, hunting huntington has led metabolic disorders that may have an origin in alterations in the brain after the brain injury you see this man is just in the recent press over the retired athletes with repeated concussions from the sports legacy institute and the work being done at boston university on the donated brains. we see the changes in the brain and a condition called chronic that's been identified as a single example of these lifelong conditions and progress of conditions.

>> mr. shimkus, five minutes for questions kit. i was giving a tour of the wounded warriors in the capitol so in that been your some of my questions will be asked. we think it is applaudable for us to try to organize these agencies and try to maximize from the focus we know that you've got federal interagency committee, the federal clearing house or tbi research database and center for near a scientist and regenerative madison. how are you going to try to coordinate these groups. everyone knows and the president has also said we've got to get

efficient and appeared on the redundancies. how are you going to go about doing that? >> i should clarify the interagency committee that hrsa is convening is really not to achieve that in a truck agency. >> do you think that's an important thing to do? >> it's a very important thing to do with each agency, ours is more of an informal group who of what other agencies are doing and better aligned with what we are doing with our resources of others there is the need for the agencies to coordinate their activities and the ticket activities of similar interest we will try policy wide in the budgetary wide to streamline this process not just in this area of health care research dollars because we do seem to have sometimes multiple agencies

doing some of them as they are not coordinated getting back the same information and there's not one clearing house, so we are not sure -- we are getting a return on that investment. the question is are we getting a bigger return on the investment as we should, and that's not even in your agency that is some of the health care research in the department of defense as you know and the like. how many states are working with returning service members or veterans? >> give me a quick number. probably about 15 or 20 from what we are aware of. some states are very advanced. the state of massachusetts for instance has a very involved and elaborate program that they have been working on for years with a had a lot of commitment of resources of the state level to bring this collaboration together and work on that what i

worry about from the standpoint of our organization and representing steve grumet is is we don't have every state working on this, but every state has returning service people. so right away we are going to be in a difficult position because we are really not necessarily reaching people. the other thing is, and i'm sure it is no surprise to you, most of the public entitlement programs across the country, especially like medicaid become the paper for long-term care services for people with various disabilities including a brain injury, and most states are seeking to reduce and decrease their expenditures under the medicaid program for the various reasons, obvious reasons, and it worries me because what is happening is in some respects people with brain injuries are being mixed in in the states with other groups people with disabilities and yet as you have heard from the experts, the

treatment and the management of these individuals is quite different. we are looking at quite a different approach to doing something and because it is a lifelong disability and because the impairment persists over time over a long period of time to really requires a lot of resources and states are not -- i don't think states don't want to do the right thing i just think they are having a difficult time with the funding and with constrictions and programs and the small amount of money that hrsa gets to support, you know, through the tbi act what needs to be done, the system is not -- the amount of money that is being given is not reflective of the magnitude of the problem of brain injury that is the simplest way i can say. islamic we appreciate that. harvey walked in at all? skype there's an organization

and arlington and in fact we have some very excellent interesting developments in a number of states where the national guard came to the state and said we would like to do something with the people we are sending out, you know, to combat and so they were pretested before they left on assignment was a base measure of the brain function etc. then when something happened to them and they grew home they were retested and because the baseline there was an ability to determine whether or not any brain damage had been sustained, and if so plan appropriate treatment for them. so both of the local service organizations as well as the state veterans service organizations as well as the federal veterans department of veterans affairs i think are interested in this and tried to work with of the organizations and encourage the states to work

with them in one in-depth 21 states getting grants from hrsa it made it difficult for the rest of the states to get the placement funding to fill the void of trying to continue the momentum of this. >> my time is expired and i appreciate the answer is. in fact especially the last point because as members of congress one of the things that we do numerous times his constituent service and a lot of the veterans affairs issues and have a baseline disability and percentages and be able to get through the system sooner rather than later instead of reinventing the wheel and some of the lifetime is just abysmal that would be helpful, too so i appreciate her testimony. thank you. >> the chair thinks the gentleman. i have one follow-up if he would. in your testimony you discuss

the importance of the golden window. an acute treatment are you aware of any studies of treatment of children with tbi during the golden window? >> yes, the question is about the golden window. it used to be called the golden hour. we are learning it's important to have aggressive care for all launder period of time as we heard terrific testimony. the fact is it is very difficult to do the acute-care research, and i think fear is worked out there to try to start abridging together in emergency departments and hospitals to try to build networks where this kind of research can be done. just beginning i personally could get back to you on specific information but a very exciting study with adults found it just cannot from the university of pennsylvania found

that early aggressive expensive care had important long-term consequences. i think we give, and i think that you would agree to a little too late, and sometimes too late, too little, even late. we really need to get in there particularly for the very serious injuries. we need to to get in there and work with the brain's ability to heal and reduce the secondary injuries that might occur from low oxygen or blood flow or the rest. the wind was a little bit longer. it's 48 hours, and i call the cdc and others to try to get that awareness out there that early recognition response is needed, but i want to challenge if i may i give you a challenge we are experiencing the growing awareness for the early

recognition has really turned into some challenges by parents who want some answers. after how many concussions should my child be removed from contact sports, how long are injured brains vulnerable to a second impact? does the risk differ by age and why does my child get a concussion when they were wearing a helmet? signs today does not answer these questions. clinician's on the front line are also asking questions. i think you might find this interesting for a concussion because of awareness had skyrocketed in the care network increasing 458% since 2009 were struggling to meet the demand. we need research and leadership to provide evidence based recommendations it can't be this broad brush because we just can't afford it and we don't have enough trained providers.

you've been very helpful in trying to make sure that we shore up the training that's necessary for the specialized care the children need. thank you very much. we need better standards for safety equipment, by you markers for injuries we can follow the course of the care, better tools to use in the field and in the clinics, evidence basted particles. these don't exist right now. and then just to reiterate for the young athlete in particular, the job is not playing on the field. it's actually learning and we can't forget that. we need to make sure that we protect their brain so they can become the leaders in society that many of them hoped to become. >> thank you. that effort for the children's hospital can be bipartisan.

my colleague was a great advocate of that as well. >> mr. chairman, i just wanted to first thank you for what you just said. your comment about concussions and sports i agree. if i could submit the statement of the ranking member mr. waxman. >> without objection, so ordered. that concludes our hearing. the members me give you questions, and we would ask that you would respond to those questions once you get them promptly and i would remind members the have ten business days to submit questions for the record, and that means they should submit their questions by the close of business on monday april 2nd. excellent hearing, wonderful testimony. we think our expert panel for your very important testimony in the answers to our questions.

without objection, the subcommittee is adjourned. [inaudible conversations]

>> we get calls going up and down the mississippi delta saying they were now revoked, and the next morning between

6,000 to 100 men poured into phillips county to begin shooting down blacks. >> they know what's going to happen but we don't know what's going to happen. we don't realize what is going to happen. but they seem to because the crowd is with us now. the momentum is behind us and they are pushing us. these stories and others from the local content vehicles in little rock. this weekend on c-span2 and cs gentry. >> house financial-services subcommittee on consumer credit recently heard testimony on efforts to implement new mobile phone based payment systems in the u.s..

witnesses told the subcommittee that consumer demand is driving the mood towards the systems of the technology is relatively new and is two to five years away from being widely available. this hearing is one hour and 20 minutes. >> the hearing will come to order. i appreciate the witnesses being here. we expect a series of votes as early as 11 thanks 30 and if we are all able to complete a hearing before the vote, we will return after the votes are completed. but we meet today to begin but i think is an exciting and important task making sure our financial system and its rigid restructure are prepared to enter the new world of mobile payments. you see a lot of press about mobile banking, certainly a lot of advertising on the mobile banking, and without saying much about my general a huge area,

this is specific in some ways considering my mother has never used an atm but she does pumper own gas i know what my children are going to be doing when my children in their 20s are going to be doing in terms of how the bank and i think that this is what i think is relevant fy and extremely interest in this as we move through the next panel. most people believe making a mobile payment involves leaving a smart fund the cash register and it may be there or is to exchange values. giving instructions to transfer values represent other forms of payment. it offers the possibility of the faster and cheaper transfers of the value, but oftentimes with the promise of enhanced security that surpasses what is possible today. we are writing on the principles of fundamental change and the way that money is exchanged

between the consumers and businesses and that is why i'm interested in wanting to have the ceiling on the future of money. while some aspects of mobile payments have been with us for a while and some business models are already developed, other aspects of the mobile payments or in the beginning pages of the programs. either we there's a lot of the banks, regulators, retailers and customers to learn. we want to make sure they are safe and secure. at least as safe as using cash, checks or credit cards and hopefully even more so bringing the strength of high-powered computers to bear on account safety could allow us to the leaders of security that help fulfill the hackers that line and wait on the internet today. stealing millions of identities and we have looked into this in our subcommittee as well and billions of dollars annually. after all, the smart phone that was essentially nonexistent less than six years ago is said to be far more powerful than a large supercomputer of the 80's or those of us that went to college

in the 70's and to computer science and we had the stacks of cars we get to see the computer in the computer room all night to make sure they went through. today's hearing is an introduction to the global payments by congress. five expert witnesses who can discuss the state of the mobile payment industry and where and how fast they see it developing. among them is richard oliver and until he retired last year he was the federal reserve top mobil payment expert and principal author of the widely praised white paper on the subject. we also have experts from the issuer side from the standard side of the mobile payments in the consumer specialist. i look forward to hearing everybody's testimony and i would now like to recognize the ranking member from new york ms. maloney. >> first i would like to thank the chair lady for holding this hearing on the future of mobile payments in the financial system

and thank you all the panelists for joining us this morning. the hearing will serve as a great first step and learning session on the rapidly evolving technology. all i feel this is another example of american exceptional loss of coming up with an innovative idea and efficient idea that keeps america moving forward employing more people, becoming more efficient and making us an even stronger country. i'm excited about this idea, and i look forward to hearing of your testimony. mobile payments in the united states are expected to generate 215 billion by the year 201,543,000,000 adults in the country use alternative financial services as a form of banking. and as the technology continues to move forward it creates innovative and exciting opportunities for everyday citizens at home and at work. the possibility is truly endless.

we are seeing what technology can do for the businesses as mobile technology opens the door to an entirely new method of financial interaction. mobil payments made by electronic means replace cash, checks and traditional credit cards. this evil in form of financial exchange can provide consumers with a greater purchasing power and allow them to market the goods more efficiently and help create a truly global electronic and innovative society. mobile payments can evolves text messages that transfer funds from one person to another or to a financial institution as experienced in the successful program to funnel aid to haiti and to its victims. i was stunned at how successful the program was. they had at every taxicab get on

your mobile phone and text $5 to earthquake victims and that is successful effort led to $5,000,010 donations from americans throughout the great country on their cell phone carriers. this happened in just 48 hours and as one example of the truly outstanding possibility for the new form of payment but and mobile payment technology can allow consumers to waive their phones at the checkout and even direct the charges to the prepaid phone deposits and phone bills. i love it. and gets better and better. we would lose our papers of the time if we had this. and if mobile phones become more prevalent as a number of methods of making payments increase, it's important to look at the hurdles facing its implementation. how much will the adoption of the mobile payments cost

merchants as the purchase and install the readers for their technology? how protective are the consumers and hackers to steal their data out of the air? what is the level of disclosure that would be provided to the consumers? how can we provide a greater regulatory clarity for this market? consumers want payments that are convenient and inexpensive but we must make sure the laws are properly tailored and that security is not abandoned for the sake of this new technology. it may be years before the technology foley becomes a reality for the majority of people away debit cards have. however, i am happy that we are discussing this important issue of the ground level. i congratulate the chairwoman for calling this hearing and i look forward to your testimony and welcome everybody. estimates before. opening minutes? >> thank you, madame chairwoman. this is an exciting time in the

industry. over the last several years innovative companies have invested huge amounts of capital and man hours to waive the ground work from many of the methods we are discussing today. during mobile payments are bringing the consumers greater convenience and a better body experience while increasing the security of the payment transactions. and interested to learn about the new products and services today i also want to hear what we in congress can do to ensure these innovations progress in the space and prosperous manner. we must and courage of free-market where innovators can realize the benefits of their investments and consumers can benefit from lower costs and products. i look forward to reviewing your testimony today and he'll back the remainder of my time. >> thank you. >> i think mr. gramm didn't want to make an opening statement so we will go ahead and go directly to the testimony. i want to recognize the witnesses for the purposes of

making a five misstatement and then we will go to the question. as i mentioned in my opening statement we are lucky to see richard oliver of the mobile payment in the united states mapping out the road ahead in atlanta. welcome, mr. oliver. estimate what may start by thanking the kennedy and the subcommittee for the opportunity to come and share information with fewer of the mobile payments environment will it's still very early in its evolution. in 2010 the payments research teams in the federal reserve bank of atlanta and boston collaborated to conduct an assessment of the state of and the potential for the deployment of the mobile options in the united states to read our interests were to determine the impact on the payments on the existing payment businesses and to isolate the potential risk to the consumers and businesses who might choose to use mobile payment options. to conduct the assessment we've invited the major players from

the mobile payment industry to discuss on a voluntary basis of the opportunities, barriers and challenges associated with implementing the environment in the country into the included major car branch, wireless operators, financial institutions, industry trade groups, retailers and other participants. this effort was not directed at global banking which is the mobile phone to access online banking functions. restricted that actually exchanging value of the point of the sale utilizing the phone. over the course of what turned out to be seven meetings during 2010 to 2011, we not only gained great insight into the evolution of mobile payments in the country, but the group helped us isolate a key factor that they collectively felt should be meant to ensure a safe implementation of the mobile payments in this country, and my purpose today is to share those with you. the first was proposed environment should be best defined as an open wallet, that

is a wallet that would allow complete access by all persons using all credentials they might want to use as opposed to the proprietary initiatives that might limit the amount of instruments available for use by a consumer. the mobile infrastructure secondly would likely be based on the field and communication technology rather than the mobile devices and in point of sale terminals. the technology is now becoming common in other countries and would allow the users to tap their phones and institutes to purchase. third from existing well protected clearing and settlement reels would likely be the way that the value would be exchanged. that is through the that part of a credit card, prepaid and automatic clearing house that works to be used for settlement between parties. fourth, some four months enhanced security to dynamic data authorization should be used to deter the counterfeiting and i detested the point of sale.

the technology is already resident in the cards used in the world. fifth, common standards should be designed, developed, certified and implemented throughout the industry to ensure interoperable become efficiency and ease of use by consumers and businesses. sixth, the regulatory oversight regimen should be made clear early on and the participants should be involved in the compliance activities. banks and non-bank regulars such as the ftc and the new consumer financial protection bureau should collaborate early on to define the regulatory environment for all of the participants. seventh, entities such as the service manager that excess in the car world today should oversee the provision of the interoperable and shared security element on the phone book. the group also recognized the possible need over time for some entities to serve as a coordinating party to keep the

per disciplines on track working together and possibly to create a road map for the future that would allow the participants to to understand how to minimize their investments in the technology that's necessary. however, the majority of the turbot time felt it was too early in the process to do this and the completion of the pilots would better inform such work. all of this information and work was captured in the white paper that you alluded to which with authorized by the participants and cooperative lee offered by the reserve banks. it's available and reserve bank website and at the conferences and trade press over the past year and was shared with all the federal regulators and law enforcement agencies at a session we held in the first half of last year that my colleague from boston and i presented. as the work proceeded, most of the participants have decided to participate in a number of pilots situations, should better

test the validity of these principles and pave the way for the deployment. the group continues to lead on issues of common interest such as the the security but they've been outspoken recently devotee the need to educate and inform government and consumers about the mobile environment and we view this as a step in the process and appreciate the opportunity to participate. thank you. >> thank you very much. our next witness is mr. troy aikman each officer safety standards council. welcome. >> ranking member maloney, members of the subcommittee -- kimmage you probably want to pull your microphone closer. >> absolutely. thank you for the opportunity to testify on the topic of mobile payment security. - troy, the chief technology officer for the industry, a security standard council also known as the b.c. on a council.

in 2006 but a major payment brand development of open industry standards to protect payment information. more than 600 companies worldwide participate in the work for many different industries in the back rows and putting the number of the players and a mobile space including a number of people will be spoken about later today. it's exciting to be here today representing the members from restaurants to banks to airlines to technology vendors eager to realize the benefit of acceptance in the most secure way possible. the standards are a strong industry framework for protecting the payment data and it's this framework we are applying to the mobile payment accepting space. the technology is exciting and dynamic with a potential to change the way that we accept payments not only in the u.s. but also are around the world. the benefits can be significant. however most merchants want to know that using mobile technology for payment is just as safe as a traditional payment from our perspective of the

council making it secure is our priority to read for the traditional security and the council we've focused on people, process and technology. the mobile payment environment is very complex more so than the traditional part scenario. our goal is to work with the industry to provide security across the spectrum. let me also clarify the council focus. there are two aspects to the mobile payments, initiation and acceptance. the first is when the consumer is using the phone and please of a card to make a purchase. that is initiation. the letter is where a mobile device perhaps even the same mobile phone is being used by the merchant to accept payment cards. there are a number of groups including some of michael panelists working on the first aspect of the aim to protect payment data. the security efforts have been focused on the second area of the acceptance can't specifically in the use of mobile devices as the planas felix weapons toole. of the first step has been to

make sure they can use mobile technology true accept the payments if the had protect their customers' information. the standards already apply to the mobile acceptance addressing the security of mobile devices and applications and the environment in which the operator. expanding on the standards with security requirements to make it possible for the merchants to use plug in devices with mobile phones to sweep the data we have to build guidance on the acceptance of petitions to process the payments securely and we will release the best practices later this year and securing the transactions. as payment security is a shared responsibility all parties must work together on this effort. the council was concerned making sure they are validated and the products and services they provide. moving forward we will explore the area even further. last, work is being done through the evidence that technology

penance. technologies are emerging that have the ability to eliminate the the the from insecure mobile the environment. the council has harnessed the technologies to address this environment and we will continue to assess and develop standards and guidance moving forward. in closing, mobile technology offers exciting potential for the payment space to help realize this securely, the council will work with the global sticklers to develop standards and resources necessary for the protection of the card ponder data across all channels and the reduction of broad consumers and businesses globally. thank you and i look forward to your question. >> thank you very much. the next ripeness is mr. ed mclaughlin global product solution worldwide. welcome. >> good morning german capital, ranking member maloney and members of the subcommittee - ed mclaughlin chief emerging payment officer at mastercard

worldwide that chile york. it's my pleasure to appear before you today to discuss the development in the mobile did payment. pra leader in the transformation of mobile phones and to secure payment devices and a champion of local mobile plowman kimmage standards. we appreciate the opportunity to share our perspective from mobile payments are developing and benefitting consumers and businesses to read as mobile payments continue to evolve, we need to constantly focus on the goals. first of must strive to pay for something as compelling as possible for every participant in the payment chain. second, we must provide the highest level of security to consumers, merchants and the financial and institutional customers. at mastercard we invest heavily in the technologies that make these possible. as you might expect mobile devices are bringing changes to the way people interact and how they want to transact. ferc symbol the acceptance of

the payments through the use of hand-held devices is opening the shells of transactions for entrepreneurs that isn't possible just a few years ago. smart phones also provide a platform for the delivery of applications that are transforming the shopping experience for consumers, for the merchants smart phones provide a channel to engage the consumers at multiple levels such as internet storefront or social media account. smart phones themselves are also becoming payment devices through the adoption of the communications technology. mastercard p. pass is at the forefront and a white 2016 it is anticipated that the majority of the smart phones will support the technology. so why are the uses for the mobile phones so important? because they provide convenience and promote financial inclusion in a very secure environment. unlike the card that's been around for decades, smart phones

provide an intelligent device in the consumer's hands that can use to interact in the financial service providers and merchants in ways the were never before possible. also, when you look at the 85% of the transactions that were still being funded through cash and check it is clear smart phone technology provides an unprecedented opportunity to accelerate the transition to the safe and secure electronic payments by enhancing the ways people connect to the network able to deliver new services to benefit consumers and reach a large number of consumers outside of the financial main street. for example, payment card solutions like prepaid cards coupled with the technology can unlock the grid to the consumers do not currently have access to the mainstream financial service. so at mastercard we have invested substantial resources and human capital and developing the technology necessary for our part in the ecosystem.

each day we strive to make them simple for all participants while providing the highest level of security. for example, this is why we applied the zero liability protection for consumers to the payment technologies including the mobile base payments. in addition, it recently announced a program to transition mastercard payment products in the u.s. to the standard of that's a global standard for debit and credit payments based on - chip technology the objective of which is to ensure in trouble devotee global the and acceptance of payment cards in the world wide basis. the adoption of the products in the u.s. will help provide additional layers of protection for consumers of the point of interaction. mastercard is extremely proud of the role we play in advancing, and technologies. the mobile phone and many of your smart handheld devices are transforming the way we conduct our lives and hold promise for

providing the value to consumers and businesses particularly in the delivery of financial services. again i appreciate the opportunity to appear before you today and i would be glad to answer any questions you may have. >> the next witness is mr. vanderhoof executive director of the smart card alliance. welcome. >> chairman capito and members of the committee on behalf of the smart card alliance and its members i think you for the opportunity to testify today put smart alliances a nonprofit organization that provides education and at collaborative open forum among the leaders in the industries including mobile payments. we applaud the committee's interest in making the mobile payments saved from a flexible and resilient with the appropriate legal, regulatory and security framework. mobile devices to be used to facilitate the payment process in many ways to define going to focus my remarks on the use of the payment application enables

mobile phone that can be used to pay as an alternative to paying with plastic credit or debit card. the hearing was convened to examine issues essential to making payments ate and ensure appropriate legislative oversight is in place. the good news is the type of payments i'm here to talk about today is built on the already established legal and regulatory security frameworks in both the payment and the wireless telecom industries. this technology is referred to as nsc mobile contact payment. the near field communication is a form of short-range wireless communications inside the phone. it's a new technology that enables secure mobile payment of the merchant locations. the nfc approach as the truth advantages in the subcommittee. third, underpinning the legal regulatory framework is the fact that the mobile payments use the phone instead of a car the

payment account remains the credit or debit card account and as such is already covered by existing laws and regulation. second the security and reliability of the program did in the global standards as devilish certification process these and industry best practices that are the culmination of nearly 20 years of work in applying the technology to provide payment accounts and mobile phone subscribers. multiple international standards have been developed for the mobile payment and are supported by the mobile industry and endorsed by the payment industry. in addition, new and existing safeguards are used with mobile payment devices to add many layers of protection for consumer account information and transactions. for example access to the parent applications to be password protected and they can be turned off instantly with one call to the customer's mobile operator. if the nfc bonus enabled with a payment credential issued by the

bank and stored in the new specially designed secure memory location and the phone. the credentials transmitted through the merchants payment terminal by the short range wireless connections. the author is isham settlement process these are the same for those used in the consumer pays with a traditional credit or debit card. market development involving many of america's largest and most trusted companies is well under way. one example is isis a joint venture between at&t, verizon wireless and t-mobile using the mobile contact payment technology we were discussing today. we will license payments provided by the american express, discover, mastercard and visa for its rollout. ..

consumers will benefit from and trust in a mobile payment's infrastructure that has a strong focus on security and uses the existing payment's infrastructure for transaction. mobile phones represent a fertile landscape for new ways consumers can work with stores and each other. mobile payment is going to evolve and as more people upgrade to smartphones smartphon

about the new services in the palm of their hand. in the summary, the future of money is being positively impacted by mobile technology. the changes in financial services you have rightfully called attention to are being well-managed and securely protected by the collective knowledge resources of the financial and mobile industries. i would like to thank the subcommittee for holding this hearing. we appreciate the opportunity to sprint information that assists in the setting of legal to implement safe, flexible, and resilient mobile financial products. >> our final witness is miss suzanne martindale. >> thank you very much for the opportunity to testify today on behalf of consumers union. the advocacy policy arm of consumer reports. mobile payments allow consumers to buy products or transfer money with a mobile device.

the market includes a range of different technologies and many ways to fund the transactions. it's unclear which trends will prevail. it's too soon to know which consumers would benefit most or be at most risk. mobile payments market is in a word complex. there are multiple ways to initiate payments. some services involve sending a text message or using an application downloaded to the device. others employ a chip imbedded in the hardware. multiple parties are involved. consumers, merchants, third-party processors, wireless carriers all in the same system. with so many players involved the risk of confusion for consumers increase is if something goes wrong. if all the parties point the finger at each other, the

consumer may be out of luck. somemer can'ts are interested in the technology because mobile payment service providers may charge lower processing fees at the point of sale. they also have the potential to serve new audiences. this may appeal to young, tech-savvy consumers and consumers outside of the traditional banking services. mobile payments may provide increased access to financial services. low-income house holds and households of color in particular are more likely be to unbanked or underbanked, and according to a recent pew study, these same households are more likely to adopt cellphones and smartphones compared to the general population. this creates an opportunity for markets to be pen operated and these markets may also be at risk. mobile payments have garnered

attention for helping consumers in developing countries. an estimated 5 billion consumers worldwide have a mobile phone but 1.5 have a bank account. a customer can deposit or withdraw cash, and they can buy goods and services with their mobile phones, all without needing a bank account. however, u.s. consumers have been slow to adopt mobile payments for some reasons. some are limited in scope and availability. the new group of wallet users and chip imbedded in the mobile device which the consumer uses with readers, but google wallet is only available to sprint customers. another mobile payment system, bling nation, uses a sticker with an imbedded chip that the

consumerrer fixes in a device and waves at a reader but it's only available in palo alto, austin, and chicago. >> in a survey released last week the federal reserve found that over 40% of the consumers cite security concerns for not adopting mobile payments. not all devices are created equal. u.s. payments law is fragmented. the level of protections against unauthorized transactions and errors depending on whether a consumer links payment to a credit card, debit card, prepaid card, bank account, prepaid phone card or phone bill. traditional credit and debit cards have mandatory protection but prepaid cart does not. phone deposit and phone bills do not neatly fit into the existing legal categories. wire's carriers may provide volunteer tear protections but they're particularly not

disclosed in customer contracts. the different ways to pay pay by a mobile device -- consumers need to know where to complain and how to get their money back in case of errors or unauthorized use. consumers, not afford to lose money. until u.s. payments law is updated to provide clear guaranteed protections for all payments methods consumers may be at risk when using mobile payment technology. but a few simple fixes could provide clarity. the consumer financial protection bureau can address mobile payments because it has jurisdictions over payment service providers and can clarify regulations. congress and other federal agencies also have a very important role to play in establishing sensible rules for the road that protect consumers and foster innovation. thank you for the opportunity to testify. i welcome your questions. >> thank you. i want to thank all of you, and i will begin with the questions.

first of all, mr. oliver, i wanted to -- i'm starting with the basics. you mentioned open wallet. can you explain what an open wallet is? >> the concept of the open wallet is it would operate on the phone the same way it does in your current wallet. you could select on that phony payment instrument you chose from any provider, and execute a payment using standard technology without having to do something terribly different from a payment instrument to another. >> you could pay out of your bank account, on your card. >> any card you may have in your wallet, compete can cards, bank cards, what have you. >> okay. my understanding is this -- i'm throwing this out to anybody who knows this -- is that europe has been much further ahead than we are on this technology. they have put in the chip in pen cards in europe, and there's some thoughts the nfc chips

would leapfrog that technology. why has it caught on there and hasn't caught on here and do you in fact think this will leapfrog, their technology? i imagine it's going catch on like wildfire once it gets going in a more robust fashion. the european model versus us and why they're further ahead than we are on this technology. >> let me open. when you look at markets and how they involve, usually starts at the baseline conditions. the u.s. benefited from having the best telecom infrastructure in the world at the times you're looking at. so the requirements in europe to handle things like offline transactions, put more intelligence in the transaction, to compensate for the instruction that was there. that led to a set of investments in underlying security technology. we have seen that cascade in

marks around the world. canada, mexico, other markets moving towards endorsing that. so, in the u.s., we now see it as absolutely time for us to move from static plastic-based credentials to dynamic protection generated using emv and chip technology. we took a plastic card and put a chip on the card. we're now taking the chip off the card and putting it in the phone. also essential that we point that worldwide interoperability so consumers know anywhere they go, they can get the same security around their payment products. >> i agree with that. a question i have on -- you mentioned all of you mentioned the contactless reader, at the retailer site. the question -- i represent a rural area, and there's always a question of costs for the retailer.

how successful of these devices? you mentioned somebody mentioned 20 retailers who are involved in this, the larger retaileres. how do you see this in terms of the retailer investment? i know when we changed the interchange -- that was a big hugh and cry from the retails of the different readers. does anybody have any kind of statement on that? >> i'd like to begin by saying that when the u.s. brands, particularly visa, mastercard and discover are moving toured the vmb chip. the important distinction the included in that road map they were going to incorporate contact and contactless technology as part of that in only to be able to embrace the mobileless technologies we're talking about here today. so they merchants have a clear

and stink path forward in terms of what will be the technology platform, not only to except existing payment card, but new and emerging chip cards coming, but also the mobile nfc payments technology. show to advantage for merchants is when they make that decision to upgrade they're acceptance infrastructure in their stores they can purchase one device that's going to support the legacy card technology in the market today, the evolving new chip contact card tack nell coming, and the mobile technology in the phone. so, they will make one investment, supporting three of their primary methods of payments. >> is that available technology available? >> is it not only available but the manufacturers of those devices have now totally upgraded their equipment to be able to absorb these new technologies, so that the same

devices that they would purchase five years ago didn't have -- >> i understand. i understand. i have a couple seconds -- because i think the security issue is something that we want to delve deep into, and i think monday -- miss martindale brought up a great way, if something goes wrong, how do you right the wrong. i think the other think that mr. mclaughlin mentioned we should be looking at here, talking with regulators out, this is regulated as a card, but then miss martindale brought up exceptions to that i think are significant with the evolution of different types of cards, and i think that's something we need to keep our eye on. so i'm going to yield to miss maloney for five mints -- minutes for questions. >> i want to thank you. mr. oliver you said we should come out with common standards.

where do you see these common standards coming from? who is going to pull them together? the industry or whatever? >> these are best and usually done by industries, and mr. vanderhoff made several comment busy the efforts of the smart c.a.d. alliance and others. forums in europe and standard forums that generate standards and allow people to adopt them. it's a critical issue, interoperability and the key to anker early question about the open wallet, you have the same experience no matter what you do. so there are organizations participated in that would generate these. >> that's great news, because on 9/11 one of our biggest challenges was the fobs from the police couldn't enter act with the phones from the fire, and if they could have, it could have saved lives. so making that common sense step forward would be important.

many of you talk about -- this would allow more access for the unbanked, and those that don't have access to banking. would someone elaborate? that's a concern to make sure that all of our citizens can find some form of banking services. how are we going to reach out the unbanked? how does it help the unbanked? >> this is something that a mastercard we have been working on a lot, particularly using prepaid products as an access tool to those who don't have formal banking relationships. it starts with providing ways of getting access to funds so they're not left to the tender mercies of the check cashers and payday lenders. if you look at the work we have done with the social security administration for the electronic distribution of funds, and the other way to allow it to reach these consumers. we think the key to using mobile

will provide people more visibility into their financial information, into their account status so they can be more informed, they can make savvier decisions and we can reach individuals we haven't been able to reach through bank branches and other areas. >> the fed has been looking into this, and they did a federal reserve report that said that 57% of all americans and consumer surveyed felt that the banks services they had now were adequate. then they looked at people who had mobile banking, and only 12% of mobile phone users reported they made a mobile payment in the past 12 months. so the technology is out there and people aren't using it. and given this finding in their report, what actions should be taken by retailers, credit card companies, banks, and nonbanks, mobile phone service providers

and others, to develop mobile payment opportunities that are tailored to customers so the customers use it? they say the technology is out there and people don't want it at this point. or use it. >> the mobile devices are still just starting to reach the consumers' hands through the mobile networks and through the retail stores that offer them. so, we're expecting that there's going to be an increasingly number of options available for consumers to be able to upgrade phones with smart card technology that can support these mobile payments. unfortunately today we have a chicken and egg situation where you have consumers who want to pay with their mobile device and are waiting for the equipment to arrive for them to use it, and that will -- when the equipment is available in consumerrers' hands then the issuers of the payment instruments that work

mobile phones -- >> that's one barrier. what other barriers exist to prohibit mobile payment options? security concern? >> i would think so. one of the areas we're addressing is the security of payment card data. we look at technology, how the data flows into the system, many of the terminals certified on our web site have gone through laboratory testing and have the capable to accept what we're talking about here today. we're talking mostly on the consumer side and we also have the security of the merchant side and we are seeing rapid growth in the merchant community, who we talked about unbanked consumers. there's been unbanked merchants and we're starting to see a new generation of merchants that before were not accepting types of payments other than cash, and now are using such devices as

peripherals that you plug into a smartphone or other types of mobile devises to accept payment, and we're seeing a new industry boom here in the u.s. >> thank you. my time is expired. >> thank you. >> i want to thank the witnesses for being here today. mr. oliver and mr. mclaughlin, which effects do you think the current regulatory environment will have on many of these new innovations, and has the uncertain and really the changing regulatory environment had an effect on or slowed the evolution of many of these new products? we'll start with mr. oliver. >> that's a great question and one of the important questions we discussed within this work group. and one of the reasons they asked to us try to rationalize the regulatory infrastructure that might be in place, begin that most of the payments will be made using existing instruments, i think people are comfortable where that is right now and there appears to be no serious legislation on the horizon to change that.

i think the real issue here has to do with both places where gaps occur where different parties are involved in a transaction now than having typically haven't been involved before. the fcc overseas the wireless industry but have no experience with payment. many of the payment firms have noer and with that that's why the collaborative effort to understand whether any regulation at all would be required is an important first step on the part of the government and should occur quickly. it's not obvious that there are serious unregulate areas at this time. >> mr. mclaughlin. >> i think it's important to recognize that the mobile phone will be one device '. albeit an incredibly compelling device, that consumers will use to access their account. so from a mastercard perspective we want to make sure all the right protections and consumerrers have is the same

whether they're using a physical card, initiating the transaction from a mobile device or shopping online, and that's the reality for consumers. want to be able to trust the transaction. we believe making sheerow don't have some independent mobile world, but rather the devices or a rights and and extension of what people have today is important. it's important we allow innovation to flourish. we need to ensure the security and consumer consumer protections what we want do is constrain or restrict how the industry to determine the highest value. >> to move into these type of innovations there's a scale of investment that has to be made. can you kind of explain again the scale of investment that companies such as yours spend on developing these products and the infrastructure? >> one of the things that is

important to point out, these are technologies we have been working on for a decade and more. we knew that we would want to take advantages of smart devices. we knew the form factors would be changing. so the first trial wes had of contactless technology were in orlando and dallas in 2002. so we have continued to build and invest. in 2005, as an industry, we began rolling out pay pass, the contact technology we have had, and we work with all of the participants in the chain, whether it's handset manufacturers, should security and chip companies to make sure there's a safe and security environment to leverage that technology. so it's an ongoing and substantial investment, not only in the consumer experience in the environment but the underlying security infrastructure. >> thank you. mr. oliver, can you talk about the potential up front cost merchant will be required to accept mobile payments and is there any danger they make an expensive transaction, only to

have payment technology veer off in a different direction? >> probably not the best person to answer the question about what the expense will be to themer chant but i would like to answer the question about the long-run investment here. obviously they're confronted with the issue of trying to understand the end game therefore make wise choices now, and there are very large merchants who have already made that decision to say, what do we think will happen in the next seven years? and they say we believe mobile technology, contact and contactless cards cards and curt instruments and they have the terminals to do that and the incremental cost is adding that technology to existing terminals is pretty inexpensive, but across the huge fingerprint for a large retailer, it's going to incur some money, but that's what they whatnot to do with this road map, is determine what is the end state and then let us choose how to transition and spend wisely.

>> thank you. i see i'm running out of time. i yield back. >> miss mccarthy, five minutes. >> thank you. thank you for your testimony. i tend to think that a lot of people would find this really fascinating. two things i would like to ask about. the europeans have been using this technology for a while. what are the statistics for those countries that are more advanced than us on the breaking in, the stealing of information, their protections? you're see that information over there. what have you done that's going to be different for here for us? >> there's several underlying technologies that we have discussed today. the european markets in particular have been using this chip technology as part of the payment card instruction for many more years and they have proven dramatic reductions in their fraud because payment

cards now are unable to be counterfeited or the information on that consumer payment product account beclowned and replicated because of the security of the chip technology. what is inaccurate is that they have been ahead of the u.s. market in terms of mobile payments. in fact, the u.s. market has a much faster potential for adoption of mobile payments because we have made this investment over the last five years in contactless payment card technology and, therefore, we have hundreds of thousands of terminals already installed in the market place that can use now a mobile phone with the same payment capability to make the payment transactions, where in europe and other parts of the world, who have implemented chip technology, have not implemented chip technology with the ability to interface to a mobile device. so they're going to require a second investment. >> on second thought, obviously we hear a lot about

cybersecurity. i know all the nations, nato, the number one issue when they talk together. have you given any thought? we're always one step -- or hopefully always one step in front of the criminals. and this isn't obviously -- is obviously going to be a big area in the united states because we have innovative people that are -- hopefully you're hiring them because they always seem to be outmarting us. but going back to cybersecurity, what mechanisms are out there when something like that possibly will happen, which many of us agree it will -- and how are we going to combat that? i'll throw that out to anybody. >> the council has written standards to look ahead to where the future is. we're a global standard body who we have already have our standard imminent europe with this type of technology. one -- last year point-to-point

i increase, regardless of technology wen encrypt this information, render if of no value to a criminal and the system itself can produce, transact, and the consumer can have confidence in that transaction in the u.s., merchant are taking devices and plugging them into the phone and they are now swiping the traditional card or using new mobile technology and they're able to encrypt this information, protect it before it gets into an insecure mobile environment and is able to process that securely and safely on behalf of consumers. we have standards already as an industry and we're looking at new standards and new dynamic ways to create data that's of no value. so even if the dat tase exposed, share my credit card information with you, we have new technologies emerging that rental kerr that of no value to a criminal. >> the only reason i'm concerned -- we all have our

black blackberries, government issued, but every day we get a very long list of those who have broken into our blackberries and likely spam or someone has gotten our information. so i understand where the american people might be a little concerned here because we're supposed to have the protection, yet we're not even supposed to use these when we go overseas. they ask us not to use them. so, i can see where american -- yo you can have a big cell for a lot of people. it might take time. i know it's used in europe quite a bit. with that being said you have to convince an awful lot of people that their checking account is not going to be wiped out. >> i think that is what happens anytime we introduce new technology. people are comfortable with the familiar, and that's why our obligation is to make sure every new technology we bring out

there is enhancing the security. it is making it safer. so consumers can understand that we can do things using the intelligent devices to make it more secure than what we could do with the static plastic device. that's the advantage of the new technology but we need to make sure we're smart about how we harness it. >> mr. graham, five minutes. >> thank you, madam chairman for holding this hearing, and i appreciate everyone's testimony today. a couple of questions. mr. mclaughlin, how much does mastercard spend annually on fraud? i know there's quite a bit of fraud now, even traditionally with cards. do you have a ballpark of how big that problem is for mastercard? >> i don't we have broken out specific fraud expenses. but what i would say is something that we constantly battle. any change, anything we do, we have to make sure that we're

making the system safer for that. so, one of the primary focuses of the organization is to make sure we're eliminating fault or mitigating it. >> do you say it's increased significantly with the advance of the internet? >> i think any new technology creates challenges to make sure that it's secure. we have been able to, over the last decade, do a lot to mitigate the fraud potential of what is online and that's something we combat every day. >> i'll take that as a yes. don't get me wrong. i'm all for the new technology. i just recognize that, with anything that's new, i slightly disagree with my colleague. i think the criminals are a step ahead of us many times with most of these things, whether it be the internet, counterfeiting cards originally was a tremendous problem. then with the inter.

the just now there was a massive sting operation in the country. people ordering online, and then fencing those items for cash at significant discount. the effect on merchants -- because i think a lot of merchant are going to have issues -- when someone comes in and does a traps -- transaction -- for example if the order of the phone and give their credit card over the phone and then they get their and i will say, oh, didn't order this, the merchant usually eats it. ...

of most important point of the environment and it's not simply the technologies that are available to us and quite often when we see proposals that are out there with or innovations rooted how do you run the network itself and make sure that you are balanced and fair for all the participants in and? that's why i said earlier as we adopt global technology we want to make sure the same rules we have to apply to the same dispute resolution mechanisms are there and in adopting the new technology is to increase the level of verification and certainty we can put around every transactions of the

issuer's benefit from reduced fraud and from the reduction of fraud. so, harnessing the new technologies provide enhanced security and enhanced clarity is the objective. we can do things like providing one time cryptogram on the individual transactions to this specifically where it was generated from moving from a static identifiers to the dynamic. we can get additional certainty of who you were and the device that you are transacting from when you do things like an online transaction. so we see the distinction between was happening at a tilt tell you purchase on-line and other things you are if transacting and looking to harness the capability to reduce fraud is the overall goal. estimate on that topic, how about the advanced fishing technology that's all there when sell phones first came out

cloning the phone constantly by using the technology to steal your id right out of the air. i am assuming that is built into this technology but it's worth mentioning said this is information from right now. >> absolutely. in reference to the trusted service managers that is why we want to make sure anything we do with the new device is more secure than what we did in the physical world, so things like fishing and other types of attacks were protected against. >> my time is expired and i yield back. >> five minutes to the gentleman from georgia mr. scott. specs before french mr. sherman. this is a fast hearing. we are moving so fast with technology that it's even hard to keep up with, and now we have

a challenge it seems to me and i have a number of questions particularly the 90% of the american people dhaka 90% of the american people own a mobile phone. that is a phenomenal situation. i have questions about who is to regulate this. >> right now people are paying their phones through their mobile units. but regulatory agency, who regulates this now, where does it come under mobile payments? is their regulation now? >> i think you pose a great question. when it comes to mobile payments the use of the phone to make a

non-communication type of transaction the fingers are pointed in all different communications and the federal doesn't appear to preserve that has jurisdiction over these transactions, and as i planned dhaka earlier when a consumer's phone gets stolen they're going to go to the carrier and they have maybe something in the contract, may be a policy, maybe there is a phone agency that is supposed to be in charge but that is at best not clear hit right now. >> that concerns me because people lose their phone all the time. the point i'm making is if you have 91% of the american people, 91% of the american people means young people, senior people, people are getting adjusted to eight. citing the there are some very serious questions here about the regulatory function.

i also think there are some issues about the complexity of this issue and with that comes a great concern about my other major concern is that who is responsible for monitoring the security risks that are here? all these questions have to be carefully examined. and i think we have the consumer protection bureau, we have the fcc, the ftc, then we have this little thing in there where these bills, who pays them, where they get the money from, how is it transacted? and in some cases the telecommunications company pays

the bill for them at the to the monthly bill and have i'm sure all kinds of fees structures are piled upon the don't pay their phone bill, but alone the other bill it seems to me the consumer can get bamboozled with a lot of financial burden coming yet right now this is going on and we don't have a record of the year for it. so, my question is where do you believe this would fall? is there one agency, should there be several, who's going to be the oversight for this? >> right now there are problems in this area. my concern is this technology is moving so fast we have got to put a priority and how we are

going to protect the american consumer as it is going to move very fast. even my own cellphone i have problems just trillion to figure out how to get all this information i am receiving. and this is going to have an economic impact. it's kind of of businesses out of business. putting up post office out of business and there is a paper trail. if i get my bill and i am paying my bill, i like to have something in my hand that says i paid this bill, i've got a paper trail. i'm just making these points to say we've got work to do. as the michaud yield of five mets to the gentleman from delaware mr. karni.

>> thank you mr. chairman and to the panel. i would just like to pick up where my colleague left off and ask the question what is driving this to the mobile payments? why don't we start with mr. mclaughlin. islamic let me open by saying i am class of '83. >> you would have to do that, wouldn't you? my archrival. i think it is absolutely driven by the demand we are seeing from consumers. what they are recognized is mobile transforming particularly younger consumers they expect to be connected and have the immediate access to information and what deals are available to them and have immediate access -- so that information would be available on their cell phone and they would make a purchase and makes a payment through the phone.

islamic i don't want myself and to do anything more to really have a hard time keeping track of what it does now. when i leave home i feel completely lost and make it without my phone. >> the use expressions like losing a limb which i find disturbing when they don't of their phone with them. i think it's right, it's become your gps, personal assistant, alarm clock, always with you. >> i think several of you touched on it to the is it more secure? >> that is the objective. keep in mind, what we've been able to do with plastic cards and the on-line authorization has been a great way to combat fraud. we believe harnessing mobile devices we can enhance that even further by using the intelligence available to, second of the wheel incorporating consumers to bring to the process of monitoring the

finance we've gotten a payment we can use the phone today mastercard is a technology where i can say let me know if it's an international transaction or online payment occurs or transaction over a certain amount so that connectivity gives consumers more information. how much is in my account before i make this payment? >> that was one of my questions the would help you not make a payment you didn't have money to cover. one of the things that aggravates folks is when the overdraft of their account and get a charge for that. this would help you not do that? >> we can do even better than that. we can tell you exactly working with mobile banking and other applications the current status of your account. we can say here is much house spent and provide this real-time access to information so the alerts and controls i think are essential to the mobile payment

experiment. keep in mind it's the mastercard network that pulls this together. so my experience -- segment just braking and how about the bank puts the advantage and how does it work? you mentioned in your opening statement that's an important group of constituents. >> the way you could set it up now so you wouldn't even need a bank account to do these transactions is you could have a prepaid debit card, which is not a bank account, and you could launch your mobile application to the prepaid card so that you are drawing down from your prepaid deposit, and this is a way that the under banked consumers could use these -- >> you would have to set something up. >> you would have to set something up, and we have a whole host of other concerns

about prepaid cards just standing alone because they are not rigid and deleted in the same way a debit card links up to a credit union already is so the prepaid card doesn't have mandatory protections should your car to get lost so if you are having another lawyer we do have a concern that this is a great opportunity to provide that information in a way that consumers will actually used and they are adopting of the cell phones and smart phones. at the same time me to make sure the payment transaction is covered by the guaranteed protections against fraud from the consumer financial protection side, beyond that is the security side. >> how do the fees' work with this? we had a big debate about that, a dispute about that over the last year. how do the fees' work for the

payment? >> from this perspective of their youth initiative from the car or the phone it's the same transaction. >> same transaction. thank you. >> thank you. i recognize the gentleman from missouri for five minutes. estimates before, mr. chairman. i guess i want to start with what type of time frame do you see all of this developing in? what time frame for her the general acceptance, what do you see as the time frame for the problems to pop up and ocher so we know what time frame we have for a regulatory fix or something like this? >> a first shot at that there's a lot of elements of change and parties that collaborate in the technology implement technology, educate the consumer and so forth and so mauney sense just

as a personal estimate is you'll see the significant a plant in the two to five-year range because many of the public's going on are going to be completed sometime next year and the slow growth curve for an extended period of time. >> do you anticipate the same? >> we talk about the consumer side of the phone but from the mobile payment acceptance we see that today at the council we have the standards that accept certain types of mobile technology to accept the traditional plastic cards. we've seen our first products come through to be certified in on the web site. so for the mobile acceptance, it's here today. >> excuse me. i would just add the solutions on mobile payment that you are hearing from the well-known recognized brands that have a clean sense of security and certification requirements of the technology are going to be

false slower than the internet startups of the world who might come up with an application you can download on your phone and be in business basically overnight but for consumers they have to pay attention to who's behind the technology they might be interested in using and what safeguards exist and it's always a wise choice to look at the established companies that are backing this and reasons why they are moving at the pace they are to maintain security. >> i'm not very technology will sevi but it would seem to me that you are going to have to have a platform with which all these transactions can occur with the same technology to be able to talk to each other. i assume that's possible, i assume everybody is already

working on the same platform or the same language whatever it takes to make this work, is that an assumption? >> i think you see the movement we work together as an industry to make sure this will work, that it's safe and secure so that's why some of the standards we talked about earlier like the underlying technology standards that are out there and things of that nature provide a baseline that consumers and merchants know they can trust. having the standards out there also allow them to compete on who can deliver the best experience and a value that's out there and they have to ensure there is a foundation that works so we can offer what works better. >> other places in the world where this is being done already? for we've the lead country? are we technologically leading in this application? >> actually, you know, we are to behind.

other countries people have mentioned europe in the developing countries. this has taken off like wildfire of it with a different set up and the infrastructure in the countries are different from not necessarily saying we would be able to replicate in the same way as other countries. i use ken as an example. african countries have been adopting mobile payments. you don't have to have a smart phone. a regular smart fun you are giving a deposit to the wireless carrier and they are helping you manage your funds. and that's something that i've not heard the industry is as interested in going in that direction right now. i think it is more the nfc enabled google bald what type of scenario you have your different payment cards yielded to the conflict up to the application. however, this is also involved a great deal of productive collaboration between the central bank of nigeria and the major telecom and the

centralized set up that we would have here. this space the key is rough riding. consumers have access to electronic payments. in many countries the doubt. mastercard has been working hard with the telecommunications and financial restitutions in those countries to provide appropriate technology. one example last year they gave us their innovation of the work for we head down with kenya working to provide a virtual master card numbers to people no access. so a whole swath of the population wasn't able to access anything on line now have access to its by harnessing the network for world was made in those networks. ceramica the def maza and son and now for many cash and years and this seems like they're

still there so maybe you're taking your first step on the road. spooks before mr. chairman. specter went thank all the members may have additional questions for the panel which they may wish to submit in writing with the objection the hearing record will remain open for 30 days for as members to submit written questions in a place they can respond in the record. this hearing is adjourned.

[inaudible conversations] [inaudible conversations]

for months until the aids 2012 international conference he also commented on the value of the meeting and what he hopes will be accomplished.

this one hour and 15 minute event is hosted by the center for strategic and international studies in washington, d.c.. >> thank you all for being with us. i am from csis. we are really thrilled today to begin the host dr. thomas frieden, director of the centers for disease control and prevention. he's been in that position since june of 2009. i want to offer a special thanks for moving into very brief opening remarks and to susan from cdc for all their assistance in pulling this together and the staff here at csis there's a lot of investment in this. there's carol lynn schroeder. we are bringing you together to really look at hiv/aids and look

up the accomplishment that is a look backward up to the present as to what's happened in this period into the efforts to bring it under control and change the ark of that and to really focused both on where things stand in the united states and the prevention and aids this is a remarkable period. it's remarkable that we would find ourselves in a situation and the secretary of state, hillary clinton, comes before a scientific rodeo here in the united states of fines and 59 to talk about with a very public health as addressed about an aids free generation and went

shortly after the president of the on the vince states use of world aids day. s. we challenged as well was the challenge of moving 4 million to 6 million as an ambitious goal. the u.s. and a fairly short period of time had existing budget levels. we are also going to be looking forward to them particularly with respect to the aids 2012 international aids conference to be here in washington july 22nd to 27. dr. frieden will tell us about that and what we might expect coming out of that unique event. returned to u.s. soil after an absence or hiatus which will be a dramatic and very promising event.

we are. his role in leading of the efforts and india for five year period after returning to new york city where he led a remarkable period of innovation from 2002 to 2009, spanning anti-smoking efforts, controls in transnet integrator disclosures another food content, electronic records and many of distinguished how complex. it brings its own strengths and its evidence base public lands will hear about in the information and programmatic trimming efforts at, and abroad.

it's remarkable looking how much the epidemic has changed cdc just ten years ago when we started interacting with the programs in their earliest stages and it was a small part of what cdc did at that time now it's become very much indebted as the institution of this organization when from to draw your attention to the fact next week we will become fannin march march 28 for an agent we passed out a flier from that that continues this series to look out. my colleague is going to be publishing next week a study she

has been working on for two years now the historical, and she'll be joined by al-kahtani for the presidency in the international co-chair. our president and ceo of the aids foundation in chicago and by iain, the co-chairs will moderate a discussion. and they will be looking at. there is enough that will be webcast live in the middle of the day, and we expect a strong here as well and i want to thank everyone joining online. we have fun to persons joining us today.

please join me in introducing our guest of honor, dr. thomas frieden. [applause] >> thanks very much to steve and everyone at csis for the excellent cutting edge works that you've done in global health and a variety of issues and also, i want to thank all of the non-governmental organizations. we are all committed to making further progress but i think we also can take a moment to look back and see how far we've come. i'm very honored to be year and on the hiv hiv/aids epidemic where it believes it fits in the health care system.

it's possible i fink to forget just how bad. has already calloused. it continues to be but it was a much worse blight on the countries that are already struggling with basic health issues. did we have remarkable progress to celebrate as welcome. i remember a woman i met in nigeria a couple of years ago when carrying twins come and she said to me on hiv-positive but i am on treatment and i feel great and might twins are hiv negative. they will grow up without aids because of the american people.

so please, go back and tell people how much we appreciate your support because the lives of our children. as we come a long way but i think in terms of our response of the epidemic, 2012 is 18-point and i would point to the trends in the area. first of that we are seeing increasing coverage and decrease in unit cost. so we are able to create more people. the second, there's increasing. my only the u.s., not only the countries in which the epidemic is an harvest, but countries throughout the world are saying do more to address hiv.

that treatment and prevention. for so many years we have this fight. treatment or prevention. now we know that treatment is prevention and it's a critical part. the mother to child transmission and the involuntary circumcision can be scaled up on how the populations reach an intact. this is crucially important, and i think in forms. of want to take a moment to describe to you. we are fortunate to have the staff in atlantic adderall the world. we have nearly 2,000 people working for cdc around the

world, and the of thousands of people lost. in hagee where we have been able to improve the ability of the government and the local institutions to respond to the cholera epidemic, we have presented. much more needs to be done and we are lacking the resources to improve water and sanitation in the way that all of us would want to have happened but we have made tremendous progress.

prevention of transmission isn't going out as readily as we would like and we know it's continuing to be from the government of nigeria to the faith the government of liguria and we're optimistic who you will see significant progress. from ten yes since we have seen the examples of the scheldt, more than to serve the fall to the patients in kenya are being tested for hiv in the found put on the antiretroviral treatment. a couple of years accounting for about one out of six. showing that there can be effective scale up using vaccination issues. in china we helped the country open up and look at things like

influenza and become a global center their posting on the internet every week. in laboratories we helped develop with their own resources because the whole world benefits from that information. in brazil where the country and signs an intervention that is going to scale up the at the. 700 million whether it is possible to get people moving on the basis. in vietnam where we have had the development seeing the progress and helping them in areas like motorcycle helmets when they have seen a dramatic and the

high-risk in india. canada went 15 months and that's with excellent monitoring, the result of focus and accountability in the billion dollar investment by the government of india where polio eradication. the man who global pause. we have the detection activities around the world, we have the immunization helping to assure the countries have the effective policies and programs. we have influenza tracking the

spread so we can have an early warning system to know what's happening and prepare for what could be a terrible pandemic and we are working with the initiative providing technical assistance with ministries of health and government programs to ensure the programs have high impact and are documented. a field epidemiology program turned out more than 2,500 highly trained epidemiologists in recent years about 80% of them stay in their home countries doing important work to document the spread of disease, design programs, employment programs and then see whether those programs are working. and you work with the department of defense in the strategic areas, and of course with of a global aids program and pepfar. we are seeing now signs of

progress. hiv remains the biggest challenge of the world. there's been 65 million hiv infections and 20 million deaths in the epidemic. in 2010 alone there were 2.7 million new infections and 1.8 million deaths. so the number of people infected continues to grow from 44 million up. the graph shows about 20% reduction in the incident and a slightly larger reduction about 27% reduction in sub-saharan africa. to achieve this, partnerships are central and learning lessons from around the world and applying them wherever they can be applied is crucially important.

hiv related mortality is also the plan, and one of the things is public health is at its best when we see and help others see the allies behind the numbers. these numbers are coming down but they are still shockingly high. at the peak of the aids epidemic in africa, hiv accounted for two-thirds of all adult deaths. can you imagine what would be like a number own village and our own community? there were communities in which the only business the was increasing was a funeral business. there were communities in which the hope that there could be progress was dissipating. the number of health care workers who could care for patients with hiv was declining because of hiv sending their own

rank and the possibility for progress seemed remote. we now have the ability to make big change in a significant progress. the u.s. government has called for an aids for the generation meaning that virtually no child will be born with hiv infection, but adults living with hiv don't progress. there's a rapid decline in hiv incidence. the combination of the prevention can turn the tide on the hiv epidemic and just as the combination antiretroviral treatment can turn on the infections and individual. antiretroviral treatment as prevention of mother to child transmission, medical male circumcision and correct and consistent condom use.

what we're seeing in this call for the aids free generation as the translation of evidence into policy to action. we are hoping for more progress but we don't have to wait. president obama has said we will be at this disease that's an ambitious goal to alves. what we've seen is the goal to reduce by 90% but not only to meet the goals and pepfar and h. levy but strengthening systems for example reducing the mortality by at least half and ambitious goals, three numbers we need to keep front and center in everything we do, 6 million

on treatment, 1.5 million women treated and 4.7 million voluntary milk circumcisions. those numbers are interest. we have 21 months and i'm confident working together, we can. at home we have for the first time a strategy for the country with a focus on reducing new infections, increasing care, reducing hiv related to disparities in the and achieving a more coordinated response for the hiv/aids epidemic, and let's not mistake we have significant challenges in the country. because it is people living with 1.2 approximately, 200,000.

this is 150,000 or so know they have them hiv but they are not on an effective treatment. we're seeing an increase in hiv incidence among. we see that more than 60% of new infections occur gunmen who have sex men and only 28% of all americans living with hiv are pressed and that means that their own health is at risk and their partners are at risk, so we have a long way to go but we also know that significant progress can be made. san francisco has scale of treatment. and we have seen that in the we

are taking a new approach to our prevention work. we are saying let's make sure in this country for our prevention dollars that we are sending the that means we will shift our funding and determine the funding based on the number of people living with hrsa and support. the testing and linkage to care, comprehensive prevention, condom distribution, an initiative to promote. she said helping health care workers' insurance and we are getting at, we want to be able

to effectively manage the epidemic and help people. in this country. 11 million more americans know their status than the mill before. three-quarters of those at high risk. we have seen 90% decrease is and doug turnage mr. and against the drug users and 90% or more loved ones. the same levels of effectiveness , the present can and what we hope to see the next few years is whether skilling up treatment as prevention can reach that kind of an impact on the sexual the transmission for hiv. not only is this. we know from a broad variety of initiatives we can drive down health care costs.

for every dollar for the halter system alone. a single family with a chevy. those interested in the future we can truly been the cost curve for caring for hiv. a fictive. increasing the understood. we know it can be highly effective and reduce transmission to two or 4% but we are at less than 50% coverage globally. we know that it does prevention. has been documented to produce by 96%. this is remarkable evidence. if you are on treatment, not

only will we live longer and healthier the you would be less. that is a game changer. how to manage the epidemic, control and prevent. we're still at only 40% coverage. malcolm circumcision. looking at the female to male transmission of hiv. the coverage is less than 5% globally. we have seen it can be. it's remarkable and it's done nearly four injured thousand voluntary male circumcision is coming and they will. fewer transmissions, elbe says,

which this still. it would be without a doubt a enormous contribution. we are looking at trying to say of the corporate,. this is the data on the effectiveness has time when johnetta didn't go down that actually went up in terms of the sedative netz o do turned it up over a longer time period so there's tremendous progress by scaling up these interventions. what we are able to do is increase our partnering to ensure efficacy increases, costs decrease and sustain a devotees increase. we've seen systems established and with the systems are

established, the costs show - dramatically but there's also been economies of scale. we transfer to the local partners and now cdc is providing most services to the local partner some industries of health and others. we have helped to expand the team care and it's a very important initiative and tool we can learn more from in this country as well. making sure every member of the team has used their fullest potential and will allow us to do better care for lower-cost and ensure we have people in the health care system working in ways to support communities. we are also seeing south africa and other countries take on a portion of the financial burden of treatment and that means to continue. this is a global shared

responsibility. the u.s. has done an enormous amount and continues to do an enormous amount and more going forward but other countries affected as well as other low middle-income countries and donor countries also need to do more. this when slide shows a model of the different scenarios and on the axis you see a member of infections from 100 years. the current model based on the best of visible modeling we have is about 2% everyone 100 this is nothing to increase. if we expand medical circumcision, that will fall.

if we don't do either it will increase. but if we look at expanding treatment and circumcision we can see reductions from 2.5 to 1.5 and if we treat the world levels we can see them going down all the way below to him. we think it is possible to drive down the incidence combination prevention. time will tell how effectively that can be done and what the impact will be but all of our best estimates today tell us an interesting evidence we have potential for significant progress. at cdc we are delighted to be part of the effort to make that.

at cdc we do a lot to develop the capacity locally and there are parallels between what we do globally for public health we provide technical guidance, technical assistance as well as direct funding. we have technical experts in more than 75 countries working on hiv and other issues. we have the ministries of health and local organizations and work in countries to build capacities and applied epidemiology is important to helping the country's looking at and act on their own information to the training programs i told you about earlier have populated as well as non-governmental organizations and countries in the world. we place them in the industries of health said the cancer that

systems, monitoring systems, implementation systems and ensure they can continue for years to come. we also use a large number of the post country nationals whose skills we rely on and were able to interact effectively with local organizations. we have copper that agreements with 63 ministries of health developed carefully over years of careful safeguards and technical assistance to gradually and steadily improve the capacity to detect and respond to hiv and other health threats. when you have helped establish the laboratory medicine to improve the accreditation of the reliable results or hospitals and others. we improved networks and improved security by helping to build institutions like cdc,

which can work as sentinels for health and as the leading edge to the response countries through the world are building programs like the cbc most recently in the yell has created its own cbc in the countries in africa are doing the same. security her nine sons we are all connected by the air we breathed, the water we drink and the food we eat and the risk anywhere is a risk everywhere to spread the drug resistance is something that takes days or weeks to spread from one to another. we are all looking forward to the international conference in july and i think it will be an exciting time. it is a welcome return to the u.s. and i know that many in the audience were card to reverse

the ban on. they were proud to plays a key role in the policy change, and we are delighted to welcome back the conference after a long pause. what a world of difference the two decades make. i trained as an internist and infectious disease position in the mid-80s. my training experience was feared by carrying for hundreds of people dying of aids when i could do virtually nothing. when i left in october of '96 it was just at the point when the combination antiretroviral treatment was coming into the wide spread. i had to for installing from aids and i figured i would never

see them again they are working full time today. so, the two decades makes an enormous difference. i think we can expect this of the international aids conference and we need to recognize that if it were not for the advocacy in hiv, we wouldn't be where we are today. not just on hiv but other diseases. the hiv advocacy community i think shows the way for people suffering from a wide variety of conditions to demand better treatment, to demand faster results and access to the latest information, and we celebrate the progress, we celebrate the ability to respond to the needs of a community with an entire partnership of commitment. we have the national hiv/aids

strategy in the u.s. and the rolling out of the strategy despite the enormous pressure the u.s. government is under and increase our spending on each budget year. we submit the commitment to the generation and we will be looking at the scale of the treatment and looking forward to the reauthorization of the program and focusing on the translation of the science, the policy and the policy to action. we will be looking at new technology and new ways to do circumcision that are simple and scalable. we will be looking at the pre-exposure and impact of treatment on the incidence. i think they are very exciting possibilities. we know that their works as

prevention between one individual and another. we are willing to focus on treatment as prevention on a population basis and document the impact of that and optimize it so we can do it as effectively as possible. we are also looking at the impact of hiv programs on the systems. moly has achieved its target, not only has it done that with a steadily declining cost but it's done at the same time we have been able to strengthen the systems and health care systems, public health care systems, delivery systems, community efforts to improve health and that's something to be celebrated and built on moving forward. combination prevention is something that would of been virtually unimaginable years ago no one entity can do this alone but i think working together we

can achieve a society in which infections are rare, progression from hiv to aids is rare and effective and accountable, helping people to live long and productive lives, and it's incident of hiv is falling rapidly. thank you for the works and you do to make that a reality. thank you. [applause] >> thank you very much. there was a powerful presentation. let's talk for a few minutes and then open up to the audience for their comments. let's talk a little bit about

budgets because obviously that is a great unknown at the moment and many of the difficult decisions are being postponed at the end of the year and into the next cycle, and the vision that's been laid out which is very powerful does imply that there will be in the ability to certainly sustain and scaled the sources moving forward. it also rests in decrease in the costs and many of the cost advantages have been captured in the last period and the modeling exercises that have gone forward have steered us towards redirecting towards the use of them. ..

>> no one wants to see a chevy assistance dollars used to supplant existing investments. secretary clinton is forthcoming on that issue. an increasing number of countries will increase their commitment. also more commitment from other countries and more responsiveness from the organization of 1/3 point* i am encouraged bipartisan bicameral administration and congress, minogue -- medical

community commitment to a chevy. we have to ensure we make optimally use of the funds entrusted to us. >> what we hear now talking to different interest on the hill with the budget year reality, part of the coalition, yes, there has to be more skin in the game. that they will return to be stronger.

also to explain the end game. maybe the exit. but a vision looking out that tells the narrative to the american people that is different from a few years ago in the emergency phase. with the narrative going for word. >> the models suggest within a few years we can bad -- fined the cost curve. there is a need for more deal let people die from aids?

the data is clear 90 then long-term. medium term. we need to see increased commitment the host countries and donor countries. it is important for other health interventions. laboratory strengthening, reducing disparities, establishing a work force, on the one hand keep accountability. use all of the precious

resources. more able to address a wide variety of health threats. >> coming after the 22 year gap which is a proposition. this says a renewed interest? lawyer politically charged debate this to ignite tensions and ray new think back historic 32 relationship quite a

turbulent the event. periods in which the u.s. government finds itself in a confrontational position. but to position this to say

what the opportunities are as we move through to connect in a different way as has been the case. >> there are responses and of to the epidemic fetter controversial. and will remain so. the u.s. has a lot to be proud of. pepfar is the largest ever undertaken and we have done more nationally. there is plenty of unfinished business. if we focus honestly honestly, objectively, to do whatever we can to save lives and stop the epidemic

of ihop m&a focus on the areas to do more. we did 380% the week spend 80% of the time arguing over the 20%. views that as a catalyst and there is widespread consensus. one generation of americans grows up to realize what a terrible scrooge -- secured a generation of gay men. buildout see their friends die. thing goodness. but we see if increase high

risk behavior across of wide friday of demographic groups. so we need to increase awareness. it is still a and incurable disease. we can hope to emphasize it is an emergency. and this is a bipartisan commitment to stop it. >>host: i want to invite our audience members to come up. we will take 30 or four at a time. we will do a couple of cycles.

>> i am from kristian connections. thank you very much. considering what we faced with combination prevention and potential of the tools to bring. the four components you mentioned were a rv rv, voluntary circumcision, and use of condoms consistently. whenever i heard the global aids coordinator talk about the importance of behavior change i presume various aspects of sexual behavior. is it a different perspective of priorities

between the two or why behavior change did not appear on your list of combination prevention? >> i am from partners and health. i did miss the beginning of your talk. i apologize we will not address mortality levels without building at better tv programs but could use the two that? we are incredibly disappointed in the illustration with tb fending. we would love to hear more about that.

>> with the aids institute, you mentioned in the united states you focus the money and the programs on the community's most impacted. think you. with the affordable care act in the news, how will that impact hiv prevention in the united states? >> one more question. >> i am from the partnership of supply chain management. they do for your clear and encouraging presentation. going back to cost of care we drive down the number of

commodities in particular drugs and rework closely in the laboratory area. it is harder to drive down cost of equipment and diagnostic test in the area. with the standardization of the overall cost. do you have any thoughts if you feel there is scope of the commodity -- commodities themselves and how they would said about driving those costs down? >> in terms of behavior change, this will remain in important part of the epidemic.

the delay has been documented as an epidemiologic role and programs would continue to reduce partners that has not been as well documented to be effective. but it would continue perk up we look at the addition of these combinations to make a huge and difference. tuberculosis is a major killer and challenge. i spent many years working on tuberculosis so i tried to keep my comments short. we need to ensure we never lose sight of basics. i did review yesterday country program where they

have run out of the first line drugs. that should never never happen. but that is the case in different parts of the world. keep the core program functioning. the patient is always the of the it. -- a vip. some are trying that but that have stood be infused if we will be effective. third, tb takes a long time to treat. it is curable but we don't know for certain with current technology we can do a lot.

we could drive down new infections but the number of cases that arise from those infected decades ago will continue for a longtime. but to continue a long time. infection control needs to be a much better job. and to account for a significant proportion of tb cases and those dues simple

ventilation month since. we have seen a lot of progress with tb. other programs have a lot to learn with accountability for all com of individual patience. we need to keep at it. affordable care act will bring health coverage to millions of americans who do not have it today. the results may be reduced pressure on some of this treatment programs but that is years from now. until then we have a challenge those who live with it have access to care. the affordable care act it will increase access to affordable health care it

will do that for hiv-positive but not eliminate the need for the prevention programs. we need to continue on the public health field. with the efficiency and laboratory networks, we look at it in this country. in the united states we see tremendous this goal pressure. compared to three years ago there are few days 50,000 fewer people working than there were three years ago. at cdc we try to identify shared services to drive costs down. we have seen from a variety of transport's, it is harder than it may -- that we wish

but to look at new technology. cdc sciences have a rapid blood test which remains a terrible threat. that cost $1 and is highly effective. it has the potential to drive cost of or down. >> that is it. let's take another round. >> i will follow-up and while it knowledge chain more could be done for existing programs and treatments, what is your perspective and new drugs or

vaccines? >> will d.c. hiv, infection at the aids conference if there is the high:faction rate? >> >> my question was about the domestic response. saying that the dollars would be prioritized a run to committee with viral load. maybe you can tell me more? >>

>> thank you for your presentation. paying attention to cost effectiveness but with the eye to aids 2012 to realize we talk to ourselves people who are well versed and realize the great opportunity we have the american public that it will be exposed to potentially to what we hope could be reaffirming new ideas.

sometimes we forget to make the next jump to value. difficult in budgetary times how increased funding, what is the incremental cost effectiveness and reducing the transmission against the value from a 1180 hip aids? those are different arguments and justifications for budgetary improvements. along those lines when they came back from overseas i found there is a range of people they thought you

could not do anything about it. it is you tile. if it was domestic epidemic thinking there is not a problem. money going to foreign assistance are being spent here at home. but a lot of you create solutions and that can come from that space. when i came to work in d.c. we could scale up coverage to reduce mortality from the system approaches from pepfar and abroad. >> we are uniquely paced to tell

the stories but also with jurisdiction no health departments and what is the value added stories that are compelling and the difference between the difference are creating motivation for the aids free generation? >> one more question. >> i am from nih. acquistion is -- the question is whenever read talk about those who provides services, the increasing quality, quantity , intervent ion.

you mentioned cdc cannot do it alone. how do they plan to work with other agencies to have prevention and treatment to people in a sustainable way? >> first, tuberculosis, we have seen significant progress on diagnostics laboratory developments. we know how to define the role of those diagnostics. we have a rapid test 14 experts tb resistance. that could be done to rapid the rule ought to 14 to reduce spread.

i know that is the best place but one thing to figure out. i am excited about l.e.t. fluorescence. india my biggest piece of unfinished business i was so frustrated was not regular electrical supply. in many countries, one-third of health centers have no or little electrical supply and another third is poor electrical supply. batteries may not last long, solar not reliable but alley d is a great technology and fluorescent increases the throughput. i don't know if this is

highly effective or scalable. figure out. we have new technology is. i said it would be a decade with the length of the treatment. i know if it will be another decade but to it is important to we develop with a wider benefits. the tb vaccine is undoubtedly the nobel prize. we have made progress but we are a long way from where we