as an example. family farms in south dakota according to the department of the agriculture the average size of a farm in my state is 1374 acres. according to the usda the average value per acre of cropland in south dakota is $1,800. this means the average value of a farm in my state nearly $2.5 billion. if you calfs a death tax lhave t exempts $1 million imagine what that will do to south dakota. we are seeing values rise across america's farmland from nebraska to montana. let's be clear. this bill would subject many more families to a punitive tax, the death tax when a loved one passes away. it will make it much more

difficult to pass family farms and businesses from one generation to the next. most family farms are land rich and cash poor. land values and that sort of thing. what you don't want to see happen is to see a family farm passed on to the next generation have to be liquidated to pay the irs because of a punitive death tax which is essentially what this policy as proposed by the democrats' plan would do. usda estimates 84% of farm assets are comprised of farm real-estate. that is where most farm and ranch families have their assets and family farmers don't have extra cash on hand to pay the death tax. instead use of land or take on additional debt in order to pay these higher taxes. that is exactly what we don't want to see happen in this country. i don't believe the president's proposal which is the $3.5 million exemption is adequate but it is much better

than what's democrat -- senate democrats have proposed. let me summarize. tomorrow we will vote on a proposal to raise taxes when americans are hurting and the economy is fragile. this proposal will impose higher taxes of $50 billion on successful small business owners and families. it will hurt the economy reducing economic growth and job creation at the same time it lowers wages for hard working american families. it will impose a new debt tax including $31 billion on 43,100 family -- and also vote i hope on the alternative plan to keep tax rates where they are to prevent a tax increase on any american. in addition to keeping tax rates where they are the proposal provides instructions to finance committee to report fundamental

tax reform legislation at 12 months from the date enacted of the bill. , connell approach is the correct approach. prevent a tax increase now and move the fundamental tax reform next year. for lip course of current tax law is only a short-term fix. we really need comprehensive tax reform like the tax reform act of 1986. this will drive economic growth higher, lead to robust job creation and result in more revenue to the federal government. more tax reform will require presidential leadership that is unfortunate has been whacking over the past 3.5 years. maybe the next president will be willing to commit to tax reform. of president not content with simply releasing a 23 page framework for corporate tax reform but until we get a comprehensive tax reform the least we can do is a short that americans are not facing massive

new tax hikes during a weak economy. and get the vote tomorrow. i hope the senate democrats will find their way to give up the boat and extending tax rates for all americans so small businesses don't get a big tax increase next year and the economy doesn't get plunged into a recession and we don't see the unemployment rate ticked even higher. those are the outcomes, those of the types of things that will happen according to wall the analysis of the tax proposal before us today. there's always this idea that if we raise more taxes we will pay down more of the dead. that is not my experience around here. when there's money around washington d.c. it gets sucked up and spent. a lot of americans would welcome the idea of seeing their taxes going to pay down the debt but you will see a massive tax increase on americans that is

going to be used for washington d.c. and that is not what the american people want or what we in the united states senate should be for. i yield the floor. >> this weekend on american history tv. >> begin to open the discussion by asking this way. what is the nature of the clash between macarthur and truman? at a clash over policy? a problem of personality? >> from lectures in history, truman and macarthur. elliott:on the president to relieve the general at the height of the korean war. advice stevenson had a bad case of hereditary policy. grover cleveland and his

great-grandfather was first to suggest abraham lincoln as president and ran twice against eisenhower. contended that 7:30 eastern and pacific. american history tv on c-span2. >> the international aids conference held in washington this week. a travel ban on people with hiv was lifted in 2010 and the conference held in the u.s. for the first time. this part of the conference begins with an aids researcher working in kenya. he was introduced by former senator bill frist. this is 50 minutes. >> dr. mugo is a research scientist and obstetrician gynecologist at kenyata national referral hospital. she has worked on two hiv

prevention clinical trials. as a regional director for the partners in prevention h s the hiv transmission study and investigator for the partner press study sponsored through the international clinical research center, department of global health and university of washington. she is currently the head of research in kenyata national hospital. join me in welcoming dr. nelly mugo. [applause] >> good morning, everybody. i would like to thank the organizers for giving me this

opportunity to talk to you and realize the hiv prevention revolution. we have heard a lot about where we are in this conference and it remained the global health challenge. thirteen million people have died since 1980. the current population of kenya is fourteen million. not a small number of people. the current estimate is we have four million people living with hiv aids and in that year 2.7 million newly infected with 1.8 million dead. close to the population of swaziland. the most common cause of death in africa and the sixth most common globally. 30 years into the hiv epidemic, we have intervention like intervention of new infections. for the very first time we can

begin to visualize a future free from hiv aids. what we need to change to delivered the hiv prevention service, we need to start thinking about the populations most at risk for targeted intervention. then we need to prioritize the interventions that work. within those populations. of and in combination with high coverage for us to get high impact. so the population -- i looked at data on where new infections coming from particularly generalized epidemic in sub-saharan africa. and data from my own home country in kenya per couples contribute 44% of new

infections. this is true of other countries in the region like swaziland where they contribute the majority of the infections. for a long time we didn't think about as marginalized populations and drug users in our country but in kenya from data analysis, a small proportion of injection drug users contribute a quarter of new infections. in addition we know that condition drug users, anyone event. and 20% in this population. and they are key at highest risk of infection and we know that these policies across many data sectors we have learned 50% of

partners of hiv infected individuals are hiv negative and when couples do not know that it is up 14% reactions of testing, it will be difficult to know who is at risk and who needs to be targeted for intervention. from our own studies we have learned couple's desire for children overshadow fear of infection and it is a risk driver that we need to think about. thinking about this marginalized population, may require prioritization by intervention. hiv populations, data from the project in kenya where 40% of men who are affected are hiv infected and 80% of the six

workers and the worker prevalence from the ages when they have these people in the cohorts' only 20% know how to correctly use a condom. many presentations in this forum looking at the issues of social and political environments for these populations that are keeping them reluctant to seek health services. there are legal issues in kenya. it can lead to a 14 year sentence. i know from our media that many countries have high percentages of men affected men and experience condemnation of the personal religious intolerance and sexual abuse. we cannot have an hiv revolution -- data shows 42% of infections

come age 15 to 24. eighty% form this infection in sub-saharan africa. as we target this population think about what a remarkable difference it could make in a couple years in a number of new infections. in addition is the young woman who has twice the hiv infection rate as young men. and looked at data from the service from 2007 where we find that 65% of infections among women before the age of 35. it is most true in eastern african countries so thinking about populations we need to prioritize to be specific to the priority population and think about their vulnerability is and deliver them to a comprehensive

package specifically designed for the population. the prioritizing intervention that work in 2011, we were vigilant because they provided very clear and people coedited the anti-viral treatment of this work for the prevention of sexual transmission of hiv. in 2012, the question is how to deliver. many of us are familiar with the data of delays of therapy. among the transmission only one word in the arm where they had that and this one section very soon after it was initiated.

cohorts had 86% reduction in hiv transmission. of interest, 25% assumed did not happen between the partnership and that is something to keep in mind when they think of treatment of prevention. this will only work when true of many things. viral suppression reflected intense strategies including an individual country so near-perfect idea. as we move into treatment and prevention we have to reflect how we can continue to achieve this level -- so go to the exposure. we have three trials resulting in different population groups. many were conducted against

across three continents with 2500 young men -- demonstrates protection of 44%. gee b.s. 2 was in heterosexual men and women in botswana, demonstrates a protective effect of 62%. a study of involved rates among heterosexual in uganda to demonstrate the effects of 25%. all of this is currently published. and the therapy works when taken and when we look at this, a lot of blood samples detected -- 81% detected for drugs with 35%.

a clear response between the evidence of abuse and if you go down you see that a study of young women only 36% of them had demonstrated will drugs and the study was not affected and did not demonstrate any affected method. so what motivates use? perception is key and it is another reminder of that interventions cannot be biomedical. we must in fact the epidemic. couples with known hiv-infected partner have chosen to stay together and this helps motivate ideas. found that 70% of the women did not perceive themselves at risk for hiv. yet hiv incidents in that

population. perception is key for any strategy to be effective as we move into the population and find how to make people understand their risk if they are going to take up the interventions we offer to them. keep in mind we don't envision this to be a lifelong intervention. it is something we perceive can be taken -- very often in a lien period of time. when you look at data from adolescent women, they see the vulnerability and prevalent in the age of 16 to 24. from our own data the highest risk of couples wanting to conceive. young men who affected men equally vulnerable.

en violence, when people have a new car near, wind depression and alcohol use and perhaps we can think about a lot of abuse going on.

used for negative individuals. in africa passage can do a lot more than what we know. just a reminder we have many tools for hiv prevention. from 2007 reconfirm that it was very effective, date and not cause much. behavior intervention and more recently talked about prep. and treatment of prevention. we have a large tube to select from and we need to use it in combination. and the condition, it was very refreshing to get these results

for extended follow up. and to see the result in kenya travel sites without any evidence of this protestation. finally have additional tools for package of intervention. we need to revisit and revise how to prioritize and focus resources of what is impact will. and get rid of policies that do not work. what we need to do is to target relative packages. delivering in combination the

coverage facilities of affected intervention combinations. interventions that reduce treatment of prevention, flexibility for the condition and pre exposure and at that level, this will need to be delivered coverage for high impact. i borrowed this slide and a good job to look at the fact that hiv prevention is an effort. police and media, coming to health care services so we cannot work alone to make this difference. testing is to prevention and

accessibility of hiv testing is high in testing. however it is important that testing is linked to service and we don't just a crew numbers of people tested. this will require effective linkage to services. we recognize delivery of prevention intervention will not be without challenges. we have seen the treatment from the u.s. and an analysis of sub-saharan data and 100% of people tested. we lose 72%. forty% -- only 25% of those eligible. to achieve treatment of prevention and impact and protesting the coverage.

and we can achieve suppression for infectious and this. and at the community level. the willingness to start a meeting -- hiv-infected people do not want to feel like they are compelled to take treatment to prevent transmission. the data from south africa in an environment where 35% of the population was hiv infected and 20% declared treatment and the most common reason was they felt well and did not see reason for treatment. we do not have a lot of experience for with people who are not symptomatic. we talked to hiv-positive members -- 42% of men and 31% of

hiv-infected men said it was solely for the purpose of lowering the chance but of their concerns including fear of stigma and being a burden and developing resistance. all is not lost. the demonstration of the improving testing and linkages. this result is from a province where patient empowerment and attention to care for groups that support patients where they supported clinical visits and had high retention of 97%. they only had two people to follow up. that was remarkable. what the community can do when they involved. other ways of improving testing

shown by having a home based testing whether it is high coverage or uptick. before counts reducing the visits and costs into the clinic and community delivery and this was demonstrated. thinking about prevention and stress for hiv prevention we find there are similar challenges and opportunities. both require people to ask about risk-taking and the balance -- sufficient to undermine the prevention benefit. from our own clinical trial we did not observe risk of this and the second condition does not show this. questions about resistance.

we know people in treatment will develop resistance and some of this has been trading in africa. it hasn't been taken to the community from clinical trial data. resistance was observed only among those who were prepped doing infection and we need to weigh this against the number of infections that were. who is likely to use this intervention? we know it needs to be lifelong. but you only need to use for it during that season of vulnerability. so it shouldn't be a lifelong intervention. discussions have been discussed by people in this conference to have had the support of funding to make this intervention work. now that we have only recently

gotten the data they have proposed demonstration projects and we see this as couples who are commencing this with -- we know those people who were eligible would be offered for six months before full suppression and hiv infected individuals would be declared prepped would be offered to the negative and those not yet eligible for would be offered to the hiv negative platform. look again at the implementation of prevention which shows differences and the difference was 80% of target populations and 41% in kenya and 0.1% in other countries.

this intervention. there are lessons learned. i got the from my colleague and friend that prevention plans must be community owned at all levels from government to local communities. become full of boulders and the composition a lot of public education and social me and population impact a need to target the position with targeted -- there is lowest rate of conditions and high if prevalence that needs to be flexible entry and monetary value so problems are caught early and interventions are built in and there is a need to start and simply just do it. reassured by results from prevention of transmission, from the mayor of this