germany, i haven't spent a lot of time digging about what it would have been like to be a correspondent there in the 20s and 30s and how would you have operated? what would you have noticed or not noticed, much less how would you have acted? >> we are showing you some of the 19th international aids conference held in washington and talking with david brown of the "washington post" who cover the conference. while this is significant about

the event being held in washington? >> well, it was the first time it had been held in the united states in 22 years, which is a very long time, particularly in the narrative and history of the hiv epidemic. almost everything has changed from our understanding of the disease to his therapeutics and the prognosis of people with the infection. it had been essentially banned from the united states because of the restriction on hiv-infected people from entering the country, which was part of what wasn't immigration regulation in the international 80s society, which runs the conference had decided that this was a form of stigmatizing exclusion, that they did not agree with and that until the united states changed it, there

would not be any conferences held in the united states of these international aids conferences. and it was lifted by president obama very early in his term. >> host: you wrote the subject of money as i was a big topic at these aids conferences, particularly this one. why is that? can you tell us how much the u.s. contributes each year to the fight against aids worldwide. >> guest: the u.s. contributes about expelling in dollars to the overseas a for. in the year 2000 i believe are the government's total global health spending was about 1 billion. so he gives you some idea of the enormous growth over time. much of it coming through the presidents emergency plan for aids relief, which president bush, george w. bush started,

announced to everyone's surprise in the state of the union address in 2003. that has gone up under obama and his flattened out the last couple of years, but is still an enormous amount paying for drugs, paying for clinics, paying for labor, paying for the whole, you know, sort of transportation and infrastructure it takes to put millions of people on this lifesaving -- that's exciting therapy. >> host: was very senseless on the latest in test approaches to prevention and treatment? >> guest: well, i wouldn't say there was a consensus, but there is more stuff to do. there's more options now than there has been ever before. once our so-called treatment is

prevention. this means that if io -- if someone is infected and you treat them even very early or perhaps especially very early in their infection, the amount of virus they have in the bloodstream goes almost to zero and they become essentially noninfectious. in other words, they cannot transmit the virus onto anyone else. it occasionally happens, but it's rare. so the idea is that everyone, as soon as they are diagnosed, you put them on the drugs, then the chance of them passed it onto someone else is hugely reduced, so that is one strategy. the other strategy is like circumcision and even taking prophylactic drugs, people that

don't have the virus, but are at high risk of acquiring it. they can take drugs to lower their risk usually. >> host: former president bill clinton, one of the major speakers, how has his foundation been so successful in driving down the price of aids drugs worldwide? >> guest: well, his foundation, which has really had a huge effect on the international response basically has helped rationalize the market for generic antiretrovirals. it is basically gotten the makers and consumers of these drugs together and said okay, if we can assure you that there will be this demand, you know, a demand for x million doses of this particular drug, how

cheaply can you make it? and is there some way we can guarantee that it will be delivered in time, hat it's not going to run out on shelves, that is it's going to be hauled up in customs, on and on, just make this system seamless and efficient. and once the makers, the generic producers know what their market is going to be, they can ramp up and produce huge quantities at a much lower price and is basically getting the price right. >> host: what is your sense after this conference? what is left to be done in the fight against aids? >> guest: well, quite a bit. there is still room for the prices of the drugs to come down. in the united states there are some very important drugs about to go off patent, which will

save some money here up to a billion dollars potentially a year, particularly doctors and patients are willing to make small adjustments to their drug regimens. the whole issue of getting people on drugs early. you can't outscores force anyone, that perhaps you can nick it easier for people to start therapy early if they are interested. there is a huge amount of room to make that happen more efficiently. and then there's things like option b., which is kind of a brand name for putting all pregnant women who are infected, putting them on anti-retroviral drugs, just keeping them on the drugs. in the past put them on during their pregnancy and reading and

if they don't have a clinical indication then stop the drug until their own disease progresses. now the idea is to forget all the stopping and starting. get them on the drugs and preserve their life for as long as possible. postcode david brown but these colleagues been assigned on the 19th international conference. read reporting a "washington post".com. ask for joining us. >> guest: my pleasure. >> closing session with remarks from former president bill clinton. he talked about the work of the clinton foundation funding aids research and health care for low-income aids patients. this is 35 minutes. [cheers and applause]

>> thank you area match. [cheers and applause] thank you area match. thank you for the introduction. i would like to thank the u.s. chair at age 2013. thank you for your leadership as president of the international aids society and the share here. we wish you and your successor while. i thought she gave a heckuva speech by the way. [cheers and applause] i want to talk a little bit about where we go from here. how do we actually propose to implement these goals that have been set for 2015?

that we believe there could be an aids free generation, even if you do find the narrowest possible terms, how can we achieve that? when the aids conference first took place in america 22 years ago, a passionate group of activists, community leaders and researchers, shouting silence equals data made the world less than, we then have the first arv, the failed cancer drug was treating a grand total of 5000 people all in europe and the united states and prohibitively high cost. that is a long way from where we are today with 8 million people in treatment around the world and the ability to treat all the rest who need it. [cheers and applause]

back then, aids was the death sentence than those of us old enough to have been fully grown man still have lots of painful memories of our friends who did not survive. then we couldn't really imagine an end to the up its imac. now all of you have created the possibility that we could have an aids free generation. as bill gates said, we still have a good ways to go, but we have come a long way. everything i say today comes from the perspective of the work my foundation has done in the last 10 years before the global fund was sunday, before there was any floor, our job was to go around and raise money, country by country, to figure out how to cut cost and to provide a

working delivery system that would save lives. now the gains made here by people throughout the world to achieve universal access, and eliminate mother to child transmission cut no infections in half by 2015. we can do that, but it won't be easy. just last week on my annual trip to africa to look at our programs, i visited wauconda, mozambique and south africa and i saw an amazing progress. i saw bitters to offer treatment to anyone in need. i saw a willingness to completely eliminate mother to child transmission in a met with program managers who don't know where the money will come from an archer would have the systems to do that.

to achieve universal access by 2015, will have to increase the number of new people in treatment by 30% a year. for example, in 2005, there were only 10,000 children on treatment in low-income countries. thanks to many of you in this room and a special thanks, the global effort to accelerate to pediatric treatment means there's 500,000 kids on treatment today. [applause] bid to reach the goal, we'll have to have 1.5 million more. to eliminate mother to child transmission, we need to test and treat women earlier and keep them on the treatment longer throughout the entire period of rest beating. when many of them lived miles and miles and miles from the

place where they get their menacing today, to cut new investments and have, will have to heed years of to implement combination prevention programs. [applause] now we can save a lot of lives if all this is done, but we're going to have to do it together to do what works, to spend the money we do have with maximum impact and to raise but will still need. it is worth remembering an adult internet has been made of this, that the dollars now being invested annually in this effort for the first time, more than half of that comes from the affected country themselves. and they deserve an enormous.

[cheers and [applause] one of the reason universal access is we can do it for less money than we previously thought. i foundation recently released one of the studies they redid his five african governments across more than 160 treatment facilities. in ethiopia, lally, rwanda and south africa, i think the leaders of these countries and all the health care personnel were taken the epidemic seriously and for the a party made in scaling up the programs. the study was the largest of its kind with the exception of south africa were lab costs are higher, treatment causes average of just $200 per patient per year that includes the cost of drugs, diagnostic tests,

personnel and outpatient costs. there is no excuse for failing to provide treatment to the remaining 10 million in need. [cheers and applause] even in south africa, there are real opportunities with the commitments the government authority made. our foundation recently read to the drug tender for them in leicester in this era in just two years they saved $700 million on what they were drugs and immediately added 340,000 people to the treatment road. [applause] more savings on the way. these prices dropped 70% since 2008. 30% since last year. $125 now and it's a good job.

the savings of that joke of a by 2015 will be $500 million. we can use the money in this fight. now i have to be fully candid at meeting the goals of treatment by 2015 will require some activities, especially community programs. you've got to that community outreach if you want to get mother to child transmission down to zero. you just have to do it. you can't do it without it. [applause] but clearly, just whatever he said to convince you that we can't meet the treatment goals. and we should. we also know that smart investments save money. the united states center for disease control presented an economic model this week suggesting that implementing a

test for key populations like pregnant women and people with tb and accelerating the skill for others would not only save lives and the burden infections, it will actually lower costs within just five years. where will we find the money? we all know the last december the global fund had to postpone the funding round because it was short on cash. but the fund is now back in business because the gates foundation in japan and saudi arabia stepped up on the heels of president obama for failing america's three-year commitment. secretary clinton recently announced here more money for the u.s. to meet the 2015 goals. and i'm hopeful -- [cheers and applause] that other donors will do the same, especially a country is growing fast like china and brazil. and don't forget a, as elton

john's presence here and bill gates presents here, there's enormous amount of profit money being raised and spent and there will be more from the gates foundation, alpine john, aids life in vienna, blockade, many others. and governments, even in the stiff of time i believe would do more. the united kingdom has followed a strict austerity program without development assistance, an astonishing fact. [applause] our foundation works with them, the irish, norwegians, swedes, government about strata, all of whom are giving and giving, even

in this difficult time. and finally, we need to make something good out of what is otherwise not a particularly wholesome government, the inequality of halt the countries commit and got a lot of wealthy people want to give more and would give it to this cause if they knew what enormous impact their dollars can have. do not minimize the possibility that we will have more private giving us we make more progress and demonstrate. [applause] i also think we can learn a great deal for immunity, which has led the way in creating a new revenue stream that has saved hundreds of thousands of life in linux variants and what it's done in putting children's aarp and second line aarp's out there at more affordable prices, leveraging short-term investments for long-term gain.

we need more innovative finances. the international finance facility for immunization may offer a good model for us. it raises money by issuing bonds in the capital markets, which are backed by long-term commitments from donors so donors can buy now, but pay later. increasing aid flows over a five to seven year period have been paying them back over a 20 year period. as we all know now, that's low interest. applying this model to raise funds to implement accelerated treatment combination prevention would mean that infections will cause the lower when the time comes to pay the money back. if we all keep producing results, i believe the money will be there. and i am committed to doing whatever i can to see it.

we do have to prove over and over again that were making most of the money. we have the lower treatment costs at the facility level for what it una said in two through the $7000 a person a year to about $200 today. beyond that, further cost productions are coming. looking ahead, there's some other things i think we should do. first, we can target the money we are spending more effectively. especially in prevention. u.n. aids were so reported were 30% of new infections were driven by high-risk population, less than 1% of the prevention dollars were spent to reach those people most of these services. we can do better than not.

[applause] last year, una published and investment framework providing guidance on how to prioritize national strategies. to focus on interventions that have greatest impact. it's an excellent tool that i'd like to see more countries develop. secondly, this may be somewhat controversial, but i feel strongly about it. we need or new level of openness about how every last dollar is spent by countries, by donors, by ngos. [applause] you can expect program managers all over the world to make the smartest decision if they're trapped in a financial black box. all donors, all nations, all

ngos, i believe, should make our spending records open and available, not so somebody can be embarrassed, so we can see who is doing better and the rest of us can copy it. we have to work together. if we do this, you know as well as i do, we can have a much bigger impact with the dollars we have. thirdly, i think we need investments based on evidence, not the politics and vested interest that too often drive spending decisions. [applause] to meet these goals, we have to encourage not only do things we need to do, but shut down programs that are working and to channel more money towards the populations that are driven the epidemic and the evidence-based interventions that are working. [applause] and finally, we've got to make

sure that we are paying for services that directly help the people involved. when businesses start operations and new countries, they often send in their people. they hoped it to work off the ground. but then management is transferred. i think we've reached a point in the ejb respond where we have to do more of that, to transfer to national government into local ngos. [applause] i don't want to imply that i think spending on international organizations can go to zero. -- it's not true. many countries still need support to grow and sustain their progress and build the infrastructure necessary to run their own health programs affect early. but international technical assistance can be very expensive. some organizations take up to

$600 a day for the cost of a day of consulting, we can put three people on treatment for a year. [applause] that is -- every time we make the former rather than the latter a choice, we have got to know what were doing and be prepared to defend it in the light of day. otherwise, we should go for the life-saving. let me say that i think channeling more money to capable governments is catching on because that will save money and because it will build capacity and produce sustainable results in the countries that need them. paccar has recently announced its intention to transition greater ownership over its funds to national government. i am very grateful for that. just last week, when i was sent

rwanda, the national government, announcing a new effort to dramatically reduce overhead in the entire health care workforce of the country. i applaud these efforts and i think more of this can, should and must be done around the world. now, having said that, we all know that money is not the only impediment to meeting our goals. two years ago in vienna we heard about the promise of combination prevention. we heard about the evidence. we heard about the impact of male circumcision and accelerated action in that area. we are to a promising ways to hear about the effectiveness, including point of care technology, something our foundation has been involved in.

we didn't know how to implement these programs of scale, but at least i do, and most of you live to vienna willing to act, eager to act a newly energized. two years worth of progress, though none of these proposals have been taken to scale. many hard questions remain and we could spend a lot of time talking about the hard questions. how do you find people earlier before they feel safe? had the richer people get the information to make their own decisions? how can we improve retention and care? wet treat men's ice prevention prevention -- what treatments are best if we do even more circumcision, what it really leaves people to give up less costly improvements have prevention?

all these questions are important. but should any of them be a bar to doing what we know we have to do? i would say no. i remember well back in 2003 when chen camp launched the three by five initiatives. there were lots of serious questions about whether we could meet the goals of increased treatment. there were people who we've been said, since you can't treat everybody who needs it, decide who gets it and who doesn't and wouldn't we be better off if it's so much cheaper, just doing universal coverage? but guess what, we responded to the challenge and now there's people on treatment. that's the way we have to respond to these challenges. [applause] ..

we should all be grateful to hurt. because -- [applause]

because now everyone of you can say how can the rest of us weight? [applause] you may think this is i use, but i have seen it happen over and over again. this is one of those if you build it there was tom. you still live up and worse the money will be there to fund it. [applause] we also talked a lot about improving treatment that works, identifying patients earlier, reaching them where they live, treating diseases that really killed people like tb and meningitis. today we know about the best practices from groups like partners in health, mothers to mothers, and msf. we know about the importance of

decentralizing services, empower and community members. we know that if we provide testing at the point of care weekend get lost a follow-up in hand. we know that if muslims play a larger role, including initiating treatments -- [applause] more people in an environment where they feel better understood and cared for. so when we still love we will stop the just paying lip service to community engagement and we will have to start to engaging and relying on community. these are things that i believe. i think the money will be there if we prove we are responsible with the money we've got, and if we prove that these approaches work.

you will know near -- no where near tap the people who will invest in these two dozen 13 goals and create an aids-free generation. keep pushing the rocks up the hill. speaking of rocks up the hill, our nation's capital where the prevalence among some groups is as high as it is in countries in southern africa. i like to say a couple of words about that. 1 million people in america living with hiv. barely a quarter of them are getting out among care. infection rates are rising among young gay man, and exploding among young black demand. latinos, native americans and asian-americans, and pacific islanders, use of them, many of them feel that because of the

overall progress made in the fight against aids there going to be left data behind. in this city government and community leaders have been reinvigorated community viral testing and strategies. they're making a difference. since 2007 there have been a threefold increase in the number of people being tested every year, a tenfold increase in the number of people -- condoms being distributed every year, 300 clean needles provided every year and 90 percent of the people who test hiv-positive in washington d.c. see a doctor within three days. [applause] president obama's administration was the first to develop a

comprehensive strategy for the domestic epidemic. the affordable care act which, thank god, the supreme court upheld will provide public facilities -- [applause] the funding that he and secretary sibila is committed this week to close the list is very important, and i want to emphasize something else. in the context of the united states, you all know that when i to policy work around the world, when our foundation does, we used generic drugs. they have made a huge difference . and money can now be used to buy those trucks first because of the people agreed that they should and second because i made an agreement with president bush

when he was an office that i would submit all of the madison anywhere in the world to the fda. he said if the fda approved them as effective and appropriate that in the local country could use their money to buy that medicine. [applause] and he kept his word. and that was the beginning of this. i am very, very grateful for that. but that means were these drugs are not available we have to do something for people without insurance account for the drugs. [applause] our foundation is partnered with major pharmaceutical companies to make access to affordable hiv medication available faster, and

a simpler way on a longer-term basis for people who don't qualify but cannot afford the drugs. here is the idea. a one-stop shop for uninsured patients to access all the patient assistance programs available. the program will simplify the paper work and cut through red tape, and i want to think we pharmaceuticals and merck, already stepping up to support harvard path with steeply discounted medicines, and i hope all other manufacturers with hiv medications will soon follow suit. [applause] one more word but the united states. besides deasy, the best -- the next three is a problem we have.

i'm sad to say since it's my own region they're still too much stigma. stigma against people who are drug users. where this is not treated enough as a public-health problem. and that plus the poverty, plus the disproportionately high percentage of people in our country in the south who live in rural areas and therefore have some of the same exact access problems that people in africa and southeast asia and other places have -- [applause] -- has created a big problem for ross. i just wanted to say two things. it is embarrassing to me to think that stigma against people with hiv exists anywhere in america. it is still a problem in other places around the world, but look at the numbers.

just this week. it is true that 56 percent of the people here need medicine now to stay alive are getting. but look at the numbers in the area where there is more stigma. central and eastern europe. weigh less than that. in the middle east and north africa. in my even 25 percent in the letter and barely one-third of the former. all of us cannot be blinded by the fact that no matter how much we come together and see the evidence that we still have to five stigma wherever we find it and support our friends and neighbors who are doing that. we also have to deal with the fact that not everybody treats these problems the washington d.c. and a lot of other nations to as a public health issue they

had a documenting -- they had an article document in the death rate from aids that has come as a direct consequence of the refusal to see drug-related infection as a public-health problem as opposed to a criminal justice problem. we have to deal with it. [applause] for me to thinking about where we were in 2002, nelson mandela and the conference in barcelona and we were literally rattling attend up for money. by the way, i was with him on his 904th birthday. i told him i was coming here. he said, i am retired.

tell them i wish them well. [applause] i think he should be excited about this. and now you're read about the money. you should be excited about this moment because you have committed to work through the financial crisis, go beyond incrementalism, embrace profoundly ambitious goals for 2015. i have been actually to work thanks to the aids life group in austria with a couple of african countries to figure out how you actually would take that child transmission to zero. because its way more than just getting the medicine out there. it is exciting, and we will do well as long as we refused so let what we don't have slows

down. we have to use what we do have to get the programs off the ground and answer the questions as we go along. we have stronger leaders in every sector and i can remember. the research community still laboring away toward the dreams of the vaccine and a cure. more and more people to the private sector. billionaire business acumen to the financial questions. civil society pushing us all to do the right thing. communities in america from an a costa and oakland to none by and sao paulo, st. petersburg and kiev taking responsibility for their children and their future. they have not gotten enough

credit, the developing world and the middle income countries, for sending even more money than the donor countries and the individuals. they are worth our supporting if they are coming out. [applause] we have also got a lot of policymakers do seem committed to keep working on this if necessary until everybody in this room is as old and gray as i already am. [applause] [laughter] if that is what it takes. this is serious. i have been doing this a long time. all this has really happened because of you and the people who sat in these chairs at every previous aids conference going back to the beginning. millions of people in an

aids-free generation still depend upon york daily tenacity and courage. no, we don't have all the money are answers that we need, we have you kept bank for the progress that has been made and you to make us believe that we can achieve an aids-free generation. all over the world in places where we work, we have millions of people nourishing their dreams and their children's dreams instead of giving up. that is worth a lot. you have to deliver for them. thank you. good luck, and god bless you all. [applause] >> thank you. [applause]

[applause] >> in this aids conference session former first lady laura bush talks about her work on aids initiatives worldwide, especially in africa. this is 20 minutes. [applause] >> now it is my pleasure to introduce our next speaker, mrs. laura bush. now the laura bush hardly needs an introduction, but she definitely deserves one. as the first lady of the united states from 2001-2009, she was universally admired for her approachable style and straight forward and gracious in that role. she was then and continues to be actively involved in issues of national and global concern with

a particular emphasis on education, health care, and human rights. during her eight years as first lady of the united states of america, mrs. bush travel to all 50 states and more than 75 countries in support of president bush life-saving global health initiative including the president's malaria initiative, mrs. bush visited africa, asia, and the americas to help raise global awareness of malaria and hiv/aids. now as the chair of the women's initiative at the george w. bush institute mrs. bush continues our work on a global health care innovation education support -- performance supporting women and men who serve in the military. the u.s. government, the susan

g. common for the cure announced an $85 million pink ribbon red ribbon initiative, a partnership to leverage platforms and resources to combat cervical and breast cancer in developing nations. the honor of having mrs. bush as a keynote speaker in our annual conference a couple of years ago introduced by her twin daughters , barbara and jinnah, also a great female leaders who gave the most touching interactions i have ever heard. they painted a fuller picture of their mother and remind all of us of the multiple roles women balance every day in ways that are truly remarkable. and so, as they did to my want to present to you a female leader of great depth and accomplishment, as i have noted, but a woman who is also a wife, mother, and a friend to all of us in this room who fight for equality and dignity for women

all over the world. [applause] mrs. laura bush. [applause] >> thank you all. thank you so much. thank you very much. >> ice everyone here. very happy to be with you today at this conference. proud that you are meeting in our capital city and hopi have enjoyed your time in washington and i'm especially glad to be with you to mark the progress that has been made and look forward to an even greater response to hiv aids. thank you. you are the perfect moderator for a session on leadership in the age response to women. thank you for your leadership and care and thank you for the life-saving work. we just heard from a leader i

honor very much. her courage and persistence is an example to women and men worldwide. when i thought about what i wanted to say about women in today's session i thought of the many women, some of whom i know and some of whom i'll never know who came before us and to lead us in our response to a pandemic disease. i thought of my own mother in law, barbara bush. my father-in-law was president during those early days. people thought you could catch aids from touching somebody. barbara bush cradled hiv-positive babies and hired people with aids. she met with families who lost loved ones to aids, and she visited the aids memorial that was on the mall then like it is now. her great example challenge to

all americans to confront hiv/aids with care and compassion rather than feared and judgment. when you look around the world he see that women are in the forefront of life changing progress. in afghanistan under the taliban and women ran underground literacy centers, risking their own lives to teach women and girls to read. in burma, despite years of oppression women remain steadfast in their dissent, inspiring the world with their grace and courage in the face of brutality -- brutality. women have been central in the fight against aids, a disease that one newspaper compared to the black death of the middle ages, global pass. ten years ago hiv/aids rage out of control. worldwide more than 22 million

men, women and children have died from aids and 15,000 people were infected every day. in 2002 experts estimated that the aids pandemic could double in the next five years to 80 million people infected with the virus. health professionals and leaders around the world knew that dramatic action was necessary to address this crisis. in june 2002 my husband, president bush, spoke to a crowd and the rose garden. he said, the global devastation of hiv/aids staggers the imagination and shocks. that day he announced a 500 laid-off initiative. anti retro viral drugs.

six months later and in 2003 that to mean in a dress, president bush announced the president resisted plan for aids relief. the largest internet -- international house directive ever directed at a single disease. [applause] members of congress sit sullenly with president bush in thunderous applause echoed throughout the u.s. capitol. sitting with me in the gallery of the castle that evening was a ugandan backer to help president bush in his senior advisers developed. as a medical professional, one of the countries hardest hit by this deadly disease.

he knew the toll of aids. remember the patients' faces that he could have stated he had medicine. on a cold january evening thousands of miles from his home he knew that the outcome would be different for future patients . committed $15 billion over five years to prevent new infection, the three those already infected and to care for children orphaned by parents had died of aids. a pediatric clinic in botswana, presidents bush and i saw firsthand the devastating toll of aids. in that pediatric clinic my daughter barbara and i met a mother who had brought a little girl for treatment. he just heard the other like an

angel to meet the american president to. this precious little child's play on the examining table so frail and that -- sick. her less than eight to 55 per mother's last act was to make a beautiful. three weeks ago he returned to botswana the same pediatric clinic has now so few patients that they are looking for a new use for the facility. so affected by this beautiful child that see resolve them to help confront the challenges this will grow faced. a global effort to recruit yeah, smart college graduates to work

in the health field in underserved areas. while george was president -- thank you for clapping. [applause] i travel to africa five times. george and i have returned to their together two times since leaving washington. in each visit us of the consequences of aids with those when left to find jobs and care for their families. orphaned children forced to grow up quickly and provide help for their younger siblings. i have seen what many call the effect, aids patients returning from that store and living a vibrant life. [applause] rather than waiting quietly for death millions to suffer from hiv are now working and participating in their

communities. in 2007 the center provides home-based care to more than 150 aids patients. the center of the support groups for female victims of violence promotes hiv prevention campaigns for yen people. the next generation will be hiv free. jim and i help pack madison, mosquito nets, baby dolls, and toiletries in the baskets of these caregivers. that way they could write that into the local community to provide a home-based care for their patients. later we sat in the brilliant sunshine listening to stories of those being held at the center.

two girls and wept as they told us how they had contracted aids the and a half. after words to not walked over to hug them and to tell them that there were not alone. and that she was writing a book called and a story about a growth she had met in central america who had suffered as they had. they said to her, right about us. tell our story. just by revealing their tragic past, these young women are building a hopeful future for the next generation. i heard stories that every one of the countries i visited during the eight years in office from africa to asia to the americans, and rural villages, capital cities, women led efforts to confront hiv, women starting their own businesses to

provide for themselves and there families. they're unborn children and women and leadership using their influence to reduce the stigma associated with hiv and to raise awareness for testing and treatment. we know that education, especially for girls is vital to efforts to stop the spread of hiv. educated girls have lower rates of hiv, help their families, and higher rates of education for their own children. last december president bush and i traveled to tanzania, zambia, and ethiopia. we met a woman whose husband was hiv-positive, but she did not know it until she contracted the disease.

when he died she was shunned by her own family. she was not allowed to sit with the more you put them before. they even gave her her own plate and utensils out of the mistaken belief that they could catch aids from her. she was introduced to a faith based organization that provided education and training for widows and orphans. remembrances taught her how to make beautiful purses, a few of which we bought out of recycled materials so that she could support herself and her children. as finances improve she moved out on her own with her children, and now she supports the family that once shunned her , extending to them grace that she received. her story is a powerful

testament to why we must do more to promote the good health of women everywhere. the health of women affects families, communities, and whole country's. healthy mothers make up the family's. when a mother dies her children are often ten times more likely to die themselves and are less likely to ever go to school. we have seen the benefit of a strong partnership to fight aids , nearly 7 million people are living with hiv now because of access to anti retro viral therapy, a new hiv infections have fallen by nearly 20%. the success has given us a proven strategy planned their resources and other health challenges. we added efforts to prevent malaria through the president's malaria initiative, and now

because we are seeing women living with their aides but dying from cervical cancer the boys institute wants to the pink ribbon red ribbon. president bush announced the is his new partnership. the bush instituted partner in on pink ribbon of red ribbon with the united states state department, you in a -- unaids to screen and treat breast and cervical cancer among women in the developing world. [applause] i am so pleased that our partners, secretary michele who runs u.n. may and my good friend from the foundation for the cure are here with us today. thank you all for joining as. [applause]

we are also happy to have several private sector partners who are supporting this initiative. bristol-myers squibb, the carriage foundation, glaxo's with klein, i.b.m., merck, airborne lifeline, and the national breast cancer foundation. cervical cancer is the leading cause of cancer death in sub-saharan africa and is preventable and treatable disease. it is up to five times more common in women whose immune systems are already compromised with hiv. the pink ribbon of red with initiative will build on the platform to screen and treat women for breast and cervical cancer. george and i launched the pink ribbon of red ribbon last december.

on the return earlier this month president bush and i were thrilled to see their progress. pink ribbon of red ribbon has expanded beyond the capitol city and across the country. multiple clinics are now screening, diagnosing, and treating line for cervical cancer. already more than 14,000 women have been screened, nearly 40 percent of those women are hiv-positive. nearly one-third of all the women screamed tested positive for precancerous or cancerous cervical cells. of those who tested positive more than 8 percent could be treated immediately with cryotherapy. [applause] and doctor in obstetrics and gynecology, and she is a champion for the pink ribbon red

ribbon efforts at the robert country. since her husband became president last fall she has worked to focus national attention on maternal health and mortality. earlier this week there was a conference hosted for advocate first lady's to discuss aids and cervical cancer. strong leadership is setting an example for african first ladies and for women everywhere. [applause] in our fight against aids we have learned that in the measure of success requires sustained leadership at every level from international organizations like unaids to political leaders in each nation and from them that -- ministers of health to local community health workers. that is why i am so grateful to

everyone in this audience today for your courage and your persistence, your persistence, you are the proven agents of change around the world. by working together we can give hope to mothers and fathers, to sisters and brothers, to wives and husbands and sons and daughters so that they and there families can live foal and productive lives. thank you all very, very much. [applause] >> in her remarks to the international aids conference house minority leader talked about the need for more aids research and funds for treatment this is 15 minutes. >> thank you all very much. [applause] thank you all very much. good afternoon. what a beautiful sight you are to see. while. thank-you for your generous

introduction, your a tremendous leadership of this as a co-chair of this year's international aids conference. watching the film in the slides and by all accounts this conference is a tremendous success. so we think dr. diane heather and dr. khalid tell of your for their great leadership in cochairing this conference. let's give them our fullest appreciation. thank you. san franciscans take special pride in her leadership as the chief of hiv/aids at the university of california san francisco because that is where for ross all of this began. this is where we started to turn the tide together.

it was 31 years ago when we first heard in our community that doctors at the university of california san francisco were seeing cases of like anything they had seen before. the symptoms that harkened back to the middle ages, many of you could tell this same story. quickly aids began to take a terrible toll. soon, we were going to as many as two funerals today. quickly, quickly we knew that this was an emergency and we had to pull out all the stops. we expect -- we took comfort in the aids quilt that had renewal and rembrandt's in the aids memorial grove. twenty-five years ago, i was

elected to congress to my first speech on the floor of the house. i said that i had come to congress to fight against hiv and aids. [applause] after my comments some colleagues said to me, why would you want fighting aids to be your introduction to the congress of the united states? why did you say you came here to fight aids? i said it because that is what i came here to do. [applause] but recognize that was the sign of the time in washington d.c. meanwhile, in san francisco we were ground zero as we saw it of the aids assault on our health,

economy, community, on the lives of our dear friends. with death, denial, and discrimination against those with the disease, aids was not only a challenge to our scientific and medical professionals. it was a challenge to the conscience of all of us, and it remained so to the state. we knew that we had to organize, not just agonize. organize, not agonize we did. [applause] over time we learned, as many of you gathered here did as well, that the aids virus resource will virus. it escapes defeat by mutating. and so too did we have to be resourceful. we adapted to the challenge, all of us. we were innovative in our

thinking, pursuing new science, mobilizing a new way, taking a fresh approach to prevention, care, and research for a cure. all of it community-based. and evidence based. we knew early on that we needed an international mobilization against aids. we needed public private and nonprofit partnerships. we had to make and national decision to act. here in the united states congress our decision to act changed the lives of many people within our borders and around the world. with the leadership of congressman like henry waxman of california and senator ted kennedy -- [applause]

who founded the evidence and community-based ron white care act early on. went further with our minority aids initiative and funding for pediatric aids case, and the list goes on and on. and most recently with the passage of the affordable care act we are delivering substantial protection to people with hiv and aids. [applause] we worked in an bap -- in a bipartisan way first with president clinton to authorize the global fund and then with president bush to establish. and when president obama strengthened these initiatives. [applause]

we thank president obama for totally listening -- lifting the travel ban enabling -- [applause] -- enabling this international aids conference to return to the united states for the first time since 1990. i was at that conference in san francisco, and i can tell you that we have come a long way, not only because we don't have the ban and therefore scientists and all could come and join in the exchange of ideas and the intellectual challenges and sharing of ideas, but because of this conference so many people with hiv/aids from around the world can join us. you are our strength and we welcome you especially.

[applause] so i say that two decades after being criticized on the floor of congress, and the four years that i served as speaker of the house to work with congresswoman you know loewy, barbara lee, advocates on the outside like mono. listen to this, to double the funding of global else from 4 billion to $8 billion per year . 4 billion. [applause] to make far reaching progress and turn the tide action was needed, required for parliament worldwide. on behalf of members of congress i want to welcome the many

parliamentarians who were with us at this conference. thank you for joining us. because, for our country to be able to act our legislative bodies must make a decision to move forward, and many have. even in these difficult fiscal times to my opening addresses, cutting back on our hiv/aids investments is of false economy that cost us more in the future in lives and in resources. hiv is still adapting and so much to turn the tide together. george bernard shaw once said, the sign of a truly intelligent person is that he, i would add, or she, is moved by statistics.

clearly everyone in this room meets that standard. most of us, though, would also move individual stories. one patient, one person at a time has led to the statistics that are so staggering that all of you have many personal stories to tell. one of the personal stories that i had, i lost so many dear friends in california. but always remembered suzie, the flower girl in my wedding. suzie died of aids, but not before becoming a champion fighting against the disease, schools and colleges and the rest. my patch in the aids quilt was

ditched in her memory. coming together here, again, many have your own stories to share. these stories have brought us to this. >> thank you for helping. [applause] >> speaking to you, speaking to you at this final session, again i say, by all accounts this conference is a tremendous success. we leave here with increased optimism weather about advancement in science, prevention of mother to child transmission. yet, this optimism must not make as complaisance. it cannot. it must instead heighten our resolve. we have an obligation to be innovative and courageous in our thinking. where there is scientific opportunity we have a moral

obligation to fund it. [applause] where there are people in need of drugs and care, communities in need of prevention, we have a moral obligation to provide it. and where there is incrimination we have a moral obligation to continue to fight it. [applause] on the brink of the aids free generation we must carry on with determination, hope to my and courage, courage is one of the defining qualities that we always want to bring to this. in doing so we will succeed in

turning the tide together. thank all of you, each and everyone of you, for your leadership, activism, a commitment to ending hiv / aids once and for all. once and for all. [applause] congratulations to all of you for making the 19th international aids conference such a tremendous success. we all look forward to working together to bring an end to aids and to turning the tide together . thank you all very much. [applause] is anybody from california here? [applause]

welcome to all of you. it. >> health and human services secretary kathleen sibelius was also one of the speaker's comments on the end of the age at the travel down in the u.s. that made it possible to hold the conference in washington and talked about providing health care and medication for hiv / aids patients. this is 20 minutes. >> good evening, everyone. i want to greet my fellow speakers, delegates, and colleagues, friends. on behalf of president obama here tonight is with the survivors and family and community in aurora, i am so pleased to welcome the international aids conference back to the united states. [applause]

and i am particularly proud to be part of an administration that respects and celebrates diversity warm, not just in words, but the people appointed to high positions. i want to give a special welcome to those living with hiv/aids who have traveled here from around the world. as has been said over and over, the hiv entry ban was a bad policy based on salty science that ran contrary to america's deepest values, and we are so proud that the obama administration overturned it and we are proud to be your host once again. [applause] as we gather this week, we have many reasons to feel hopeful. around the world new infections are following. the ranks of those on treatment are growing, and in countries

where aids has taken its greatest toll, life expectancies are beginning to rise once again . in the united states infections among injecting drug users have dropped more than 80%. pediatric cases are down more than 90%. the last time this conference was held on american soil 22 years ago there was no effective treatment for hiv. today someone diagnosed with hiv and treated before the disease is too far advanced and have a nearly normal life expectancy. now, these gains have been accompanied by a long awaited breakthroughs in science, including the recent finding that treatment itself is among the best forms of prevention. so as a result, we have reached a point where the goal of an aids-free world, once a far off stream, is now within sight.

yet, we don't have to look too far to be reminded of how far we still have to go. right here in washington d.c. our nation's capital, one in every 16 black men is hiv-positive. that has shown an alarming rate in the increase in direction rate among black woman. nationally our infection rate has stopped growing and is actually rising among young gay and bisexual men. millions aund the world living with hiv are not getting the retrovirus treatment that could save their lives. so we have come together this week because we know that now is not the time for easing up, slowing down, or shifting our focus. if we are going to reach our ultimate goal of an aids-free generation we must all challenge

ourselves to do more, to reach even more people, to make programs even more effective and accountable, to push the boundaries of science even farther. now, for president obama that has meant starting from day never want to build on the extra mirror legacy left to us by president bush's administration. celebrated as one of the great health success stories of the 21st century. [applause] it is a terrific achievement. the american people and programs and partner countries can be very proud. our task is to make it even stronger. under president obama we are on pace to achieve an ambitious goal of reaching an additional 2 million people around the world with lifesaving treatment by the end of 2013.

and at the same time we are putting a renewed focus on the key combination prevention intervention that has proven most effective in combating hiv. also looking to the future and strengthening partnerships with local governments and other organizations to ensure our efforts are sustainable and have a lasting impact. i am proud that about half of the treatment impact is supported by our departments centers for disease control and prevention. mainly through local partners, including ministers of health, which can often as you'd better results at lower-cost. the what to personally think our colleagues for their terrific partnership and certainly to ambassadors for his tremendous lead -- leadership. [applause]

we also must continue adding to our arsenal for fighting this disease. this week our department's food and drug administration will announce that more than 150 anti retro viral drugs are now available. and we are pushing forward in other areas, too. for example, our department recently developed a simple laboratory test that detects recent hiv infection, a major development that will help us better evaluate and improve our prevention efforts. and we must continue to support efforts to make life-saving aids drugs more affordable, more affordable. now, one of the more important developments of the last decade is the drop in price of generic aids medications from what was

$10,000 a year per person to now as little as $85 per person in some countries today. $10,000 to $85 is a big step, but there is much, much more work to be done which is why the united states has increased support for the global fund, and that is why we will continue to support the declaration on trips a public health. [applause] of farming country's rights to protect public health, including the flexibility supported by the trip's agreement. here in the united states there is much work to be done also. when we work with countries through. [inaudible] the first up is to develop a comprehensive national strategy, but until president obama came into office we had never taken that basic step right here at home. now we have.

[applause] the national hiv/aids strategy has given a nuisance of domestic and purpose to our domestic response. it starts with more funding. roughly a decade before the president came into office domestic hiv prevention funding had been flat. since president obama has come into office resources of increased every year he has been here. and on thursday we announced nearly $80 million for hiv/aids treatment. [applause] that will help us expand care for 14,002 patients, and say stella's that is the amount needed to allow them to fully clear the waiting list. that is a good step.

[applause] under our new domestic strategy we are also targeting existing resources more effectively, to the communities that have been the hardest hit. already we have made key changes in how we distribute funds to help departments. moving to a new formula that better reflects the needs of today, and we are focusing on the interventions that have been proven to work best, including testing time care and treatment. and i am proud to say that today americans have better access to these life-saving interventions than ever before. thanks to the historic legislation signed by president obama over two years ago, america is finally on its way to joining the rest of the world in making affordable health coverage available to all of our

citizens, all of our citizens. [applause] and with that comes the worst abuses of the insurance industry, but also seeking to lock people totally out of the insurance market with hiv/aids, to put a cap on their coverage or cancel their care without cause. yet we know it is simply not enough to make hiv testing and treatment more available. too many people are still slipping through the cracks. we can do better. we must do better. just last week i visited an organization called the community education group, just a few miles from here they are getting some pretty impressive results with their approach to hiv testing and treatment. when you get tested instead of just handing patients a referral

slip when they get a positive result, the area the schedule a doctor's appointment for that day or at the latest the next day. then they provide transportation for the first five visits. if someone stops going, they come find them and have them come back to treatment. now, nationally our linkage to care rate is just 77%. with see e.g. it is up above 96%. which is a huge step forward. ..

to do whatever is necessary to jack and key people in lifesaving treatments. perhaps the most important principle in our national strategy is one we've been reminded of over and over again in our response to hiv/aids. none of us can do this alone. and that is why we are making a new effort to reach out to community-based organizations, business leaders to foundations, ngos to faith organizations and others. this evening i am proud to announce four new public-private collaborations and make it easier for americans to get hiv care. first we're launching a partnership with walgreens to begin a three-year trial exploring how pharmacies can help their patients stay on medication.

second, [applause] second, we are working with netscape's, the leading provider of online continuing education for u.s. clinicians to create new training programs to help our health care providers better understand and address the needs of their patients with hiv. [applause] third, were announcing two partnerships with the mac is fine, a mobile texting pilot program called, you care for life, to help patients get important reminders and tips for managing their disease and a joint project with pepfar to exploring how lessons through pepfar and can be applied back in the united states.

[applause] and finally, we've joined together with the eighth largest aid drug companies to create a single application form for aids medications offered to their patient assistance program. [applause] long overdue, but on its way. [applause] at the application will make it easier for patients to get their lifesaving drugs and all eight companies, laboratories, brought ingelheim, bristol-myers squibb, genentech, johnson & johnson, merck have agreed to begin accepting malformed starting to number first. [applause] now, i want to thank all of these partners for stepping up. we're going to continue to seek out new public-private collaborations that will help us eat this disease.

the unifying principle behind all these efforts at home and abroad is that they are guided by science and evidence. i am so proud of the leading role in america's national institute of health have laid in the research breakthroughs that have brought us within the site of an aids free generation. [applause] earlier this week, we took another step forward with the approval of turnout at, the first drug shown to reduce the risk of hiv infections in on infected individuals at high risk, the first time. [applause] in the days ahead, you hear about promising next step in other areas for basic science to microbicides for women, to voluntary male circumcision, to

improve therapies, two potential vaccines for hiv and tb come into the ultimate goal of the care. science is the reason this conference got started and it remains the driving force behind our effort to combat this disease. in the weeks leading up to this conference to aids 2012, i've been feeling in thinking about the aids quilt, which is not being displayed on this conference at locations across the city. some of those 48,000 panels hang on the first floor of the building where i work. the panels are personal, covered with photos, family chokes come of love letters, prayers and doodles from the careful cursive of mourning parents and partners to the cricket lack letters of children too young to fully know

what they have lost. many of those individuals memorialized designed their own quilt pieces is one of their final acts before succumbing to a disease that was at one time a certain death sentence. if we were to gather all those people together and tell them about all the progress we've made in the last two decades about the scientific breakthroughs come the millions now on treatment, how people can now live long and protective lives with hiv, i think they would say you've done a good job. but then i think they would immediately say, how come we have effective care and treatment, but still have millions of people living with hiv who go without it? they'd ask how we could've done so much, more understanding of prevention and still has millions of new infections every year. and they would ask what we're

doing to make sure that hiv is no longer a death sentence for anyone anywhere in this world for anyone. [applause] i think they would say that's great that you set a goal for an aids free generation. now you must hurry up. and that's what brings us together for this important dialogue this week. this is a chance for each of us to arm ourselves with the latest science, to trade press practice is common to learn from one another and then go back to our communities and our country is with renewed energies and a determination to finish the job. so again on behalf of the united states, we are proud to be your host for the 19th international aids conference and we are honored to be your

partners in this most important work. thank you and goodnight. [applause] >> now, part of today's "washington journal," which haiku by shimkus reporter about economic issues in the presidential campaign. >> host: well, our person this morning, front page story from the "washington journal" written

about john hilton rot and damian paletta better off for them in the election. and damian paletta is on the phone with us this morning, economic policy reporter for "the wall street journal." mr. paletta come you hearken back to ronald reagan's famous moment in october 1980 in a debate where he asked the question of voters. we are going to play that clip for a little historical context. let's watch. >> next tuesday all of you will go to the polls come and stand there and make a decision. i think when you make that decision, it might be well if you would ask yourself, are you better off than you were four years ago? is it easier for you to go buy things in the store than it was four years ago? is there more or less unemployment in the country than there was four years ago? is america as respected throughout the world as it was? do you feel that our security is

as safe? that we are a strong as we were four years ago? if you answered all of those questions you ask him a wife and i think your choices very obvious who you vote for. if you don't agree, if you don't think that this course we've been on for the last four years is what you would like to see us follow for the next four, then i could suggest another choice that you have. >> host: on the phone, damian paletta was spent packing of voters in key states in election 2012. let me ask you about your story is accompanied by charts and graphs and historical averages over presidents, the ronald reagan framed this as a personal question to individual voters. is that how people are processing this year? >> guest: i think so. this is a cut check question in order to get checkpoint in the economic recovery. a lot of folks are almost maybe

back to where they started four years ago. maybe they've been doing a good job about taking care of personal dazzler companies have been able to kind of tighten their belts and get back on firmer footing. there hasn't been much progress beyond that. obviously there's been a lot of frustration with democrats and republicans on the pace of the economic recovery and a lot of folks wonder now, where are we? could we be doing better or should we be thankful the financial crisis was a person who was? and our conversations with voters, we heard about it people saying, on the one hand, i am better off. obviously i still have my job or job market is still in a little bit. but on the other hand, we've really had to make tough choices at home or in our business. we are going out to eat as much. we are buying the new car we wanted to. there's a real kind of uneven sense among americans right now about where they are and where

the next five years will take them. >> host: may just run through four of the graphs that accompanied your story and look at some historical spirit you look at gdp with inflation adjustment in the black line of black box says president obama prepared to his predecessors going back to president carter and his was the lowest growth of the 16 terms of 5.2%. pretax excluding government benefits, the lowest at minus 8%. not worse comes in the middle they are an increase of 10.6%. household real estate in places up to market value the lowest at 12% as opposed to when he took off his beard when people look at those numbers though, what is the context they placed this presidency and in his response ability for these numbers? >> guest: a lot of voters from both parties recognize that kind

of blunt trauma the first year and a half, two years the country went through. the financial crisis really push the start racket down heavily. we were down below 7000 in the early part of 2009. number up about 13,000. housing prices fell off quite sharply. people of disposable income when you have high unemployment, that takes a big toll as well. folks realize that the first two years were really hard for businesses and americans to regain footing. it is kind of complicated is we've had little spurts of strong six-month periods, but they have been met with kind of tough headwinds, so the recovery has been really kind of painful for a lot of americans. obviously none of this presidency mentioned entered office in the face of the

science of prices that president obama did. the question a lot of voters will have a comp consists of a couple we've endured, the kind of thing we can build on and improving the next two years, or is it time to change course and try something different? >> guest: in the minds of voters, how much culpability turns to congress with this outcome the fiscal cliff and other financial urgent items with much progress. >> guest: that's a huge question. the white house is counting on voters and the pending some of the blame on the congress in making the case. president obama on the campaign trail every day saying congress is to get his act together and doing the best he can with a congress. the question is does the buck stop with him or will americans tend to buy into this idea that congress has been kind of obstructionist and getting things going? that's going to be a key

decision. the election could hinge on who they blame for the recovery and there's not that much time left, so voters make up their minds very soon. >> guest: damian paletta has been out talking to voters, trying to ascertain, are you better off than four years ago? >> i do not envy the drowsy harmony of the republican party. they squelch debate, we welcome it. they deny differences, we bridge them. they are uniform, we are united. [cheers and applause] >> host: the choices this year and i just between two different personalities are between two political parties. they are between two different visions of the future, two fundamentally different ways of governing. their government to pessimism,

fear and limits or hours of hope, confidence and growth. [cheers and applause] >> we are showing you some of the recent 19th international aids conference held in washington. talking with david brown at the "washington post" to cover the conference. what was the significance about the event being held in

washington? >> guest: well, it was the first time it had been held in the united states in 22 years, which is a very long time, particularly in the narrative in history of the hiv epidemic. almost everything has changed from our understanding of the disease to its therapeutics and the prognosis of people with the infection. it had an essentially banned from the united states because of the restriction on hiv-infected people from entering the country, which was part of -- was an integration regulation and the international aids society, which runs the conference had decided that this was a form of stigmatizing exclusion that they did not agree with and that until the united states changed it, there would not be in a conference is held in the united states of

these international aids conferences. and he was lifted by president obama very early in his term. >> host: he wrote the subject of money is always a big topic at the state's conferences, particularly this one. can you tell us how much the u.s. contributes each year to the fight against aids worldwide? >> guest: the u.s. contributes about $6 billion to the overseas aid efforts. in the year 2000 that believe the government's total global health spending was about 1 billion. that gives you some idea of the enormous growth over time, much of it coming through pepfar, the president's emergency plan for aids relief, which president bush, george w. bush started

announced to everyone's surprise in the state of the union address in 2003. and that has gone up under obama and flattened out in the last couple years and an enormous amount paying for drugs, paying for clinics, paying for labor, paying for the whole, you know, sort of transportation and infrastructure it takes to put millions of people on the life-saving -- life extending therapies. >> host: was very consensus this year on the latest and best approaches to prevention and treatment? >> guest: well, i wouldn't say there was a consensus, but there was more stuff to do. there's more options now than there have been ever before.

big ones are the so-called is prevention and this means that if you -- if someone is in fact did and you treat him even very early or perhaps especially very early in their infection, the amount of virus they have in the blood stream goes almost to zero and they become essentially noninfectious. in other words, they cannot transmit the virus on to anyone else. it occasionally happens, but it's rare. so the idea is everyone, as soon as they are diagnosed and he put them on the drugs, then the chance of them passing it on to someone else is hugely reduced. so that is one strategy. there's other strategies like circumcision and then there is even taking prophylactic drugs, people who don't have the virus, but are at risk -- high risk of

acquiring it. they can take drugs to lower their risks usually. >> host: former president, bill clinton, one of the major speakers, how has his foundation been so successful in driving down the price at eight drives worldwide? >> guest: well, his foundation , which has really had a huge effect on the international response basically has helped rationalize the market for generic antiretrovirals and it is basically gotten the makers of the consumers of these drugs together and say okay, if we can assure you that there will be those -- this demand, you know, demand for x million doses of this particular drug, how cheaply can you make it?

and is there some way that we can guarantee that it will be delivered in time, that it's not going to run out on shelves, it isn't going to be held up in customs, on and on, just make a system seamless and efficient. and once the makers, the producers can a generic producers know what the markets going to be, they could ramp up and produce huge quantities at a much lower price. it is basically getting the price -- to praise ray. >> host: what is your sense after this conference? what is left to be done in the fight against aids clinics >> guest: well, quite a bit. there's still room for the prices of drugs to come down. in the united states, there's very important drugs about to go off patent, which will save some money here, up to a billion

dollars potentially a year, particularly if doctors and patients are willing to make a small adjustment to their drug regimen. the whole issue of getting people on drugs early. you can't of course force anyone, but perhaps you can make it easier for people to start the therapy early if they're interested. there's a huge amount of room to make that happen more efficiently. and then there's things like option b., which is kind of a brand-name for putting all pregnant women who are in fact dead, putting them on antiretrovirals drugs for life, just keeping them on the drugs. in the past and was put them on during their pregnancy and breast-feeding and if they don't have a clinical indication, then

stop the drugs. until their own disease progresses. now the idea is forget all the stopping and starting, just get them on the drugs can preserve their life for as long as possible. >> host: david brown with the "washington post," along with alina sun reported on the 19th international aids conference. read the reporting of "washington post".com. thanks for joining us. >> guest: my pleasure. >> at this year's aids conference, secretary of state hillary clinton announced tens of millions of dollars in new funding for combating hiv and others around the world. it includes all of eliminating other two chat rooms mission by 2015. this portion is 40 minutes.xecui

>> please welcome, executive [ap director of human names. [applause] >> fran's, when they got from the opening ceremony, to the of extreme, to think of opportunit. , we are to have thiso epidemic. to be able to say 20 years fromr now, not their generation shoul, cross over the finish line. our generation made the decision be finally end a for all of us.

and to be given the honor to introduce a great leader who is turning -- she's an advocate for hiv. [cheers and applause] president obama, secretary clinton, secretary sebelius and my friends. vi [applause] secretary clinton is a person of vision, courage and intellect. o a leadership impasse, so manyple

people to educate. a and to promote global healthr e, good for example in appointingos global women's issues. she was the first global leader to speak out about the economic impact of violence against women. [applause] and lastly, she was the first global leader to call for an aids free generation. [applause] she challenged us all to imaginl a world where all babies are a

born free from hiv. for everyone needs access toomed treatment, for the right of women and girls are protected and promoted. >> [applause] where it is met with global solidarity and where all people, especially those most effect to drive the epidemic by the stigm. discrimination. .. and governments around the world. it will -- introducing one of the most inspiring leaders but also, as one of its most effective and committed

visionaries for change. >> [applause] >> at a moment when she has so many other obligations from syria to afghanistan, this is a powerful testimony of heart and sincerity. and despite her global comilments she has always found time to be a caring mother of her impressive daughter. it is my tremendous pleasure and honor to introduce, the secretary of state of the united states of america, hellery rodham clinton. >> -- hillary rodham clinton.

>> good morning! good morning, and -- >> [chanting] >> hillary! hillary! >> now, what would an aids conference be without a little protesting! we understand that.

>> [cheering] >> part of the reason we've come as far as we have is because so many people all over the world have not been satisfied that we have done enough. and i am here to set a goal for a generation that is free of aids. >> [applause] >> [cheering] >> but first, let me say five words we have not been able to say for too long. welcome to the united states! >> [applause] >> we are so pleased to have you all finally back here,

and i want to thank the leaders of the many countries who have joined us, i want to acknowledge my colleagues from the administration, of the congress, who have contributed so much to the fight against aids. but mostly, i want to salute all of the people who are here today who do the hard work that has given us the chance to stand here in 2012 and actually imagine a time when we will no longer be afflicted by this terrible epidemic and the great cost and suffering it has imposed for far too long. >> [applause] >> on behalf all of americans, we thank you.

but i want to take a step back and think how far we have come since the last time this conference was held in the united states. it was in 1990, in san francisco, dr. eric guzbee, who's now our global aids ambassador, ran a triage center from for all the hiv positive people who became sick during the conference. they set up i.v. drug drips to rehydrate patients, they gave antibiotics to people who aids-related pneumonia, many had to be hospitalized and a few died. even at a time when the world's response to the epidemic was sorely lacking, there were places and people

of caring, where people with aids found support. but tragically, there was so little that could be done medically. and thankfully, that has changed. caring brought action, and action has made an impact. the ability to prevent and treat the disease has advance dollars beyond what many might have reasonablably hoped 22 years ago. yes, aids is still incurable. but it no longer has to be a death sentence. that is a tribute to the work of countless people around the world, many of whom are here at this conference,

others who are no longer with us but whose contributions live on. and for decades, the united states has played a key role. starting in the 1990s under the clinton administration, we began slowly to make hiv treatment drugs more affordable, we began to face the epidemic in our own country. then in 2003 president bunch launched pepfar with strong bipartisan support from congress and this country began treating millions of people. today under president obama we are building on this legacy. pepfar is shifting out of emergency mode and starting to build sustainable health systems that will help us finally win this fight. and deliver an aids-free generation.

it's hard to overstate how sweeping or craicial this -- crucial this change is. when president obama took office we knew that when we were going to win the fight against aids we could not keep treating it as an emergency. ehad to fundamentally change the way we and our global partners did business. so we've engaged diplomatically with ministers of finance and health, but also, with presidents and prime ministers, to listen and learn about their priorities and needs in order to chart the best way forward together. now, i will admit, that has required difficult conversations about issues that some leaders don't want to face. like government corruption, and the procurement and delivery of drugs.

or dealing with injecting drug users. but it has been an essential part of helping more countries manage more of their own response to the epidemic. we've also focused on supporting high impact interventions, making tough decisions driven by science about what we will and will not fund, and we are delivering more results for the american taxpayers' dollar by taking simple steps, switching to generic drugs which saved more than three # on million dollars in 2010 alone. -- and crucially, we have vastly improved our coordination with the global fund, where we used to work independently of each other, we now sit down together, to

decide, for example, which of us will funds aids treatments somewhere and which will fund the delivery of that treatment. that is a new way of working together for both of us. but i think it holds great results for all of us. all of these strategic shifts have required a lot of heavy lifting but it only matters in the end if it means if we are saving more lives, and we are. since 2009, we have more than doubled the number of people who get treatment that keeps them alive. we are also reaching far more people with prevention, testing, and counseling. and i want publicly to thank, first and foremost, dr. eric

guzbee who has been on the front lines of all this work since the 1980s, in san francisco. >> [applause] >> he is somewhere in this vast hall, cringing with embarrassment, but more than anyone else, he had a vision for what pepfar needed to become and the tenacity to keep working to make it happen. and i want to thank his extraordinary partners here in this administration, dr. tom frieden at the centers for disease control and dr. raj shah at usaig. >> [applause] >> now with the progress we are making together, we can look ahead to an historic goal. creating an aids-free generation. this is part of president obama's call to make fighting global hiv-aids at home and

abroad a priority for this administration. in july 2010, he launched the first comprehensive national hiv-aids strategy which has reinvigorated the domestic response to the epidemic, especially important lower in washington, d.c., which needs more attention, more resources, and smarter strategies to deal with the epidemic in our nation's capitol, and last november, at the national institutes of health, with my friend dr. tony fauche there, i spoke in depth about the goal of an aids-free generation and laid out some of the ways we are advancing it through pepfar, usaig and the cdc, and on world aids day, president obama announced an ambitious commitment to the united states to reach 6 million people globally with life saving treatment.

>> [applause] now, since is that time -- since that time, i've heard a few voices from people raising questions about america's commitment to an aids-free generation. wondering whether we are really serious about achieving it. well, i am here today to make it absolutely clear. the united states is committed and will remain committed to achieving an aids-free generation. we will not back off. we will not back down. we will fight for the resourceses in to achieve this historic milestone. >> [applause] >> i know that many of you share my passion about

achieving this goal. in fact, one could say i am preaching to the choir. but right now, i think we need a little preaching to the choir. and we need the choir and the congregation to keep singing, lifting up their voices and spreading the message to everyone who is still standing outside. so while i want to reaffirm my government's commitment, i'm also here to boost yours. this is a fight we can win. we have already come so far. too far to stop now. i want to describe some of the progress we've made toward that goal and some of the work that lies ahead. let me begin by defining what we mean by an aids-free generation. it is a time when, first of all, virtually no child anywhere will be born with

the virus. >> [applause] >> secondly, as children and teenagers become adults, they will be at significantly lower risk of ever becoming infected than they would be today, no matter where they are living. >> [applause] >> and third, if someone does acquire hiv, they will have access to treatment that helps prevent them from developing aids and passing the virus on to others. so yes, hiv may be with us into the future until we finally achieve a cure, a vaccine, but the disease that hiv causes need not be with

us. >> [applause] >> as of last fall, every agency in the united states government involved in this effort is working together to get us on that path to an aids-free generation. we're focusing on what we call combination prevention. our strategy includes condoms, counseling, and testing, and places special emphasis on three other interventions: treatment as prevention, voluntary medical male circumcision, and stop be the transmission of hiv from mothers to children. since november,by have -- since november, we have elevated combination prevention in all our hiv-aids work, including right here in washington which still has the highest

hiv rate of any large city in our country, and globally, we have supported our partner countries shifting their investments towards the specific mix of prevention tools that will have the greatest impact for their people. for example, haiti is scaling up its efforts to prevent mother to child transmission, including full treatment for mothers with hiv, which will in turn, of course, prevent new infections. and for the first time, the haitian ministry of health is committing its own funding to provide antiretro viral treatment. >> [applause] >> we're also making notable progress on the three pillars of our combination prevention strategy, on treatment as prevention, the united states has added funding for nearly

600,000 more people since september. which means we are reaching nearly 4 1/2 million people now, and closing in on our national goal of 6 million by the end of next year. that is our contribution to the global effort to reach universal coverage. on male circumcision, we have supported more than 400,000 procedures since last december alone. and i'm pleased to announce that pepfar will provide an additional $40 million to support south africa's plans to provide voluntary medical circumcision for almost a half a million of boys and men this coming year. .

could participate. in zimbabwe some male lawmakers of the wanted to show share constituents how safe and virtually painless the procedure is. so they went to a mobile clinic and got circumstance sited. that's the kind of leadership we welcome. and we're also seeing the tralopment of new tools that would allow people to performt safprocedure with less training dd equipment than they need today without comprising safety and when such a device issuppt approved by the world

getting the number to zero. over the years, we have invested more than $1 billion for this effort. in the first half of this fiscal year, we've reached more than 370,000 women globally, and we are on track to hit pepfar's target of reaching an additional 1.5 million women by next year. there also setting out to overcome one of the biggest hurdles in getting to zero. when women are identified as hiv-positive and eligible for treatment, they are often referred to another clinic, one

that may be too far away for them to reach. as a result, too many women never start treatment. today, i am announcing that the united states will invest an additional $80 million to fill this gap. these funds -- [applause] these funds will support innovative approaches to ensure that hiv-positive pregnant women get the treatment they need to protect themselves, their babies, and their partner. the united states is accelerating its work on all three of these fronts in the effort to create an aids-free generation. and look at how all these elements have come together to make a historic impact. in zambia, we are supporting

the government as they step up their efforts to prevent mother- to-child transmission. between 2009 and 2011, the number of new infections went down by more than half, and we're just getting started. together we are going to keep up our momentum on mother-to-child transmission. we will help many more zambians get on treatment and support a massive scale-up of male circumcision as well, steps which will drive down the number of new sexually- transmitted infections by more than 25% over the next five years. as the number of new infections in zambia goes down, it will be possible to treat more people than are becoming infected each year. so for the first time we will get ahead of the pandemic

there, and an aids-free generation of zambians will be in sight. think of all the people who will never be impacted by this disease, and then multiplying it across the many other countries we're working with. in fact, if you are not getting excited about this, please raise your hand and i will send somebody to check your pulse. [applause] [laughter] but i know treating an aids- free generation takes more than the right tools, as important than they are. ultimately, it is about people,

the people who have the most to contribute to this goal and the most to gain from it. that means embracing the central role that communities play, especially people living with hiv and the critical work of the faith-based organizations. we need to make sure we are looking out for orphans and vulnerable children who are too often overlooked in this epidemic. [applause] and it will be no surprise to you to hear me say i want to highlight the particular role that the women play. [cheers] and sub-saharan africa today, women account for 60% of those living with hiv. women want to protect themselves from hiv, and they want access to adequate health

care, and we need to answer their call. pepfar is part of our comprehensive effort to meet the health needs of women and girls, working across the united states government, and with our partners on hiv, maternal and child health, and reproductive health, including voluntary family planning and our newly launched child survival call to action. every woman should be able to decide when and whether to have children. this is true whether she is hiv- positive or not. [applause] and i agree with the strong message that came out of the london summit earlier this month -- there should be no controversy about this, none at all.

and across all of our health and development work, the united states is emphasizing gender equality, because women need and deserve a voice in the decisions that affect their lives. [applause] and we are working to prevent and respond to gender-based violence, which puts women at higher risk for contracting the virus, and because women need more ways to protect themselves from hiv infection. last year we invested more than $90 million in research on microbicides. these efforts will close the health gap between women and men. if we're going to create an

aids-free generation, we also must address the needs of the people who are at the highest risk of contracting hiv. one recent study of female sex workers and those who traffic in prostitution in low- and middle-income countries found on average 12% of them were hiv-positive, far above the rates for women at large. and people who use injecting drugs account for about 1/3 of all the people who acquire hiv outside of sub-saharan africa. and in low- and middle-income countries, studies suggest that hiv prevalence among men who have sex with male partners could be up to 19 times higher than among the general population.

now, over the years, i have seen and experienced how difficult it can be to talk about a disease that is transmitted the way that aids is. but if we are going to beat aids, we cannot afford to avoid sensitive conversations, and we cannot fail to reach the people who are at the highest risk. [applause] unfortunately, today, very few countries monitor the quality of services delivered to these high-risk key populations. fewer still rigorously assess whether the services provided actually prevent transmission or do anything to ensure that hiv-positive people in these groups get the care and

treatment they need. even worse, some take actions that rather than discouraging risky behaviors actually drives more people into the shadows where the epidemic is that much harder to fight. and the consequences are devastating, for the people themselves and for the fight against hiv. because when key groups are marginalize, the virus spreads rapidly within those groups, and then also into the lower- risk general population. we are seeing this happen right now in eastern europe and southeast asia. humans might discriminate, but viruses do not. and there is an old saying that goes, why rob the bank? because that is where the money is. if we want to save more lives,

we need to go where the virus is and get there as quickly as possible. [applause] and that means science should guide our efforts. today i am announcing three new efforts by the united states government to reach key populations. we will invest $15 million in implementation research to identify specific interventions that are most effective for each key population. we're also launching a $20 million challenge fund that will support country-led plans to expand services for key populations. and finally through a civil society that works, we will invest $2 million to bolster the efforts of civil society groups to reach key populations.

[applause] americans are rightly proud of the leading role that our country plays in the fight against hiv-aids. and the world has learned a great deal through pepfar about what works and why, and we have learned about the needs that are not being met and how everyone can and must work together to meet those needs. for our part, pepfar will remain at the center of americans' commitment to an aids-free generation. i have asked the ambassador to take the lead in sharing our blueprint for the goals and objectives for the next phase of our effort and to release this blueprint by world aids day. what all of our partners here at home and around the home want to have a clearer picture of

everything we have learned and a road map that shows what we will contribute to achieving an aids-free generation. reaching this goal is a shared responsibility. it begins with what we can all do to help break the chain of mother-to-child transmission, and this take leadership at every level, from investing to health-care workers to removing the registration fees that discourage women from seeking care. we need community and family leaders, from religious leaders to encourage women to get tested and demand treatment if they need it. we have a share this possibility to support multilateral institutions like the global fund. in recent months, as the united

states has stepped up our commitment, so have saudia arabia, japan, germany, the gates foundation, and others. and i encourage other donors, especially in emerging economies, to increase their contributions to this essential organization. and then finally, we all have a share in responsibility to get serious about promoting country ownership, the end state where a nation's efforts are led, implemented, and eventually paid for by its government, its communities, its civil society, its private sector. i spoke about how the united states is supporting country ownership, but we also look to our partner countries and donors to do their part. they can follow the example of the last few years, in south africa, namibia, botswana, india, and other countries who

are able to provide more and better care for their own people because they are committing more of their own resources to hiv-aids. and partnered countries also need to take steps like fighting corruption and making sure their system for approving drugs are as efficient as possible. i began today by recalling the last time this conference was held here in the united states, and i want to close by recalling another symbol of our cause, the aids memorial quilt. for a quarter century, this quilt has been a source of solace and comfort for people around the world, a visible way to honor and remember, to mourn husbands and wives, brothers and sisters, sons and

daughters, partners and friends. some of you have seen the parts of the quilt that are on view in washington this week. i well remember the moment in 1996 when bill and i went to the national mall to see the quilt for ourselves. i had sent word had that i wanted to know where the names of friends i had lost were placed so i could be sure to find them. when we saw how enormous the quilt was, covering acres of ground, stretching from the capitol building to the washington monument, it was devastating. in the months and years that followed, the quilt kept

growing. back in 1996 was the last time it could be displayed all at once. it just got too big. too many people kept dying. we're all here today because we want to bring about that moment when we stop adding names, when we can come to a gathering like this one and not talk about the fight against aids, but instead, commemorate the birth of a generation that is free of aids. now, that moment is still in the distance, but we know what road we need to take. we're closer to that destination than we have ever been. and as we continue on this journey together, we should be encouraged and inspired by the knowledge of how far we have already come. today and throughout this, we

must restore our own faith and renew our own purpose, so we may together reach that goal of an aids-free generation and truly honor all of those who have been lost. thank you all very much. [applause] allergy and infencer diseases an sp anthony s. fauci outlines the steps necessary to end the spread of hiv and aids. he's followed by the substitute in paris and nobel

prize winner. [applause] >> thank you. [inaudible] it's ab honor to introduce [inaudible] of the 2012 conference in what she tends of science and what science can do for public health. the reason i'm really dloighted

to introduce these persons. ton anthony s. fauci on infencer disease. since 1984, he has overseen an extensive research using forces to preventing -- [inaudible] and treating infections and immunizations. he was is the chief of [inaudible] where he has made numerous important discoveries related to hiv-aids and one of the most best scientists in the field. [inaudible]

1,200 [inaudible] including several others. [inaudible] he has received [inaudible] including the national medal of science, merit -- [inaudible] and the presidential medal of freedom. i'm pleased to call anthony s. fauci. [applause] thank you very much for the kind introduction. i want to thank the organizations for giving me the opportunity kick off the

scientific component of this international meeting and take the theme that was developed last night with great enthusiasm and discuss with you all of my time a lotment why we now have the scientific basis to be able to even consider the feasibility and the reality of an hiv-aids screen generation. i want to start first with a little background. i love matt. i love the deep blue of the oceans, the refreshing green of the plains, and the mountains. but we look at maps in the room over the past couple of decades they have taken on a different complexion within the dreaded differential shading indicating prevalence in different regions in the world with 34 million people lifing with hiv/aids.

if you look at the upper left-hand corner of the slide you see the united states we have 1.1 billion people living with hiv and focus in a little bit and see washington, d.c., now there a couple of issues about washington, we welcome you here, but it was twenty five years ago that the international aids conference was in washington. i've had the privilege and the opportunity to participate in every one of the nineteen conferences of the international aids society. but i want to play a little bit moment with you with washington when you talk about what we share globally like i said i like maps inspect is a google map of washington, d.c. this is where you are sitting. again, the dreaded shadings because in washington, d.c., we have a prevalence that in many

respects equals some of the nations. as she said last night, it is the best of times and the worst of times. the worst times is the prevalence. want hope for the best of times is as you heard from the mayor last night, washington, d.c., has implemented an aggressive and innovative program to have a major impact which can serve as an camp, i'll get back to that in a moment. let's get to the gist of what i want to develop with you over the next several minutes. we want to get to the end of aids that. will only occur with some fundamental foundation and the town dailingses are the clinical research give us the tools which will ultimately lead to interventions and ultimate these will need to be implemented together with studies about how best to implement them.

so let me briefly go through each of these with you. the basic and the clinical research. we have had a stunning amount of advances in the arena of basic and clinical science which are the delineated on the slide. i don't have time to go through each and every one of them with you. there are some that stand out. some as great things as the initial identification of the virus. you can -- the demonstration that is the agent by galway and the colleagues. the increment of breakthrough, the incremental science each year learning more and more about the hiv virus themselves as well as the path againic mechanism. this is a confusing slide. i put on one slide about 30 years of incremental research. and with a we know now a lot

about the virus the prier mare infection, the establishment of infection in the tissue massive -- [inaudible] of organs and partial but never complete imneurological controls. and the ab sense of therapy. very important in the process of incremental scientific knowledges is understanding the early events in hiv, particularly as it surfaces with the vulnerable a host and vulnerability of the virus and understanding it is extraordinarily important in insight transmissions and vaccines development. probably the most important of the cumulation of scientific advances is understanding the hiv rep indication cycle on the binding fusion insertion of r

and a reverse transcription into integration and viral budding. each of that year after year has given us targets of vulnerability or of on the part of of the -- it brings us the next step. that is a step of intervention, precome innocently in the arena of intervention. let's start with treatment. i dub this slide out of the archives a picture of me and fellow students in the early 1980s when we were frustrated clinically but beginning to make headways scientifically. i refer to these as the dark years of my medical career. but what kept us, myself, and my colleagues not only here but throughout the country and the world going forward, even though we were much in the dark, was reading what people were going through in the community and e

consequently stated by jones in some of the film what was going on in the san francisco. larry crammer in the normal heart describing what was going on in the village. but things began to happen, the sign lead to intervention, and if you look at the evolution of treatment strategy, the first drug in 1987 give a glimmer of hope. virus goes down very little. doesn't stay down. resistance occurs. years go by, new drugs, virus go down further for a little bit longer but not enough. then the transforming meeting and crewinger in 1996 with a three-drug therapy brings down the virus to below the detectable level. stays there potentially indefinite nately. we have a new dawn of therapy pediatric with hiv/aids that transformed the life of

individuals. we now have up to 30 hiv antihiv approved drug by the fda. multiple classes used in combinations that have completely transformed things. but we can't stop there. because there is still those who are not responding to these strugs and we need long-acting drugs particularly with regard to hearings. the result have been speck lar. i'm going pick out a couple of examples. if you look, this is a study from holland, i told you back in the dark year of my experience, the survival of my patients was -- if a person walk into a clinic at the nih or any other place that has availability of the treatment is young 25 and recently infected yu put them on combination therapy and look in the eye and tell them it is likely they adhere to that regimen, they will live an

additional fifty years. there is not only confined -- [applause] just in the developed world it's known now in countries, for example, analysis at the same similar results with normal life expectancy. that's the good news. there's challenging. this is a very scary slide. because if you look at the united states the 1.1 million people infected, 20% don't know they're infectded. 162% are linked to -- 41 areed contained. only 36% on antiviral and 28% are sur pressing. we have to do better that than. we have the tools. we need to implement that. it can -- question take example from the developing world. whey need to do is we need and are doing it having continuum

that is seeking out testing, linking to care, treating when eligible and making sure they adhere and in fact getting back to the d.c., there is astudy ongoing now with six cities two. of which are implement cities the south bronx in washington, d.c., where we're starting to see can actually a cur if you put the effort in it . i'm sure you'll be hearing more about it later. it doesn't only happen in the developed world. that's when people keep saying. is it going to be able to be done? take a look what's going on in rwanda. you have a community-based program, two-year retention 92% with 98 percent tested at two years had suppressed viral loads. similar results in bots wan a that. extending the intervention what about prevention?

combination hiv prevention the message to this is prevention is not dimension fall. we all know that. terrorist a combination of comprehensive on the lower level of the wilding blocks are interventions that are not necessarily biological driven. we were implementing them before we knew there was a virus. as the years went by, science lead us. some examples prevention of mother to child transmission. the breakthrough study of o76 indicating by treating the mother you can actually decrees dramatically now. now we treat mothers for the disease and together with the mother's help the baby is born uninfected. in the united states this is transformed what you see now on the red bars the estimated number of hiv infected

ininfants. remember what mayor said last night, in this city with hard prevalence there has not been a child born with hiv infected since 2009 in a city with -- [applause] that's the good news. 600,000 we have a challenge. there are 330,000 new infections in 2011 alone. what about male sir come suggestion? this is a stunningly successful. the initial trials in the south africa, kenya show that in the confines of a trial it works. the real question is, was it work in the field and as a matter of fact you anemically, this is one of the few prevention interventions that actually gets better with time because the initial result was

55 or 60%. it you go to the district in you began d.a. five years out in the effectivenesses in the community is 73%. good news and challenging news because of mixed results the capricious study proved the concept you can have a woman dated intervention on -- [inaudible] when you adhere to it. this study and the press study has been issuerly told something. biological interventions work but don't work if you don't adhere. which tells us why we have marry biological with behavioral. there's no doubt about that. [applause] we know that from the voice study which shows the study continue -- [inaudible] fertility hopefully get the answer from the fact study. getting back to the long-acted

moral the same thing has to do with -- [inaudible] we're pleased at the approach of use if two studies starting to see the aspire study and the studied which will hopefully bring a greater debris of hearings to show that can equal effectivenesses. again, mixed results. the breakthrough study was the [inaudible] in the recent apriewl by the fda both for men who have sex with sex and heterosexuals. but there are some studies that show it doesn't work. it doesn't work with some biological effect with the continues concentration of drug. hammering home to us the concept that biological will not be effective without adhering. probably the most game changing advance over the last couple of

years of the treatment and prevention with the famous trials which we reduce by *eu69% the likelihood that someone will transmit to their uninfected partner if you treat argue a great argument for getting people on treatment. before i go on to the implementation. i want to mention that i'm telling you a lot of good news about science. we have challenges. we have challenges in the arena of vaccination, we have challenges in the reason of cure. what about development of the vaccine? fee f we were able to plug in a vaccine block, we would surely have a very robust combination, prevention package even if it wasn't a perfect vaccine even if it wasn't out% we could do that. you're familiar with the rv144

trial. it's a humbling trial because it showed an honest degree of -- when you behind down and try to figure out the potential, we find out that it's nonnews losing related

what about a cure a couple of days ago, sponsored an extraordinary about approaches to hiv cure. two general types either eradication purging it which would be difficult or perhapses what i called years ago a functional cure. mainly either enhancing hiv specific immunity or moving the whole cells to be resistant. i want to i'm sure people in the room understand. others don't. it's not an implementable intervention. it's way upkeen on the basic discovery level. so that you can put an end to the hiv pandemic as mark said is an epidemiological without curing anybody. you cure a few people without putting an end to the hiv

pandemic. it's a scientific challenge. let's go on to implementation. we have been able to implement what we've discussed over the last day or so. the extraordinary effect of the program the global funds, philanthropy, the clinton foundation but importantly recently the assumption by host countries of their own responsibility, and this has been very important. so i want to -- let's take a look at this. a couple of minutes of this. what happens when you take an clinical trial based scientific observation and you try to scale it up regionally or locally to see if it becomes effective. there are many examples, i'm going to give you a few, what about the positive impact of scaling bots wanna. take a look at the red dot which

is is a percent able of mothers who are being treated. taking the diminishing blue bars, the number and percentage of children who are born with hiv. it works. what about the fact that if you treat people do you really save their lives? we now have 8 million people receiving antiretrovirals in low and middle income countries. a ton of deaths have been alerted in 2011 alone. as to the question, what about the positive impact of therapy on the hiv disins in you go to a place where you have 30% coverage [inaudible] and another section there's 10% coverage. there's a 38% lower risk of acquiring hiv in the high coverage areas. treatment as prevention works in the field if you implement. we know that scientifically. [applause]

what about impact of voluntary men. if you look at the study, if you take nonmuslim population who generally don't get circumcised and increase the circumi guess up to 35% by 2011 you have a 42% decrees in accusation of infection. what about -- [inaudible] art and tv. a very marriage between the two diseases. but look what art is doing for it it reduces it in the best way to prevent it is by treating the hiv. it's decreases it by 67%. it has the recurrent rate and reduces mortality up to 90 plus%. you're going hear a lot of models over the few days important models, models in the complex and confusing depending upon what the assumptions are.

you model scale of the -- [inaudible] rather than go to complexity of the model, i want to talk now to scare you just for a minute about a very uncomplicated aspirational model. we know now the incident is going down from 2.7 to 2.5. the slope going down. notice in the lower right, i don't have the date there. we can't talk about a at a time. -- date..