important to play political games. and we are solving a significant challenge. and through our ability to retract business. >> a think it is a characterization not the attack. [laughter] >> supervisor foust being stalled the past three years of changes made in the number of destination of flights around airports called the perimeter rules. faa authorization is expected to come up during the next congress. what would you do to keep more flights in order to protectñ dulles airport from

northern virginia? . .

i should also note in 2007 when he ran for office he opposed dulles rail. one of the first things he did when he was elected with say, write a letter and say let's stop the project. let's do a different way something is senator kaine and congressman wolf said would have derailed the project altogether. i would note at the ribbon-cutting we were both that he was hanging out with a labor union guy who is trying to put the project labor agreement back on there so that was one of the game changers working together in a bipartisan way with congressman wolf in their governor to get that forward is why we were able to get the project going and i supported and will continue to work with all the eye. >> robert a question for

delegate comstock. >> delegate comstock the latest estimates suggest that u.s. companies are losing a staggering $250 million every year in intellectual property theft due to cyberespionage figure apart from the white house's council of advisory on science and technology found that fewer than 40% of students who enter college intending to major in a science technology engineering and math were s.t.e.m. field actually complete the s.t.e.m. degree. what we do to expand secondary and higher education programs focused on careers in s.t.e.m. and thus in america cybersecurity workforce, two minutes. >> telesis such a leader on cybersecurity so thank you and we need to have more members of the chamber working on national security and cybersecurity as members of my table were noting. that's something we can do but on the education front we have been doing that in virginia. we passed the higher education

bill that was very much focused on s.t.e.m. and we know my husband was a math teacher, came to fairfax county served in the schools for 30 years. i know how important it is. we have amendments in our budget that delicate grace and who is one of our pro-creation members worked with me and joe to have money for its steam education out because we had the arts for wolf trap so so wolf trap can do work with preschool children. they have programs that are now modeled around the country on s.t.e.m. education, steam education to get that science, technology and know-how at the beginning. i think we have great opportunities again to highlight the expertise we have in virginia. my husband has been the school system for over 30 years and my mom is here today. she was a teacher her entire life. i come from a family of educators. i think him and the only one on the state to help children in public schools.

i support school choice and opportunity for everyone so let me say that too but we have to improve our science and technology education. congressman education. congressman will this carry that out working with nasa and orbital science and are great companies here. i will continue to make sure for my family tradition that education on s.t.e.m. education will be a top priority and work with great companies here in lowden to do that. >> supervisor faust one minute. >> in the 21st century knowledge economy we absolutely have to focus on these types of educational challenges. s.t.e.m. is something we have been talking about and working with in fairfax county since i've been on the board. certainly working with the community colleges to ensure the programs are in place, working with george mason making sure programs are in place but more importantly in terms of getting kids started down the right path working with fairfax county public schools. they have a chair significant commitment to s.t.e.m.

education. something i believed then and it's something we are doing. we need to create a workforce that is trained in the subjects but also that is trained in creative problem-solving and get away from a standardized memory. we can do that and we are moving in that direction. i'm very excited about the prospects. >> thank you. getting close to the end here. karen a question for supervisor faust please. >> supervisor faust cole provides 40% of america's electricity. on september 15 the government accountability office issued a report indicating that 13% of the country's coal-fired power capacity would be taken off-line by 2025 due to federal environmental rules. affordable and abundant energy particularly electricity is vital to northern virginia and their country's economic well-being. do you support or oppose epa's efforts to regulate greenhouse

gases, greenhouse gas emissions to the clean air act? >> i support the effort to regulate greenhouse gas emissions to the clean air act. the issue is obviously what is the impact going to be. i believe climate change is a significant challenge that we must address. we have got to get away from the carbon emissions that are going into our atmosphere. however we really can't just get there overnight. we have very good things happening in terms of natural gas in the production that is being generated in this country that is far less polluting than cold. and i think that we need to focus on that. we need to look at the coal-fired, the carbon generated coal-fired plants to make sure we are not having to dramatic an

impact or having a dramatic impact on ratepayers. also we have to be concerned about the economy in the areas that are dealing with this. i believe that we have to get away from carbon generators as the primary source of energy in this country and this is one way that needs to be explored to do that. >> delegate comstock one minute. >> like the nlrb the epa is another agency that's out of control. i know you all know that and certainly our coal companies in the state of virginia know that. your democratic senator from west virginia knows that and he talks about that often. the policies my opponent discusses are killing our coal industry and not supporting things like offshore drilling the keystone pipeline in other ways we can offer affordable energy. the way you get an economy moving is to have affordable energy. our gas prices have gone up.

if you are thinking about a single mom who's out there trying to improve herself trying to get to school at night, trying to get that better job if we are making her gas costs more everyday, her electricity costs more she cannot get ahead. we need to have affordable energy to have a good economy and that is why we need in all of the above energy policy. part of the bill is going to go to alternative energy resourc resource -- research and our universities so you would have assigned to technology folks coming up with good new solutions while we use our natural resources to make a more affordable economy and better opportunity for all. >> this is the final question. it's the 11th question of the debate so i'm going to give each candidate two minutes to respond and that will keep us on time. mary who you address this to telecom stock. >> delegate comstock to remain competitive in the demand for

products and services many businesses need access to skilled and unskilled foreign workers. this is a potential two-part question. one, you support comprehensive immigration reform including resolving the status of undocumented workers already turning to the economy and second if not what specific immigration reform proposals would he support and do you favor implementing those reforms by amending the law to the legislative process or by executive order by the president. >> i certainly think immigration needs to be done by legislation and not executive order. i think that's very important. i think first and foremost we need to stop playing politics with this, secure the borders. we know how to do it. fedex can track packages coming here over time. we can track people coming to the country and we could do that right so we secure our borders, we enforce our laws and we do things like passed a h-1b visas

which i support which is very good for our economy. i think we need to do a step-by-step process. people need to have trust in the process. so often when you have these huge monolith bills whether it's obamacare or other huge bills you have all these unexpected consequences. when you can have base hit you all know that in business when you can go in and get good base hits and get something done right. that is what we can do with immigration and i think that's why we need to have by and with the community. we need to have people supporting that and they have to trust the system is going to work. we need to have one immigration system for everybody that's fa fair, equitable and people play by the rules given here and they don't have to wait long. one of the most beautiful things to do is go to a naturalization ceremony. this is a wonderful process. we are a nation of immigrants and we are also a nation of laws. they can be both and we can get that right. we have the technology. if we use our technology

community let's give those h-1b visas end-user technology community and get the immigration issue right. >> supervisor faust, two minutes. >> thank you. i think barbara comstock's answer is know she does not believe in comprehensive immigration reform. i do. i think that the united states senate passed a very reasonable bill. i believe last year that a trust in a conference of a conference avoid the challenges we currently have with immigration. of course those include securing the border but it also provided a way to deal with a 10 to 12 million undocumented immigrants in the country currently. provided ways to help grow the economy with the h-1b visas. it'd just across-the-board the challenge we have. the united states senate was able to come together in a

bipartisan way and support that bill. it moved over to the house and they can't get the republicans in the house of representatives to support it. why? this is one of the biggest challenges we have as a nation and also one of the biggest opportunities we have is a nation. the workforce if we would bring out from under the cover of not having papers would make tremendous contributions. we need whether it's social security or medicare we don't have enough people in the workforce paying in for all of us by age and older. the comprehensive immigration reform is just an intelligent and smart thing to do and we should do it. it's very unfortunate that it has not happened. >> binky candidates. time for closing statements. each candidate will get five minutes to deliver a closing

statement because of a coin flip held earlier delegate comstock he gets to go first burt five minutes. >> thank you so much for the opportunity to meet with you all today and thank you for the privilege of being able to represent you in the house of delegates over the past five years and also the privilege of being able to work, start a business work with our federal government, work with their congressman frank wolf all these years and please no agger congresswoman i will take all of that experience and all the knowledge i have gained from working with you on all of these endeavors we have worked on for over 25 years and take that to washington and on day one hit the ground running to get results. i have that record. i am the only one here who has passed legislation and gotten bipartisan results. we have got to get people back to work and i know how to do that. that's what i spent a career doing from when i started with congressman wolf and we did things on tax reform back then.

in the 90s we worked on welfare reform. well for reform is an issue that this president has unravel. we did all these things to make welfare reforms that people would get back to work and now he's unraveling them. we need to put people back in good high-paying jobs where they get on the ladder to prosperity and advancement in their children can too. when you look around so many people are concerned. i hear this so often. their children aren't going to have the same kind of life that they have. my parents are here today and my mom and dad were the first in their family to go to college. they worked very hard so i could go to law school. i started working when i was 14. i had two babies while i was in night school so i nursed to kids while i was going through law school and worked hard. we need to rework that american dream again. we do have very different visions. my opponent hasn't talked about

job creating legislation. when you look at something like the data center legislation i worked with all of you to get back. the teleworked bills. that's a great transportation issue. we know the jobs of the 21st century don't all have to be in an office although for those of you who have office buildings we want to film those office buildings and we want to make sure lots of people are working in offices too. there's no reason the offices can't be closer to you. everyone doesn't have to go to washington. more people can stay here and you can have more local offices and we can expand and economy there. i will always be working with you in the business community as i have over the past 25 years to make sure the get go smart solutions. we now need to have higher taxes. when they are taking half of every nextel or we know we have to find new ways to do things.

how can we stretch the transportation dollars for there? that is what we can do in so many different ways on health care. if we returned our health care and put it back to the citizens and said you get to decide what you want in your plan, you get to have a deductible come you can't take it from job to job. you don't listen when you get a new job. you will have pre-existing conditions covered. your kids can stay on the planet you want. these are all things that are possible without having a one-size-fits-all health and human services department coming in and telling all your business is what you have to do. so many people me how miserable it is. i talked to a business who have spent thousands of dollars on software to adapt to this program it turned out it didn't work. who is reimbursing you for that? nobody. if we put more of this in your control we know he'll do it better because that's why virginia is tops for jobs. we give you more control over

your dollars and how you do things and that is a great way to get the job done. on the education front, again we need to have more choice and opportunity. we have the best schools in the country. when we look at the top 100 schools many of them are here in this area. lowden county was just named the best place in the country to live. this is the tenth district is the best place to work. it is the best place to demonstrate all that the modern technology and all of our innovation and what we can do. that's how we lift people out of poverty and get them back to work get them on a path to the model class. really experience that american dream that my parents experienced when my dad came from a farm and my mom lived in a one-bedroom tenement apartment. i never knew they were poor because my grandmother kept the

house so clean. i just thought it was neat that they lived in an apartment that had a porch. when this is the american dream that we have all that to my family is lifted and we all want that for children and we can do that in this great diverse community. on november 4 i ask for your vote. >> supervisor vows to five minutes for closing statement. >> thank you very much for this opportunity. i do want to point out my delegate comstock talked about job creation and talked about legislation that creates jobs. i think all up in this audience realize what it takes to create jobs in northern virginia. a tax credit here and there is a good thing but fundamentally what we need is a community that will attract the people with the innovative product -- thought processes and people who want to

create new businesses who want to live somewhere that is trend oriented that has a great educational system as a transportation transportation system that is not dysfunction dysfunctional, that invites women into their community and doesn't tell them how to practice, there doctor how to practice medicine. these are the types of things in the 21st century that make a difference. i grew up in the steel mill town. there was a plant there and people went to that plan to work. that is where the jobs were. today we have a tremendous community that attracts the best and the brightest. they are now coming to us. we need to continue to make investments in transportation and respect diversity and work to create a committee that attracts those types of people. when i go to congress my priority will be to get past the partisanship and work across the

aisle so we can deal with the challenges and make washington work again. i demonstrated i can do that. we need a functioning congress to address and solve our fiscal challenges and to create job opportunity by investing in job creators like education, infrastructure, research and development. we need to improve education at all levels including expanding early childhood education including placing more emphasis on s.t.e.m. education and especially let's make college more affordable. we need to pass comprehensive immigration reform so we can take advantage of everyone's talents and make it easier for highly educated foreigners to come or to stay in our country and contribute to our prosperity. i hope i have earned your support by demonstrating i have a record of working with democrats and republicans to cut

waste and to balance budgets, to make investments in education and transportation and to support a woman's right to make her own health care decisions. i will not accept the status quo in washington. i will work with both parties to find practical solutions. elections are about choices. voters in the tenth district athlete will have a clear choice in november. i believe there will be a choice between my commonsense problem-solving record and barbara comstock's extreme right-wing right-wing agenda on transportation, education, a woman's weight -- right to make her own health care decisions. on transportation as did with the northern virginia business committee and supported governor mcdonald's bipartisan transportation funding bill. we were told by the business community was very very important and we stood with you. barbara comstock stood with the extreme, extreme tea party members in richmond and voted

against it. on education i stood with the northern virginia, i stand with the northern virginia business community and support investment in k-12. barbara comstock with the extreme right-wing republicans in richmond voted to slash $620 million from support for public schools. on women's health care, this is an issue that is relevant to our economy. women are running businesses. they are probably the most dynamic part of our economy at this point in time and we have a delegate who wants to tell them if they bring their businesses here leave their choice behind because they are going to have to let the state tell them how to make health care decisions. that is not acceptable. so you know i will conclude by saying that this has been a

tremendous opportunity and i want to thank you but i also want to thank you for everything you do day in and day out. i see so many of you at different events. i know you are working together. that is why northern virginia is as successful as it is. i don't know what party most of you are in but i do know we are working together to get things done and i thank you for that. >> thank you very much. a round of applause for our candidates please. [applause]

>> i am pastor harry waller. at one time our homeless veterans signed a contract with the united states government that said we will go to battle and give her life if necessary. >> when you talk about homeless veterans any type but the va hospital in the veterans this cemetery to hear lee lee terry's name. thank you for giving us an opportunity to serve them. >> i am lee terry and i approve this message. >> my dad who my dad who at the 26 bomber over france on d-day. he taught merely might never forget those who serve our nation. my disagreements with congressman terry our personal or dispose against veteran veteran -- veteran sailor. congressman terry shut down the government defended its own pay while soldiers were on the battlefield and protected congressional perks like taxpayer paid health care for life while cutting veterans care. >> i am brad ashbury. our promises.

>> lee terry is fighting to keep her neighborhood safe and strong. he secured grants to strengthen community policing and he has fought for the violence against women act, supported new laws to crack down on human trafficking and lee terry pass a law empowering and neighborhood activists to start a new fm radio station giving voice to a community working to stop street violence. lee terry, working hard to keep us safe. >> i am lee terry and i approve this message. >> on the running for congress to represent any political party. i'm running to make a difference for nebraska. reducing partisanship in washington is in one easy step, one single day for electing one new member. i'm going to work from day one to create coalition of 25 members of congress who set aside partisanship and focus on solving problems. just like i've done for 16 yea years. i am brad ashford and i approve this message. >> brad ashford working together, changing congress.

>> c-span campaign 2014 debate coverage continues thursday night at 9:00. according to a new report from the centers for disease control it could be 1.4 million people at cases in liberia and sierra leone by the end of january at the outbreak isn't effectively control. that's next on c-span2. then nih director dr. francis collins talks about medical research, bioterrorism and lab

security.

>> over 28800 deaths have been documented since the first cases

of ebola were reported six months ago. next, the head of the centers for disease control dr. tom frieden takes part in a discussion about the outbreak of ebola in western africa. this event is hosted by the university of pittsburgh medical center. >> we are going to begin. as people do come in please grab your lunches. i am the senior foreign-policy adviser for senator coons on behalf of senator coons and senator flake's offices i would like to welcome everybody today. we have a remarkable panel and we are very excited to have so many people interested of course in this critical, critical issue. i would like to thank anita cicero for her effort to pull together this event. thank you so much. i would also like to recognize

the upmc center for health security for hosting this event. thank you for that and i would like to turn it over to tom inglesby our moderator today who will introduce our distinguished panel. thank you. >> thank you hayley so much and thank you to senator coons. senator flake and the senate foreign subcommittee on african affairs for cohosting this event with us today. welcome to our distinguished guests whom i will introduce at a moment and welcome and thank you all for joining us for this important discussion. we are very glad to have c-span here as well so others can take part in this. for those of you don't know or center are a nonprofit organization dedicated to protecting people's health from epidemics and disasters we are pleased to be here today with you. we are here today for a discussion of the urgent ebola

crisis in west africa. there have been estimates in the last few days that protect as many as 20,000 cases of ebola by november and as many as 1.4 million cases of ebola by the end of january without an immediate and massive scale of ben's's successful response. and the affected countries there is economic hardship on the ground. doctors and nurses have died in high numbers in the health care systems have largely stopped functioning even for normal health care. ebola combines an extraordinary case for talledega rate with the capacity to spread by contact and inability to treat with medicines were preventive vaccine and it doubling time is short as 20 days. there's no other infectious disease like this. it was once relegated to small villages is threatening to take hold in small villages of

africa. but there are also major new efforts underway by the u.s. government and other governments in the world. cbc is making his largest international response in history, more than 100 people on the ground. in west africa hundreds of people in the cdc's emergency operations center in atlanta providing expertise contact tracing etc. which you will hear about from dr. frieden. usaid is providing home protection kits and training in information. people are moving 100,000 units of ppe two west africa personal protective equipment in the u.s. department of defense is providing 3000 forces for the response establishing a regional staging base to facilitate the arrival of equipment and supplies building a bullet treatment units and preparing to train hundreds of health care providers. we know w.h.o. has created a roadmap for response providing expertise in west africa and is seeking funding from governments

around the world and ngos like doctors without borders are heroically leading to clinical effort on the ground. in our discussion today we are going to hear about the situation on the ground in west africa by people who have been there quite recently and who are leading the effort. we are going to learn about what the u.s. government is doing in what detail and perhaps most importantly we are going to discuss measures we can take to end this crisis in the time ahead. each of our panels will give opening remarks for five minut minutes. after that we will have a panel discussion and then turn to questions and answers from the audience and from twitter. our four speakers today who were so fortunate to have given all of a are doing in this response our first jeremy konyndyk who is the director of the usaid office of u.s. foreign disaster assistance. tom frieden is the director of

u.s. centers for disease control joseph fair adviser to the ministry of health and sierra leone and the foundation and co-founder of the well-known organization -- and andy weber who is the assistant secretary of defense for nuclear chemical and biological programs. we are sorry not to have kg on the agenda. we thought we had kg on the agenda and the agenda until director chan said she needed him in new york today. with that i'm going to turn to jeremy and feel free to make your comments from their were come to the podium, whatever you would like. >> thank you very much and thanks for the opportunity to speak. it's great to see this level of interest here on the hill. this is a remarkable challenge and i think it will take, it is taking the whole of government and it will take the whole of society responds for us to fully

support the liberian sierra leone and governments in tackling this crisis. i think the level of public interest we are seeing is a crucial piece to our ultimate success. i will talk for just a few minutes about the overarching u.s. strategy the president laid out last tuesday and usaid specific pieces of that and i will turn it over to my colleagues to go into more depth on their agencies perspective pieces. as a president laid out on tuesday we have a four pillar strategy that the u.s. government is pursuing across all of its many capacities. to try and control and ultimately defeat this outbreak could also look beyond the immediate outbreak of the longer-term leads of health systems and the resilience of these countries to what will be likely future outbreaks of this

as well. now that this is in the environment as we have seen in other countries such as uganda it's likely to recur again and we have is they don't want this whole episode to result the next time it happens. we do know that this can be controlled when there is the place to do so. the first focus, the first pillar of the strategy is to focus on controlling the immediate outbreak. the second pillar focuses on mitigating second-order impact so that things like food security economic stability and political stability and ensuring as these countries struggle with the immediate outbreak that we don't see second-order impacts that are equal to if not greater than the outbreak itself in terms of human impact. the third piece is to coordinate an effective global and u.s. government interagency response.

coronation will be critical to the success of this both at the country level in the global level. there are many countries that are looking to play a role here and in any major response that we undertake there is a large coordination element. hundreds and hundreds of ngos that famously showed up in haiti are an example of this. in this case it's more critical because this is something that none of us have ever done on this scale before. so having coordinated action is all the more important for that reason. the fourth pillar is fortifying the global health security infrastructure such that in the future in these countries and in the region beyond theirs and ability to prevent future outbreaks of this magnitude. it's critical obviously for the long-term future of these countries but also critical in the immediate term that some of the neighbors did not see outbreaks on this scale.

it's an indicator of the risk of also the potential to keep this managed with swift and decisive action. just to speak briefly about usaid's world. the office of foreign disaster assistance usaid has a stand in the government as a lead for coordinated disaster response. in that capacity we have sent a team to the region that has representation across the interagency and works closely with the larger is cdc team that's also on the ground. the focus of the dart team is due both coordinate the interagency but also to deliver and execute on usaid's the pieces of a response. our current focus and i won't

reiterate everything that the president has announced that our current focus is along five lines of effort. the first being effective in country management and leadership of their sponsored so we were pleased to announce that as of today the liberian national emergency operation center has opened officially assault of the elements of the governance coronation of this response it under one roof under u.s. government support for the second element is to focus on scaling up isolation treatment so we are focusing heavily on getting etu setup and working working with dod in that effort. excuse me if i use acronyms that you don't recognize. just raise your hand. it's hard to think about -- the third piece of that is a safe burial. we are on track, we are on track and i think that's one way to

see the most rapid progress. we are on a good track there. the fourth element of this is infection control more broadly within the country and a thick piece of that will be community care strategy that the president announced tuesday that will focus on beyond etu's and going into communities and when necessary households to safely isolate them provide care to community members went full on the etu treatment is not available because that takes time to scale. and the protective kits that tom referenced in the opening remarks are an important part of that and we will be happy to talk more about that. in the fifth element is communications and social mobilization. obviously this is a new disease in these countries. there's a lot of misinformation and misunderstanding about it and ensuring there's accurate understanding and information the people know the basics on how to protect themselves is a

critical piece. underpinning all of that is a huge logistical effort that both we and dod are working on intensively to insure both adequate procurement adequate transport as well as adequate supply and supply management within the country. the volume of personal protective equipment and other supplies that are worried to run medical operations on the scale is enormous so that's a huge piece we are focusing on as well. thank you. >> thanks very much for bringing us together to senator coons office and to all of you for your interest. i have been doing public health, running public health agencies for a few decades on a few consonants and i became a doctor working in new york city in the 80s where i cared for literally hundreds of people dying from aids with the limited

ability to do much other than help them die comfortably. that experience was searing for me personally. i have never seen anything like that until i was in monrovia recently and went to an ebola treatment unit run by doctors without borders, nsf who are working with justin credible effort. their largest response ever is stretching the limits of their operations that we went into the treatment unit and we saw really a scene out of dante. it was patients who were in all stages of the disease from those suspected that maybe didn't have it and maybe might get it there if they weren't effectively separated from others and our lab next door was working more than 12 hours a day confirming

within a few hours whether people had disease or not. people who are just getting in and cared for and desperately needed rehydration to survive. patients who are recovering including one guy who is healthy enough to complain about the food. i thought he should probably be helping to make the food if he can complain about the food. but also tragically three patients who had died in the past few hours and the staff was so overwhelmed they could not remove their bodies. this is a facility in which there are 14 to 20 bits per te tent. so one person in one tent who had died was next to the other patients who are struggling to live. that kind of situation is the

real world exemplification of what it means to have an exponentially increasing outbreaks. it's a very hard term for all of us, myself included to get our minds around that it's doubling in 20 to 30 days in the region. that's facility had 60 bodies removed that day. so, the situation right now in west africa is an absolute crisis. it is moving faster and it's easy to understand particularly in liberia. we have hardly seen exports to both senegal and nigeria. we now have a field team in rural court to bar looking at the possibility of cases they are. but if i were to just summarize here for a minute what we need is an immediate response that is

sustained and then make sure that this doesn't happen again. and if i can just outline those three concepts for a moment. i have never seen a public health situation with this much need for immediacy. if i add -- as i've explained to people and adequate response today is much better than a great response in a week. it's that urgent. and that's the case really in all three countries that are effective even though liberia has by far the most out-of-control situation. but there are districts within liberia that are having relatively few cases. they have the opportunity to stop it before it spreads widely they are and where there are many cases we are intensively trying to scale so we can reduce the spread. in sierra leone where cases have not increased quite as quickly

as in liberia we have the opportunity to prevent a liberia like situation. in guinea were in guinea where cases have had three consecutive ways where it has expanded and control they have the potential of keeping it under control. the best analogy, the best metaphor is a forest fire. we see the forest fire raging in many districts of sierra leone and liberia especially that tri-country area. there's a three border area where the three countries come together. it's a deeply force to the region. it has poor infrastructure and very poor relations with the rest of each of the countries but it is the crucible of this epidemic. and now the capital cities of free time in monrovia which are experiencing the world's first extensive urban spread of ebola in the context of the world's first ebola epidemic.

an immediate response is critically important and that is why president obama's announcement that the cdc last week is so important that the department of defense is on the ground. usaid dart process as they are. the needs are extraordinarily large and that is what's so hard to get her mind around. not only are there needs large today but they will be twice as large and less than a month away at if we are going to be successful we have to build where they are going to be in a month. we are going to have to sustain this because once we tap it down controlling ebola something that the cdc has done for decades with w.h.o., with host countries. in 2012 in uganda where we worked with ebola many times tragically a 12-year-old girl died from ebola. what was striking was that she was the only one who got ebola. that's the only time in history we have seen a situation like that but i'm aware of other than

in a laboratory where they're someone who got it but people immediately thought this might be a bullet. they isolated her in an isolated setting. they confirmed it was ebola. they ensured that when she died she was safely buried and they ensured to make contacts were tracked and if they had gotten how they would not spread it further. if that kind of core public health service of finding problems quickly and responding abruptly at -- percolate. if that would have been in place a year ago on these three countries the world would be a very different place today. but the fact is we now have an outbreak that is likely to continue for a significant amount of time and to protect other countries who need to serve. so when one individual went to lagos is city of 21 million people about the same as the three countries in west africa we immediately got on the phone with the governor of lagos and

sent 10 cdc experts within 48 hours to go there. we brought in 40 people who they trained as part of the polio eradication work who were in nigeria and have been working effectively on that. now they are not completely out of the woods but it does look like they have controlled the outbreaks in lagos and port hardware. that involves health care workers doing among other things more than 19,000 home visits to measure temperature of nearly a thousand name contacts. that was to address one case of ebola. we need to have a response that's immediate, that is sustained and that prevents future events like this because we could have prevented this in the first place. sires cost the world $30 billion in just about three months and the economic implications of ebola in west africa notches for

west africa and not just for africa but for the world are quite substantial. w.h.o. in their publication yesterday raised the possibility of ebola becoming endemic in africa. that would mean for those of you who aren't in the public health world that it would continue on an ongoing low or medium level indefinitely. we think that's not inevitable. we think if that were to happen it would be an enormous problem not just for west africa and africa but for the world because we were wise not to be thinking about the possibility of ebola and anyone that might have had of ebola. i would just reiterate the approach that president obama has outlined is exactly what we need and need to get the scale and the speed that will match the exponential growth of the outbreak to ensure that we have an immediate response that sustained it prevents this from happening words not happening

now and happening again anywhere whether it's ebola or any other health threat. thank you. >> joseph. >> thank you for the invitation to talk to dan let me start b by -- sorry. let me start by saying i completely agree with the director's comments. we happen to see each other in sierra leone while he was there and i would like to preface my remarks with the understanding that i'm mostly speaking from my own experiences in sierra leone and liberia so my remarks tend to be skewed towards those countries which are currently experiencing the worst parts of the outbreak. when we say the situation is dire in sierra leone and liberia liberia, we which is can emphasize that strongly enough. what we are facing is an end of day scenario locally of biblical proportions. people of those two countries largely feel abandoned by the international community however that response is now starting to trickle and then there is hope.

there's a light at the end of the tunnel hopefully although it's going to become worse before it gets better. and i would like you to keep in mind when we are talking about those two countries we are talking about two countries that endured a decade of civil conflict. we are approximately 11 years out from the end of festival complex and considering building a public health care infrastructure in 11 years is an enormous task. we were dealing with regions which were almost on the brink of not being able to offer sufficient health care on a normal day and what we have seen since the onset of the outbreak is a complete breakdown in the public health and health care infrastructure. schools are closed. hospitals that he'd been even experienced ebola are closed and i think from that we may never know the toll of deaths that resulted from nonebola cases from a very normative connections that occur every day in sierra leone. there was a headline today on

"cnn" that you have a ebola unless proven otherwise and that is indeed the case. before the outbreak that could argue that the case would be you have malaria unless proven otherwise. we have complicating this factor that ebola is occurring in a highly mobile environment that is well connected by roads. we are dealing only with colonial borders. these are not tribal borders. the tribal languages amongst these countries are all the same so it's considered much as we would consider going to canada from united states. we are still very much experiencing an upward trend in the number of cases in library especially but also sierra leone as director friedan mentioned. while i truly applaud the move by nsf to reach out to the united states military for support the building of treatment centers is something

that i don't want us to commit -- put complete faith in stopping this epidemic is frankly we could build treatment centers for the next 12 months. at this point in time where overcapacity for treatment centers. as director friedan described is a horrific scenes scenes. justin camomile alone a month ago we were in a situation much like dr. friedan described where we had 10 persons that have passed. we had no body bags because nearly all commercial flights had stopped coming into the country so that delayed the delivery of body bags. approximately 10 bodies stacked just outside of the treatment center as director friedan mentioned. as a patient you can imagine you are trying to survive this disease in their mentality in trying to survive this disease is very important. you were looking to your site to people lying next to you the day before hours before and looking at 10 bodies stacked up. all you can imagine as you are going to be next.

so you can see why there is a tendency which we have all read about about people fleeing, running, not coming into treatment centers and that's largely because treatment centers are considered a house of death. i think we are turning the corner in that opinion and the reason we saw that early on was part of the messaging. much of the messaging we gave early on in this epidemic which was accurate but not locally understood was there is no licensed treatment for the oak -- people left virus. what we had as a result was a large portion of the population wanted to believe in ebola virus to start the two white sugar portrait treatment centers there is snow is treatment for ebola. rather than hearing supportive care will increase her chances what they heard was there's no treatment for ebola so that led to almost half of your population to seek out traditional healers. a lot of that involves bloodletting which is probably the worst thing you could do

during an ebola outbreak and that is also greatly contributing to the spread of the virus. where we are today and it's going back to the treatment center in my opinion are absolute number one party has to be stopping the transmission. we are going to do that with boots on the ground, with trained epidemiologists and a very sustained effort. is this on gheni we almost thought they outbreak was over. we went two or three days thinking is completely over and we missed two or three contacts and that's all it took to start the largest ebola outbreak in history. concurrent with that is construction of the treatment centers for those that are already infected but speaking as a public health professional i think her number one party has to be to stop the transmission, save the people that are not yet infected and treat those that are currently infected. i want to caution that the

phenomenon we have seen since the introduction of things like zmapp and introductions of experimental vaccines, what that has resulted in locally as the believe that that's going to be the answer to the outbreak. the local population thinks we have these miracle drugs, these miracle vaccines that will stop this outbreak and that is how we are going to stop the outbreak. again i go back to the number one priority is epidemiology. we are going to stop the outbreak by stopping the transmission chains and improving our infection control and treatment centers. in the long-term what this is going to require is almost a rebuilding of the public health infrastructure these countries. i would say this is conservatively setting those countries back in that regard five to six years. and we are also long-term going to be dealing with the truth of the effects of the ebola outbreak, put security most commercial airlines with the exception of one of supplying to these areas. we were largely depend on them

for cargo and a lot of commercial trade of those countries are doing. tankers including oil tankers have now threatened to stop talking interior -- interiorly in liberia. we are still working on getting mobility and transport in place. those are all things we are going to have to deal with concurrently. lastly i will say we are facing a unique situation especially in sierra leone and liberia and a lesser extent gheni. this is the first time almost we have had an outbreak in an area where we already have a hype hyperepidemic hemorrhagic fever. as of last week we are entering the dry season in sierra leone. the areas which have been most effective especially in panama and ki lesson they areas of library that have been affected affected those happened if they

are hyperendemic areas for fever. shortly and we are and we a party soon as we are going to have multiple hemorrhagic fevers presenting at the same time and right now there's not even a place to put the ebola patients. now we are going to have to be thinking about how to please separate the loss of patience from the ebola patients because that's not something we want to mix. the chances of survival with -- are greater than those with ebola enters an approved treatment that. so my comments are done. >> thank you. >> well, thank you tom and upmc center for health security and the u.s. senate for organizing this meeting today. clearly there is a lot of interest in this very important and urgent crisis. .. and tom and i

regularly for the last five years, we have a very strong partnership between the department of defense and the hhs elements and cdc that goes back many years. this is not new to global health and going back to our tradition of walter reed and the work that he did on yellow fever virus. last week we established operation united assistance which would either dod support to this global effort that is led by the united nations and the special mission was established this week in support

of our civilian agency counterparts, working with allies, including the united kingdom and france and others that have reach into the affected countries. the dod will focus our contribution on her strengths and our unique capabilities and capacities, including command and control and logistics and training, as well as engineering support. we established the joint forces command under the u.s. africa command and major general darrel williams has been on the ground since last week doing the assessment. he is also the commander of u.s. army africa. the command headquarters is being established in monrovia, in addition to a regional and

intermediate staging in senegal that provides a lot of logistical support to ensure the flow of personnel, equipment, and material for this very large area of west africa. and in addition the united states this week will send to more and diagnostic laboratories some of our best scientists and microbiologist from the medical research center will deploy with the units to liberia and one in liberia and they will be associated with ebola treatment unit so we can have the diagnostics. and the department is providing a hospital that will be staffed

by international health workers and medical personnel. the department of defense will not be involved in direct patient care is a part of this. we are going to construct 17100 bed ebola treatment units in liberia. and the planning and preparation and contrasting for that activity is under way. and that should start to show results on the ground in the next few weeks. and these units will be staffed by local and international health care providers. and again the department will

provide training based on msf and what they have established in belgium and we are going to establish a similar training center with the goal of training 500 health workers per week. and the focus of that will be on infection control. the department of defense is requesting support from congress for up to $1 billion to commit to this effort and they are pending here on the hill. and this includes the

cooperative biological engagement program that is also going to invest over $60 million in strengthening global health security capacity and laboratory capacity of affected countries and also the neighboring countries as well. in the department of defense program has been involved for many years in the development of therapeutic vaccines to the affected country as well as personal protective equipment. and so i'd like to note that the very 13th of this year, the u.s. government launched a global effort and that has grown and it

wasn't in response to ebola, but the white house will be hosting an event of 44 countries at this level and we have health ministers, defense ministers in different sectors which is necessary for the whole of government response and to build those that west africa could have prevented this from becoming an epidemic to prevent and detect and respond to infectious disease outbreaks as required under the international health regulations. secretary hagel will participate at the agenda on friday and

secretary john kerry and it will be hosted by ambassador rice with the participation of president obama. i would like to finally think people like joseph and the workers that are on the ground. those that are on the ground who have just returned from there for their truly heroic efforts and we owe them all a deep debt of gratitude for the work that they're doing on the ground every day in west africa. thank you. >> thank you, andy. and thank you all for setting up this discussion for so much insight and information to start the discussion. we are now going to turn the discussion for those of you following along.

for those online, submit the questions to ebola on the hill. so before we get too specific questions about the response, because i think people really want to understand the nuances with the leaders here. i just want to ask one more question about the consequences if we get this wrong and if we don't rise to the occasion and he began to paint the picture here about what is at stake. but we hear things in the media along the way in the long lines of this country has enough on its plate and we love our national security threats. why is it important to invest so much of our time and talent on this problem and what happens if we get this wrong. the usa today headline was that it could the ebola epidemic on forever, which i think is one way of saying pandemic, which was talked about. so what are the consequences for

african security if they get the strong? >> earlier in my career i spent three years living in guinea, working with refugees from liberia. and as joseph said we're only about 11 or so from the civil wars in this country. and the u.s. invested a large amount of effort and political capital and resources to bring peace to these countries and this outbreak is unchecked, if it is unchecked, it could undo a lot of effort in terms of strong investments that the u.s. has made for international interest reasons. but at a human level it threatens to devastate and it

already is devastating in these countries and i think that there is a strong humanitarian impulse in the politics and it's the reason why we are a leader. and i would say the global leader on humanitarian action and disaster response. and anytime there is a disaster on this magnitude, the u.s. is on the frontline and this is this is an absolute national security priority and the president has articulated it as such. and so i think if you look at the level of interest in the media, there is a clear desire to beat this thing and we know that we can. >> i think that the sad fact is that the worst-case scenario is

really bad and yesterday the cdc outlined what would happen if the ex-potential growth were to continue at the rate that it was growing a few weeks ago. we don't think that that will happen because of the response the u.s. and others that the worst-case scenario within a relatively short period of time, not only would affect one's africa but would inevitably spread to other countries, we have two disease exportation events with the first couple thousand cases. how many events will we have as the president said for hundreds of cases and whatever we may think, it is not possible to seal the borders. it just doesn't happen as it did in troll of drugs and diamonds

of people and it just doesn't. and so what that means is that we really are all connected. and so while we do not think that they will continue to spread as we believe it has been spreading it all along, it will present a significant health risk to people in the u.s. and it could change the way that we work and the economy of the world and the way that we assess anyone who has traveled anywhere that might've had ebola. that is why a president obama highlighted the whole of government response with what they can do to stop this as quickly as possible and recognizing as the president said that it's going to get worse before it gets better and we have to recognize that although we have to work immediately, it's going to take time as it comes around. and the other key findings was

that progress is possible and when you isolate this, the disease stops spreading and can decline in numbers almost as much as the numbers we're seeing now. but what we found particularly striking was the mathematical documentation of the urgency that we all feel even a delay of one month and scaling of the response resulting in a tripling of the epidemic and that kind of shocking increase is very hard, as i have said, to really get our minds around as we try to make sure that we are anticipating what is likely to be recognize the situation is fluid almost beyond description

and it changes day to day. but the response has to be with the urgency that will turn around and i think that we can do so. but the risks are not just to west africa but the whole world. >> sure. first of all, i would like to draw attention to something we've mentioned several times. there were two other nations, nigeria and senegal. and we looked at the response in those countries and how they contained it very quickly and we can't ignore the fact that the gdp is approximately $503 million per year and when you compare that to the gdp of liberia, around 1.9 billion, you cannot ignore the fact that the socioeconomics of the disease are upsetting. so it disproportionately affects

the poor. i would argue that we are experiencing a level of mental and social, not seen since the civil conflict and a lot of us may question the mentality with ebola. and it's a direct result of the conflict at the time. the only way that you're going to talk about is to see live with live with her family in that sober talk about right now. we are turning the quarter convincing that bite keeping someone in their home, not only are you greatly increasing the chance of that person will be okay, but you could infect your family and that has happened many times for that message to come through and we are likely to see major impacts on the governments of these countries. for example, liberia.

johnson was certainly one of the most popular presidents in africa until this epidemic and now you have seen a determinist of negativity flowing towards the current administration and we face a similar circumstance. but the current episode, if you look at it, the book will divide is much like we have in the u.s., a two-party system. where the current epicenter occurs is the opposition party stronghold in this includes those that are all being used as political fodder in office in sierra leone even though they have greatly improved the conditions in the past 10 years. and i think everyone on this panel is familiar that we have spent much of the last 10 years focusing on bioterrorism since i'm 11 and another term which we

use, bioerror. this is the worst case scenario that we have thousands of individuals with the ebola virus. taken by technicians that are baseline phlebotomists and a lot of infections occur because of this and there are no good trappings for that. in addition, all of the clinical laboratory services that are needed with illyria, common infections of people have, it's understandable because when you receive this sample you assume that it is the ebola virus. so to echo this, i think were going to have a lot of long-term effects, which we are also going to have to address and to echo

the previous comments, every single day we delay, we are experiencing an ex-potential increase in these number of cases. >> opening it up to the audience or questions as well as online. but it relates to the pillars of response and we will need numbers of nurses that are not available now. there's an element of training going on in the planning and recruiting and so how do doctors and nurses get involved in this in our country and also in the world if they are willing? >> is a critically important question and prior to that there was no global reserve capacity

in every previous response had been a relatively modest scale in comparison to this one. and so the global capacity to treat this was premised on that sort of response and we are now faced in a situation where we need a response scale that involves funding institutions, organizations, and nonprofit, medical teams are able to come forward and it involves identifying this traffic and staff those and one thing i think is important to underscore is that the treatment unit model that is being widely applied, only five to 10% of the staff are professionals in the vast majority of the people who are taking a rest risk on putting

themselves on want to control this are nationals of other countries and we are working seriously to set up training models and the world help organization has been reorganizing training in the country itself as well. in working with, working with people to put them through this training, and the health organization recently opened with a large complement of the staff and we are looking for those to join in the response. and it is reachable from our webpage. were we are collecting contact information for people that are interested and we are making that information available to ngos and other partners who are

looking for staff to step up their own responses. and it's a resource for them that they can draw on to help to comput understaffing >> >> i would just add to that there is natural causes despite the fear the african union with cdc in department of state has supported with e.u. dollars that are now on the ground in the country is helping out. this is the great example of what is needed. there are some barriers to break down for people to go back to their own country so some african countries have put up travel restrictions

even with their own citizens but 90 percent of the staff are local staff intensively trained and willing to work in these areas so the numbers become more manageable that way but still they are very large. just this week cdc has a large trading course outside of the msf model with traders and we could scale that up. >> great. we will take questions now from the audience. just to make it easier save it wait -- it may not be accurate the senate by percent of the current victims are women and children. if that is true what you

think of the socio-economic impact and psychological impact and how does that change or alter your response? >> de publication found although there was the impression of the maleuú dominance which we have seen in the past to the females give more of the care giving it seems a 50/50 response. women -- chilled -- children seem to be affected less directly but we see those implications. i was speaking with one survivor and her nephew was they're bouncing off the walls. he was about four years old the and they said the papers don't let him go outside to play because they're so afraid of him. i held a survivor of a young child whose parents died.

she is now with an aunt so we see a terrific problems. and i saw one of our staffñ who has done oppose deployment screening and they said the stories that they tell like for example, one of our staff described babies left of the streets by parents who thought they would infect them and they hope somebody would pick them up. the implications are enorm is just by the society themselves. >> if they are fortunate enough to survive there is the stigmatizing when they re-enter the community if they are allowed.

and the maturity of care giving that we are experiencing the 5050 split but considering the burden of that with mint period they are the primary farmers in addition to that we had entire family is wiped out. oftentimes the children had survived because they were distanced but now we have the untold number of orphans now the social that was already under developed so now going back to the civil conflict we see numbers now that are not equivalent to what they saw during that but now it is reaching that 11ejez thea most effected areas.

>> the second pillar of the strategy is focused on exactly that is why we focus on that. even that immediate outbreak under control there is some effects that will take years to address. >> next question. >> i have a question about the abolition of the virus. it has more human host than ever before and it in an article published through those human host what is the current and ongoing efforts to understand the direction the virus will devolve now it has sc ever before? >> we are in the abstract

area. we have see less than 5% which is relatively small. i thing the fact we have seen tanner 20 different generations puts us at a different environment than before. we had some groups looked at this is the need to track their genetic changes over to ibm and there are those making the time to do that but who knows so little about the genome and the questions and we're likely to pick up the of course, of change but they should be going hand in hand.

>> following up on your comments about containment in the response of the of expansion? >> working on surveillance act point of entry. can you elaborate when you see a threshold and how does thathj correlate the thinking carefully about how to do that most effectively and most practically. the first is to stop the that the source did africa.

we have been talking about that and that is the most effective but it will be a while so we need to do more than that. the second with stopping those who may have ebola from leaving the country and then to put people in each of the airports of the affected countries doing multiple temperature readings, as well as a questionnaire and removing anyone with a five -- a fever or have ebola. that is not the perfect way because somebody could have just been exposed and the incubation period is between eight and 21 days. it does that mean and it has

kept those arab alliance& is not impossible but someone what may come in with real already worried with symptoms considered with ebola in the area and have been affected and they have called ben narrative.

in terms of border projection ray have a close working a relationship. anyone if they might be consistent in that could respond. sojourners stand how could we could manage effectively we could reassess with others. . >> -- ada jazz and other.

>> that was handed a microphone. >> we heard from our panelists that the effort to that not go had a hard over three months than we are done but we heard about the u.s. response this is what you represent period"eñ including the $1 billion of sending that would cover six month period to build up the efforts. can you give us a sense of what you mean sustained by a length of time? and the response that you believe is needed from other countries besides the united states? because we're doing a lot but it needs to be a major international response. >> i will say a couple things. basically give them un number and the dates but not

together. but we do know this sooner we get out there the sooner they will control it. so it is critically important.$uax with of waterfall collaboration several parts of the department of defense and then i h them french in the italian all running laboratories but there has been a robust global response as with the peacekeepers is on the ground. there is a robust international response to have that unique ability to have those skills and scope

>> is focused on that very question reno the u.s. government could carry this entire response on its own with the u. k stepping up in a substantial way to mention the international partners stepping up doing regular calls. been passed have the day we have been on twice with the u. k and donor partners. that make intents -- intensified the efforts. >> international of reach is the area that president obama emphasized in his announcement in atlanta us cdc. the u.s. objectives is to mobilize the community to

improve the of coordination among the international community. next week you k will host an event focused on sierra leone to coordinate contributions. of the private partnerships for example, the gates foundation has pledged $60 million to this effort and others are contributing. the agenda we will leverage that the real commitments commitments, real commitments fraction of funding for in kind contributions for security around the world also specifically the current crisis.

and does ambassador paul to lead this effort for the donor coordination the. >> i forgot to mention the world bank. they have been terrific they have already put 100 people in the field. but they get not just the emergency or the immediate response but those laboratories that would have prevented that in the first place. and can prevent similar events in the future i will discuss at the white house on friday. >> i would like to add i don't want to speak to the timing.

the with the decrease in number but for me sustainability so we can prevent this from happening again. there will be medium term training and a long-term training coupled with investments and sustainable technologies. that will take time and effort and will continue to do so throughout the life span of the outbreak. but the african union secretary it all of them being extremely responsive and is coming together as far as governments. and the dates foundation all of them have started to contribute funds. when you look at the on the ground situation it is those

bodies in the local population of government health care workers met that will be key to sustainability. >> the stakes for getting it right are extremely high because even before we succeed in liberia or sierra leone it seems like a crucial element of the response. >> thank you. i am wondering as to evaluate the funding streams and the short-term time lines is their limitations to the current funding or those challenges? >> can i add on to that question? it would be great to hear from the panelist what they

believe congress in particular could do since we are here today. bad is that that particular point what can they do to support this response. >> i will address cdc just for the 11 weeks of the sea are cost $30 million we're grateful for congress to do advocate that just at the level we're going. that is no scale up that is just 11 weeks and it does not involve addressing other countries which may deal with large outbreaks to strengthen their resistance to surgeon in that area as well to produce the risk that would ignite forest fires elsewhere it does not deal with the medium long-term issues to make sure we have the technical

capacity in the country to do that. we're working very closely with the world bank and others these are substantial and will continue for some time. >> just as the panel reflects. and with those potential toecaps and with the prospective the highest priority with the programming request. with the overseas contingency operations.

so immediate attention into those two will avoid any possible operations. >> from the usaid side one of the top priorities is to ensure the dod reprogramming is improved because that will allow the large scale cooperation in the way that with this response just like any others that dod and aid worked extremely closely together where it works with dod to route those requirements that is well-suited. so having that resources

available will turbocharge the type of scale of response that we absolutely need to mount. of the '80s side come as we move into 2015 we have a better handle on what this will look like. but i don't want to get ahead. >> i think we have talked about the short-term financial needs i will speak more thinking about now as well as save holistic approach but in the medium term and long term objectives for sustainability, and to prevent this is we will require investment in infrastructure or laboratory setter permanently based you diagnose these log their own and investments of human capital with regards to new

training and epidemiology and the laboratory. and another aspect is something that will be implemented is training of crisis management in the emergency operations. prior to the outbreak they did not have to deal with acute humanitarian disasters. they were long-term but not acute. so that is the medium and long-term investments i argue to ensure this does not happen again. with the holistic aspect in addition to stopping the outbreak how do we deliver fuel to the area?

and then to rebuild right before the outbreak and hopefully the silver lining they would have strengthened healthier systems. >> with the alliance from buy a security but a couple of you mentioned misinformation we have seen with the outbreak so far and i am worried about government to engagement to fix the problem to address those concerns about getting a the correct messaging in the understandable way to the affected communities. what is the level of engagement and how is that going? and how critical is it done correctly in this timeframe for success? >> thank-you.

i would be happy to talk to that. with regards to the issue -- mr. j remember there have been conflicting messages within a the government. there are opposition parties and political opposition but we have seen a term in that. and with the political consortium and maybe not so accurate. but still dealing with messages from groups -- groups you may not immediately suspect bike from nigeria and that is something we've tried to fight against but that being said it is essential to work

to religious leaders in the area but with that armageddon like situation people are flocking the large focus is on the religious community that was miss portrayed as a lot down there really the mobilization is how you can identify it and has a well as identifying cases in the home. so a the messaging is taking place. i feel we're turning the corner but the messaging needs to be concise from everyone. >> can each of the three

countries has a point person. our role at cdc and dod is a support and noted the group is moving into of management building for more than by a coalition. and the incident manager this week moved into his new office. in and within the system so instead of everyone doing their own thing the coal is to have clear evidence based objectives based on information in coming back in with the household survey+% done by sierra leone's showing a surprisingly high level of awareness from the

key messages that involves the logistics' sending someone to be cared for safely. >> time for a few more questions. >> afternoon. you spokejs about the history of the region with a decade of civil war. how will the reaction be when there is such a traumatic path dealing with their own military and their mistrust of the services provided prior going back to the rumors that there is no care or we cannot provide care? what is the military doing to address that psychological impact of that

force showing up on their doorstep? >> i believe the involvement of the department of defense will actually will build confidence in the government's hand in the region the resources commensurate with the scale of the challenge to support the response. >> that is absolute a right to. there was the desire on the part of the liberian government and people to see a massive scale up of the response getting from the teams out there and the

arrival of three resources has been extremely well-received. people can easily distinguish between what the u.s. military comes to do with that conflict that they have. >> if i may i will add to that is specially liberia is the the first time they have experienced u.s. troops on their soil we have a large station there that has been training with over the past four or five years. all in there is much the same where5thec< u.s. was straining the militaries of the two countries. in liberia and happens to be one of the most staunch allies. so liberians are is static and adding to do that was

the request that the dod to participate. that despite being a humanitarian organization operates like of the tilt -- military so the military is widely known for having both of those qualities and it is welcome to everyone on the ground. >> i have two quick things. what about the front line health workers and also dr. frieden group of staffers were able to meet with the team combating the response.

to help ministers don't always get as much attention and. and had to make get their attention for long-term growth? >> it is our experience people pay attention in the middle of an outbreak. within countries you will find the public health aspect is weak. but for senator harkin to establish to run laboratory networks. in that would be a tragic

that as we respond to you ebola that would be the systems that prevent the next outbreak to get out of hand as it has. >> and health care workers on the front line? >>. >> they say you vermis challenges in the enormous risks. and those innermost dash risk working in the whole system. it does not have the equipment#ç it needs or the staff does not have the training that they need. with these are countries with extremely weak health systems.

so with those procedures within the health system and the knowledge. the community care program which it is intended in my part it will pave the prior day across liberia providing training and equipment so the health workers can better protect themselves. there already popping a. that's not getting support. this will provide support degree of training so that hopes facilities to have a place to go so those effected with ebola rather than keeping in a health center roy they cannot handle it. >> but the doctor has the

unviable final comments about the situation.rc >> thanks for the opportunity. i am more than welcome to talk to people after words. largely liberian and health workers take a tremendous tool we're at the beginning of the epidemic we have ben working in this space for decades. the supports has they try to provide community care centers in it is critical.

that we give those family members living care givers the best opportunities for those practices to have the units fully functional and support with the duty and others. there are some tragic stories but the most compelling reason with those workers on the front line day or there.r they just want to be trained to to show them how to do the job effectively. but prevention control that touche -- will have long-term benefits long after the epidemic is under control and will decrease of

clients of possible acquired infections as well as protecting health care workers. i will stick around. thank you. >> thank you for being here. >> many of us have friends or colleagues working on the front line in west africa. but to share realtime information m. we call it the t. levin knowledge forumé to put first impressions the anecdotes and stories for formal guidance so now we are

pastime. i'd like to thank our distinguished panel last for their time and the end to all of you looked -- you worked to put this together. [applause] and. [inaudible conversations]