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]

"washington journal" continues. >> host: this morning here at the "washington journal" we are going over to the national institute of health in the washington area to talk to the institute and director about what this national institute of health does. research facilities and as well as news that has been made about ebola and what they are doing over there to fight that and bio terror and lab security. joining us is dr. francis collins, the director of the nih. i want to begin with

breaking news yesterday. cnn tweeted this out saying if there are no additional interventions, the ebola death toll could rise. this according to the cdc. dr. collins, what is the role of nih in fighting ebola? >> guest: good morning. yes, nih is deeply engaged in thest to try to turn back a frightening outbreak of ebola in west africa and yesterday, tom freeden did make this projection that if nothing happens, we could look at more than a million cases of ebola over the next few months. a frightening number. but we want to make sure everything is don't to keep that from happening. what is our role? largest supporter of research in the world

including research on infectious diseases led by the best known infectious disease expert in the world, tony fauche. partly the development of vaccines and developments of new treatments for people infected. vaccines moving forward at unprecedented rate and this is an effort we started 13 years ago anticipating there might be a need for a vaccine because ebola has been around since 1976. albeit small outbreaks. this is the 5th generation ebola vaccine. looks very good in the animal models. you don't know until you try it out in human patients whether it will be safe or work. we did start three weeks ago what is called a phase one trial of this vaccine. 20 individuals have now been injected with that. they are volunteers here at the nih clinical center. so far, all is going well.

no red flags to indicate there is a problem with the vaccine but it will take a couple of months to see whether or not those individuals mount an immune response that you would think would be protective against acquiring the disease. once we have the data, we need to move quickly to get this into what you call a phase two trial in west africa in individuals that are at risk. all of that is very complicated in a circumstance where in liberia and sierra leone and guinea, a great deal of stress as you can imagine on the health care systems but we're determined to figure out a way. >> host: what is the time line? >> guest: november before we have the evidence about whether the vaccine is looking promise in this phase one trial. if it looks good, shortly after that, meetings are going on today and every day exactly about how to do the design, we would try to then set up this more extensive

trial in west africa that would determine whether the vaccine is actually effective or not. there's a second vaccine we also played a role in, developed in canada. that is also getting tested sort of parallel and we have partners in england in the welcome trust tufting one of our vaccines in a different population, all hands on deck here. everybody is trying to do everything possible to speed up a process desperately needed. >> you said this is unprecedented. so, describe what it has been like to ramp up this vaccine research and effort. >> guest: well, we've been working hard on this for 13 years. we didn't know when this outbreak might happen but many were fearful it would. nobody anticipated it would be as bad as it is where the disease spread into the cities making it difficult to follow. frankly, if nih had been in a better position as far as research support over the last 10 years, we would be

further along. this is a consequence that we're not in a position to already have this vaccine ready to distribute. but we pulled out all the stops. colleagues at fda have been hep full speeding up the process of approval but i wish we were a little further along. i promise you that working with cdc and other partners, we're trying to make this our highest priority. people's lives are at risk. >> host: did you get more money. congress voted for a continuing resolution that funds the government. extra money in there to fight ebola. >> guest: for c tv and organization trying to speed up the therapeutic development. let me say a word of that. vaccines are preventive but for people already infected, vaccines will not help so there you need a treatment. people have heard about

zmapp. cocktail of antibiotics shown in animal model to be protective against dying from this disease. we want to be able to see how that works. a total of seven people have received zmapp as part of a come passionate use effort inclusion the two individuals we first heard about that were air lifted to emory hospital in georgia. we don't know with seven individuals whether this work in humans or not. the problem is those were the only seven does that's existed. nobody expected a big push so barta is pushing forward with dollars from the cr, a scaleup of thattest. for technical reasons, that is not trivial. acts are developed in a tobacco leaf program. and that doesn't necessarily turn into something where you just turn the crank and have lots of it. it is taking a while to do that scaleup.

two or three other therapeutics are promising but none in human trials. we have a big push there as well. as far as nih, we did not receive additional dollars in the continuing resolution. that goes through to december 11th. clearlily, whatever happens after that, we hope norad additional dollars because this is going to cost a lot of money. >> host: all right. we're talking about ebola with the director francis collins. join us for that conversation. the nih funding for 2013 is about $30 billion, $29.2 billion. and the 2015 request from the white house is $30.4 billion. founded in 1887. located in bethesda, maryland in sprawling campus. 37 separate institutes and centers. world's largest hospital

dedicated to clinical research. a little over 23,000 unique patience in 2013. your questions, your comments for the director of nih. get your thoughts in a minute. william is up first. vicksburg, michigan. democrat, thanks for hanging on the line. go ahead. >> caller: actually i'm from mississippi. >> host: sorry about that. go ahead. >> caller: first of all, thank you to c-span for allowing me to comment on this subject. first of all, first of all, i shouldn't say this but i'm a free mason and i don't want you guys to lie about health and thing like this because one thing about it is i love to help other people. it's one of the things that i love to do.

if you guys are funded for this ebola operation, then you can put forth the most earth to it and i understand that what you're saying and everything but if you reach out to the other cities, countries, states and ask them for funding, if they won't give you funding, ask the other people will they fund you to help the ebola. because first is the country of america needs to survive and if anything happens to america, then i believe the whole world is just out of hand. >> host: dr. collins, are you preparing for ebola outbreak in the united states? >> guest: i think the chance is low. on the other hand, it would not be shocking if someone with ebola got off a plane at some point in the next few months in the united states because this is such

a large outbreak in west africa though efforts are being made to do screening at airports, that is possible but our public health system is excellent and such an individual would be rapidly identified, isolated, we would make sure that kind of quarantining took place. i think the chances therefore that you would have a widespread outbreak in this country are low. a testimony to the public health system that has been built up over many decades to make it possible for me to say that. the caller is also suggesting that we do need to lean on other countries and i agree with that. the world health organization is a major convener of all of those countries trying to help. lots of ngos involved and particularly to doctors without borders carrying a great deal of the load in the early parts of this outbreak. we've all got to work together. greet that, you mentioned the statistics about nih. also important for callers to know most of our money is

not spent in bethesda. goes out in grants. 85% to our best and finest universities and research institutions. when you hear about a break through that happened at stanford or the university of chicago or the university of mississippi or wherever, it's very likely if it's by a medical research, it was funded by nih. >> host: let's go back to the situation with ebola in the news that was broken yesterday, the wall street journal has these numbers, 1 .4 million. cdc worst case easy mat by mid january. 2,811 the latest death toll. this 1.4 million is if nothing were to happen and doesn't take into calculation what the president announced recently with more money and sending soldiers, sending the u.s. military down to liberia. >> well, exactly. that projection, we have

many miami doing this kind of modeling and they come up with somewhat different answers but it does look quite frightening when you're on a exponential curve which is what is happening now in liberia, then over time, you can see numbers very fast into this kind of category of over a million but we want to stop that. so the president's announcement which i was heartened by and involved lots of input from different parts of the government including nih was to make a bold step here to try to put in place efforts to stop this outbreak in going further including asking the department of defense to set up in rapid fashion here 1700 beds in liberia so those individuals who aren infected or thought potentially to have been exposed can get the kind of treatment and isolation they decurvee serve but that won't be enough. we also have to have a plan actively pursued about how do you handle individuals who are potentially exposed

outside of these treatment units because we won't have enough space for all of them to come in. lots of work being done on that. obviously the countries where this is all happening, liberia, sierra leone, guinea, with the leaders increasingly effective in engaging with communities, this has to be a full bore effort on the part of efficient everybody involved. the u.s. of course has an i want worldwide in trying not just to be sol injuries to the world but doctors to the world. i think we're pulling out all the stops to do what we can. >> larry in alexandria, independent call you are. yes. >> caller: good morning. i want to thank you first for putting himself in harm's way in dealing with these issues because we have some things out there that i know they just haven't yet spoke of but what noters me is it is taking so long for them to get a handle on

potential answers to questions like they said, they've had since 1976. is there any way to cut down, anything we can do to cut down the time lag in fighting these? we have to analyze them after so many deaths before we get the idea that maybe this is important? >> guest: very sobering question. one we all struggle with. no one anticipated when the first case of ebola appeared in new guinea in march of this year that there was the potential for this kind of explosive outbreak and for the first couple of months looked like it was under control and then by the summer things started to happen that were alarming. it is very challenging given the already difficult circumstances in these west africa countries as far as public health systems which

are in many cases quite rude men try to mount effective effort. that made this difficult. the fact that the outbreak han in the cities has made this much harder than previous since 1976 mostly in rural a areas, more easily contained. it was sort of the perfect storm. i share the caller's sense of urgency and frustration about how hard it has been to get on the ground every resource we think is needed but i'm heartened by the steps taken in the last couple of weeks especially by the u.s. government. we do need more partners on the international stage and i'm hoping more of them will step up to the plate as well. this is an international worldwide public health emergency. no one should hang back if they have resources to contribute. >> host: i want to introduce another topic, dr. collins. that is security at labs. it's a story in the news

recently with lab agencies, not just your own but cdc and others, here's u.s.a. today yesterday. what has nih done since reports have come out about mice being infected with the ebola. what has nih done? >> guest: we're taking this very seriously greta, an issue we really need to attend to maintain public trust. important to point out that though there have been surprise discoveries of agents around for a long time, decades in some instances that have been lost track of, no individuals were hurt as a result of it. no risk to the public. at the same time, recognizing that it is possible for things to slip through after many years of people coming and going from

an institution like nih or cdc. we are in the midst of doing a thorough sweep of every freezer, refrigerator, shelf, drawer, to make sure that everything is where it should be and we're well along with that and by the end of this month will have a full reporting of what we have found here at nih and likewise, we have asked all our granting institutions, most of the people in the u.s. that do medical research to do the same. a good opportunity to take a full inventory. again, i will not want anyone to be alarmed that there is a serious risk to public health as a result of this, but it is prudent for us to be sure our house is in order and that's what we're doing. >> host: is there enough money for the nih and laboratories at universities, enough money separated out for security? >> guest: i think so.

we will put in place today a new sort of recommendation that will be announced later on today about how they should pay attention to biosecurity issues in relation to research that might potentially be used for nefarious purposes by those that have malintent about what they want to do with certain types of research, dual use research of concern. universities are struggling now. nih is struggling. frankly in answer to your question, maybe i should point out that nih and all granting institutions have lost about 25% of our purchasing power for research over the last 10 years. putting a stress on the system and a lot of great science that we'd like to do is slowed down or stopped as a result of this ten year decline. it's rather ironic when america has led the world in biomedical research for about 50 years that we are now slipping in that regard when other countries are coming up fast. that is bad for the

potential here of medical sad vanses, bad for our economy. i'm hoping that over the course of time and very soon, in fact, decision makers in the congress will figure out a way to turn this corner and bring us back into a stable support for this remarkable engine of discovery, biomedical research in the united states. >> host: who has oversight over the university labs? is it the federal government? >> guest: yes. every one of our granting institutions as part of the contract they sign on with us in order to receive taxpayer money to do research have certain obligations they have to follow and institutional biosafety committees that oversee this issue of biosafety in place for a long time. those are activity involved in this current business of looking for any evidence that their are agents in places that shouldn't be. they are strongly in a place i think which ought to provide a lot of confidence that these institutions are

very much taking care of the issue. >> host: we go do michael, north carolina, independent caller. good morning. >> caller: hi. how are you today? >> good morning. go ahead. >> caller: dr. collins, with all the good help we do around the world, that's what america is about, when are we going to remember the three million people here that have help tie at this time b. add450 coming out. fda is real slow on letting that out. they let everything else out. commercials that you wouldn't want to be stuck with the disease you have before you try the side effects. this is no side effects. for three million nonresponders. $120,000 for a 90 day course of steadily funded technology. they use federal money to come up with this drug. my tax money and right now, i'm dying. i'm in stage 3. the insurance companies with

the no caps are turning me down. on getting this medication. yet you have three million people in the country that are nonresponders. you are a cure, a proven cure for this disease yet i have no problems with helping the rest of the world, doctor, but three million people, out of the three million, how many people are not going to be able to afford this with insurance companies turning them down to buy the medication and the next step is a liver transplant. i'm 258 years old. i will not take a liver transplant because a 4-year-old deserves a new liver before a 58-year-old. >> guest: that's a troubling story from our caller from north carolina but there is a lot of excitement right now about the ability to cure hepatitis c with the new come points just pushed through and approved by the fda. i'm deeply troubled that the caller is not able to get access to that because of the cost and there is a lot of discussion about the

cost. point out however that even though the drugs are expensive, it is very expensive also not to be cured of help tie at this time c an such things as transplants cost more than the drug. i don't know exactly the caller's situation but i would think in this circumstance tans, there oughted to be a plan by the drug manufacturer to make this available to those that can't find the resources or don't have the insurance to cover it and i don't know how to handle this on the air but i would encourage the caller certainly to get in touch with the company and ask if there is some way to get access if the insurance is not providing coverage. >> host: okay. fred in florida. democrat. >> caller: good morning. i'm confines are fused. about 10 or 12 years ago, you made a movie about the ebola virus in africa, dustin hoffman, morgan freeman. all these people was in the movie and another question,

why is it you got the white doctors out and two of them but left a few behind causing all of these illnesses. doesn't make sense. at. >> guest: i'm not sure about the relationship to the movie. halves an opportunity to raise consciousness about the facts there are these new viruses emerging all the time that place potentially a worldwide community at risk and something we should be working hard to anticipate, develop therapeutics and vaccines for. what we've been talking about. the two individuals that were air lifted from liberia, that was something that their organizations, samaritan's purse wanted to put in the resources to do. that was not. money that was responsible for their traveling to the u.s. and being cared for. but in fact, u.s. citizens, as they were, are entitled

to ask to come back into the country if they need medical care. there was no reason to refuse that. happily, both of them recovered with the care they got at emory university hospital. of course, there are now thousands of people in west africa who are infected. there is no practical way to move them out of the space where they current are so the big effort now has to be to provide care for them there in country. and that would apply also to health care providers. many of whom sadly have always been infected and hundreds of them have died as a result of ebola. but the big push has to be to get things on the ground in liberia, in sierra leone, in guinea, to make it possible to treat those who become infected and reduce the number of new infections. that's what this is all about. >> john, independent, good morning. >> caller: good morning. my question is about the z pack. are you guy making more?

is that what theater using to treat the people that came back? they ran out. is there more and all the troops that they're sending, are they going to get the vaccines before they go? >> guest: so the vaccine is not ready yet to be delivered to anybody right now. it is just this face one trial in healthy volunteers to see if it is safe and generates an antibiotic. the troops going now to set up the 1700 beds are not able to have access to that because it's happening right away. in terms of zmapp, as i mentioned, this is a biotechnology advance where these are antibiotics directed against the ebola virus but they're generated using a recome bin national airport dna factory which happens to be tobacco plants. tobacco plants have increasingly been used for that purpose because they have the machinery to turn out proteins.

but it doesn't scale easily. and the production of zmapp was not anticipated to be needed on this kind of scale any time this year and so at the moment, we're in a bind. what barta is trying to do is pull out all the stops to scale that up or find other ways to make the zmapp abilities in a different system such haas been used in biotechnology for other purposes. unfortunately, there is no solution that is going to provide large numbers of doses of this in the next few months. it will take time. taxpayer. [please stand by]

the containment, how much trust show the public have in vaccines developed? can we see things going to legislation like the patriot act that protects eli lilly from possible litigation if they fail safe vaccinations and cures and treatments, and what do we have in terms of backup to

prevent this from becoming a worldwide epidemic? worried about avian flu, many people have been discussing. thank you. a lot of questions. let me try to take them quickly. in terms of confidence we ought to have in containment, a huge challenge in the circumstances inflict west africa. the department of defense is sending resources to put in place 1700 beds. but it is very challenging to come up with a strategy which requires a so it is an public education so people know what to do. critical issues about people affected, burials of people who died whose bodies turn out to be infected. do not touch and do not wash.

a huge effort is underway to achieve those kinds of strict public health measures. it is challenging indeed. in terms of what we're doing in terms of other parts of outreach, this is a huge priority. you mentioned the possibility of a flu outbreak. we worried about that about age five and one, which has been there for south east asia. it could potentially turn out to be a worldwide effort. we're working on a universal flu vaccine which would be effective against all vaccine strains and we believe we are in a pathway to get there. we would be further along if nih had not been in a circumstance of losing more purchasing power. this takes a lot of time and effort but we have not been able to move up the pace we would really like to. a wake-up call about the consequences of having those limitations when there is really a serious risk of worldwide illness.

much of your work is focused on preventing illness and how much is focused on treating illnesses? >> it of course has to be both. vaccines are an incredible contribution to the world. that hasok at the way prevented countless deaths, from childhood illnesses and such things as influenza, it is worth every penny. sick.ople still get we want to have something to offer them, whatever the illnesses. we put a huge amount of effort into therapeutic spirit we work as part of the ecosystem, basic science researchers funded by the government, doing things that would not get done by the private sector, but we work with our partners in biotech and industry. this vaccine for ebola, we would not be able to promise we could scale that up and have thousands or maybe tens of thousands of doses without that kind of

partnership. full-page ad in the washington times this morning from peta with the picture of an infant monkey, and it says, nih, millions spent scarring monkeys and making them depressed and drug. stop it now. what is the policy about using animals for the research you do? >> a good question. animals are essential for many of the things we are trying to learn about how to prevent and treat human diseases. with humano things patients ethically nor would we necessarily ask them to be involved in some of the studies that can be done on animals, which give us great insights, whether it is diabetes or heart disease or heart -- or alzheimer's. there are particular concerns i think when those animals are close relatives of ours. i want to point out we recently pretty much to

scale back or maybe even stop altogether research on chimpanzees. after extensive debate, we have the potential of small colony chance we would be for the kind of research that can only be done with chance. when it comes to peta concerns, they are also pointing to other monkeys where they are concerned about the way in which animals are handled. i want to reassure people this is done with intense oversight by a variety of groups that look at protocols to make decisions about whether the results of the research are justifying the kinds of studies being done. there is a great deal of attention to avoid pain and suffering. but reasonable people will still disagree about whether we have the balance right here it >> let's go to harriet, a miami beach republican caller. >> two questions.

first, there was a study not the ago that showed possibility that ebola was airborne. have you done any follow-up research to see whether that is true? is, there is aon magazine put out and sent to i believe everybody, every nih and ibout the wonder how much money the taxpayers are paying for the nih pr magazine. guest: to take the second question, i am not familiar with any. there is a small publication published by the national library of medicine that highlights things happening in research that you might find in a doctor's office. it is a modest budget and an

opportunity to inform people about wings that are happening they might want to know about medical research and implications for health care there has been a lot of discussion about, is it possible the virus could become transmissible by the airborne route, which would be a dangerous development. one animal study was actually quite different than anything you could imagine happening in thens that suggests possibility of that. frankly, i think the experts looking at that say that is not likely to happen in the current circumstance for humans with any serious possibility. the other concern is the ebola's mutating,la virus is as many viruses do. a lot of copies of the virus have a chance to change properties. we think it is unlikely those changes would make a big difference in transmit ability. it deserves close watching and the best solution for the risk

is to end the outbreak at the present time, we think airborne transmission is extremely unlikely to develop. that is good there it you do not want that to happen. >> a lot of questions this morning about ebola in the news. before we let you go, remind our viewers the role nih plays in the medical research community. >> it is the largest supporter of biomedical research and the world. the research is funded by grants we give to institutions all over the country, as well as what is done here at the is the campus has been over the course of many decades the reason why lifespan have been increasing and deaths like heart attacks and strokes -- we're making great strides against cancer and all kinds of conditions. this is a noble institution with a noble enterprise. privilege for me to serve as its director. i wish it was more widely known

about in the public. anybody who looks at the mission of the accomplishments, the trains, the vision of what can happen next, if we really pulled out all the stops and applied all the resources we need, would be truly excited about the promise for dealing with a whole host of diseases that currently cause a great deal of suffering. host: dr. collins come up next we will talk to patricia grady, the head of nursing research there. why is this important, to focus on nursing and having the research there? , as theatricia grady director, can no doubt tell you a lot of exciting work they are supporting. we have 27 institutes and centers at nih and we're trying to cover the entire landscape of biomedical needs. nursing is a critical part of our health care system. they also have great ideas about the way the system could work better. she will tell you more about

that. that is part of the integrated whole that covers the waterfront from basic science to translational science to clinical trials and everything in between. we're doing everything we can to against world safer disease, to come up with strategies for treatment that people just really need. host: a big thanks to your and your team for letting "washington journal" to come out to nih. we will continue this conversation and we will talk with patricia grady. we will talk about what her team does and what sort of research they're doing in the role of nurses. later, we will talk with dr. griffin rodgers in the national institute of diabetes and digestive and kidney diseases. that will be our conversation coming up. we will keep taking your calls until we get to patricia grady.

a republican caller, kimberly. we do not have a guest right now but what are your thoughts on nih and pacific lee what they do there? >> i was thinking a lot of the vaccinations they do our greed driven. i take care of a lot of senior citizen friends at 75 bus. despite the fact they have never whatever, ibox or noticed they're pushing the shingles vaccine, for $200. even though i am there with the person and they're telling the it, theyey do not want still try to do the shingles vaccine. that is crazy. havethe fact that i myself taken my daughters to the doctors, upper respiratory problems, and they wanted to give her a vaccine while she was sick.

not supposedu're to do that, you know? but if you tell these people, they get an attitude and you're not as smart as they are. the truth of it is, if somebody is already sick, you're not supposed to give them a vaccine. i wonder how much of this not sd to do that, you know? is money driven. host: you're wondering about the profits of vaccines. caller: physicians and nurses are pushing even though the patient is not qualified at the time when they are sick, or the person never had chickenpox to justify it. why would they push that? ok.: new york, democratic caller. help me with your name. in westborough, new york. caller, go ahead. one last call for a westborough, new york. host:democratic caller. caller: hello. host: clifton, new jersey,

democratic caller, go ahead, curt. caller: when ebola comes up and the ice bucket challenge and everything, i have to wonder who will do the research? what happened in new jersey is the biotechnology and pharmaceutical research has been decimated. most of biologists do not have anywhere to work. pfizer came into south andswick, fired everyone, the plow was bought, they got rid of all the chemist there. they closed a, site. i am wondering who will do the research, because all the people i know do not have jobs in chemistry and i do not know where the people in seton hall and princeton and russert -- and rutgers will find jobs. known will do the research after this. >> ok. back to the national institute of health, were patricia grady is joining us.

she is the director of the national institute of nursing research. , what is they institute and what do you do? >> we provide information for clinical practice and also for promoting wellness and health across the nation for individuals regarding their stage of life. because of nursing research, teams are better able to manage diabetes, young minority women are able to increase -- we have a better understanding of how men and women respond differently to certain pain medications, and we have provided tools for helping end-of-lifeiscuss with family members and patients, and also to try to approach the issues regarding that difficult time of life. >> why is that an out you know it? what contribution is nursing research making?

>> nursing research does studies tot address chronic illness help us identify the issues, and how better to identify interventions to help make that better. we engage in studies to determine how to change toaviors in individuals , and we determine what is important for these patients to want to know around the time of their end-of-life. we have an effort on the patient's and what their symptoms are and how to make their symptoms -- their conditions better. we also focus on the family's of those individuals there we know the caregivers require well.ance from us as

the area of end-of-life is particularly important. as the population ages, people develop more chronic illnesses with age and develop serious illnesses. we know that it is really important to focus on the symptoms, pain and suffering, at any stage of serious illness, and also family members. there is awhat we found out is great deal we do not know about pain management, communication among the health providers, and also patients and families, so we have identified ways to strategize communications systems to improve that and better address what patients need at the very serious time of illness. another area is incorporating the patient in planning their own care so they get the type of care they want and do not get the type of care they do not want. we also have, and studies have shown this, that is very important to the patients but also to families. if the condition has a serious

and negative outcome, if a person does die, that the time after breeze meant -- grieving is improved by someone understanding they did with their loved one wanted. and can rest assured of that. there is a great deal we do not know about painhost: we are talking with patricia grady, a trained nurse with a masters in nursing and a doctorate in physiology from georgetown university. our topic this morning is research and the role nurses play in health care. we have four nurses and we want to hear from you. get to joshua in rockville, maryland, and independent caller. good morning. we lost joshua. let's go to joy. independent caller, missouri. aller: i would like to see program on exactly what the nih does to monkeys and other

animals. i bet the average person would be shocked at the cruelty involved. ok.: right. patricia grady, is the use of monkeys part of your institute? a small amount of rescission animals, but not monkeys. but nih does. we did have -- we did hear france's college, the director of nih, speak about that type of research. >> christine, buffalo, new york, democratic caller and a nurse. caller: good morning. i have been a nurse for 48 years and have seen tremendous from the old to the new. i started out in the diploma program and got my bsn degree when i could afford it. i'm just wondering, have you done any research about what the impact of the 2020 resolution

before a lot of the nursing board as to having a bsm for all willes and what impact that have on obama care? >> we have not done any research in that area. we have done studies that show that the more education and background and experience nurses have is associated with debtor outcomes for patients with serious illness. but we have not done studies on specifically the 2020 proposition. >> susan is next, a republican caller in waldorf, maryland. >> i have been an outpatient for the past six years after having brain cancer. i am currently an inpatient watching myt here tv in the neurological research division. i cannot say enough about nih, the nursing staff, the doctors, everybody. i have been so impressed and in love with nih.

>> specifically, what is it about the care you are receiving? >> i am receiving excellent attention and care. i do not have to push that call button more than once. i cannot give enough love to this place. i wish i could give some way back to it. all right. that is a patient right there at nih right now. -- you watching, nursing, nurses interact with patients for best practices? guest: we are in most of the research we do is directed toward improving best practices for the over 3 million nurses across the country. i would like to thank the caller to -- for her contributions to nursing. i am pleased that as a practitioner and someone who has

been so much a part of the health-care system, that she is feeling very positive about nursing and its contribution. the clinical center is a specific example of nursing at its best. nurses there are involved in research protocols and really where there is state-of-the-art care being given. it is good to hear that you're there and that you are watching this morning from your bedside. nationaldget for the institute of nursing and research, the request for 2015, 100 40.5 million. in 1986 atblished the national center for nursing research, elevated to an institute in 1993 and more than 80% of the budget goes to researchers and trainees. registered nurses in the united states. in 2012, nearly 3 million registered nurses. the estimate for 2002, 3 .2 million. what does the health care system

need to do to prepare for that increase? -health-care system desperately needs additional nurses. that, thecause of nurses who are graduating, the increased number of nurses will be welcome and the environments will be prepared to take them in and make certain they become part of the new system seamlessly. our graduates are well prepared and very excited to be part of as new health care system our country moves into the 21st century. we have so many more opportunities for taking care of people well and for helping keep them healthier. we spend a lot of time in difference that test different settings. we have a number of studies that help teenagers and manage their diabetes, for example. problemss health across the spectrum of life, from helping premature infants leave the natal intensive care unit earlier and healthier, two

managing theirns diets any health problems they have, and also the older population who are living with chronic illnesses, to help them manage and be part of their own management of care. most people now are living older and healthier at that age. they really want to be a part of their health and care. studiesve a number of that are helping us assess that and develop strategies for helping people to dissipate in their own health. we're working with technology that helps people age at home, as it were, and it also helps them be active while we are monitoring the situation. if their activity level increases or decreases according to it ever chronic illness they manage, that will be noted and if help is needed, that will be sent so if all of these technologies are becoming much

more technology for these people to help monitor their own health, and also to be able to be as active as possible for as long as possible. press we will go to george next. independent caller. .> thank you so much i was there with the ebola situation and i'm also a clinical researcher. my question is, we in the medical community have been trying to reach out to nih and cdc and the body that are actually trying to help the situation in west africa right now. we have not had success with regards to national. that is involved in trying to help stem this disease. my question is, we know there are training programs that have been organized by cdc by obama

and we know there are links your sending in your resume's, but we are finding it extremely difficult for us to actually be contacted at with regards to helping. for me, i am a clinical researcher associate. that lincoln health, directly, given that link. is there a way that there may be so that can actually directly contact cdc or nih or any other body so we can have a direct impact from the get-go? -do not have a specific contact information for you on the ground in africa, but i do know we are excited people want to help and are trying to help. we are going through the process of trying to get active people. there is a great deal of preparation that takes place even for people who are already

involved in clinical care and clinical research, so that the process of going through the identifying and devising training programs to help people, when they are on the ground, is in the process. checkd suggest that you our website. we have a special link on the nih website related to ebola and will help you get from there to hopefully wherever it is you need to be very -- be. host: vicki is a nurse, democratic caller in oregon. i have been a registered nurse since 1966. i was wondering, i'm still working because i was called back by my organization to do teaching. wondering about the trend for the 12 hour shifts, how that across the country, the trend is

that nurses work 12 hour shifts. there at the workplace, 12.5 hours. i hear in many situations, they do not have rest rakes and breaks for lunch. how does that impact our 100,000 lives campaign and is there any association with increased errors with medications and other types of errors? when somebody is working maybe 3, 12 hour shifts in a row, and their commuting and they have a 14 hour day or whatever, and maybe there's lead to private and not getting the rest they need at work on any research being done on that or has there been any research in the past? are funding a fair amount of research on sleep and sleep disturbances and sleep patterns. it has been shown that decreased associated with impaired thinking and the ability to function. we have noted that in particular with soldiers and shift workers.

it is important that everyone needs rest, but particularly important to have proper sleep and have rest so you are better able to function and and effectively. >> caffe, democratic caller, berlin, illinois. click yes. patricia, i've a question for you. how do you determine your criteria when you are given money to these medical students in the university's? what is the criteria that is required for giving money for research? how do you know they are being upfront and telling the truth, actually, and not just getting the money for kickback money? that,ctually a victim of being used as a human guinea pig

. a university in the chicagoland i am not quite, sure yet if it was funded by the government or the nih, but i did contact the nih and they would not help me with it. they were very rude to me. that wasrocedure done an idea in a peer-based journal. i am disabled and now. -- disabled now. when i spoke to nih, they could not answer me any questions. >> patricia grady, could you answer the criteria question? >> that is a difficult story and i am sorry to hear that you had that unfortunate outcome. the money he have for research, about 80% of our budget goes out to research studies and for trainees across the country. we keep very close monitoring of those funds. they are given to the university

on behalf of of researchers for studies. there is a fairly brisk surveillance of how that money is spent and to make sure the goals of the research projects are met as outlined. we also have very strict oversight for human subjects. anyone who participates in a clinical study. because we understand how important that is and how they are helping us to make lies that are for future generations. there are very strict oversight for inclusion of patients in studies. i would think -- and that is that a local site as well. those are usually our oversight plus the institutional oversight, it tends to be very strict. inwe will go to paul next hollywood, florida. an independent color. hello, paul. >> good morning. i have a question regarding research in the area of pain management and the emergency

room for patients with sickle cell disease. , the healthitute institute, have they done any particular research in the area, and have you dispersed the information out to local regions and local hospitals to make use of that? i have seen some research in the area at duke university that seems to be pretty the successful. north carolina as well, and chicago. does notinformation seem to be reaching the rest of the nation. >> what is your experience with sickle cell? experience as a survivor, i am 65 years old now, has been slowthe treatment is very as the patient comes in. the area of fluid administered right away can decrease some of

that a patient will have to wait for as the doctors at emergency rooms are very crowded and doctors cannot always get to you right away. but there is very little protocol, like immediately given fluids, as opposed to saying, wait over there and we will get to you. that type of thing. and the patient remains in pain. >> describe the pain. for as the doctors at emergency rooms are very crowded and doctors cannot always get to you right away. sickle cell pain is rated in the emergency room from 1-10. anything of eight and better is considered to be crucial. the pain is in the joints. many times, in the chest, and the head as well. though, if i could describe it, it is as though somebody is squeezing your joints or squeezing your chest. your breathing is restricted. excruciating as a result of oxygen being denied

or the blood lay let's, the blood cells clogging in ottery's -- arteries and joints. but his not being supplied to areas of the body, especially organs. oxygen and blood is not reaching organs. this is producing pain. it can be disruptive to organs sickle cellwithin the body. >> ok. patricia. >> all is a good example of great deal knows a about his condition, sickle cell, and is able to describe it to us and also to his care providers, if you do go to the emergency room. in our institute, we do not focus on specific diseases. we do focus on symptoms. so we do have a fair amount of research directed toward the pain related to sickle cell. it is acute and serious.

part of what we do in addition to getting information is for how toategies improve it. some of the ones paul has mentioned are some of the ones we have been able to identify. we also, his question about getting information out, we also have a responsibility to get the information that we generate, new information from the research, out to patients and their families. we make a concerted effort to do that through our website and messaging, as well as publishing in not just scientific journals, but also lay journals and publications that are more available to the general public. that is an important part of what we do. we have, for example, at the end of life, we have a brochure on the website available in spanish and english and we also have written a chapter on the senior health website for how to stay healthy related to end-of-life and end-of-life issues. in we have a campaign

pediatric care that discusses issues related to conversations. it is called "conversations matter." those are very important because we have information about how to manage systems and how to communicate with the health care system, and, in general, they are intended to help health care providers work more effectively with patient populations. and also, for the patients and families. >> we will go to our line for republicans, naomi, republican and a nurse. ask how going to say or are actively active nurses. i am retired 45 years. license current

because i volunteer for the american red cross now. and they really make it hard for you keep your nursing license up. you have to attend so many classes for so many credits. wondering, what is your comment on that? >> we do recognize that as the population is aging, that the nursing population is also aging. we are facing a serious issue of retirement in the upcoming years. licensure ande the requirement to taking further education classes is important. there is so much new information. much of it, we are generating in our research. so much new information does affect our clinical practice for health team members. , and i know it

is inconvenient for the person, sometimes but it is very important for patients and their safety at the people providing that clinical care are up to date on the latest research and the latest findings to improve clinical care. those requirements for continuing education are likely to continue. about nursingng with the director of the national institute of nursing research. patricia grady. a couple of minutes left. our last call, christopher, in alabama, a democratic caller. go ahead. caller: i have a general comment on nursing. i pay out-of-pocket and i do not have insurance. i have a great doctor. to a clinic for things like blood tests. i have diabetes and i am treated for anxiety. what i have downed is that the nurse, because we have more time

to talk, if i am at the doctor, it costs more to -- more the longer i am with them. i found in talking to the nurse, i have gotten more information of how to treat my medical problems. christopher, i will leave it there and have patricia grady jump in. guest: so much of having a known as are the symptoms that bother us. that is the focus of our research, on symptoms and symptom management. determining what causes the symptoms and how to intervene and how to create comfort and relieve systems. a great deal of what we do in research and what nurses do in practice is related to that. it makes sense the nurse will be the community.

we have people who are very mobile dealing with chronic illnesses and symptoms related. it does make them. i would say, talk to the nurses, find out the variety of approaches that can be used to relieve symptoms and make you feel better so you can feel as healthy as possible. is about wellness, preventing illness, and increasing quality of life, so that every individual, regardless of the stage or age or background, will have as high a quality of life as possible. that is our goal. to work with you, the public, to make that happen. >> for more information, you can go online to the national isn't it of nursing research's website. thank you very much for your time, patricia grady. our conversation continues here about the role the national

institutes of health plays in medical research today. up next, we will focus on diabetes, digestive, and kidney diseases with dr. griffin rodgers. towardbut they tend continues with a stop at northwestern university. we will talk with the president there. we will keep getting your calls until we are joined by our next doctor. let me go to marjorie, a nurse and independent in missouri. what are your thoughts on the nursing field? i am retired but it brought back some of the things they're it i was a missionary nurse and i taught research. i have a masters, also. 1989, when i encountered the ebola virus in south sudan, we dealt with it and we were able to do some things that contained it a little.

had to keep off people and burn them and keep -- give the ashes away. i did want to answer a question with epidemics. why they sendnder out the american missionaries -- the missionaries to america. it is common. you always save the people who can save others first. you want those alive who could help more other -- help other people. the other question that i think he did not come up but perhaps it is relevant, we, in iran then intaught, and sudan, it was totaled as -- total denial. you get anybody working overseas. the health service will not admit it. epidemic.huge cholera

no one would admit it. our students would lose family members and we were not allowed to call it that. the third problem i might mention that might be relevant, it is a different type of epidemic but i was wanted to bring it up. a research problem -- project because he always thought a home there were 10 times as many physical and medical of underage mothers that give birth. infants would have mental status and things. you cannot i just for the social conditions but in iran, you could. there were many early mauger is -- marriages. we get a research study and it had to and when we were kicked out clutch or years later. but before, children and mothers, as ashley under 14, but under 16, were still mentally about four years below in doing

it is aasks, and problem today here in america. i think we need to do some research here. sri. on that, i will jump in. we want to go back to the national institute of health and here in bethesda, maryland, a sprawling campus close to the capital in bethesda, maryland. the budget overall for 2013 was $29.2 billion. about 30.2ey got billion. the white house requested 30.4 billion. this institute founded in 1887 and comprised of 27 separate institutes and centers. theof those institutes is national institute of diabetes and digestive and kidney diseases. we are joined by its director, dr. griffin rodgers. just tell our viewers what sort of research you do at the institute. >> the national institute of

diabetes and digestive and kidney diseases is responsible for some of the most common and chronic, costly, and consequent so diseases affecting americans today. we have research in diabetes and related endocrine disorders and metabolic diseases. we funded studies of digestive diseases, liver disease, as well as in kidney disease. the nine neurologic diseases. a vast see it is spectrum of disorders we are responsible for. your budget is 1.7 billion dollars. how is that money allocated out and for what? componentse are two of our funding scheme. inter-more -- inter-murrell -- a program here in bethesda that funds a number of laboratories and branches. we have had a laboratory in near the rivera

reservation, where we study obesity and diabetes among the indians, who have among the highest prevalence of diabetes of any population in the world. roughly 10% or slightly less of our budget goes to our program. about 85% of that budget funds research at universities, medical schools, hospitals, around the united states and, to a limited extent, internationally. >> let's focus on diabetes first. in 2012, according to nih, the effect is -- the affected is about 30 million people. aged 20 and older have prediabetes. 200-8000 under the age of 20 estimated to have diagnosed diabetes. how big of a problem is this? is a huge problem. the fact that there are 29 million americans with diabetes,

perhaps a quarter of them are unaware they have diabetes, but that is just the tip of the iceberg. 89 million you described that have prediabetes, a condition in which the blood sugars are high, but not quite high enough to designate them as frank diabetes, that is a major problem. no these patients, however, are at high risk for developing diabetes sometime within the next 1-5 years. i think we all agree that prevention of diabetes is certainly a goal that is critical. we want to prevent the high risk group from developing, preventing the development of diabetes as long as possible. host: the wall street journal this morning has this headline. a sign of progress. certainly, that is some positive news. notuld say that that is seen in all populations.

although overall, the numbers may be trending and finding out, a higherroups have proportion. certain racial ethnic groups. people over the age it -- as they age, the baby boomers increasing the numbers of our population, this is a risk factor for diabetes. family historya is certainly another risk factor. ,nd so, putting that altogether while it is somewhat comforting the numbers may be leveling off, that trend is not apparent in all populations. >> dr. rogers, where are we with treatment of diabetes? what is new? >> the two forms of diabetes, the major forms of diabetes that i should mention, first, there is type one diabetes, which we used to refer to as juvenile diabetes. this exists in individuals who have a genetic priebus a bit ash

predisposition -- a genetic pancreasition -- their inducing the insulin. these individuals are not able to produce sufficient insulin and that is required to sustain life. about 95% ofrity, individuals, have type 2 diabetes, or what we previously called adult onset diabetes. then, their body produces a sufficient amount of insulin and it does not work very well. they consist -- a condition called insulin resistance exists. it really drives the epidemic we're seeing in type two diabetes. is directly related to the obesity epidemic we see in the country. just read isne i this one in the wall street journal. pledged by 2005

5. coca-cola, pepsi company, dr pepper, snapple, will work to cut calories in the american diet 20% by 2025 by promoting bottled water and low drinks and smaller portions. treatment is one thing, but the treatment combined with a bad diet does what? you offset the positive effects one receives. i have to say we are really gratified that a number of these companies are taking the effort to actually reduce the calories. one of the things we know is att in those individuals high risk for diabetes, those our nih fundeds, research for diabetes prevention program showed that in that high risk group, losing about five or 7% of one's body weight through exercise and calorie restriction

can greatly reduce the risk of going on to develop type 2 diabetes. the fact that you are seeing companies now making this effort really is gratifying. host: 83 -- a tweet -- to smoke toe needs live, but you have to eat to live. the types of strategies effective in the antismoking orpaign do not exactly match can be utilized in the obesity campaign. these really require important efforts in behavioral research and usually, people respond to different ways to rewards.

a lot of the research we are actually funding now are really efforts in behavioral research, or the science of behavioral research, to understand why people do certain things and not others, and how one can best and or makeectively explain certain that the recommendations given are carried out. >> according to your institute, obesity in the united states, approximately one third of u.s. adults and nearly 17% of children and teens. let's get to call. conrad is up first, independent. hi, conrad. >> good morning. i recently had a kidney transplant, after a few years of being on dialysis here. concerns is aest billf bills, a bipartisan

with a beautiful name, the comprehensive immunosuppressive drug coverage for kidney transplant patient acts of 2013. in 2009 and 2007, going back a decade. , byas bipartisan support subtest bipartisan cosponsors in both houses, and yet, after a decade, it has never even gotten out of committee. i was just wondering if you knew about the bill, and if so, if your organization had any public support for it. i am not certain of the details. i suspect the caller is referring to an effort to make certain that after patients who have in stage kidney disease were either required dialysis is a semi-for a kidney transplant, and the situation in which individuals receive a transplant, of course, they are receiving an organ generally

or otherose relative donor. of course, one has to take immunosuppression regimen or drugs to make sure the body does not reject the transplanted organ. i suspect, but i am not certain, that the bill you are referring to allows for ongoing coverage for those medications and that is an area in which, we really provide the research to understand what drugs might be more effective, how long one needs to be on the drugs, but specifically, for the legislation, we are not a part of that area of governance. immunogen z's in past 20 million americans. what are you doing on the research front and where are you with treatment? wewe have a number of things

are undergoing. just like diabetes, what is inving the diabetes epidemic this country is obesity. in turn, the leading cause of chronic kidney disease in the country are diabetes and secondly hypertension. if one can effectively mitigate or prevent people from developing diabetes, which is our effort, then in turn, one could prevent complications associated with diabetes, such as chronic kidney disease. we have a host of efforts underway to see whether, in fact, one can first identify people at high risk for developing chronic kidney disease, again, there are genetics associated with this. people with kidney disease, it runs in families. we want to make sure people who have a family history or a history of high pressure and diabetes, are aware of that, so they can go to their doctors to

be tested. because if one has been found to have early kidney disease, one can introduce therapy that can gradually slow down the rate it progresses to in stage disease, requiring a kidney put chet -- a kidney transplant or dialysis. currently, we are involved in a number of studies to understand what it is about the kidney that could potentially lead to the damage, either acutely or chronically. and whether some of those, that damage, can actually be reversed inside kidneys. for people who already have in stage kidney disease, there are a number of efforts underway. when -- when we typically do a clinical trial, it involves recruiting individual patients versus the treatment other, a standard treatment, for example. oftentimes, those are very costly and it takes a long time

before one can obtain the results of those trials. we are trying in addition to that effort more pragmatic trials. one trial currently underway is a timed trial. the patient being the unit of randomization, it is actually the location or the center providing care. in this country, we have verylly teamed up with two large dialysis care providers in the unit of randomization, actually the center. there, one center can prepare a standard treatment to another center, who can make very modest adjustments in the dialysis regiment and now, instead of talking about 400 patients, we are talking about 4000 or 40,000 patients. you get a result much more rapidly. if that result is positive, that can gradually improve the

standard of care. leslie will go to michael in massachusetts, democratic caller. thank you for hanging on the line. >> good morning. i am a type one diabetic dr.. i am 43 years old. i've had diabetes since i was four. apparently, according to my mom and dad, i did not really have a chance against it. i had gotten sick with a virus that happened to a pack -- to attack my pancreas. i was four, i was fine. after, i was always a type one diabetic. my mom is in her late 60's, and i'm getting concerned because she is on the line of diabetes type two. an excellent group of physicians, i am pleased with the care i get and i'm pleased with everything that has been going on with my care, except for the fact that our stem search -- stem cell research

development got stopped when our last president was in office. i want to know if we can do anything to bring that back in what we need to do to bring that back. --t is very them written very important for the cure of this disease. host: dr. rogers, do you believe it is important for the care of this disease? guest: i think we need to examine all areas of research, including stem cells, both in humans and also other models. one introduction of a new , which we fund this type of research, is giving us clues to how one could actually take an individual with type one diabetes, take their skin cells, and then put them in a test tube with a combination of agents, reprogram those cells back to pancreatic cells reducing insulin. in this regard, one can begin to

test a variety of therapies that might be more effective in making certain those cells survive for much longer times. that research is very important. we funded studies to really understand everything that is necessary in terms of the development and progression of cells that we funded. now the knowledge learned from that has really developed in number of tools that might be applied in the future to expand, even in people who have only a relatively small pancreatic functioning this type of research is an area that we are actively involved in. your color really highlighted a very important point.

these individuals live with type one diabetes for over 30 years. he mentioned he was doing fine until the age of four and then he developed a virus. something about that virus that .riggered his immune system more --ally became much ultimately required insulin because he had type one diabetes b. because we no so much about the genetic predisposition of diabetes, 85% of the genetic risk factors are understood. we think it's time to now study patients at high genetic risk and understand what in the environment is triggering this. it could be a virus. there are camps that believe

that it's something in the night. we have a study just an ambitious study looking at the environmental triggers of diabetes in youth. we screened half a million individuals to find 8000 at were following-- we are from the time of birth to 15 years of age. we are doing very careful follow-ups with them and their positions. we are collecting samples of stool and saliva and blood and other factors. we are determining what types of vaccines they are receiving care be collected millions of samples so far. what we will learn from this study is what are those triggers to people with high genetic risk for developing diabetes. if it turns out to be a virus, a vaccine can be developed to soat this successfully patients never develop. ,f it's something in the diet

some sort of dietary restriction will be important. this is a bold effort and we really think that because of this combination of a genetic risk and and environmental interaction, this study will set a gold standard for understanding other diseases and which genes and environments come and apply. host: canton, georgia. don, republican. caller: my mother had triggered diabetes. i don't recall what type it was. i have a brother and sister that are 10 years older than i am. shots andtake insulin have had difficulties with this disease. life, am so far in my i've been disease-free of sugar diabetes. -- if theyc makeup have the gene and i don't, i

would like to know why i succeeded in life without becoming a victim of that illness. our genetic makeup says a lot about what we are likely to become. you may or may not have the same risk because we have two parents and you inherit half of your genes from one parent and half from the other. , thatld be that susceptibility gene, you may have been lucky to not inherit. a lot has to do with our environment. how much we are exposed to, what we eat. as it turns out, and diabetes, our environment begins even earlier. bothtudies we have funded, in our phoenix branch and other sites nationally, determines that our environment begins in

utero. a mother who develops type 2 diabetes or who has diabetes , theg pregnancy infant born to that mother when they have diabetes is more likely to develop diabetes later on in life then an infant born to that same mother who was not affected with just a small diabetes -- gestational diabetes. there is something in our environment we are trying to understand. that's another factor to be considered. of course, if it runs in your family, that does put you at higher risk. it sounds like you're doing the right thing and you are being checked periodically to determine whether you have any signs of it. good prescription, however, is exercise and maintaining your weight at a level that your doctor recommends. we are talkingt:

with dr. griffin rodgers. dk.nih.gov. you can follow nih on twitter. they are like tweeting right now. a conversation we've been having here with several doctors at nih. to see if you qualify for a clinical trial, go to clinical trials.gov. steve in manchester, new hampshire. democratic caller. caller: hi. rogers, i have a brother who worked in the diabetes research project. a prominent diabetes research clinic. .e was laid off some time back

they told him the project had come to an end. it coincided directly with the , what theion government did. how much of this research has been affected by the sequestration and other types of budget cuts? the sequestration you are referring to is something that occurred back in fiscal year 2012. that had a direct effect on funding in that year until 13. or fiscal year 14 and 15, the funding is at a level approaching where we were back in 12. obviously, the more funds we have to fund research, the more research we can fund. it is axiomatic.

i understand the concern the caller has and i've heard from -- had important projects moving on when they had to cut their budget by a certain amount. they have very little choice. i'm hopeful that some of those positions are now opening up because this research is so vital. especially given the numbers that were cited early on in this program. host: jacksonville, florida. jack. independent caller. caller: my wife was diagnosed disease thatmmune attacks your lungs and kidneys. i would like the doctor, if he the lungs andts

the kidneys. she's been on dialysis since 2007. right now, she's in a nursing home getting good care. , nobody was diagnosed had ever heard of this syndrome. when she was in the hospital, the doctor took an educated guess and he diagnosed her right. guest: i'm really sorry to hear that your wife suffered from goodpasture's disease. that is an area that we actively are involved in researching. this is a disease that can affect both the lungs and the kidney. like type one diabetes in which the body is producing antibodies directed at the pancreatic cells . here's a condition in which the body is producing antibodies directed at the cells within the kidney. cause scar tissue to

the kidney and overtime, as the kidney loses its function, patients will require dialysis. we are making a substantial benefit to understanding the underlying cause of this. people in the pharmaceutical company are looking at potential a conditionreat such as goodpasture's disease. you were seeing drugs in the pharmaceutical companies which are called biologics. rather than a pill, these are treatment center directed at antibodies or neutralizing in the interaction that are occurring. goodpasture will be an example in which there are better therapies that will become available. host: edgewater, maryland.

angelica is watching us there. republican. caller: good morning. i wanted to thank you for your important work and all the good that you do. have a question for you. i feel the root of the problem is not being addressed by the fda. see and hear is that there are so many things now in the food, especially processed food, from sugar to antibiotics to chemicals from gmo produced food that are having all kinds of impacts on the human body. i feel there is a failure on the de of the government because the sugar, in particular, is a huge issue. i used to buy organic orange juice. i don't do it anymore. i was not aware that 24 grams of sugar per cup meant six teaspoons of sugar. guest: i think the caller raises

an important point. we are beginning to understand causeme of these products disease or contribute to health. for example, the food labeling suggests it's better to have more fruits and vegetables, more grains, lessre sugar. chemicals that she is suggesting may have direct negative effects. what we're learning now is that a number of these sub lenses me,ually affect the microbio a combination of bacteria and viruses that live within us. variousocesses these nutrients or additives, it

changes our own chemistry in a actuallyit can contribute to the number of conditions. this is an area of active research by investigators that we fund. basis or some of these adverse effects that we are seeing with the specific nutrients that we are ingesting? host: silver spring, maryland. independent caller. acua, cohead could -- go ahead. caller: i've heard you on our local radio stations providing really great information about combating diabetes and related diseases. thinkman's terms that i are very effective. i only hear it periodically. i'm wondering if there is any major campaign to get that information out on multiple

radio stations into the schools. the way you say it makes so much sense. people will understand how to address the issue. guest: thank you for giving a plug to our radio stations. you can go on our website. 85 series archived and readily available for your listeners. this on a daily basis in the baltimore-washington area and richmond and chicago and norfolk, virginia. four times during the year, we air this nationwide on about 50 stations. coming up on the first of december, this national airing in observance of world

aids day in which we are talking about the importance of aids is an issue -- as an issue. there is a wealth of information that we did not have time to cover that if you visit our you can not only get reference to that healthy moments, but also things for kidney education, diabetes education, weight control and a host of other things that are extremely important. support andte this come up with observations on publicly funded research, we have to make this available to both patients, families and the providers. host: dr. griffin rodgers, we want to thank you. everybody over at nih for talking to our viewers and lettin

[applause])/ date you very match. good to see you again john foust and an opportunity to meet you also. we will begin with opening statements each candidate will have five minutes. the timekeepers in front shows how we will do this. i will let you finish the sentence because that serves the audience. there is no complaints afterwards i favor one side$>ñ(

or the other. >> of one of the references your opponent that is an obvious opportunity for me to give that person to speak. because of the coin toss barbara comstock goes first. >> good afternoon. today is not about left verses right but the past verses' the future or status quo verses moving forward. when i love about this district is the opportunity to work for the people who were inventing the future. understand invexq%=9 on cliffs people out of poverty and would get its back on the path to prosperity. the virginia general assembly of the science and technology committee have

worked with you to get us on that path to get the job done. my priorities will be to get people back to work to grow the economy with 21st century jobs. to repeal and replace obamacare with reforms in control of your health care. and reinvesting in military to stop sequester cuts that threaten not only jobs but our national security. my opponent and i have different visions for the future he thinks the answer is to raise taxes. he has voted property-tax is 20% sales tax increase. medical device taxes. and the purchase of a car or this day in the hotel but

now he says no. we need to ease the burden of taxpayers. i have bipartisan success. the legislation that i know that in virginia and to provide mom and dad's was workplace flexibility and also the credit we passed this year that so many of you have worked on that was si1jed this year. and read the 21st century tax reforms in washington. and to go so far to attack me personally to said never had a real job for i don't

know about real jobs. but now they have endorsed me with u.s. chamber of commerce, national association of women business owners and realtors in credit union and former chairs of the technology council court former chairman of the chamber. also to pash reform legislation on infrastructure projects already saving as hundreds of millions of dollars. legislation my opponent opposed. also to experience in energy development. with today's increasingly volatile trial situation and our economy is not only about jobs. not only dedicated money for

education but to crack down on human trafficking and this year i have legislation for testinga÷ newborns for congenital heart defects so we can save those babies lives early on. coming from a family of educators to hear about george washington everything they are doing their windows previous democratic governor made to the schools. and then to% rebalance the budget together we balance the budget every year without raising taxes and also support a balanced budget amendment. our best-- are ahead.

and everything here in the tenth district allows us to grow on that. in one of the most diverse districts in the country we know if you get back on the path i can hit the ground they number one to continue the tradition of my mentor congressman frank wolf i ask for your approach to work with you and for you. thank you very much. [applause] >> this brings me to something it should have said earlier. please hold your applause. it is an important voice that you have is the voice you cast on election day. applies takes away from our

ability to question the candidates. so we asked politely do not applied. after the you will will not but moving forward. thank you in advance. five minutes for opening statements. >> thinks. good afternoon. it is a real pleasure to be here i have enjoyed working with you in the business community in the past couple years as a board of supervisors. before that as an active member of the business community for many years. i'll look forward to working with you and continuing to work with you. i have to tell you a little story. a story about my background. basically i was born in

johnstown pennsylvania. for a working-class familyl9 we cannot pay for that so i had to do it myself. i got an mba in the finance economy department and go to school full-time. i tell you that story so i can answer the question why a guy running for congress? because i have tremendous opportunity a good education to old men the in my opinion work the american dream. because there is not enough opportunity, education is too expensive