the executive order coming up too soon but i think that just ties the speaker stands and the majority leader stands in terms of delivering their members for some of these other issues. gives them a reason not to do it. >> the democrats, are they going to want to go along with the? does harry reid tried to block everything the republicans pushed through? >> you mean like the republicans didn't? >> yes. or does the work to compromise? >> i hope the compromises without violating, you know, the core principles that the party stands for. ..

because it's the right thing to do but i can't. and i said i would've voted against it because it would help me politically but i can't. but everyone knew it was going to be listed. all of the rhetoric would take place, the accusations. but eventually we would vote to raise the debt ceiling as we always did. and it was amazing to me that eventually became such a critical issue that it could have resulted as the country going into default, an issue

that the previous congress had been debated and people express themselves and they knew what they needed to do at the end and we are in a different kind of environment now. >> speaking to the governor earlier about the business community and how they are looking for certainty and stability and how that is one of the reasons -- >> and they will send an extension with some conditions. the president has never had anything. >> that would do him some good. in effect when the congress doesn't pass that much to begin with at this point. >> yes and the president

indicated he would be willing to do that on the occasion. he said the congress is likely to pass things that i object to and i will veto it and i'm likely to do things the congress objects to. but that part of our democracy, that's always happened. but i think the president may be able to sign some things. i think i do know that the bill is going to be passed soon. but those kind of matters will come before the president on a rather frequent basis during the next two years and it will be interesting to see which bills he chooses to sign for the reasons that are important to him. >> you brought up the idea that

the compromise for power we've got about nine months. then all of a sudden -- it reacts to that accordingly. >> obviously ohio is critical and virginia emerged. how do you see the 2016 presidential race this early. in general, the landscape. what are the challenges. >> the house of representatives today is structured in a way that democrats have a 1.4 million for the house two years ago and the republicans did the total houseboats. you add to that residential sorting patterns and the

presidential races there are now 18 states plus the district of columbia that voted democrats debate delete code six straight times and they have the 270 that you need. we call this a blue wall. they have their own red wall. that's 102 electoral votes. so the republicans have to go through ohio and florida and virginia. they don't have a margin for error and so that puts your governor and senator on the senator stage and rubio center stage because they develop the key states and in virginia we don't have the republicans officeholders. but you have the appeal to the urban elements. so you'll see somebody that makes a lot of sense because

republicans have no margin for error unless they can track a new coalition without immigration reform it's difficult to do that in my opinion. >> i'm guessing that you like hillary clinton? >> like is a strong enough word you could choose a stronger word if you like. but i like a lot of candidates. secretary clinton i think has done very well in ohio in the past as did her husband bill clinton. there seems to be sort of a i don't know some sort of special appeal. and ohio has voted for the winner for most presidential elections. since abraham lincoln, no republican has won the

presidency without winning ohio and only one democrat has won without winning ohio and that was john kennedy. so ohio and virginia as you said has become and i don't know if you like that or not but as they come in and spend a lot of money and help the economy of the state, so you know, ohio to host the republican convention in cleveland ohio i don't like it. [applause] >> in the running they could possibly host -- spinnaker that would make it easy for the journalists. >> come to to ojai you know and we will treat you well. >> is it true that at the democratic electorate in 2016 and up the the issue of hillary clinton in the nomination and

she is a woman seeking the presidency. >> somebody that ran the campaign twice what we saw this year is the democratic base didn't really show up. what obama was able to do is to invigorate people that never participated before the process. african americans, students that came out in droves for him and that turnout was through the roof and turned states like virginia around. the question is this obama centric or democratic centric sweeping the terms. there are some democrats. they put that together in the gubernatorial win last year. but the question is can the democrats hold this coalition together and excite the voters that ordinarily don't have the same level of participation. and that you worry about the politics sometimes and there are

some articles that if you are two senators you don't drive the base out and hillary clinton probably pulled a coalition together. parts of the coalition like him and part of them don't. i want to make it up to the agency. >> you know, the country needs a strong two-party system. iab leave that and i think the analysis is correct that when it comes to the house of representatives the republicans are in the driver seat and will be at least until the next redistricting and maybe beyond. the senate is a more evenly divided body but having said that, the country is changing and we all know it. the demographics are different. i represented for 11 years appalachian congressional

districts that ohio is a very diverse state and the country is diverse and it is growing. as i said earlier and i don't say this with joy because i do think we need a robust two-party system that's national in scope but if texas were to become a blue state and moving in that direction. it's not going to happen immediately but it's moving in that direction florida, virginia, new york, california, we are getting to the point where the democrats are going to begin the presidential election with having already wrapped up most of the votes unless there is in my judgment and i'm speaking as a democrat and forgive me if i'm being unfair

but it seems to me and i think the party will leave old in a way that keeps it in contention. that's the best thing for the country quite frankly but i don't see that right now. i think it's going to be really difficult for a republican candidate under the current circumstances and positions and policies to win a national presidential election. >> we look forward to covering that. we are going to open up to your questions for the governor at the policy politics and less of an interesting thing to ask about. i think that we have somebody with microphones.

>> it seems like we've lost the moderates why he and by and how would you fix it if you could? >> even the members that are moderate there is no reward for going over and voting on the other side. you lose your base. and i would make this observation when we first came to congress you were in the minority party and they were the shareholders and government so you participate sometimes and emily raikes the -- familiar eight the facts. they've become one-party voters. it's the best way to put it so what happens and they come to washington they behave like a parliament system so instead of the minority party or the

opposition party and to say no to everything and that's got to be broken, so the good news coming out of the elections on tuesday we have three states now that have runoffs with the top two from the primaries. democrats, republicans, california, louisiana, washington state. they tested 2-1. so there is some movement out there even in the state democratic districts or are some we have to cater to. my plan is that it gets people to vote on occasion instead of having to just stay and be punished in the primary. and until you break that i think that it continues to get bad. >> if i had the power to make the changes, i was change the way that we created the congressional districts in this country so that it is done in a way that is not so partisan. both parties engage in that kind

of behavior. it just so happened that the last in the 2010 election they gave them an advantage in doing so so i wouldn't go so far to say that it's a threat to democracy but it diminishes the legislative process to work. >> and you take the voters out of the equation. >> absolutely. the saying is the politician chooses the voters into the voter chooses the politicians into and that is what redistricting does with such severe gerrymandering so that's one issue and the other is a money issue and i wish i had an answer to that. i've almost come to the point where i think the minimal that we should expect in the money and the politics is that it's all very transparent as we ought to emphasize greater

transparency so people at least know where the money is coming from. >> the fact is that when he lost the seat in georgia he was the last white southern democrats in that group. they are basically gone now. >> we have another question. >> i live far away way out in an obelisk but what is amazing is that over the last six to eight weeks i've seen more than a dozen bumper stickers on cars and i wonder whether this is unique to maryland because he happens to be at hopkins for whether this is a serious movement because as i understand she's planning on being the candidate. any comments? how many have you seen?

>> they are all over the place. >> republicans are a racist party. at this point what you see this is all the lecture in south carolina. i think that she's her very articulate them he gets on talk radio a lot and the social conservatives are an important piece of the coalition. the social conservatives drive the nomination process in the party caucuses so we are going to see our candidates at this point competing for that. michele bachmann was one of the leaders less time and carson depending how well he can organize in iowa can come up on the map at this point. but how serious is it?

those people are more enthusiastic than the other people and you never learned to discount. >> i haven't seen very many stickers but i have seen the sponsored trigger feeds. he's prolific to get his name out there essentially for running. >> you can provide other names. you don't discount anybody in this business. >> don't forget rick santorum. governor mike romney -- mitt romney. >> i think that they both occupy a space that doctor carson would try to enter and that would make it increasingly difficult for him because santorum and huckabee have a head start. >> i will add a question to the governor on the democratic field that's governor martin o'malley for his interested in running

for president and if hillary clinton runs he might be in the primary together but are his chances hurt at all by the fact that this democrat is not able to win in maryland and is surprised? >> i doubt it that his chances would be hurt. i i can't see that being something that in the general sense that would be generalized nationally and i don't know what he's going to do if he's going to run for president or not. i think that he certainly wants to. >> they should have called an underwater in his own state. voters in the presidential primaries don't vote strategically. >> another question. >> i'm with the hispanic outlook

magazine and congressional correspondent. two years ago i covered the nomination conventions of both parties covering the hispanic delegations and it was interesting because both of them had organized the afternoons different. the evenings were the same but the democrats all met in the caucuses. they had the women's caucus and latino and the black caucus is. they had everything according to the identity group ethnic politics and i think people got really tired of that in this election that the woman's vote and the obsession with the war on the way men and i am offended by it. not all women to vote the same and not all latinos vote the same. we saw 34% turnout for the republicans and latinos. now this -- do you think coming

to 2016 we might see the democrats move away a little bit to this ethnic identity voting bloc? because i think it's harming them. >> i guess that's directed towards me. while i tell you what i want the democrats to do in 2016. i want them to form a strong and robust candidate clearly articulated, easily understood economic plan that focuses on getting the jobs created an opportunity expanded into those things. i hope the 2016 presidential race will focus primarily on bread and butter economic issues and that's the kind of things that all of the constituent groups have together regardless of the particular individual

identities. >> we have time for one last question. >> i'm from strategic applications international. first thank you for your time i appreciated how candid you've been. i wanted to target a question towards you. with that relationship going the relationship going in to the 2016 election into the un opening of the sustainable development goals that will be released by the summer or fall, do you think there's any hope that it would gain traction among the american people as a conversation for part of the election and what we can do as major cities of the world to help the un sustainable development goals and our own impact in the world as a nation? the >> my answer is i would certainly hope so. and i think we can do that, keeping in mind our own self-interest. it's a big world.

it's an interactive world and we are impacted by everything that happens regardless of where it happens in this world and i think we have a special obligation as the only really the only major superpower both economically and militarily to provide leadership on the sustainability matters that are before you. >> i want to thank you both former senator thomas and senator strickland. [applause] thank you, christina. are you sure that you don't want to run again? i want to wrap this up by thanking everyone for joining us today and remind you to take your member guide to follow the conversation and cq is beyond

the pay wall service and you can get an insight into our analyst is like following the twitter feed at cq now. so please join us at cq now. i would like to thank the sponsor for the roundtable and the former general john engler for his remarks in support as well as our sponsors of the federal news radio, the national review, federal computer week, the young government leaders for senior executives association for got the center for american progress action fund and 720 strategies but most particularly all of you for joining us today, we will see you in two years. [inaudible conversations]

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but he was right on target this morning. >> i am calling to say i think like many people, c-span is wonderful but for criticisms, i almost have none and i'm a very partisan kind of person. the reason i almost have none if you did a tremendous job. i'm showing just about every side of everything on the way that people look at things in dc and elsewhere. i take my hat off to thank you very much. >> continue to let us know what you think about the programs, call at (202)626-3400, e-mail comment@c-span.org or send a message of c-span hash tag comments area to join the conversation, like us on facebook and follow us on twitter. to a discussion now on the current international health and security challenges medical defense analyst discuss the spread of the ebola virus,

health concerns related to warfare and humanitarian crisis in the conflicts waged by isis and several other terrorist groups. the event hosted by the center for terrorism studies is just over two hours. >> okay i guess we are ready to start. i want to welcome everybody again to a very timely seminar and i want to thank all of his people who put this together with a great deal of haste considering the topic. the health challenges we have in the responses from ebola to terrorism and of course i think it's extraordinarily timely and we have a super panel. i will let her do the introductions at the right time and so on, but the panelists douglas today by having a panel with a love military experience into government experience and medical experience, a lot of all

the kind of experience if you will that you need to talk about this topic along with dawn and his international legal fights and all that kind of thing. somebody told me one time when i was a young guy if you want in idea read a good book and i think that is very timely. here's a book that was written after 13 years ago and the title is the terrorism and the medical responses u.s. lessons of policy implications. that says it all. >> thank you for your kind words i would like to call your attention to the book general

gray has and we have information in the package that we provided to you with if you read this book you know what it's all about and we have to learn the lessons about what works and what didn't work and the general made many contributions as we know for many years. before we move on to the speakers, i have as an academic first of all i want to thank the cosponsors of this event of course at the potomac institute and the chairman who unfortunately isn't here today but we do have some of the colleagues.

kathryn, where are you in the back, and i think that we do have a few other members here. and my colleague for many years at the international law institute and i do have to mention our colleagues that are not here but that work with us for a long time in the center for national security law, the virginia school of law and particularly the professor bob turner. i have to mention my professor who died several years ago. we worked together at the center for legal studies and the international law. with me first introduce our

panel and then i have to make some remarks. number one, doctor robert right here and then you will see a very impressive biography. we have some former senior officials, the u.s. senate and so on. so you can read the biographies of the speakers. the next one has a very rich background and the third panelist is with the southeast

study and participated in the government, the un and so forth. now, you have the program in front of you both as academic and i think that it's my obligation to try to put some context and rationalization in the discussion. before that, i would like to mention that in general when we discuss the issue discussed the issue of security and terrorism, we dedicate the seminar or the session ended the discussion for

the memory of the victims of the violence of both man-made and mother nature which i will come back to it. with respect we have to keep in mind that we are living with a challenge which is very serious with implications and we certainly have to think about the victims and of the specific segments in the society that are targeted by terrorism for example.

those cover the events and try to bring the information in pakistan in 2010 and to the islamic states a video of the execution of james foley. so one it is a dedication to the victims and to suddenly also we have to separate the work of those that serve to protect our societies and in this case the medical communities, the first responders, the enforcement people, the military government and civic society in general. second, i think that if i may i would put together a seminar that in other words one is the

actual disasters of -- i have a few slides. and all of the major challenges earthquakes to the deadly diseases and second of course. obviously we have to deal with both of them to understand what are some of the major challenges that we have to deal with.

we have as well the contemporary science. the under the sun except the technology. we have a publication here that was published yesterday we provided it with ebola as was the terrorism challenges.

it's very clear what happens to the societies at that time and the victimization but it is interesting but for the reactions to blame for the disaster is natural as well as man-made and then we can look to point fingers as guilty but i think the best answer was provided by schema than when

they built the ark for developing the policies he said look there is no room. there is no room for the delay or in decisions. in order to deal with the challenges. at the time of the pharaohs if you will end at and the middle ages the thing is the middle ages they are a chapter in history. even today we find in the contemporary struggle. we try to push the idea that one can call for example.

there were communications that they are poisoning in order to kill more and more people. basically you can see the oilcloth with a splash of vinegar. i found that the professor and i remember we were together at the conference and the monuments of

the turkish republic just celebrated the anniversary of the turkish republic and in this particular statement. it was really on the mark. it seems to me that the set of the values follow the humanity that we cannot look at the situation as it is. to deal with the virus and the threats of ebola and what we learn from history that there are two emotions that drive

people. one is fear and one is hope which fear we see what happened even if there were very few cases in the united states and in the west and it generates a great deal of fear and we do have the experts the deal with that but again we are surprised because we didn't level that anticipation with the infectious diseases all the way from. so number one, we are going to some of the challenges that we are going to face in the coming months and years.

we are going to discuss also the security issue with isis as i suggest we look at some of the other groups as well and we also mark this month in october the french forces and i think that we have to look at hezbollah as well because we find that it's very much engaged. they were able to upgrade its capacity with 100,000 in case of

hezbollah and israel we are going to see that kind of capability. now, in addition to this end and the next one of course. the al qaeda central we have to look at this and we are going to discuss it as well in maghrib and so on. then this is in the beginning of

the year and obviously we are going to have upgraded to indicate what's happening now in the region and elsewhere with the emergence we have to deal also with the issue in particular now we find the most recent attack that we've witnessed the attack on the egyptian army and have made some connections with the other external groups. they must construct a buffer zone in the region and israel

and there is no doubt that we have to pay close attention to the stability and egypt which is the most important country in the middle east. finally, the islamic state that we are going to discuss in some details on the islamic state so they are able to recruit the thousands of volunteers all over the world for example there are about 3,000 i think volunteers despite the fact that this somehow developed a democracy and there are elections as we

know but they fight for the islamic state and it's very well known but also women and children and so forth. so, they control the territories as well and the concern is the strategy and we have to be concerned about this. finally, in regards to the role of serving the links in the security, we are going to discuss the humanitarian crisis in the middle east and africa

into some details in the country that we know if you take for example serious the total number of refugees it around 10 million if you take into account the refugees over 3 million for the various countries in the middle east. and i think the same thing is in the maghrib and we are going to discuss this. so basically what are we facing in terms of security and i submit to you that we must discuss not only of ebola dot the challenges in the society and of course in order to deal with the issue we have to strike

a balance. it's in the human rights and civil liberties. with that alaska them to come and speak. >> professor alexander, my distinguished colleagues on the panel is a great pleasure and privilege to be here today. i am reminded of a quote that only have seen the end of war and i would amend that to see the terrorism and disease and so on the topic of ebola it represents an interesting point in time and historical reference is an interesting one because it

will highlight some point i will make about the risks that we face in the 21st century for the future plagues like not only ebola but other things like climate change, things like globalization. i will talk a little bit about that later. the issues i would like to highlight for you is to give you a sense of we enter into this circumstance with a great humanitarian crisis and quite frankly the crisis in western africa after a fair bit of work that has been done in the last decade to improve the game into preparedness and the security. what remains to be done in a policy perspective exists both for the current administration, whoever is president next, he

can she, whoever it is. i think the current crisis at least in the u.s. perspective highlights the great vulnerability of our health care system to a single case of ebola that basically walks through the emergency room door in dallas and was immediately sent out after all the warnings and messages the centers for disease control have said saying that it's possible that ebola can walk into your emergency room or hospital. what is worse about this is the effect and you could argue this has been largely the media hype but i would argue something different that there is a very core fear in the public that predates the events what happens at october that goes back to 1946 so many of you may not

realize that during world war ii, the two manhattan projects were conducted and one was developed and the nuclear bomb and docked doctor oppenheimer that there is another gentleman by the name of george merck whose name may sound familiar because there is a billion-dollar multinational pharmaceutical company named after him but he was the american oppenheimer for the program and quite frankly during the years that it was existing in world war ii, quite frankly they never were able to create a biological weapon they intended to use that had either japan or germany used those kind of weapons against us. i make that point because i think there is a historical point about the world of intelligence. because in 1943 when president fdr was worried about the possibility of the biological warfare by the community than in

the u.s. have basically warned him that germany had a biological weapons program and japan didn't and we just found out after the exact opposite was true. you probably can relate to the more recent example where the committee hasn't been 100% right on these issues but i think that it's worthy to note that we may be very disappointed particularly about not only terrorism and the use of these kind of weapons but also about the disease itself. the point in trying to make is that he released to the american public of the efforts to develop biological weapons and it is one of the few cases i know of where the report was unclassified public and theater classified and secret and pulled from the shelves. why was that? because it scared the american public. it created a firestorm at that

point in time and you can recount that if you ever go to the archives of the magazine where they are printed on paper and actually evaluate what was not only the scientific debate but the fear in the concept that you could create agents if you could be totally alien to the senses that could kill you in a rapid fashion. i would argue that everybody has been taken to life until there is an element of personal to the idea of illness. few people have had ebola in america but if you recall robert princeton's book, he certainly make the very compelling case why you should hear such an organism like the ebola virus. so, in some ways there is fear by the american public and there's also if you will the fear by public press and popular

movies of the subject and obviously the media certainly hasn't missed their chance to sell the print or advertising today's world. there is a nexus for the potential of terrorism and that is what we have experienced around 9/11. i would warn you for the purpose of this in some ways while we view the crisis they would migrate into a different space should someone take advantage of the availability of a viruslike ebola and use the means to basically deliberately infect people. but this isn't news to you but i do think that in some ways we need to understand the health care system that we have to date. it's a $2.8 trillion activity in

the u.s. government currently spends about $225 million. that represents 1% so you could imagine the federal investment helps the preparedness is evident from the single case of ebola basically walks through the door or it could be any other disease like smallpox or influenza that quite frankly the affordable healthcare act doesn't have a thread of preparedness and we threw it to ensure that health care system that we would develop they have the right to health care as a system that is prepared to meet the challenges of the 21st century. and ebola represents the poster child correctly for the challenges we face ahead of us.

the other thing that i would understand and throw out this quick anecdote we spend the amount of money on the preparedness 3% of what the american people spend on potato chips. we don't put a lot of investment or priorities or significant around this. but on the monetary side i think that we need to convey to you that there is a wealth of things that have been done beginning back in the mid-90s during the clinton administration that really have if you will evolve to policy and legislative action to the point that we are today that in some ways i would say we have enough policy, we have enough legislation to do what we need to do but we failed at that execution and commitment to priority to do the things that have already been established by the presidential policy and legislative statute. and i will give you some examples of that.

first of all, as i mentioned president clinton basically recognized the concerned about the bioterrorism and it was around the book by robert princeton and another book about a synthetic virus someone comes up with what the point is much like the letter of the 1940s president clinton got a letter from the distinguished laureate who earlier in the decade in 1992 did a study by the institute of medicine that indicated the emerging diseases were going to be a significant consideration in the future. before the issues if you will of the global climate change and before the issues of the globalization were realized.

they basically recognized that we were on a converging path potentially for the disasters as a possibility of emerging diseases and bioterrorism. and it was their work in the morning to clinton that basically if you will initiate im a great i am a great believer in the system of government that the best we could hope for in perfect incrementalism and look at any issue in the united states history whether it be civil rights defense policy or i would argue in this case the public and medical preparedness. that we would make one step forward and one step back and realign and move forward again. so it is with that but there have been a series of legislative initiatives that

basically happened after 9/11. they have a preparedness act. i would like to take credit for it for the committee that drafted it, but it's actually senator richard burr from north carolina and senator ted kennedy that championed the bill and the significance of the bill is that it's basically used the lexicon of national security to basically define and if you will redefine the u.s. government role preparing for these events. interestingly enough, and it will make reference to the project project to that of general grey was involved in in his career, but we used the goldwater nichols act as a template for this bill, not because we think public health or medical capabilities should be a line along the dod axis but it did identify in the goldwater nichols act the idea of having joint operations putting somebody in charge and creating

a kind of command structure so with that a position was created at the health and human services for the assistant secretary of pyramids and response. -- preparedness and response. ..

we talked about it before these proceedings. that really did assess why did things fail, it'd that case desert one, because what they identified in the blueprint day late and a vision they left was one that over two decades went from the point in time when we had a tremendous failure in the iranian hostage rescue to the point in time that we can also put the demise of osama bin laden. that didn't come overnight. that didn't happen because somebody just said let's do it. it literally took decades and commitment by the special operations community to do for essential things. for essential things that i would argue to do with essential elements of the kind of public health preparedness went to address the current ebola crisis in getting future public health crisis we may encounter. when his recruit the best people. i think you look at the record

right now we have a tremendous brain drain, people operate state, local polls basically ensure that people abide by the court in, the people do do the things that basically for the risk to the public to disease. we also acknowledge that in the medical community that in many ways we don't necessarily train or equip them to manage these events. i think the events in dallas prove come as they did prove in the case of desert one, there's no such thing as just in time preparedness. the idea that you need to the force that is ready, then you be trained, equipped and they need to exercise. yesterday i spent the entire day, i co-chaired a panel of the institute of medicine on preparedness and we spent the day looking at what has already transpired with the ebola virus then. and we heard from a local public health and medical leaders from

atlanta, from nebraska, from new york and from dallas, or at least indirectly from dallas, their experience so far. in which he said is, you know what we really needed to do was make sure the equipment at hand and we were well trained. not just in time training that continue thank you for sure that we could meet the nation. and so these are essential elements of the challenge that we face right now in terms of preparing it. you hear of ad hoc teams from cdc, department of defense, those are truly ad hoc gap fillers. but as we look forward to the events before us i think it does raise the question, how much are we going to invest in this space? how much of a priority are going to put in this space after this ebola crisis is overcome realizing the next one may be on

the near horizon. now, there are two major political -- i won't say political but policy issues that are outstanding that need to be addressed. and then i think i will probably be at the end of my time but i will leave you with some final thoughts. first of all one of the lessons that we learned in the early 2000 period from the standpoint of the anthrax letter event, it could've been a lot worse. we know from the wmd commission report by senator graham, that they recognized it had the perpetrator likely bruce iversen from fort dietrich, taking that going into the ventilation shaft in the metro it wouldn't have killed several people. it could infect several hundred or several thousand people. this points out a very important issue of imprint i think has happened. in the policy towards these

events. we talk about inversion about his companies moving overseas. and give your policy of urgent about health care. number one is on the critical element here is in considering these events, it was always believed in some ways bioterrorism, by where for the state after conducting this or a group conducting these kind of attacks using infectious disease agents would create a situation that was not seen in nature. that the risk was that you could basically infect millions of people near simultaneous by releasing an aerosol cloud of infectious diseases. over time the belief is in some ways if we prepared for natural events like ebola, which don't have the same epidemiology, that somehow we will get the benefit of improving our public health and medical ever structure may be at a lower cost but in some ways that's a more likely

scenario. well, it's like telling an army to say, well, or basically better yet let me use a football analogy taking the washington redskins and telling them they're going to be one of the local high school teams as the way to practice they will play the dallas cowboys for the seattle seahawks. if you define the problem in a certain way i think we're on the wrong track out of the current time, then we will basically not prepare ourselves to address, i won't say the worst-case scenario, but certainly a reasonable case scenario for terrorism basically tries to use these kinds of agents has weapons. and as i think you can see in the events of the ebola case, we have not proved ourselves necessarily competent to deal with a single case of a natural occurring disease as has been imported into the tourney.

the second issue is, another policy issue is in all the efforts and even the effort that i was a participant of, the preparedness, health and security preparedness, was from outside the domain of regular health care. kind of an add on, an adjunct. and the answer is it has to be integral with. and that another major policy issue that i think is outstanding. i think in the construct of my comments today, and again alluding back to the points professor alexander made around black death, we have to look at the events that are going to make our life challenging no matter what, whether it's a disease that is natural in origin or deliberate in origin. and that is three essential factors. talk about climate change the little bit, globalization, the opportunity that someone can get

on a plane today and be in the united states not the same day but the next day carrying a disease that either he acquired or she acquired a could represent a public health threat, or by basically having 10 people purposely inoculated by particular these being, infiltrating the united states by commercial l. niners -- airliners. the other element here is this idea of urbanization. because the ebola wasn't a problem in the past because what happened in remote village somewhere. people would get sick, people would die, and because there was thno access if you will to moden transportation, the outbreak was naturally if you will contain into the settings. now there are better roads in africa. people living in large urban environments like monrovia were you when many people living in a highly dense urbanized environment. and somebody gets sick in that

environment, particularly when sanitation and other conveniences of life that we take for granted are not available, it basically creates a circumstance where these things can rapidly propagate. i think i will probably if anything went off my time, but i hope i left with a sense of the landscape that we have done, which again, first, imperfect incrementalism, we are two decades and a dedicated effort to improve the preparedness of all public health and medical infrastructure. we have many more miles before we sleep, before we get right. this is not rocket science. i think the experiences or the analogies we've done in other areas, and i use the socom experience as being one point, but there's a way to rapidly fix this problem but it's not entirely expensive but it takes priority. it takes leadership, and some amount of resources to do so. and the last thing is we need to

define the problem collectively. that in some ways of challenges before us are likely to be more frequent. they may represent a deliberate component that represents something entirely different and we're dealing with now and we should have the wisdom and the fortitude to develop what we need before it happens because that is not just in time preparedness. with that i will conclude my remarks. [applause] >> distinguished guests come it's always difficult to go after somebody who i respect him and his accomplice mentor and advisor for many years, dr. kadlec. and some of the policy issues. so what i'm going to do is i'm going to specifically focus on

some of the facts and some of the ethical issues related to this particular disease. in africa the ebola primary occurred in remote villages come in tropical rainforests in central and west africa. confirmed cases were reported in democratic republic of congo which is, formally known as zaire, uganda, public of congo, ivory coast and enforce time wasting cases in guinea, liberia and sierra leone. between 1976 and 2012, 2388 cases, 1500 as for recorded. women look at that and look at the numbers today, we are amazed. that is something that we want to keep in perspective. another important thing to understand and appreciate his how does ebola spread? recent studies have clearly indicated that fruit bats are a

reservoir for ebola and nonhuman primates such as the eight and the monkeys are carriers that transmit it to humans. now, let's move to human to human chains nation, the way in which while it appears in human, human at the start of the outbreak is so far unknown. when the outcomes but really don't know what exactly happens. the first patient becomes infected through contact with infected animals such as fruit bats and as i mentioned in primates, which is called a spillover event. a person-to-person transmission can lead to large number of people getting infected. and small pass the ball outbreaks primates were also affected and a lot of primates also died during these outbreaks. and humans when they consume the meat of those primates are touch those primates are dealing with those primates got infected. once the infection comes and humans the virus can spread in several ways through direct

contact as we all have heard, broken skin, mucous membrane, eyes and nose, mouth, blood and bodily fluid of a sick person. and it's not limited just to human saliva, sweat, feces, vomit but also breast milk and assuming. needles can also contaminate and transmit the virus, and from, as we also making, the fruit bats and the primates. past research as we know has established now and we're still working on it and there's still some questions but past research has grew suggested that the spread, that the disease does not spread through air or by water or in general by food. in africa the ebola may spread as a result of as we mentioned earlier, handling of the bush meat which is very critical to understand and appreciate. there is no evidence that

mosquitoes or other insects can transmit ebola. once someone recovers from ebola they can no longer spread the virus. however, the ebola virus has been found in semen for up to three months. so that is something also to consider the as of october 29, the current epidemic in west africa caused by the zaire strain has resulted in inspecting over 13,000 people, and close to 5000 deaths, which brings the current case fidelity or mortality rate to about 36%. the three main countries are liberia, sierra leone and guinea. nigeria had 20 cases and eight deaths and was declared a bowl of fruit on october 19. senegal had one case that survived in the courage was declared a bowl of fruit on october 17. mali just recently reported a child who died of ebola. all-district of sierra leone has now reported at least one case of ebola, and ivory coast due to

its proximity to guinea as at the highest of being the next potential country that could get the disease. over 500 health care workers have contracted the disease, out of which 50% have died which is a very high number because the case fidelity rate right now in the general population is about 36%. interestingly, the first outbreak that happened in 1976 come case fidelity rate was about 80% and that was the zaire strain. the last outbreak that was around 2000, 2001 which was due to the zaire strain had a fatality rate of about 32% to we are getting close to the percentage is that we anticipate that are going to be for this particular strain. we all know that in spain there was a case on october 6, and enters was taking care of two missionaries contracted the disease on october 20 come no trace was found in her blood come and spain will be declared after 21 days people afraid of

actually 42 days of ebola free. we all know about the cases in the united states, and dr. kadlec tied about in detail and the problems and issues with our preparedness and recognition of disease is big, something that we need to look at very carefully and appreciate. there were a couple other cases, there's one case that is new york right now that was diagnosed on a cobra 23rd in a physician worked for doctors without borders and is being treated, and all the tracking in terms of the people that he was in contact with is being done in new york. there was another potential case in new york, a little child, five year old child was taken to the hospital but who tested negative. there was a case in maryland that was taken to the university of maryland medical system on october 27 and it turned out

that was not a positive case of ebola. so two very interesting things that happened on october 27. cdc outlined plans to monitor travel. most health care workers returning from west africa or the ebola hot zone would be considered to be at some risk for infection, while health care workers tending to a goalless patience and training facility would be seen as low but no threat to the population to these guidelines were short of the controversial mandatory quarantine being opposed by some united states states such as new york and new jersey. same-day united states department of defense came up with its own policy well beyond previous established military protocols. u.s. isolate about a dozen soldiers at the base in italy, including major general williams who oversaw the initial response of the ebola outbreak in africa.

dozens more will be isolated in the coming days as they rotate out of west africa where the military has been building infrastructure to help authorities treat ebola victims. all of you know with about 3000 boots on ground in rotation in africa helping with this particular problem. one of the critical problems of ebola is how do you diagnose this particular disease? we did not have a very effective way to diagnosing it. in response to the epidemic on august 5, fda issued what is known as the emergency use authorization, or du for the defense department for the real-time political chain reaction after ebola. on october 25 fda issued an emergency, another emergency authorization for two new diagnostic tests which is called the bio test which can be done on urine or blood and can give you results in about an hour. france is also developing to which is called the ebola d

screen which has been developed by the french atomic energy commission and taken potential diagnose a patient in about 15 minutes. when it comes to treatment there is no approved treatment available for the disease. clinical management is focused on supportive care of complications. however, multiple therapeutics or drugs are being developed or are in potential process of being developed that would help work on this disease. there are two particular vaccines that are of interest overcome one being developed by glaxosmithkline, and the other one by data link which is a canadian vaccine being used essentially in ames, iowa. both of these vaccines can, if tested, if test of all the safety in humans that is being done right now comes out okay, then there should be a decent amount of supply in the mid-or

the first quarter of 2015, for population within the next its work to be given to health care workers and first responders in africa. one of the other important factors to consider is what is going on in terms of the beds in africa? there are just not enough beds for the patients. the latest data from w.h.o. indicates that only 22% of the planned ebola treatment center bids and 4% the planned community care center beds are now operational which leaves a huge void in terms of providing health to the population. -- help. the current epidemic is the largest and the most complex on record with an unprecedented number of affected countries, thousands of cases and deaths come and general publishing and hundreds of health care workers infected. the estimates scale and mortality of the outbreak has reinforced the urgent need for large-scale accelerate

development of available specific and effective medical intervention. subject to the outcome of safety, studies and trials come we expect as i mentioned that there will be fair to take and vaccines that will be available to work on this disease. all of you have heard that experts have predicted that if appropriate measures are not taken, we can expect approximately 10,000 cases per week starting in december in africa. let me say that in two of the countries that outbreak is really going on, we are seeing declinadecline in terms of the . so there is some hope that this potential outbreak can be nipped by genuine if appropriate measures are taken. as dr. kadlec has suggested, the world is making this up as we go and we have become more comfortable with this.

it is a huge problem. the current epidemic which africa struggles with is something that we should have thought about. they do not have a health care structure that can do with a record issues that go on over there from health care perspective. now we're adding to the injury by ebola, major injury to the countries with the ebola outbreak. the first focus needs to be on relative simple thanks to decrease mortality in west africa. they suggest intravenous hydration replacing electrons, managing nazi, fever and superimpose bacteria infections with relatively inexpensive measures that could be part of a bundled package that would dilute the west africa. there is critical need of the dance as i mentioned in the most affected countries the proper training and protective gear need to be provided to the hospital staff take care the patients into the burial staff dealing with the corpses.

that are complex, ethical challenges which abound and are related to the use of untested interventions, quarantines, special care and other issues. in the u.s. national institutes of health biomedical research has always played a critical role in improving physical and mental health of americans and the globe which in terms of yield significant social economic and societal economic benefits. federal funding has been the cornerstone for nih, the cornerstone for the american biomedical research sector that leads world in investment innovation. nih budget being stagnated after 2003 and declined after 2010. the cost of conducting biomedical research has rapidly increased also at the same time. this was further hurt by the recent budgetary cuts and sequestration but in order to secure america's position as a global leader in biomedical

research, for the foreseeable future congress must pursue significant new investments. there's no evidence so far that we have appreciated in the scientific literature that says that closing borders will cause the disease to stop to come to a specific nation. we also need to do with some of the other ethical factors in terms of -- should we do that? yes, we should accept those workers but we must make special arrangements and special commitments to health care workers that are currently working in these particular countries, frontline dealing with the disease that is extremely deadly. these doctors and nurses must be promised not on high quality of training and protective equipment going forward, but also that if something happens we must take care of them. someone must take care of the heroes, not just the civilians who are there but 3000 troops that we have in the hot zone

when they come back. we have to make sure that they are taken care of. in summary, there are signs that epidemic is slowing down in some areas. it will cause a bigger devastation that we could ever think about. a vaccine i believe is the only hope of containing the outbreak, but the u.s. investment in vaccine research is a drop in the bucket. a nonpartisan effort in the u.s. need to increase funding support for nih and the u.s. department of defense for research and development and advanced development of vaccines and therapeutics as well as diagnostic devices. we also have to make a concerted effort to develop manufacturing facilities right here in united states. for diseases such as ebola and other infectious diseases that we might encounter in the future, or emerging threats, countries, ngos and funding

agencies private and public need to fulfill the pledges but only 40% edge but sorry to 70% of the pledges so far been fulfilled. countries promised and pledged private. those pledges never come through. they need to stand up and fulfill their commitment. and the last word is, remember, diseases do not know boundaries. so we can have these diseases, to united states or any other part of the world if you are only reactive and not proactive. thank you. [applause] >> thank you, yonah. with doctor alexander's permission of the guess more importantly our media colleagues approval on the going to speak from the table but rather than the podium. i appreciate the opportunity of being here. i've been asked to speak a bit

about terrorists and insurgent groups that are operating not just in africa but also in other parts of the region. and a little bit about how that affects humanitarian can potential for humanitarian disaster in the region. there's been plenty of literature analyzing these groups, some of the best has been done right here in this building. so not going to go into what al-qaeda is all about what isis is all about, except just a little bit. but what i want to do is talk about the activities of these groups and the potential for the development of to humanitarian crises in the region. and that is primarily through the issues of refugees and displaced persons. i've got some statistics are i will kind of rattle off. the sources of these, most of united nations, the high commission for refugees or undersecretary general for

humanitarian affairs. in africa, boko haram, a group that is certainly made headlines recently. there are probably 10,000 nigerian refugees in cameroon. i don't know if anybody would go to cameroon to seek refuge but there are 10,000 nigerian refugees in cameroon. there are probably 50,000 nigerian in me share your more about that in a minute. there are several hundred thousand internally displaced persons within night you but maybe even up to a million because these numbers of course keep changing, as things evolve. moving a little further north in the mali situation and in the activities of al-qaeda and the islamic maghreb further north, mali and algeria, there are 300,000 internally displaced people within mali.

imagine 50,000 in 105. some of those come from mali. and both of those situations, the u.n. is monitoring not for ebola necessary but for yellow fever, cholera, and this sort of thing. although i want to emphasize that the humanitarian disaster that can happen are certainly won't than just medical related disasters. in libya, one can argue this kind of the beginning of this whole process, especially in northern africa that are 60,000 internally displaced persons within libya, a country where any sort of government, whether it be the central government or regional governments, their rich ashman their reach does not extend very far beyond their building in which their meeting. there are also 1 million refugees according to the u.n. in tunisia, libyan refugees in tunisia. president of tunisia who will be

president at least for about a month or six weeks says it's up to 2 million libyans in tunisia. navy even one-third of the 2011 population. now, tunisia has capable medical capabilities. and this is a bit of a joke about that. if we have time i'll tell the joke about tunisia but this is still, it really taxes the capacities of countries to handle these people. let's talk about isis a little bit and i will talk about the refugee situation which adores these other numbers. relatively. and then i'll talk a little bit about isis itself at the end of my remarks. that you insist there are 3.2 million registered refugees. that is registered refugees, registered with the u.n. from

the isis-syrian civil war and sectarian fighting within iraq. there are refugees, more than a million each in jordan from both iraq and syria. and jordan has seen successive waves of refugees from 1948 right up until this year. about 1.3 million in turkey. these are registered. 1.2 million out of lebanon. 500,000 syrian refugees are in iraq. in other words, they went from syria, from the frying pan to the fire if you will, or the other way around and they sought refuge in iraq. there are 900,000 internally displaced people within iraq. syria, the numbers suggest, there are about 4 million syrians that are displaced within syria. some live with relatives, not

necessarily all in refugee camps but this certainly is a lot more than 3.2 million refugees. as winter gets close, about 5.2 million people in iraq, says the united nations, are in need or will be in need of humanitarian assistance as winter sets in. fuel, shelter, that sort of thing. and in iraq and syria, this is a chilling statistic and i'll talk about that towards the end, there are now about 10 million people living in areas controlled isis, the islamic state, 10 million people. in syria and iraq, in both countries. that's larger than the populations of most of the states in the region. now, this of course creates a

large refugee population in camps, emergency needs and there are as we heard by our previous speakers, and i don't mind going after previous speakers. i learned a lot from the folks who have spoken before me, the are a lot of obstacles to both governments and international organizations and ngos. there are obstacles to their providing the necessary humanitarian assistance. ranging from, well, seemingly ridiculous teams that are vaccinating for polio in pakistan are actually there to sterilize their daughters. so don't let them into the village. in fact, several have been killed. medical workers are actually bringing ebola, you know, into your part of the country to stay away from those people. it reminds me of the black plague picture. it's misinformation and it's

also propaganda that we have to counteract. obviously there are terrorist attacks and insurgent attacks going on in all these countries that i mentioned. and that threaten especially foreign ngos, but not just for and ngos, indigenous or native ngos also. in niger, the government has said that any ngos come any humanitarian teams provide assistance needed armed escorts outside of the capital. that certainly inhibits people flocking to help the victims there. there are kidnappings and objections of humanitarian aid workers in mali. isis has targeted him and train workers also, and we've seen the beheading of two bricks that were therefore humanitarian

purposes. the undersecretary general of the united nations for humanitarian affairs, and i will quote her says, we have had -- this is in this area crisis, civil and isis. we've had 66 humanitarian workers who've lost their lives since the start of the conflict, and hundreds more have been kidnapped and objected. this is what she says. within syria. that is certainly an obstacle to bringing the assistance necessary to take care of these people. and as we have seen in refugee camps in jordan and probably elsewhere, the war in syria, or the sectarian fighting in iraq, can spread to the camps themselves. in other words, fighters from each side can infiltrate the camps are go there as refugees and carry on the fight within the camps. which is really stresses both

the national street versus -- forces, the u.n. if they're running the camps, and other organizations. so we've got this situation with the millions of people facing, and it wouldn't take much to have a medical humanitarian crisis, but certainly other crises in terms of food, water, shelter, in these camps. let me talk a little bit about isis because this represents a new situation. we called it isis. that's what our government insists on calling it. i'm no longer part of the cover. i am an ex-fed. not fedex but an ex-fed. i actually retired and so i'm speaking just for myself but our government insists on calling it a isis, islamic a isis, islamic state of iraq and syria, but isis has its eyes on a lot more than just iraq industry. if you look at their map of the worldwide caliphate, it

resembles no caliphate that ever existed in the history of islam. most of northern africa. in fact, into sub-saharan, south asia. it is, it is a very globally looking, whether they have the capacity to execute it but they have this vision of this worldwide caliphate. this is the first organization of its kind that has been able to control territory in the daytime as well as the night. and this is key territory. these are cities, these are infrastructures, roadways, rivers, that sort of thing. key territory. as i said, 10 million people supposedly live in the area that they control. we can say that aqim and groups like that an african drum the desert and strike at will. that's very true but these

people control territory. they have displaced the governments of both the national governments and the more traditional tribal authorities, that sort of thing in the place, places they control. but they haven't fill the vacuum, the governance vacuum that they themselves created, or that had been growing before they even came upon the scene, such as in iraq and in syria. they are not providing services to the people, these 10 million people that live in the area. they don't even seem to care about providing services to these people, or interest. i don't surf the jihadi websites to see what's going on, but i haven't seen anything from isis that seeks to show how they have made life better, you know, for the people in mosul, now that maliki and this corrupt iraqi

government -- all the propaganda is about beheadings and that sort of thing. this is a totalitarian organization in the classic sense of the word. if you're not one of those, we will kill you. even if you are one of us and you don't toe the line and believe what we do and do what we do, we will kill you, too. so this is a different, a very different organization than al-qaeda. al-qaeda never really took that line. and now we are seeing isis sort of a clone type organizations in northern africa that are swearing allegiance like they did before to al-qaeda, al-qaeda central, the isis. [inaudible] in mali end in northern africa, certain elements, boko haram are doing that. so we are getting a sort of almost a nihilistic totalitarian organizations that are

controlling a lot of the territory. very little is getting into these places that isis doesn't approve. the international committee of the red cross says that it did manage to provide some medical equipment to a hospital in mosul, which isis controls, and the icrc says it has established contacts with some people inside fallujah, in iraq, but these are very, very small, very small. so that's the situation as i see it in that particular region. and we are facing a very difficult situation, underresourced as her to previous speakers state. thank you. [applause] >> oh, and foreign fighters. want to mention foreign fighters.

i'm a grandfather. young men worldwide find ways to get in trouble. i don't care where they're from. and in tunisia and other places are no exception. it could be through video games or through drugs or through a call or something like this, but fortunately at least in the west and in europe, the outlets for getting in trouble are much wider and much less lethal than they are in that particular -- it is not surprising that young men of that age would see something -- everybody wants, yoyou know, be the person in the video games. a lot of tunisians before, say before the revolution in tunisia were drawn into these groups when they were in your. in other words, they left tunisia to go to europe to find a better life, which they didn't find it and so they were therefore attracted by these groups because they were separated from their real

families, they had to find a virtual family which is on the internet someplace, and they get sucked into these groups. a lot of them went to syria. not every recruiting with in tunisia itself but a lot can be said, i think there's a lot you can blame on the job, the economic, and social despair they have, but essentially there's always a group of young men that are going to find ways for excitement and to get into trouble. >> would you like to make any comments now? okay. >> many of you have come to the program -- [inaudible] >> microphone. >> will is that okay? is that live? many of you have come to these

programs, and there's always one golden thread that runs through them. i think it's the sheer, the goal, the richness of what is said that i sometimes find a little bit difficult to pull it all together in my head, but i think today we have a fairly common set of themes but i mean, i thought initially we would be talking about the fear but i think we're really talking about the underlying reality. so we don't have to get into sort of the excessive reaction. someone mentioned the core fear, i think dr. kadlec. and i think, let me talk about isis briefly. we've had a program on isis before, i think called isil at the time, and i think yonah or someone called it terrorism but i think it's probably deeper than terrorism. terrorism is something one of the things that spawned, and i think this is something we really have to be concerned about. i think we've seen the collapse probably of the middle east.

it's interesting, so imagine yesterday or the other day was the 91st anniversary of establishment of the turkish republic, roughly the same time at the end of the caliphate. i wonder when people turn into the turks have ended the caliphate? i think there's a real unraveling there. the problems are profound. i think s.o.b. of these problems come with america, fear comes from ignorance but even if you're knowledgeable and not afraid i think it's very hard to get a total grip on the underlying reality that is evolving. this is something will come back to again and again and yonah has been drawing that park, that picture, the art keeps on growing and deepening and it is deadly there. on the other side i saw this rather interesting but i didn't think that we would link able to this but now i see. it's really the inadequacy about the ability to cope, yes, difficulty in coping with isis but even bigger a greater difficulty coping with ebola and

then possibly bioterror. and i think there it gets buried deep in america which are our priorities but i'm a republican. i'm certain that the tea party republican. their belief that private life is what it's all about, the atrium's and buildings, beautiful houses, the meals, we think there's something wrong with her man who didn't want to spend money on public goods, a get dr. kadlec pointed out we do that. it's not the same as what yonah said before. yonah said before that as we cope with security problems we mustn't neglect our civil liberties. i agree completely. i'm a lawyer and lawyers tend to be interested in that. and they are not the same but nonetheless our regard for our liberties is somewhat related to our regard for untrammeled freedoms, our unwillingness really to sacrifice in the short and long-term. and i don't know whether we were

just is about or not but even in the face of emergencies, crises. what we are not our marines. the military has a discipline. the civilian public of the west do not have it. so i think we're going to lurch and lurch and lurch and incrementally your word a little better, but we are just going to put up with and hope we don't succumb to fear in the process. thanks. >> well, we will open up the discussion here. it's not just the question of fear. it's the question of hope. so the big issue is that we tend to exaggerate sometimes the proportion of fear and also the hope, you know? we hope, we pray that things are going to improve. so we have to start with some

realistic -- [inaudible] anyway, i think you are ready. spirit thanks very much. i spent many years and counterterrorism for state agreed to of been working on the ebola issue with a group called global health spawns reliance but i think there's some parallel in fighting terrorism to one of the things, special that president bush was we find it in overseas before they can hit them here. and one of the efforts in fighting ebola is to try to contain it in africa. as you all know, there's been big efforts to help the people there. and there's a certain irony here that in countering terrorism we spend millions of dollars in training of the countries to

beef up their counterterrorism forces but, in fact, we can't overlook the time of in gaza, jordan and indonesia broke up a couple of rings with the tried to attack our embassies, oath countries received a lot of trained in the bio areas as you know better than i do we try to improve the capabilities of other countries. but now we're running into a problem and her to we're tryingo encourage health workers to go overseas, doctors without borders, story by reuters today said there's a chilling effect on the quarantines that have been imposed in new york and new jersey, and governor christie admitted he didn't talk to health officials. we have two major allies, canada and australia, which have good health systems, but very reluctant to send health workers because they're worried about how they're going to train. so what i'm trying to get at is we are being countered protected by bringing quarantines for discouraging people for going

overseas to there's nothing that's going on, not much publicity. here's why disagree with you little bit. the oldest solution is not vaccines. but there are proposals to develop sort of a phase two, to develop quarantines or develop containment zones in areas countries already effected and around the countries, to keep people from spreading. the idea is to help educate the villagers, to abandon some of the burial practices in which even, a cup or a drink -- passed around among the family and other things. sierra leone has made some progress with this effort. there's some teams that are going out there, but the basic effort is to try to educate the villagers and put in some teams to deal with the psychological and other aspects of phase two. and this group of alliance which includes mainly a group of

public health specialists and some former military people from dhs is trying to put that together. my point is that we have to look not only at the immediate problem of getting enough people and health workers and train them up for it exists now but also develop a better way of containing it before it spreads further. >> thank you. thank you much, mike. >> so i agree with you that vaccine, developing a vaccine is not the only way to deal with this problem, not what i wanted to emphasize was, that if you really wanted to get rid of this problem for good, we need to have a vaccine. you know, the primary thing that is needed is to provide the affected countries with the basic needs and those are the

basic needs the ones that i identified, you know, which are from beds to iv fluids to antibiotics, for example. going from there we got to understand and appreciate that we've got a cultural bias that we've got to deal with in those nations. and that has to deal with the way that they deal with food and the practices. dr. kadlec pointed out very clearly that they are clearing the rain forest, and the forest in a lot of plan in africa and what that is doing is it is bringing the food back in two close proximity to the population, not only the human population by the primates. and once the primate gets it and food supplies are short in those countries, and guess what they depend upon for food supply perspective? so the the the apes and monkeys and basically that's the meat that they utilize. and did the animal is infected,

once they slaughter the animals they will potentially compare the animal is infected come will get the disease and those practices have to change. practice have to be modified. a lot of work needs to be done. one of the critical things beyond all of that is that we've got to help those nations builder health care infrastructures. i just don't have the best capacity to deal with regular issues and count on a day-to-day basis on top of this ebola problem. it is impossible for them to do with it. [inaudible]

>> the first thing i think to understand, to highlight the fact that the guidelines of cdc is published have evolved. and what they've evolved to in terms of the current setting and i think is one of the areas that's causing some concern and maybe a little confusion with the states because states do have authority under the constitution, those things that are now reserve by the federal government in public health bills into debt so they have domain over this, so it's their interpretation of how they should take recommendations from cdc. but a short point is i think the point, right now the two greatest risks to ebola transmission our close personal contact of people with ebola

virus and health care workers who are treating ebola virus. i think the difficulty in terms of the guidelines as stated in the current setting is that we do not perceive the current setting to health care workers are at greater risk. it flies lived in the face of what happened in dallas went to nurses became ill. we understand why they became ill. they didn't have the right personal protective equipment. they probably didn't receive proper to me. they did know how to take the equivalent off. but the short answer is i think that's causing people to ask should we not use health care workers have been in contact with ebola patients, someone at a higher risk. with at higher risk, what is the considerations? should they -- for people working on the frontier, that's the recommendation is that they should go home and can't stay

out of public places for 21 days. but obviously in states where there is a lot of fear, and i think ignorance to go with it, there seems to be a demand lyrically for action. and, obviously, we know in the states of new york and new jersey, those quarantines orders didn't last very long. and so i think that as the events evolve and the event evolves and guidance is refined you may see the politicians will be a little us likely to lead with their face on the event you may see refinement by cdc to suggest some kind of maybe higher consideration for health care workers who have been in direct contact with ebola patients. it still doesn't change the nature as they are in maine today with the governor is seeking a court injunction to enforce quarantine on the nurse who is out there right now, to

be determined. so i think as someone told, some very sage said, just wait, it will change again. and i think that's kind of like the watchword that probably needs to be invoked, a bit of caution, a bit of prudence, but certainly some of the efforts so far have probably figured one way ticket -- [inaudible] along the way. >> so one more thing to just quickly add to that. the first thing is map-21 days is a safe period after which if you're not a listening any symptoms, you should not have the disease. that's the number one rule that we are following here. number two, we've got to have compassion for the health care workers. and we cannot ostracize them. and from an ethical perspective we have to take that consideration and consider the law as well as the ethics that

we fall -- follow in this nation. we've got to make sure that we follow all of those things and provide them all the support that we need to provide them. one of the critical things that i would like to see is, and as was mentioned, there has to be a voluntary executed quarantine that individuals impose on themselves. and i hope that after doing such tremendous work and working with patients with ebola and being on the front line in dealing with the situation, they will have enough sense to stay indoors for 21 days. because we definitely do not, and i repeat, do not want resources being spent on this particular issue at this point. we should spend resource on the critical issues that are needed in africa. i can assure you that after

november 4 a lot of this type is going to disappear. >> yes, please. >> thank you. i am the egyptian consulate in washington, d.c. i have really learned a lot today from this super panel actually has today. so thank you so much. just quick comments regarding what was mentioned by professor velte and professor lawrence regarding the region, especially in the middle east. because what was mentioned by professor wallace regarding the cooperation of the international cooperation in fighting even epidemic like ebola is still very low. i believe actually the cooperation -- is much lower than the cooperation in fighting academic -- disease and slo so t what i was living in iraq and syria come it's not only

contradict with islam but also contradict with human values, which all should believe in and so on. ..