all of you heard that experts predicted that if appropriate measures are not taken, we can expect approximately 10,000 cases per week starting in thames in africa. well, let me say that in two of the countries that the outbreak is currently going on, we're seeing -- in terms of cases. so there's some hope that this potential outbreak can be nipped by january if appropriate measures are taken. as dr. cadillac had suggested, the world is making this up as we go, and we have become more comfortable with uncertainty. 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 healthcare structure that can deal with the regular issues that good on over there from a healthcare perspective. now we're adding to this injury by ebola, or nature is adding to the country's with ebola outbreak. the first focus needs to be on relative simple things to decrease mortality in west africa. intravenous hydration, managing nausea, fever, and superimposed bacterial infections will relatively inexpensive measures that can be part of a package that can be delivered do west africa. there's critical need of beds in the most affected countries. proper training and protective gear needs to be provided to the hospital staff, and the staff dealing with the corpses.

their complex ethical challenges which abound and are related to the use of untested interventions, quarantine, special care and other issues. the u.s., u institutes of health played a critical roll in improving the health of the american and the globe. funding has been the cornerstone for nih, funding of nih has been the cornerstone for the american biometric research center that leads in innovation. and just 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 bit the recent bubble tear cuts and sequestration jessica in order to secure america's position as

a global leader in biomedical research for foreseeable future, congress must produce significant new investments. there's no evidence so far 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 deal with some of the other ethical factors in terms of ailing foreign healthcare workers. we must make special arrange. s and special commitments to healthcare workers working in these particular countries, front line, dealing with the disease that is extremely deadly. these doctors and nurses must be promised not only high quality of training and protective equipment, going forward, but also that if something happen we must take care of them. someone must take care of the heroes-not just the civilians who are there but the 3,000 troop wes have in the heart

zone, when they come back. we have to make sure that they are taken care of. in summary, although there are signs the epidemic is slowing down, if not for sustainable international response it will cause a bigger devastation than we could ever think about. safe and efficacious vaccine i believe is the on hope -- only hope for containing the outbreak but the u.s. research is a drop in the bucket. a unanimous partisan effort in the u.s. is need teed increase funding support to nhi and the u.s. department of defense for research and development and advance development of vaccines and therapeutics as well as diagnostic devicesment we also have to make a considered effort to develop manufacturing facilities right here in united states. for diseases such as ebola and other infectious diseases. countries, ngos and funding

agencies, public and private, need to fulfill their policemens. only 40 -- 17% of the pledges so far have been fulfilled. countries promise and pledge private institutions promise and pledge, those pledges never come through. they need to stand up and fulfill their commitment. and the last word is, remember, diseases do not observe boundaries so we can have these diseases come to the united states or any other part of the world if we do not -- if we are only reactive and not pro-active. thank you. [applause] >> thank you. with dr. alexander's permission and our media colleague's approval, i'm going to speak from the table here rather than the podium. i appreciate the opportunity of being here. i've been asked to speak a bit

about terrorist 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 -- the potential for humanitarian temperatures as in the region. there's been plenty of literature analyzing these groups. some of the best has been done right near this building. so home not going to go into what al qaeda or isis is all about, except for just little bit. but what i want to do is talk about the activities of these groups and the potential for the development of true humanitarian crises in the region, and that's primarily through the issue refugees and displaced persons. i have statistics i'll rattle off. the sources of these -- most of the uted nations either the high commission for refugees or the

undersecretary general for humanitarian affairs. in africa, boca haram, a group that has certainly made headlines recently. there are probably 10,000 nigerian refugees in cameroon. i don't know if anyone would go to cameroon to seek refuge but there are 10,000 nigerian refugees in cameroon. probably 50,000 nigerians in niger and there are a displaced persons within nye -- nigeria, maybe up to a million because this numbers keep changing. moving further north in the mali situation and in the activities of al qaeda ask the islamic in the north, mali and nigeria, there 300 are hundred thousand

internally displaced people within mali. i mentioned 50,000 niger. some of those come from mali inch both situations the u.n. is mon doering for yellow fever, cholera, and this sort of thing. i want to emphasize that the humanitarian disasters that can happen are certainly more than just medically related disasters. in libya, which one can argue is kind of the beginning of this whole process, especially in northern africa. there are 60,000 internally displaced persons within libya, a country where the -- any sort of government, whether it be the central government or regional governments, their reach does not stepped very far beyond the building in which they're meeting. there are also a million refugees, according to the u.n. in tunisia. libyan refugees.

the president of few nyeshia, who will be d few -- tunisia, says it's up to two million libyans in few nyeshia. a third of the 2011 population. tunisia has medical capables, and this is a bit of a joke about that. i'll tell the joke about few nissan -- thank -- let's talk at isis a little bit and talk about the refugee situation in isis, which dwarfs these other numbers relatively. and then i'll talk about isis. the u.n. says there are 3.2 million registered refugees. that is, registered with the u.n., from the isis/syrian civil

war ask sectarian fighting within iraq. there are refugees, more than a million each in jordan, from both iraq and syria. and jordan has been -- has seen successful waves of refugees from 1948 right up until this year. about 1.3 million in turkey. these are registered. 1.2 million in lebanon. 500,000 syrian refugees in iraq. they went from syria, from the frying pan into the fire, or the other way around, depending on your perspective. and they sought refuge in iraq, and there are 900,000 internally displaced people in -- within iraq. syria, the numbers suggest, there are 4 million syrians that of displayed within syria. now, some go to cities and livewill with relatives, not

necessarily all in refugee camps, but this is a lot more tn 3.2 million rev. [engine revving] fujiis. is a winter gets closer, 4.2 million people will be in need of humanitarian assistance. fuel, shelter, that sort of thing. and in iraq and syria -- this is a bit of a chilling statistic, and i'll talk about that towards the end -- there are now about 10 million people living in areas controlled by 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 large refugee populations,

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

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 foreign, indigenous or native ngos also in niger, the government said any ndos, any humanitarian teams providing assistance, need armed escorts outside of the capital. that certainly inhibits people flocking to help the victims there. there are kidnappings and abductions of humanitarian aid workers in mali. isis has targeted humanitarian workers also, and we've soon the beheading of two britts that were there for humanitarian

purposes. the undersecretary general of the unites nations for humanitarian affairs -- i'll quote her -- this is in syria civil war and isis -- we have had 66 humanitarian workers who have lost their lives since the start of that conflict and hundreds more have been kidnapped and abducted. this is what she says. within syria. that is certainly an obstacle to bringing the assistant 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 and carry on the fight

within the camps, which stresses both in the national security services, trying to police the camps, the u.n., or other organizations. so we have this situation with millions of people facing -- it wouldn't take much to have a medical humanitarian crisis, but certainly other crises in terms of food, water, shelter, in these camps. now, let me talk a little bit about isis because this represents a new situation. we call it isis. that's what -- our government insists on calling it, and i'm no longer part of the government, i'm an ex--fed, not a fedex but an ex-fed. i actually retired, and so i'm speaking just for myself, but our government insists on calling it isis, islamic state in iraq and syria. but isis has its eyes on a lot more than just iraq and syria

of. their map of the worldwide caliphate resembles no caliphate that existed in the history of islam. most of northern africa. into subsaharan. south asia. it is a very globally looking -- whether they have the capacity to execute it is another story 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 infrastructure. roadways, rivers, that sort of thing. key territory. 10 million people live in the area that they control. they have -- we can say that aqim and groups and -- roam the

desert and strike at well and that's truitt, but these people control territory. they have displaced the governmentsing are both the national governments, such as they exited, and the more traditional tribal authorities, that sort of thing in the places they control. but they haven't filled the vacuum, the governance vacuum that they themselves created, or that had been growing before they even came upon the scene, such as places like in iraq and in syria. they're not providing services to the people, these ten million people that live in their area. they don't even seem to care about providing services to these people or interested. now, i don't surf the jihadi web sites to see what is going on but i haven't seen anything from isis that seeks to show how they have made life better for the people in mosul, now that al-maliki and this corrupt iraqi

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

organizations controlling a lot of 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 efforts. so that's the situation as i see it. in that particular region. and we're facing a very difficult situation underresourced as our two previous speakers said. thank you. [applause] >> we can do that during q & a. and foreign fighters.

>> i'm a grandfather. young men. worldwide, find ways to get in trouble. i don't care where they're from. and tunisia and other places nor except. it could be through video games or through drugs or alcohol 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 leslie than that they are in that particular -- it is not surprising young men of that age would see something -- everybody wants to be the person in the video games. a lot of thank tunisiaens. and they went for a better life and were attracted by these groups by -- because they were separated from their real

families, they had to find a virtual family, which was on the internet someplace, and they get sucked into these groups. a lot of them went to syria. now they're recruiting within tunisia itself. a lot you can blame on the economic, the social despair they have, but essentially there's always a group of young men that are going to find ways to -- for excitement and to get into trouble. >> would you like to make any commends now? okay. >> many of you have come to these programs -- [inaudible] >> is that okay? is that live?

many of you come to those programs and there's always one golden thread that runs through them. it's the sheer, the gold, the richness of what is said. i sometimes find it difficult to pull it all together in my head. i think today we have a fairly common set of themes. 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 the excessive reaction. someone mentioned the core fear. and i think both -- let me talk about isis briefly. we have had a program on isis before, called isil at the time, and i think yonah or someone called it a terrorism. but i think it's probably deeper than terrorism. terrorism is simply one of the things that is spawned. this is something we really have to be concerned about. i think we have seen the collapse probably of the middle

east. it's interesting. someone mentioned that yesterday was the 91st anniversary of the establishment of the turkic public, roughly the same time at the end of the caliphate. i think there's a real unraveling there. the problems are profound. i think, as so many of these problem, when america -- fear comes from ignorance, but on if you're knowledgeable and not afraid, it's very hard to get a total grip on the underlying reality and this is something to come back to again and again. yonah has been drawing the arc, and the arc keeps growing and it's definitely there. on the other side, i didn't see how we link ebola to this but now i see. it's really the inadequacy of our ability to cope. yes, difficulty in coping with isis, but maybe even a greater difficulty coping with ebola and

then possibly bioterror, and i think there you get to something very deep and american, which is our priorities. i'm a republican, certainly not a pea-party republican. now, the disinclination of americans to spend money on public goods, the belief that private life is what it's all about, the buildings, beautiful houses, meals, we think there's something wrong with our manhood in wanting to spend money on public goods, and yet we do that at our peril. it's not the same as what yonah said before. he said before as we cope with security problems, we mustn't neglect of civil liberties. i completely agree. i'm a lawyer and lawyers tend to be concerned with that. they're not the same. but in regard to our liberties is related to our regard for our untrampled freedoms, unwillingness to sacrifice in the sort and long-term, and i

don't know whether -- even in the face of emergencies, crises, what we are not is marines. general gray is a marine. the military has a discipline. the civilian publics of owest do not have it. so i think we're going to lurch and lurch and lurch and do incrementally, your word, little better, but we're just going to have to put up with and it i hope we don't succumb to fear in the process. >> open up the discussion here. it's not just a question of fear. it's the question of hope. so, the big issue is that we tend to exaggerate sometimes -- the fear and the hope. we pray, we hope that things are going to improve. so, we have to start some sort of a realistic --

[inaudible] not be surprised all the time. i think you raised your hand. would you please identify yourself. >> thank you very much. mike craft. i spent many years in the counterterrorism state and have been working on the ebola issue with a group called the global health response reliance. i think there's some parallels. in fighting terrorism one of the things, especially by president bush, was we fight them overseas before they can hit us here. one of the efforts of fighting ebola is to try to contain it in africa. as you all know, and was described, there's been efforts to help the people there. and there's a certain irony here that in counterterrorism we spend millions of dollars in train ago countries to beef up

their counterterrorism forces. in fact, at the time of benghazi, jordan and indonesia broke up a couple of rings trying to attack our embassies. both countries received a lot of training. in the bioarea we try to improve the capability of other countries. but few we're trying to encourage healthcare workers to go overseas, doctors without borders said they're worried about, there's a chilling effect by the quarantines imposed by new york and new jersey, and governor christie admitted he didn't talk to health officials. we have two major allies, canada and australia, are reluctant to send healthcare workers because they're worried about training them. we're being colored productive by imposing quarantines and discouraging people from going overseas.

and there's another effort that is going on, has not gotten much publicity. the only solution is not vaccines. whether proposals to develop sort of a face two, to develop quarantine -- develop containment zones in areas, countries already affected and around the countries to keep ebola from spreading. the idea is to help educate the villagers, to abandon some of the burial practices which even cups of drink are lifted to the lips of the dead person and passed around among the family and other things. sierra leone has made some progress in this effort. there's teams going out there but the basic effort is to try to educate the victimmers and put in some teams to deal with the psychological and other aspects of face two. and this group of reliance,

which includes mainly a group of public health specialists and some former military people and 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 where it exists now but also develop a better way of containing it before it spreads further. that's basically it. >> thank you very much. >> i agree with you that vaccine and developing a vaccine is not the only way to deal with this problem, but 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. ...

we are clearing the rain forest and dewolf were saying a lot of land in africa and what that is doing is it is bringing the food back into close proximity to the population, not only the human population but the primates in the wants of primate gets it in the food supply is short in

those countries and guess what they depend upon for food supplies perspective? subeight eat that apes and monkeys and basically that's the meat that they utilize. if the animals infected once they slaughter the animal they will potentially at the animal is infected will get the disease and those practices have to change. those practices have to be modified so a lot of work needs to be done. one of the critical things beyond all of that is that you've got to help those nations build their health care of the structures. they just don't have the capacity to deal with the regular issues that they encounter on a day-to-day basis. on top of the apollo problem it's impossible for them to deal with it. >> hi. to follow up on your question

what is your view the medical expert to your particular this 21 day quarantine that is effective in some states and not effective in other states. some health workers defy that. where should we go from here? >> the first thing i think to understand and not to highlight the fact that the guidelines that the cdc has published have evolved and what they have a ball to in terms of the current setting and i think it's one of the areas causing some concern and maybe a little confusion, states do have authority under the constitution for those things that are not reserved by the federal government and public health falls into that so they have to -- so it's their interpretation of how they

should take recommendations from the cdc but the shore point is the point that rashid chotani made right now the two biggest risk groups for ebola transmission are close personal contact with the people with a bowl of virus and health care workers who are treating the ebola virus. i think the difficulty in terms of the guidelines that they have stated in the current setting is that we do not perceive in the current setting that health care workers are at greater risk. this flies a little bit in the face of what happened in dallas when two nurses became ill. now we understand why they became ill. they didn't have the right personal protective equipment and probably didn't receive proper training. they didn't know how to take the equipment off but the short answer is i think that's causing people to ask, should we not view health care workers who have been in contact with ebola

patients yet high-risk with that higher risk what are the considerations collection of a self isolate? that's the recommendation is that they should go home and kind of stay out of public places for 21 days, self-imposed. obviously in states where there's a lot of fear and ignorance to go with that there seems to be a demand politically for action and obviously we know in the states of new york and new jersey those quarantine orders didn't last very long. so i think as the events invol involve, as the event evolves and as guidance is refined you may see that politicians will be a little less likely to lead with their face and on the other hand hand he made peace seeing refinement by the cdc to suggest some kind of maybe higher consideration for health care workers that have been in direct

contact with ebola patients. it doesn't change the nature as it remains today where the governor seeking a court injunction to enforce quarantine on the nurses who are out there right now, to be determined i guess. so i think as someone said just wait, it will change again. 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 effort of the efforts of our probably feared one way along the way. >> one more thing to quickly add to that. the first thing is 21 days is a safety word you are not eliciting any symptoms you should not have the disease. that's the number one rule that we are following.

number two we have got to have compassion for the health care workers. and we cannot ostracize them and from the ethical perspective we have to take that consideration and consider the law as well as the ethics that we follow in this nation. so we have got to make sure that we follow all of those things and provide 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 -- voluntarily executed quarantine that individuals impose on themselves. i hope that after doing such tremendous work in working with patients with ebola and being on the frontline of dealing dealing with the situation they will have enough sense to stay indoors for 21 days because we definitely do not, and i repeat did not want resources being

spent on this particular issue at this point. we have spent resources 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 with the egyptian council in washington d.c.. i am really learning a lot today from this panel you have today so thank you so much. some quick comments regarding what was mentioned regarding terrorism in the region and especially the middle east. professor wallace regarding the cooperation of international cooperation the epidemic like ebola is still very low. i believe actually the

cooperation is much lower than the cooperation in fighting the epidemic disease and so on. what isis is really doing is not contradicting with the human values. the egyptian government has been calling for international support to fight terrorism in the region. like every single western country we are reluctant in cooperating a few months ago and the foreign fighter problem emerged and to give you an idea what really will happen if changes took place lately. the "washington times" a few days ago or a few weeks ago published statistics about the foreign fighters in the middle east in iraq and syria and they

mentioned something interesting regarding tunisia. they have more than 6000 tunisians, foreign fighters in the region and 330 something and we are wondering if the regime stays or at least the former regime in egypt stayed in place that compared the countries how many foreign fighters will be there. really in my opinion just like professor chotani mentioned the situation in the sinai and we still find many criticisms for what the egyptian government is doing to fight terrorism. actually if we look at this statement, the public statements made by the former government we were actually supporting the mali terrorist group. we called for jihadists

determining the whole situation by the public to a sectarian conflict. i think we still need by you and all the presidents we need to explore the opportunity for more cooperation in fighting isis and later to islam and other areas. thank you. >> my name is craig childress. just a quick question. we talked about decontaminating and proper training of health care workers at the thought just struck me that i haven't heard anyone in the press described how you decontaminate a health care worker.

seeing as how this is already taped in presumably going out to a fairly wide audience, i'm sure there are some of us in the room, myself included who have actually been through decontamination for a nerve agent. from full mop floor down to the skin. it's not a quick process. it is very time-consuming. it is a resource intensive and you have to decontaminate the decontaminate years so it's not easy which goes to your point sir about training and training often and continuously. if you know can you describe how you decontaminate a health care worker that has been treating someone with ebola? >> thank you. actually the analogy between the

exposure particularly a persistent agent is similar to what you'd be concerned about in the case is being exposed to the ebola virus through human secretions of one sort or the other. so in many ways the principles are the same though the equipment is different in terms of some of the types of equipment that are available n now. but the principle measure is using bleach so that is the principle rents were some kind of bacteria side or microsite that basically will render the of ebola virus dead. it is time consuming and sense that it is a buddy rule that you have in the military. basically you would start primarily with removing the gown first comer retaining the gloves in removing the boots first going through probably a shuffle. iq would with nerve agent

exposure and then retaining if you will do respiratory protection in the gloves as the last pieces of equipment that you would take off before you would be clean. now obviously in settings that are in africa which are very different than in the united states you would probably have people then shower out as a final step and change their clothing because they probably wore scrubs underneath. in africa they don't have those opportunities. in fact in africa they were using gloves and using the gowns and many in personal protective equipment as we see as disposables. they would use them because of limitations in short supply. that is kind of a rough description. >> just to give an example and i can't remember the exact breach in the vigilantes to be decontaminated you need 32 gallons of water, eight gallons of bleach, for a

day about six to eight changes of gloves, at least two to three complete coveralls which costs about $32 approximately in africa. you also have to have these boots that go over your boots so it's very expensive and an intensive process. as dr. kadlec mention you don't have those resources available in africa so a lot of things are happening over there that should not be happening. people who are in those situations have to improvise and that's why the costs of this epidemic is so high. right now the united states has approximately spent $700 million for spending $700 million in sending troops over there etc.. you have to put in the numbers

that are going to be used for gowns and gloves etc. and all the equipment that is needed. it's a very expensive and tedious and resource intensive process. >> you just spouted off all of that equipment list. so being an ex-military guy look around and say and going back to this preparedness point and professor wallace's comments about spending for the public good outside the defense department how many sets of all of that but saying the state of texas that could be brought to the hospital in dallas? >> not enough. that raises the real critical thing. the old military axiom amateurs talk strategy and policy and this is all about logistics. the answer is whether

domestically and internationally big domestic -- domestic supply chain for these materials to address this help whether it be monrovia for dallas are not sufficient. >> the statement that you made, that belongs to a poet who describes it all humanities are made by the same creator and belong to the same body. if any part of the body aches and nobody bothers you cannot name those people human. >> just one quick footnote on isis.

i think the professor spoke about the territory which is true but we do have obviously some parts of the territory referred to that are in libya and so forth and declared regions with isis but aside from the territorial which is very important is the financial i think capability of isis with all the funding bear, and the oil. that capability is very important for them in order to rebuild people in the refugee camps as well as in casablanca and elsewhere. many have spent thousands of dollars to allocate to those who

would join them as volunteers. by the way those with a military background will get more funding because of their experience. number one when they talk about refugees this great humanitarian issue that you have discussed that deserves much greater attention and support but it's also i think a potential for future equipment for many years to come. in other words the children of today can become the terrorists of tomorrow. because of interest of time let me ask one question that each panelists are welcome to respond. to try to link the issue of the disease, in this case ebola and terrorism the protocol for these

disasters can be predictable. in other words can we do the homework and prepare ourselves as you indicated so it won't happen again. this is number one and number two we refer to it to some extent, we be prepared to mitigate disasters in the future and can we have a get now back. [inaudible] >> thank you professor alexander. that's a great set of questions and i'm recalling the contemporary philosopher yogi berra that the future is hard to predict. so the answer is i don't know -- i take my page if you will from a book is called the black swan which has nothing to do with public health, nothing to do

with disasters of the classical sense but certainly economic disasters. it's the whole notion of whether you can predict those things from happening. in retrospect it can. of course we can see the recession of 2000 may coming. look at all the abuses and look at all the loopholes that the answer is in some ways his contention is that in some ways you can predict these things and really the approach is really about preparedness to become resilient. by the way they're a good black swans and bad black swans and you have to be prepared to recognize either one and prepare to take care of the good and mitigate the bad. that is how i will leave it that in some ways we probably are not going to be 100% accurate in terms of our predictive capabilities but we certainly know what works for better preparedness for these things and it certainly seems in light

of investments we have made in other areas and i will accuse the national missile defense is an example, that investments in these areas which are insurance policies are probably reasonable and affordable. >> so quickly as dr. kadlec mentioned we honestly cannot predict anything but we can't be prepared for things and what i was pushing for in my talk when i talked about the resources that i needed for science and technology in this nation that have been the switch which used to be on all the time has somehow been shut off and the numbers in terms of funding have decline. if you continue to do that we will never have a safety net that dr. kadlec you talk about because we won't have those. we understand and appreciate that sometimes those

manufacturing facilities that we need to have in this nation are not going to be doing a lot of active work but if you don't have them when the time comes they cannot do that active work. we also need to invest a lot in looking at the ecology of diseases. we have not recognized all the diseases. now if you folks feel you get the influenza vaccine every single year and you don't get implants we are mistaken. what is at 65 to 70% of the people who will get the vaccine will be protected by 30% will get the virus. apart from not, a lot of people who get the vaccine still get something which is similar to influence every single year. we have not invested enough money to investigate and those things and that is what is needed from a national policy perspective to invest.

if we don't do that we will never be able to be prepared for anything. >> thank you. this is a little bit out of my -- we certainly could predict hurricane katrina. we know it was coming but which brings to my mind the comment that you made dr. kadlec about rocket science. actually this is harder than rocket science. the losses physics don't change. you put the right numbers and you will hit it so would hurricane katrina comes ashore it's like a pinball machine. you pull the handle and you hope you get three cherries but if you don't it's a disaster and we don't really know what you're going to get. you have a combination of human failures. you have bureaucratic issues at all these things that affect it. finally, yogi berra, a great american philosopher also said he and i didn't actually say all those things that i said. [laughter]

>> i certainly, this is an extraordinarily intellectual group of presentations here and i think we are all a little bit smarter this afternoon than they were this morning. i think many would say your first inclination would be to throw up your hands. it can't be done. it's just too much. i happen to be the eternal optimist so i think something can be done. on page two of a recent on africa you'll notice that the owner said what we need for the ebola challenge in africa is some kind of the marshall plan type approach. that is sort of what i would underscore for this whole global topic that we are confronted with here today and will be for

a long time. it's going to take a long, long, long, long time. a lot of investment, a lot of brainpower, a lot of thinking and a whole bunch of different areas that sometimes may seem unrelated before we can come up with their reasonable capability in my opinion to confront these various challenges. on the other hand we have faced these kinds of things before not only in the manhattan project and things like that. i have to say the second manhattan project, i was born in raw way new jersey and in east broadway is the whole establishment so we learned a little bit about that as youngsters and so on. the thing that we need to remember is all of these challenges, the medical challenges, the nuclear biological chemical challenge

the solution to all these as many times different. you don't do the same thing in the chemical threat as you do in the biological threat. in one case you gather up in the u. spread out. so these are the kinds of techniques that we have to think about. when you look at the enormity of it is kind of innocent to throw up your hands. he we faced a big threat in the 1970s that was extraordinarily complex in terms of whether and in terms of physics, in terms of the ocean etc. etc.. it was called the russian submarine threat. was called the u.s. american anti-submarine threat as well. it was enormous, so much that we almost didn't want to tackle it but we did. we used an approach where we bit off a little bit of the apple at a time. a little bit more at a time, a little bit more to time and you know after a while after 10 or

15 years we had a pretty well flipped. that is what i think we have to do here. we have to develop a long-range conceptual plan. i call it a campaign plan. we start out by saying this is the end state that we really want. we would like to really be able to say with the 75 or 80% chance we will these kinds of challenges whether they are chemical biological medical etc. etc. etc. and then we put together an organization to do that. it will look like the military. it will involve the military because the military today in the united states of america is the only organization that's really big enough to comprehend the challenges and big enough from the standpoint of command and control and intelligence reconnaissance, big enough from the standpoint of logistics and all that type of thing. that's one of the reasons why in the mid-90s we formed the army

development command for this kind of thing that pulled in different disbursed outfits, government and otherwise that were doing these kinds of things. they were big enough to comprehend this and big enough to meet the challenge. the marine corps is small as it is for 15 years now has had a chemical biological force in indian head maryland which is a national asset. it's a national asset. that is their whole job is to be able to handle the chemical and biological challenges and be decontamination, all that kind of thing. so we have spread out now throughout the united states. it's the responsibility of each state and they can be used by the state and local. there's an inroad here and many of these units are in the national guard and the national guard is a state-controlled

organization until the president for whatever reason federal isis it. we have embryonic capabilities in all of these areas. we have to marshal the national science foundation. we have to have a tremendous amount of focused research in these different areas and we have to have the ability to pull all of this stuff together and a common word of government which is integration. above all we need to integrate these disparate pieces of information and knowledge and capability into a hole. it's an enormous challenge. it would be much easier and simpler to just forget about it and worry about luck and all that kind of thing. i don't think that's the american way. i think we can tackle this challenge. it's going to take a long time. we need to get started yesterday and so on and that's sort of what my suggestion would be. thank you all very much for being with us today.

it was a very great panel and it was helped immensely by your comments and questions and thoughts. thank you very much. [applause] [inaudible conversations] next on booktv in prime-time ronald rosbottom describes nazism in his book "when paris went dark." in his book no good men among the living he writes about ho how -- and walter isaacson writes about the creation of the personal computer and the internet in the innovators. in "when paris went dark" ronald the city of light under german occupation, 1940-1944 writes about the nazi