other things are going on though. the hollowing out of middle class jobs as over the last 1515 years in particular, has affected men quite badly in some particularring pockets of the economy. the incarceration rate affected men in parts of the economy. we have a lot of young, particularly african-american men in prison from working age, of working age. and that is a very, that shows up in these statistics. that is a reason why labor force participation is down among those men. >> host: before groshen, speaks, what about type of jobs we're seeing growth? this is july report. health care and professional business services lead job growth over the year. mining continues to decline. so we're seeing a trend, you know, as the economy works its way through the recession and pre and postrecession where

certain jobs are declining and other jobs are increasing. >> guest: yes, that's true. mining in particular is the effect of low oil prices on fracking areas of the economy and that has been a big hit to really good jobs often held by men across the great plains and other parts of the fracking belt in the country. those 130,000 jobs lost over the last year, that's, those are in many cases very good middle class family-wage jobs that you could do without a college degree and that is a, that is ag big hit to those families. so i think this is one of those instances where a bar chart can show us real personal pain. that is one of them. that is a loss of good-paying jobs. upside to that is the construction is up and construction often has paid also a gadd rate. not as much as the mining wages sometimes but often a very good wage. that is good thing. we didn't have as much

construction activity in the early part of the recovery because of the housing bust. so you know, in these stats we see real pain and realse opportunities for family. >> host: so, dr. groshen, you looked puzzled when the caller threw out the statistic. why is that? >> guest: i think the caller was referring not the unemployment rate but the non-employment rate, which is quite different. so the labor force participation rate, which is the share of men, the share of people in this case, men, who are either working or looking for work is, is, in july 2016 is 71.7%. so that's, that's not unemployment rate. that's the participation rate. okay. and so, so there's a big difference. unemployment rate is 4.6%.

so, what the caller is talking about is more the decision to work or not. and some of that, you know, a large part of that is aging population, but also, you know, older, tougher times we didn't have as much of a safety net. so, some of the people are not participating, are people who, who we as society have decided to, that we, that we are going to support in some other way. >> host: will in eugene, oregon. good morning. >> caller: good morning. i have a question about, for the bureau of labor statistics lady about, was there a definition of small businesses? >> host: was there a definition of small businesses? >> guest: we, let's see, that's actually, it is kind of a funny thing. across the statistical agencies

we have a group that tries to make common definitions across agencies to compare such information and small and large businesses are one of the areas we've all been struggling. it means different things in different industries. in some industries small business is larger than other industries. pointing to fact classification can be issue. this is one of the places where it is a little trickier. we don't have a standard definition of small businesses. it depends on situation we're talking about. are we talking about small establishments or small enterprises? that makes a big difference also. so i encourage you to be he had cade the reader to look at any statistic and how people define it. that makes a big difference. hope hope asheville,

north carolina. good morning. >> caller: finally someone getting to issues causing our country to implode. the one -- i have two concerns. i'm listening to all the numbers being thrown out, but if we can't use our numbers to solve our problems they're useless. that is my first concern. the next concern is, i read a few years back, it is probably still going on, that the working age public, there is 93 million unemployed, of working age. that is my first question i would like to address. has anybody read in papers, books publication. what are they basing that on? my next thing is she mentioned the unemployed rate and i mean, people wanting jobs and part-time workers being around . 9.7%. then the actual unemployment

rate is like 4.6, i think she mentioned? >> host: 4.9. >> caller: the thing that is, if you add those two together, we're at an unemployment rate of about 14.6 maybe. >> host: we heard people say that, made, tie the two numbers together to say the unemploymena rate a lot higher than you actually hear but dr. groshen, what are your thoughts on that? >> guest: let me start offle saying number of unemployed people in july 20,167.9 million. >> host: not 93 million. >> guest: not 93 million. our estimate of number of people who did not work in the past, month, the past week, and who, but who did look for work and ready to take work during the past, during the past month.

and, we provide a wealth of numbers so that people can add them up and use them for theirir various purposes. we can't force anybody to use numbers. we can't even force them to usea them properly.an but we do try to help anyone who wants to use our numbers. call us at, you can go our website, bls.gov. and you can, you can email us, you can call us, and we can take you through all of the numbers that you might be interested in looking at.ig and help you to use them properly. so i'm going to encourage people to do that. if you have any questions about numbers, we work for you. call us up, email us, and we can answer your questions and direct you to the number that will help you make the right decisions. >> guest: u-6 number, 9.7, those include people included in the u-3 number? >> guest: that's correct. >> guest: can't ad those

together, the 9.7 includes the 4.9 in there. think there is one hill and then we go over another hill over that and it is all put together. >> guest: thank you. >> host: jim tankersley, you touched on this before, wage growth from the bls, real earnings increased for sinceat 1979. but up chained for lowest workers. what is happening in the economy? >> guest: unchanged for lowest workers. unchanged for the middle class. it feels like stagnation over this century, essentially.si since the end of the wage growth boom in the '90s. if you include the small up tick in the 2000s erased by the, by the recession and then now the slow recovery, although there is some evidence that wage growth is picking up in this lastro year-and-a-half, two years, it doesn't feel like, people feel like they're working just as hard as they used to, not getting ahead or working harder, not getting ahead.

this is something i write about a lot. this is something animating our politics in the count youtry.. it feels to a lot of workers they are not moving ahead in thw way they expect to in an american economy. >> host: the final chart here, over past two years earnings growth outpaced inflation. what does that mean for policy makers? what does it mean for the federal reserve? >> guest: this means the federal reserve already raised interestt rates once. finally gotten up off what they call the zero lower bound but we're still very close to zero. and now the question is, how fast will they raise rates again? there is not a lot of evidence still that we're about to see runaway inflation or even hot inflation. this is still sort of lukewarm inflation. and the fed theoretically has 2% inflation target. undershot the target consistently. you might make the case overshooting a little bit would be okay. but fed seems more likely to raise rates to try to head off

any real overshooting of that.ti so, i think we will see over the next-year higher interest rates. we'll see how much higher. but that also will be a function of what else happens in the economy. we thought they might raise rates this summer. "brexit" happened and all these threats to markets and to growth and they held off. so events have a funny way of messing with the plans of policy-makers. >> host: peter in michigan, good morning. >> caller: yeah, good morning. i like to point out the factik that the commissioner failed to answer one of the questions from the previous caller fromth maryland and question was this what is the definition of a full-time employee? if definition according to bls someone who works 35 hours a week or more? now expanding on that, that statistic, back in 2008 in the month of december the last month of the bush administration, there were about 123 1/2 or

124 million full-time employees in the labor market, ie, those people who work 35 hours a week or more. since then we've added $9 trillion to our debt. we've gone from $10 trillion in debt to $19 trillion in debt and yet as of june of this year, just a month 1/2 ago, probably had 124 1/2 or 125 million full-time employees in the labor force.em our debt has gone up 90%, and yet the number of full-employees in our country or society has gone up less than 2%. now, the problem with that is this. the full-time employees are people who pay income tax. so we haven't had the growth of full-time employees, as been painted out to us by the media and the press and pundits, the bureaucrats and policymakers. we have stagnating -- >> health reform. on behalf of our honorary

cochairs, senator cardin and senator blount i would like to welcome you to today's briefing. we'll talk about the zika virus. for 25 years the alliance for health reform has been a balanced source of health care policy information for policymakers and the media in washington, d.c. . . of our time, ebola and now zika. the director of the national institute of allergy and infectious diseases.

he after dr. faucis remarks he's going to take questions and then is going to have to leave us. after he is finished, we're going to turn to the second part of today's program, which will be panel that will focus on the federal response and the challenge of actually controlling the mosquitoes, monitoring and diagnosing cases, and educating patients and medical providers on the ground. at that time, we'll have panel that consists of rick bright, of the biomedical advancement and research and development authority and the office of the assistant secretary for preparedness and response, which is part of the department of health and human services. kelly murphy of the national governors association, and lamar hasbrook of the non association of county and city health

officials. now i'd like to turn over our program to dr. fauci. >> thank you very much. it's real pleasure to be here. i'll give an update on zika and i hope it will answer lot of your questions and will trigger additional questions you'll have which i will leave time to hopefully answer them for you. so, let's see if this works. it does. so, i've entitled this presentation "a pandemic in" because it's obvious that is what we're seeing because literally every day, week or month, we get new and important information. now in december of 2015, i wrote an article for the new england journal of medicine and show it to you here because of the second part of the title: "yet another virus threat" when we

recognized zika was a problem. this is not a new phenomenon. if you look historically at what we have seen in the americas over the years and over the most recent years, we have seen arbo viruses appear, and that's are so for arthro pod born virus and that's the mosquito. we have west nile, chikungunya, dengue, over the years and most recently, we now have zika. so, having said that i'll tell you about zika, divide it up into four parts of the talk. the first being zika brown, and i know at this point, in the attention that has been paid to zika, probably most, if not all of you, are very familiar with so it i'll good through it rapidly because there are some point is want to underscore that maybe have note underscored.

zika is a single stranded rna and the family is -- whys that important? it's important because we have a considerable experience over the years with very closely related virus of the same family and genus, such as dengue, yellow fever, west nile virus and we have successfully develop vaccines to more than one of these. so the issue of a vaccine is not completely new territory. the other issue is it's transmated primary with i the aedes gene news mosquito. so let's take the history. it was first recognized in 1947, in the zika forest of uganda. first recognizeed doesn't mean it evolved at that point. it didn't all of a sudden start.

zika was probably around for a long time before that. it was only recognized then. the first human cases were reported in nigeria in 1952, and as you well know, the mystery that still has not completely unfolded is, what happens to zika in the decades in africa and southeast asia? certainly was there. we did not have any recognized outbreaks. we'll get into in the question period how you can go back and look at the start and find out if maybe there were serious amount of infection. going to be compounded by the cross-react different we have with other diseases but that's not story. now, things change dramatically. as i have spoken many times, diseases that smolder, may have aspects that are unrecognizized until you have an outbreak you need a certain number of cases withbutow things up common or

rare in 2007 there was an outbreak, and in 2013 there was an outbreak in french polynesia and then a very interesting epidemiological issue unfolded. if you want to write a text book on epidemiology, it's right here on this slide, it's worked its way across the pacific, until, as we talk about in infectious disease and immunology, the perfect storm. the perfect storm was a naive population in brazil, a big country that has densely populated people. not just in little villages throughout the country, a country in which you have a healthcare system that can recognize things that happen some you have copious mosquitoes. that was the perfect storm in that area. let me tell you about zika that sometimes and often compounds and confounds the issue. about 80% of the people are without symptoms. 20% have symptoms, usually mild,

skin rash, aches and pains in the joints and muscles, fever and conjunctiveitis or red eye. somebody gets really very serious disease but that's really rare. we'll get into the other things that have unfolded. if you take zika in a vacuum, as a disease, excluding pregnancy, it is a disease that is relatively mild, often unnoticed. okay. the modes of transmission are shown here. let's briefly go through them. mosquito bites are overwhelmingly the most important and most predominant modality of transmission, and you have to have a comment about mosquitoes i think, looking at the audience, have seen you all here in times when i have mentioned this before, but mosquitoes are bad actors. the two types of mosquitoes that we have that are capable of

transmitting at least, the adeed egypt tis and the aid -- aid disease -- enwhenever we have overlapping populations, almost invariably -- i say almost because i don't want to be wrong -- but invariably the aid egypt disoutbites the other mosquitoes. so it's the aid desegypt tis. and we can get back to that in the questions. you do mosquito control by a variety of ways. they're shown on the slide. clean up the environment, standing water, lavaicides, insecticides, to the extent possible stay indoors with air conditioning, make sure screens are intact. proper clothing when you good

out, even though might be uncomfortable in at the heat and insect repellent with 30% deet. use it liberally. perimateal transmission. we're all now aware of the complication of microcephaly. we'll get back to that when i talk in more detail about microcephaly and other complications. sexual transmission. another complicating issue. so, not only is this the first mosquito-born infection that can be resulting in a congenital abnormality in a whom infected during pregnancy and now sexually transmitted. the efficiency of sexual transmission is unclear. we know it happens. we know that every time another report comes out, the virus is sequestered in the semen. first 62 days. the sexual transmission is

predominantly from men to women. no sooner did we say that, there was a case report of one that looked like it was from a woman to a man. so, that's what we mean when we say, things evolve, they may be outliers but you pay attention to outliers but you don't let the outlier dominate the picture. you still got to look at the most usual thing that helps. blood transfusion, it can be transmitted through blood which is the reason why there a screening test developed. and then there's the other. i say other because this gets back to what i said a moment ago about don't let the outlier dominate your thinking. there was at the case of a lab worker in pittsburgh would accidentally was infected with zika. that happens all the time with laboratory accidents. luckily it was a mild disease. but there was a patient in utah, as you know, who was a gravely

ill man, who had the highest level -- everien noticed of recorded with zika who was tan care of by his son, and the son got infect. was it's particularly voracious virus? no because the son had a mild disease stop there's something there about a very high level in a man who had somewhat of on uplying illness. that's something you need to keep an eye on. the current outbleak in the caribbean and latin america. a number of countries, at least 55 countries of territories, 46 in the americas and the caribbean, where there is active transmission as of this month. august, 2016. what this slide shows you, if you look at the dark orange, people who are in the americas who live in areas that are environmentally suitable for zika transmission, and environmentally suitable means the wright -- right weather and

the right mosquitoes. living in those areas are around 3,400,000,000 people, and within the 300 million people there are over 5 million births per year. those are just numbers. don't make anything out of that it isn't. that's just the denominator of susceptibility. now moving on to more details about microcephaly. clearly, there was now unquestionable documentation of the relationship between microcephaly -- when infection during pregnancy and microcephaly. obviously there's going to be some that were overcalled, mainly areas where there was microcephaly for another reason, but the change in the rate of an incident of microcephaly is clearly shown on this slide. it's a very tragic situation,

how baby fetuses are terribly involved with this infection. this is a typical picture of an imaging of the differences in size. notice the black area above the brain on the right-hand side. that should have been tissue. that's not tissue. so, there is microcephaly involves a couple of things. involves the interference by destruction of neural tissue of the developing jane also we know there's a situation where you have a fetal syndrome where you have development of the brain and then infected later and the brain actually collapses and that's the skin folds. the risk still needs to be completely nailed down but it looks like we're circling and getting there. win one and 1% of women ineffected in the first trimester will have a risk. one to 13 percent. be careful because we know from other studies that you can have problems if you're infected in

the second and even up to the third trimester. we're only talking about mike resell live. a baby conclude born with rubella that looks normal but may have cal-ification of the brain, blindness, intellectual impairment. so the full spectrum is going to depend on following cohorts of babies for years. that's something we and the cdc will be doing. it isn't only microcephaly. don't have time to go through each manifestation. they're very uncommon because several you will not be able to pronounce but one you can pronounce because you'll hear more is arthroposigrnposis -- we're just starting to appreciate the mechanism of that. there was a recent state that

came out a couple of days ago, from brazil in which seven children with document ode zika infection of the mother during pregnancy had -- here's a picture of it. the curling of the limbs. guillain-barre, we know it's associated. we don't yet know the precise incidence of it. there was a study from french poll knee should which showed it was -- polynesia. zika in the united states -- remember, puerto rico is a territory of the united states. and puerto rico was having a very terrible problem. they have 3.55 million people there. and they are in the middle of very serious outbreak. the reason it was predicted accurately by the cdc that it would be a serious outbreak is

that it's the same pattern as we have seen with chikungunya. may 5 to june 4 to july 4 to august 12. you see the red coloring of people infected with chikungunya. the same mosquito, so there's no reason to believe exactly the same thing is not going to happen. in fact, what is happening in puerto rico is that one percent of the population is being infected every week. four percent every month. so right now we're in a crisis situation where you have a considerable amount of infection and over 1500 pregnant women are already infected. that's a very serious issue in puerto rico. now, if you look at the potential for imported cases, this is a flight map -- more than just a flight map. a travel map showing that in any given year there are a couple hundred million passenger jr. yo the united states from areas

that already have local transmission. why is that important? because with themakes -- again, show both mosquitoes -- focus aedesaegypti,. >> host: in united states, 1800 cases of travel related zika. the u.s. territories, the 5,548 on the bottom is motor e most -- mostly puerto rico bus many of the cases are in florida, over 400 of them in florida. so when you have a situation of infected people in the area with mosquitoes that are capable of transmitting, what you are going to have is a situation which we'll get into. of note theres 479 and probably more pregnancies in the continental united states of women who were infected. now, of that group, it's interesting data that again you

got to be careful with confident iality but these data reveal there have been 15 live-born babies with birth defects and six pregnancy losses. so've you have 21 out of the 471 telling you there really is this connection we're talking about. now, as was predicted, and unfortunately happened, we talk about the perfect storm that i mentioned in brazil. you have travel-related cases. the right mosquitoes, and sooner or later we said there we be a local transmission, and it likely would occur in the gulf coast states, and in fact it did. florida has a semi tropical climate right now in august of 2016 they have a consider number of travel related cases and they have the mosquitoes and right now as of last count there were 22 cases in florida that are locally transmitted. this is just to give you a

perspective of the location and the restricted locality of it. if you go down by that red dot, towards the tip of florida, it's an area just north of miami in which most of the cases are originating within that one-mile radius, the red lines. that green box is this cluster. those cases aren't all connected. there are some singles and then some that are associated with each other. not unexpected. that's not anything that people are surprised at. as i mentioned recently there is a case in palm beach county. this was just a few days ago on august 8th. importantly that person likely traveled into the miami-dade area. so let me close up with the role of research and development. i can't go over all of it

because i want to stay within my time frame, but what we have done is what we did with ebola and other outbreaks, is try and understand the disease, work closely with the cdc, who is involved in the public health issues and the surveillance, and by the knowledge we get, determine whether or not -- in this case we can -- develop countermeasures, and countermeasures are diagnosissics, therapeutics and vaccines. this is now a well shown slide. various candidates lined up in their appearance in the human studies. this doesn't mean that the one on the top is the best vaccine or will be the best vaccine. we don't know what the best vaccine is going to be. but the one that is on the top is a dna candidate that we started a phase one clinical trial on august 2nd at the nih clinical center. the other sites will be emory and the other sites will be the university of maryland. there will be 80 individuals in

the trial. it should end by the end of 2016. if it is safe, and induces the response you predict would be protective, which is the only question you ask of a phase one trial. a., is it safe and, b., does its induce the response you hope it would? if it does, you move on to the second phase, and the second phase will start in early 2017. right behind them are other candidates such as the one that is second, the walter reed -- that will almost certainly go into phase one trial in october with the same thing going on, getting the information that you need. and there are multiple other candidates. this is just a picture of the first patient which i had the opportunity of being in the room and watching them give the first injection, and is a mention thread will be 80 volunteers in that. i'm going to end with this last slide to remind you about what i

said in the first slide, is that we're not dealing with a phenomenon that is unheard of. emerging infectious diseases have always been around. they're around now and we'll continue to see them and it's up to us to be able to be prepared to move as quickly as we possibly can to address it in an appropriate manner. sory stop there and be happy to answer questions. >> okay, fantastic. i ask you to please identify yourself and start in the back. >> hi. ali at abc news. i'm just wondering, from what you said, this isn't something new, but what, if anything, does differentiate zika and its spread thus far that causes worry and what keeps you up at night about zika? >> um, welling are that's assuming i go to sleep at night. so, the thing about this that's really disturbing is that it's

the dichotomy of this disease. if you put aside pregnant women, it is really a relatively mild disease. 80% don't get symptoms, 20% get symptoms that are mild. the virus lasts in the body, the blood, for seven days, it's gone, its lasts in the the semen of men for variable periods inch pregnant women you have a regulartively mild disease that when a woman gets infected during pregnancy can be absolutely devastating to her and her fetus. that is an unusual situation particularly when you're dealing with a mosquito-born infection. in some respects, apart from the mystery part of it, is very similar to what we were seeing in the 1960s wildfire rubella. rubella as a disease is a relatively mild disease. if children get infected before the vaccine, i got infected with rubella before the vaccine.

if children get infected, you would hope that all the young women, babies, are going to get infected because then when they get older they're protected. but some of them didn't and they got infected during pregnancy, and although erv else has the mild disease we had the con generaltle rubella, 20,000 babies in the united states. so that's the thing that keeps me up at night if you want to use that metaphor, concern about protecting pregnant women. >> jennifer vazquez, producer with nbc washington. in your presentation while you mentioned mosquito control, you talk about removing standing water. our investigative team has found an increase amount of cases here locally where local health departments and agencies have received complaints about standing water in backyards and city fountains. how critical is it for local governments to address this and how should they be responding?

>> that's a very good question. it is not an easy thing to accomplish. for me to say, clean up the environment, pots, pans, tires, bottle caps. it's easy to say, and even with the most vigorous effort it often is not adequate, not because of a lack of trying on the part of authorities, but because water gets in some places that are just nonaccessible. if you just go out -- i live in washington, dc. guy out of my backyard and i have plants and they have these little pools of water on them so i spend my morning, instead of exercising, i'm knocking water off the plants. just kidding. so, the answer to your question is, authorities are trying very hard to do that. and there's a balance between being intrusive upon an individual's home by authorities versus trying get the population to realize that they need to do that themselves.

because you can't go into every yard of someone's home and do that, but that's where themakes breed. >> public city owned fountains, public pools? >> again issue don't want to make statements that will certainly get taken out of context about someone who isn't doing something. so i won't do that. >> right here in the front. >> thank you for doing this, doctor. without asking you to dive into the political realm, my name is james rosen, i report inthe "miami herald." i think what is a little bit confusing is on one hand health officials like yourself and then some of the members of congress have said that the extra money is urgently needed. it's an emergency. president obama asked for 1.9 billion. the amount has been lower than that. on the other hand we see you

guys developing vaccines, doing aggressive mosquito control and so forth. in other words, acting very aggressively. so how do you reconcile for the lay reader the fact that you're acting very aggressively in all directions and yet you say you need a lot more money. >> that's a very good question, and i will give an example what i had to do at nih and the cdc had to do similar things in their own arena. so, when zika first came -- and i mobilized my team in december of 2015, there was no designated zika money. so i got my vaccine people and i got my people who had been working historically on viruses and i said what we got to do take your attention and try to develop a vaccine. there was no additional money to do that.

so what i did is i moved money from other accounts of money that i would have spent four, five months from then. so, remember, we're in december. january. so money i might have spent on malaria or tuberculosis or universal flu vaccine that i was planning to spend in august and september of the same year, which the malaria people weren't spending it. so i borrowed money from myself to get it started. then when i sort of ran out of money i could borrow from myself, the department, hhs, with the secretary and approval of the white house allowed us to move money that was in other accounts outside of the nih, and gave us a certain amount of money to spend. i got to nih $47 million from unexpended money from the ebola account. now, nih had already spent all

our ebola money but ebola in other accounts we still need. i don't want to give the impression we don't need the ebola money. we need it. but it was moved from another account to allow me to do the things i'm doing now. right now we're reaching the point dish told you i started the phase one trial. i paid for that with the resources i've just described. the phase one trial is in no danger. it's paid for. however, once you start a phase one trial, you need to prepare the sites -- there will be at least 20 or more sites -- in which we will do the phase two trial, and that will be in areas where there is active infection. south america, central america, report peek key -- puerto rico and some sites in the united states. and i hope to start phase two in january. need money to prepare the sites. hire people, rennovate clinics,

get nurses and other staff hired, get the re-agents ready to go. we have reached the point now, in august of 2016, that if i don't get some additional money -- because we're already used up the money i borrowed from myself, using up the modify that the secretary allowed me to spent from other accounts. if i don't get additional money, literally within the next days to weeks, then what is going to happen is that the transition into the phase two trial will get dramatically delayed and may not even be able to go forward. is that clear? >> basically the vaccines -- stopped in its tracks. >> i will not be able transition. you have a phase one trial. starts in august. august 2nd. it takes several months to finish. it finishes in november and december. when you start the phase one trial, if you want to -- i'll

use the word -- transition smoothly from phase one to phase two, namely don't delay. go right in and start testing if it works in order to do that, you have to start preparing the sites now. so, what i'm saying, if i don't get that extra money now, i will not be able to prepare the sites to do a phase two trial. if that happens, there will be a gap that is unnecessary. i will finish the phase one and i will not be able to go into phase two. is that clear? how much do i need? i need $33 million. for that. >> okay. over here. and then we'll come to this side. >> page, with the "washington examiner" of the 1800 or so cases in the u.s. i just wondered why are so many pregnant women -- you said 400 or more -- they're getting routinely tested --

>> a good question. what is happening is when you're dealing with a disease that has a devastating impact on pregnant women, the pregnant women are the ones that go to get tested and go to their physicians and say, i think i had a rash when i was down there. whereas if you had a man who didn't even notice it, he wouldn't care. so it is a bias in the numbers that is generated by the concerns of the people who have the most devastating consequences. >> -- physicians testing for this? is this routine with pregnant women? >> i'm not the cdc is. the cdc has a very important recommendation. what the cdc is saying is that on -- in the united states, all over the united states, when pregnant women go for ante natal visited they should be assessed -- not nestle tested but assessed for the possibility that they may have inadvertently

been exposed to zika. how does that work? i'm an ob/gyn person. somebody comes in for routine. they say i may not have asked you this before but have you done any traveling in the following areas. if the answer is, no, the next question is, your husband and or sexual partner, has he traveled to that area? because he may have been inadvertently infected. 80% of them are without symptoms, and come back. then if that triggers a red flag, then you get tested. >> over here. >> tom howell with the "washington times." you need 33 million to make sure the phase two goes smoothly. with come deadlocked are you able to joining round the couch cushions and get that 33 million? >> the secretary burwell in her capacity as secretary of hhs,

has the authority to transfer money within accounts. in other words, what she can do is to say, i'm going to transfer some money, some other things going on at nih, to give to you to do your $33 million trial. and that's something that is under very serious consideration right now. in fact there's movement in that direction as we speak. >> you said you're moving in that direction. what are you looking at to target and swipe from? >> i don't want to say that if i want to continue to have hi parking space at nih. the secretary will allow the director of nih to tap the other institutes a certain amount, at the one percent transfer authority to come up with the -- wouldn't have to use it. we have a $33 billion budget. but we can tap the nih's budget

to give to a particular area in an emergency and that's called the transfer authority. the secretary has the legal authority to do that and he has been discussing with us, and very well may have already happened for all i know. so maybe you can check that out when you get out of here. >> hopefully we'll maybe hear a little bit more about that on our next panel. maybe? >> not anymore i told you, i can assure you that. >> all right. yes, let's -- we have a couple questions on this side and then move back to the other side. >> nick with "inside health policy." so fda recently released their finding of the impact on genetically engineered mosquitoes. looking at that, the florida mosquito control board has agreed not to move forward with the trial until they hold a referendum in november. the manufacturer of the mosquitos said the same thing. wonder if you can comment how that will use the --

genetically -- >> the go ahead for the fda was not for widespread use of this technology of genetically modified mix it gave the go-ahead to do a clinical trial to see if it works in a defined area. the only comment i can make is that is certainly something that northeasts to be pursued, as i'm sure you're aware there always is understandable but we'll see what the science tells us -- concern about anything that might be a permanent modification of the environment, including modification of the mosquito population that might have what we call unintended consequences. you have to balance the concern on unintended consequences with the potential benefit of that approach, which is the reason why you actually do a trial as opposed to an all or none phenomenon.

>> hi. with gsk -- making their commitment and other companies out there that have said they're working on zika vaccine, are you still afraid that the companies will back out if this funding doesn't come through from congress, and what more can industry be doing right now to be moving forward with this? are they moving as rapidly as you'd like to see them move? >> well, you know, we're very pleased with the collaborations that we have now had with industry, with gsk and others. what you'll probably hear is that it isn't that the companies are backing out. the companies in many respects are dependent on that kind of partnership that they have with the federal government, with barter, which provides them with things that derisk what they do. you'll hear more about that from

rick. >> med page today. can you talk about gaps you feel are remaining in your knowledge -- the knowledge of the disease, how the disease works, the attack rates, any of that? >> well there are a lot of gaps, epidemiological gaps and scientific gaps. what is the precise mechanism whereby the virus can get through and interaction with the placenta to get to the baby? that's one. the other scientific gap that is very, very important, is the fact that we still don't have a highly specific antibody test for zika. we have really good specific mow electric rahr tests to determine if you're infected or not.

where we get into trouble, particularly in regions where are there other flavey virus inflections going around, is if you ask the question, was i infected three months or two months ago, the cross-reactivity we're working on, the more specific, the lessenstive it is. that's a very important -- what is the exact percentage of guillain-barre? what is the exact incident in various periods of pregnancy? first trimester, second, third trimester, with regard to the incidence of congenital abnormalities. importantly for the babies, what happens to babies when they're born from an infected mother but they look physiologically normal? what about their developmental landmarks? what about intellectual capacity? what about vision? what about hearing? those are the things we don't know a lot about.

so, that falls under the epidemiological gaps and other scientific gaps. >> laura with ap. we talk about the machine for testing vaccines in pregnant women or women thinking about conceiving and can you talk about the rationale about going forward with the dna vaccine. >> well, generally when you're dealing with vaccines -- with pregnant women, as is always the case, the safety issues of pregnant women are paramount, the safety issues with any vaccine. to when you talk about a vaccine, we're aiming a vaccine not for pregnant women. we're aiming a vaccine for women of child-bearing age to protect them before they get pregnant. because if you look at what happens, if a woman gets pregnant by the time she is -- knows she is pregnant she is

well into their first trimester so it's already too late. the real target is going to be women of child-bearing age and their section all partners. you can't forget the men here. with dehand have sexual transmission here we would only be worrying about women but their sexual partners can give themmen asia. this idea with the daab vaccine is the fact is that it was ready first and we're in a race of time to get the best vaccine. the reason why people will ask -- i'm surprised haven't - why do you have so many candidates? are you duplicating -- no. whenever you develop a vaccine, you almost always need multiple candidates, and multiple platforms. so we have dna -- a very promising platform because it is so easily to scale up and if you really need it. then we have the purified

inactivated, which is as the whole virus would say it might give a more powerful response but it's more difficult to make. the reason why we'll start later and not go into phase two later. so there was nothing special about the dna to go first except it was first. >> tony clark from reuters. if you could talk more about the budget transfer? you mentioned that one percent -- is that one percent a year? and then how does the decisions get made within nih which other programs get cut? and thirdly, do you have any concern that you will never get that money back from congress and that this could set a precedent for future funding discussions if people say, well, you can just transfer money around. >> you asked me bad news questions. so the secretary has the authority to make a one percent transfer within an agency.

in other words she has authority on a given year to transfer money and that's exactly how -- the nih will be up to the director of nih, dr. collins. he will decide what he will do. would he just -- what usually happens to be fair, he'll probably do a pro rated same amount across -- based on a percentage of your budget. cancer institute has 5 plus billion dollar budget. you won't take the same from from cancer institute as a small institute. so it will be fair. this fact it is being done so late in the fiscal year is going to make it very difficult to pay back them except in the next budget cycle, attention will be paid to pay back to the institutes that got tapped in the previous year. the authority is a year-by-year basis. not a one-shot deal. you're allowed one percent

transfer per year out of that. and that's just an emergency type of authority. >> doctor, while you were speaking, the administration announced that secretary burwell transferred -- >> i knew that but didn't want to announce it. >> so, with this action today, why wasn't that done sooner and it was four $33 million for the phase two trial. there are other areas you will similarly have to reprogram or do a similar transfer for? >> no. what i need now until the end of the year -- money was mostly for the vaccine, phase two. there was a small amount of -- a little over a million for the zip trial, the zika and infancy and pregnancy child at the child health institute. now, you asked the question, why

did with wait so long? was -- we were hoping, continually hoping, that the congress was going to appropriate the money for us, and we are in -- when i say constant contact, i mean daily contact with either the secretary herself or people very, very close to the secretary at a high level of leadership within the department, and we were continually being asked what do you need, and we had a recent meeting in which we confirmed -- this is taken very seriously by the secretary -- that to make sure the right thing was done -- is what is the latest that you can wait before we start getting into trouble? and we had different answers depending on different agencies but my answer to the secretary was, i will rub -- run out of money this month if we do not have the money for know smoothly go into phase two. she took that under advisement and i think wisely made a courageous decision of saying

we'll have to tap in a one percent transfer other components of the nih. >> [inaudible] -- >> when you say -- other things with zika -- i'm actually good now until november, december. we'll start getting into trouble because i do need -- remember -- i want to make sure it's clear so i'll say it slowly -- that we ask for $277 million for the comprehensive nih approach to zika. the money that the secretary is allowing to us get by transfer is paying for the preparing the sites phase two for one candidate. if you remember the slide i showed, we have three other candidates. we have a zip trial, the zika infancy and pregnancy, so we still need, in addition to the

original 47 that the secretary allowed us to spend, to the $34 million that she is now using through the transfer authority. we need about 196 million more. if you do all the adding up, you take 277, can be are subextract, we need $196 million more. otherwise, the second, third, and fourth candidate will get not only slowed down. we wouldn't be able to start them. >> so, i was beside to say this is our -- about to si the last question but its everybody clear on the numbers? >> what is unclear? we asked for 277 -- >> wait for the mic. >> i'm just playing the difference advocate here. -- devil'sed a vow sow cat here. seems what you're doing is exactly what the opponents of the 1.9 billion or the 1.1 billion -- you could have been saying for a long time you

could do, which is you could find previously appropriated money and use it. i think what we're trying to kind of put a finger on is, when do you get to the point where, whether it's ebola or malaria or other critical needs where you simply can't do it anymore. >> it's a good question but let me answer it in a way i'm very convinced of. i'm talking to you in a way that seems -- not casual but i'm saying, i took money from this account and money from that account, and then we'll have -- all of that is extremely damaging to the biomedical research enterprise. so, enthough you say, well, you took 47 million from this and moved it over. you took this amount and you did that and you're going to do a pun percent transfer authority. that is really bad. that is bad for the biomedical research enterprise because we're taking money away from

cancer, diabetes. so just because you can do it, what the secretary did -- she made a courageous decision to do something she really did not whatnot to do, is take money away from other areas. so i don't see how that plays into that, it's okay to do that. it isn't okay. and if i gave the impression that it's okay to do those transfers, it's not. it's damaging to the biomedical research enterprise. >> okay. two more questions. -- we have a desperate question in the back and we'll take that one and one here and then we are going to need to wrap it up and let the doctor go back to work because it's a desperate situation. >> hi, si darcy -- sue darcy. i'm curious about 2017. what if the democrats take over the senate, hillary clinton gets elected.

seems to be a very political battle. how much money do you need next year and can you get it? >> well, the money i will need through 2017, when we were asked by the president and by the secretary how much money we need to go through the effort, at least get us on the road to what we would need to adequately address, that's when i put in the 277 million. so, 277 million would take me through what i need to do, but the landscape changes. you never know what is going to happen with the outbreaks. so right now, i'm okay for 2017. but as happens whenever you're dealing with an outbreak, depending upon how things shift it may turn out in the middle of 2017 i may say, we really need more money. i don't know what that's going to be could be a supplement in the next year's budget. so the 277 is the number you need latch on.

to that's what i need to do what i need to do. >> pharmaceutical executive magazine. for the phase two study that you're contemplating, are the subjects mostly going to be young men and women and are there other therapeutics or medical diagnostics that you need besides the vaccine to treat people now? >> let me answer the second part of the question. that gets to what other dish think the gentleman from -- ck, gk -- i don't have time to read that sufficient. a very good we. there oar things we're focusing on vaccine but other things. there's diagnostics, there's screening for therapeutics, a whole variety of other cohort studies that need to be done. so yes, that's what we mean by others. so there will be need for that -- for resources. i'm sorry. the first part of your question was? [inaudible question]

>> that, again, we'll roll mostly -- not mostly -- nonpregnant healthy young men and women. when you get into a trial, depending upon the incidence of the trial and -- indense in a country, you may need to expand. so the trial is designed for 2400 up to 5,000 people. the price of that will vary depending upon the numbers. so if it's 2400 it will be x amount of money. if it's 5,000, it's that. and you could change by amending the protocol. you start off with generally healthy young people of a certain age group. you then extend it to children. you can extend it to the elderly. you might recall, we did the same thing when we were doing trials for influenza. remember during the pandemic, we started off by just a certain group and then we extended it to pregnant women, to children, to the elderly. we can do the same thing with zika if necessary.

>> thank you very much. we appreciate your time. want to ask folks to respect the doctor on his way out. won't have time for anymore questions. thank you. >> good afternoon. mitt power to introduce our speaks. we just heard about the scope and method of zika spread. now we turn to the folks on the front lines, developing michigan diagnostics and countermeasures, supporting prevention and preparing to respond street-by-street, neighborhood-by-neighborhood. with us today we have dr. rick bright, acting director of the influenza division in biomonday advancement research and development authority. they leading the zika medical products development program. dr. bright has served as an

adviser to the w.h.o. and the u.s. department of defense and has spent many years working on influenza vaccine. kelly murphy is program director for the national governors association. center for best practices health division. with a focus on maternal and child health, opioid abuse and childhood obesity. previous question kell where was policy adviser for the alliance for a healthier generation. dr. hasbrook. representing 2,800 local health departments across the united states. previously the doctor was the top doc in illinois, managing the state's public health agency and has spent many years at cdc serves as the country director, focusing on polio eradication. let's start with dr. rick bright. >> thank you.

thank you all for inviting to us participate in the briefing eye. grateful for dr. fauci for giving such a comprehensive overview of the zika outbreak. i'm from the biomedical advance research and development authority which i called barta, an office in the assistant secretary for preparedness once which i'll 'cause aspr. -- has been critical since we were created in responding to a number of public health emergencies, including the 2009 h5n1. the ebola outbreak in 2014 and recent situation with the lead in the water in flint earlier this year. the response to zika is no different. it will take all of us at this state, local, federal, international level, to be able to coordinate and protect the best that we can public health response. we do this by working carefully

together with health care coalitions nationwide, and we develop resources to inform and guide response at all levels. to help ensure that local and state public health responders have the resources they need. they have a hospital preparedness program. at the program is carefully collaborating with the centers for disease control, to develop a checklist for hospitals to help them be prepared for the zika outbreak. we are working carefully to prepare primary care, emergency care, and urgent care providers and give them the resources and information they need, including carefully written cdc issued guidance to help them prepare and respond to the zika outbreak. we have also created a number of resources that are currently available, including the zika resources at your fingertips guide that was developed by our hospital preparedness program

and is available onat our site. it's a technical resources assistance center and information exchange at asper.hhs.gov for more information. we also work very closely with our partners to provide resources to their membership as well and very glad to be on the panel today. we are also very instrumental in leading the advance, development, and medical countermeasures and other products our country needs to respond to zika. barda was credit evidence with an important mission to accelerate and support advanced development of medical countermeasures for chemical, biological, radiological and nuclear threats as well as emerging infectious diseases and other things such as pandemic influenza. as part of tower mandate we have a critical mission to accelerate development of medical

countermeasures including vaccines, diagnostics, therapeutics, platform technologies, pathogen technologies and other measures needed to combat the zika outbreak. barda is focusing on three main areas. number one to be able to detect who is or who has recently been infected with the zika virus. that means supporting the advanced development of diagnostics that can be used nor the current outbreak. number two to prevent people from getting infected. that means supporting the advanced development of vaccines that can be used safely in people before they are exposed to the zika virus. and number three, to ensure the safety of the blood supply. that means by supporting the advanced development of rapid screening diagnostic as says that -- assays that can dedefect vehicle -- defect zika virus in

blood. it's very, very important to know that the developing a vaccine for any disease is extremely difficult. it takes a significant amount of resources, including time, and money, to develop a safe and effective vaccine. it also must be guided carefully through development, including manufacturing, scaleups and clinical evaluation that is guided by our regulatory authority, the fda in the united states. barda works closely with industries to bridge the gap and bridge the valley of death, the industry falls in very quickly when they develop a new vaccine candidate for any disease. and this is usually that valley of death that occurs after phase one clinical evaluation, before phase two clinical evaluation, because of the difficulty and the excessive costs involved in developing vaccines through development.

for zika we're working closely with industry partners to understand the landscape of technologies and platforms and approaches being used to develop the zika vaccine candidate there are over 30 different technologies and companies right now working very hard and very quickly to develop a zika vaccine candidate. it's important to know we're leveraging everything we have learned in the past from other virus vaccine development strategies. ... experience and knowledge and

regulators have vaccines and adjutant vaccine development. we anticipate three or four vaccine candidate will enter clinical development with adequate funding and additional resources we anticipate several more vaccine candidates entering political development in 2017. we are supporting some approaches to accelerate vaccine developed including supporting platform based technologies, technologies that leverage platforms that develop and license other vaccines meaning they have vaccines that have experience in the clinic, sufficient safety database with a number of people in clinical trials, they are in front of the regulatory authority, the vaccine for zika is not phenomenal, we can use it to respond more quickly.

we are collaborating carefully with us government policies, at the cdc and the department of defense quickly to bring together all our experiences and resources and unprecedented collaboration to develop zika vaccine candidates. that was mentioned on the landscape story. we are bringing to bear the national countermeasure emergency response infrastructure which includes infrastructure for clinical studies, manufacturing vaccines, filling in the vaccine that can be used quickly and other regulatory experience that we have. we are activating one of our centers for innovation and advanced manufacturing capabilities that established emergent bio solutions, one of the other ones is engaged

through support to begin developing zika vaccine candidate and once it is developed we will finish manufacturing networks, infrastructure to fill the vaccine and quickly go to clinical studies early next year. we are also developing and supporting development of rapid diagnostics, cannot stress enough rapid diagnostics in the zika outbreak. it is critical to note who is infected, who was recently infected with zika virus if you are a pregnant woman or of childbearing age who may have traveled and be infected with the zika virus. it is in critical to gate -- guide prenatal care and inform her of her condition. right now we have a lot of

diagnostics developed using pcr technologies which can detect if you are currently infected but we don't have sensitive essays to detect recent zika virus infections. if you are beyond that infection you cleared the virus. we don't have sensitive assets, and you might also be infected. it is working rapidly with industry partners to develop these assets, they are antibodies for zika virus in your serum or plasma or your urine or other body fluids and understand if you have been recently infected. and established the working group, when critical needs to develop diagnostics for any

outbreak, you have clinical specimens that contain the disease target or specimen you can validate your asset, it has been difficult to collect specimens from people who have been infected with zika to use those serums and specimen to validate diagnostic assets. there is an international working group to rapidly collect specimens to validate the assets. the final area of countermeasures, the pathogen reduction technologies. they activate pathogens and donate blood so the blood supply can be used safely in transfusion patients. it is important to know we are coordinating with other agencies within the department of health and human services as well as across the us government to assure adequate resources are available to avoid potential impact of the zika virus outbreak.

we hosted a number of meetings to bring together scientists from around the globe to address gaps in the science and response to the zika outbreak and understanding the response, global need for a response is going to require a coordinated effort of all our local officials, state officials or national officials and international officials to respond to the current outbreak. thank you for the opportunity to participate in the panel and i'm happy to take questions. >> hi, everybody. thank you for having me today. my name is kelly murphy. i am a public health expert and program director at the national governors association and center for best practices, i lead our

public health work, and all of our others. i have a quick presentation today. i will skip through some of it and talk about what the national governors association is and who we are, public health preparedness, public health implications, zika virus covered that pretty well, with all those slides and a summary of state actions that have been going on. really quickly, the national governors association, the oldest organization serving the nation, bipartisan leadership, governor mccullough from virginia, vice chair is brian sandoval from nevada, and the collective voice where i sit, we are a hybrid think tank, we work to surface evidence-based practices and innovate around

policy challenges. the governor's role in public health preparedness, coordination has been talked about and that is no different, federal, state and local government critically important roles in public health preparedness. typically when we see them coordinating among partners with the federal government, parts of their local partners within state government and the private sector, communicating after a timely targeted information internally and externally, using their executive authority. a couple slides on public health implications of zika virus. doctor fauci talked on all of this. this slide i want to show briefly because it shows columbia -- colombia's zika

virus demonstrating how infections can build over time and accelerate quickly. a fundamental principle of public health preparedness is prevention and control efforts to avoid getting to that tipping point. some key responses, we have been working a lot on this which won't surprise anyone. started by giving an issue bulletin, to get the information that was breaking as quickly as possible, we hosted webinars for governor communication directors and messages and strategy around zika and governors did ask whisk action on funding, you have that in your packet. the nation's governor urged the administration and congress to work together for agreement on appropriate levels of funding to prepare for and combat zika

virus. summary of state actions on zika virus. governors have been at the forefront of zika response and preparedness focusing on jurisdiction, risk based zika plans that include a variety of strategies, everything from coordinating state agencies and departments, targeting their resources and deploying them effectively, increasing surveillance and vector control which you have heard about, launching efforts for healthcare providers and at risk individuals, pregnant women come to mind, provided educational material, disseminated zika prevention tips and public education campaigns, working hard to control zika virus. i am looking forward to taking questions at the end. >> good afternoon.

i want to recognize some other panelists, the voice of local health departments here, i am going to focus my comments on four points, much of this has been alluded to but i want to be clear from the board of local health departments, this is a public health emergency and not a healthcare crisis. we are really focusing on upstream activities that can prevent the clinical case from happening. when you talk about communication, mosquito control, the other prevention strategy, screening women and if there's a vaccine those of the upstream things in the domain of public health. it only becomes a clinical issue when a zika affected woman is pregnant, facing the prospect of having the children with

microcephaly. this is a preventable defect so we need to focus a lot of efforts and resources on upstream activities. and emphasizing the concept of local this, we have taken turns from federal to state to local perspectives. the public health system is made of several layers. we represent the 2800 local, city, county and health officials and resources, money, guideline, vaccination tends to flow downstream so you start at the federal level and go to the large cities but most often the ultimate responsibility to plan, prepare, respond and mitigate a public health emergency lies with public health authority. we see that play itself out.

really, it happens on a local level talking about vaccination points we have in schools, churches, case detection, quarantine, clients that have been exposed, talks about mosquito control, west nile virus and focusing on mosquito control, public education screening and vaccination for zika. resources must get from the federal level to the ground where we hit the road and the local level is .2. .3 is the capacity for the local health department, has absolutely been decimated the last 5 to 10 years so we do not have capacity at the local level over the past five or six years of capacity for infrastructure to react not only for zika but any other public health emergency.

we notice decrease in funding had to pass the environmental health division of public health departments and mosquito control programs specifically. of 2800 members many of them don't have many mosquito control programs, so as you might imagine there is a range in terms of preparedness for the zika virus and any other public emergency. health department depend on federal money from cdc or others. 55% depend solely on federal money, no federal money, no emergency preparedness activity so there's a wide range of readiness in cities and counties that pivot on the infrastructure, west nile virus, those that have nothing and do nothing more than inform the general public.

.2 is the concept of local this. the third point focuses on capacity. the last point should be obvious from previous speakers, very simple, response to any public health emergency, there will be others before is directly proportional to readiness which we call preparedness. for a local health authority, mosquito control program, environmental health department, to be prepared and stay prepared, there is sustained investment them to do so. there is a stubborn lesson we are learning in terms of other things that happen, toxic

contamination, outbreaks of natural disasters, not maintaining infrastructure capacity to respond to public health emergencies. i can tell you our 2800 members are crying out for additional resources, they have guidance but not resources or manpower to implement many of them. in closing, to make it on the record congress cannot and should not expect local healthy parents to pull a rabbit out of the hat if there is no funding forthcoming in terms of the parental funding. the firehouse does not wait for a 3 alarm fire to get trucks and hoses to recruit firefighters and train them. they maintain that capacity so we do well to think about the adage that an ounce of prevention is worth a pound of cure. >> wondering when you are talking about capacity and the

needs, where specifically is the greatest need right now? where are we seeing the greatest challenge? in mosquito control? having the ability to perform diagnostics? where specifically do you see an expansion here? where are we going to see the whole? >> there is always going to be one of the tenets of public health is communication, good communication. as has been mentioned we can't it every receptacle, we have to make sure we are vigilant in terms of community at large, they know how to reduce their risk, those types of things so communication is going to be one and vector control programs which include tickborne lyme

disease, is going to be key also. many health department's don't -- we need that capacity. bringing staff in, training them up. laboratory identification of mosquitoes and other things need to be done to reduce the mosquito population so we keep the community at risk. those are desperately in need. >> questions? >> i wanted to ask, given what you hear how local health departments don't have funding, what can our governors do, whether it is calling into special session or other ways?

>> thanks for your question. a great question. governors are trying to coordinate the best they can. that coordination, they are looking to their local level folks to find out what their needs are and how they can reallocate funds as i mentioned previously and get the local level resources they need. to keep the lines of communication open and identify those gaps a little more. >> i had a question for you, you were talking about diagnostics. i am trying to get at you don't have enough test kits to go around or their haven't been enough diagnostics approved by fda or government -- government

authorities, not the precise diagnostics you need. >> fda has been working hard to evaluate data from all the developments and they made a number of emergency clearances, to tell you if you're currently infected with the zika virus. the challenge is in development with sensitivity, accuracy of these diagnostic assets, the challenge we face is across reactive nature and antibodies to other viruses like dengue or yellow fever so if we are trying to develop a diagnostic to detect zika virus infection, that person coming from an area where dengue was previously

circulating they will have antibodies hopefully and when they are infected with the zika virus and we use zika virus diagnostics the antibodies to dengue are going to cross react and give false information for those diagnostics. the challenge is to develop the right agent and component that put in diagnostic aspects that distinguish zika virus from dengue virus and that is where we are in development of antibody-based diagnostics, several can tell us you were exposed to a virus and where developers are working now is to improve and optimize those and specifically you have a zika virus issue so that is where we

are with technology. >> candidates right now who could possibly do that? >> there are a number of candidates, 1000 developers working very hard on that challenge and some are already collecting data and in communication with that data. and and from people who co-infected with the dengue virus, we use antibodies from known infections to validate those, have the confidence to reliably reproduce and attack the zika virus infection to give the most accurate information.

>> national journal. this is up for grabs but i wonder where local and state health department are pulling money for zika from and what programs are going without funding. >> from the local health standpoint it is similar to what was described robbing peter to pay paul. and and to sewage, and vectorborne things, to the epidemic at this epidemic at this time. they siphoned off money from what was prepared to address zika and that was impacting the basic capacity to do other things. zika is here but everything else hasn't stopped but we are asking staff to do more with less and

replenish the funds, and one thing we do with the impact study, local health department to find out how it shifts at the federal level. many of them will have to lay off staff. many will be impacted in terms of shifting resources and equipment. we are doing the same game at the local level but desperately in need of additional funding. >> i don't need to repeat anything that was said but it is very much the same thing. >> how are you? i wanted to go into more detail about companies that are partnering for the vaccine. what are the other platforms,

types of platforms -- >> they change a bit, and they change it. a number of approaches i use, some are traditional platforms we are familiar with, activated by smarter vaccines, grow the virus and treated with chemical to kill the virus, and we are adding in those using that with vaccine. there is an attenuated approach, we are using a diversion of the zika virus, it is unable to replicate very far in causing the disease. the vaccines have been used for

dengue virus or something similar. another version is the chimeric vaccine, the zika virus is on the outside of the virus and you blend them and merge them with a core article like yellow fever. and they use the dengue service for the yellow fever core. one approach some companies are using is to approach things for yellow fever or dengue, other approaches are nucleic acid-based vaccines, a vaccine candidate that was mentioned and there was a company that started the clinical study with another vaccine and even newer approach for nucleic accident vaccines, instead of using dna as your

starting material, delivering to the person to make an immune response, using are in a, reverse mirror of dna. rna-based vaccine, gets into the cell and reduces the protein, the immune response. other approaches include commonsense proteins, a number of companies have platforms expressing proteins and other cell substrates and using the same productions to express zika virus proteins and using that is the next crunch. all of these platforms and production systems deliver the payload of the zika virus are in play right now for zika vaccine candidates. >> all these companies and technologies are given

government funding at this point? or some of them? >> hardly any of them are at this point. many as they usually do are moving forward aggressively on their own. biotech companies, large and small pharmaceutical companies are trying to respond to the current outbreak, as quickly as they can with limited resources they have. in many cases they set aside how resources from large, profitable programs or vaccines or drugs, they turned their attention to work on the current outbreak. they rely on the us government to be their partner and to bring to the table our knowledge in reducing the risk and increasing chances of success. we collaborated with the industry a number of times and

partnering with industry to accelerate develop into vaccines. right now they have funds, bio solutions as part of the infrastructure for rapid response. we are in negotiations with several other companies right now for vaccine candidates. because of the limited funds it is difficult for us to build a strong portfolio to take those through clinical state development and the pipeline. we are fortunate for the reprogram funds for example to put those candidates in play and hopefully have contracts in place for the next months and with additional funds those candidates won't be able to go very far and we won't a personal candidates and the pipeline. in those cases many industry

partners may decide without government partnerships to help them reduce the risk to accelerate development pipelines to shift to their other priorities. they may decide they can't afford on the ground and have to go back to other priorities so we are at risk because we have made it such a high priority and engaged aggressively with industry. by not being able to partner with them effectively or quickly enough we are at risk of losing those industry partners that have a lot of experience developing vaccines for dengue and yellow fever and other candidates and reducing our chances of making a successful zika vaccine in a short time. >> great. this will be the last question and i would like to remind you you have an evaluation form in the package if you will take a

moment to fill that out before you leave today. >> i want to ask you to clarify that this is a health emergency and not a healthcare crisis. how you differentiate the two. >> the distinction is the umbrella of health, there is healthcare and public health. .. in terms of mosquito control and surveillance, monitoring and identifying mosquitoes and personal responsibility. those all the things upstream. we want to prevent it from crossing that threshold where it becomes clinical and now we have

to get a physician involved and we've got to get therapeutics hopefully when they come down line in some of the other stuff. thank you. >> we come to the end of our time to i would like to thank all of our speakers, dr. fauci, calvin murphy, dr. hasbrouck and rick bright for being with us today to talk about this very important pressing topic on this ticket buyers. once again a big thank you to the foundation and the health fairs for the partnership on this series of briefings for reporters. we hope you will join us next time. thank you. [inaudible conversations]

[inaudible conversations] [inaudible conversations] >> if you missed any of this program you can see it in its entirety later today by going to our website at c-span.org. the hill has an article today actually the article came out yesterday but it's is a group of democratic lawmakers from florida is called on the obama administration to take money from other areas to continue work on a vaccine to fight the zika virus. health officials have warned the national institute of health will run out of money for

vaccine development at the end of august and phase two trials could be delayed. they say the ideal solution would be for republicans to agree to pass the white house request for music of funding but with contractual action stalled it will be administration to on its own and use money from other areas. a group of eight signing a letter to health and human services secretary sylvia mathews burwell this led by debbie wasserman schultz, former chair of the dnc, who is facing a primary challenge. that's from the hill today. earlier house speaker nancy pelosi and the number of other house democrats held a briefing on the hill and the call for house speaker paul ryan to convene the house to do with zika funding. here's some of what she had to say. >> halfway through this break. we can come back and act upon it. they're going to do in appropriations process may be? and by the way, they already

have the obstacles to the zika funding. zika is a sexually, if you're infected by seek it can be sexually transmitted. we had this discussion before. and yet they are saying every and any funding for zika it cannot include contraception. well, i wonder how many of their at home, just wonder, how many of the families of our republican colleagues are not practicing birth control? how come the left any more children? how come they don't have children the way i did? what is it with them that they don't understand? sexually transmitted disease can use contraception. i grant them their position on many issues. we have a different philosophy but come on. comeback, do your job. do the job. anytime i see one of our republican colleagues, what was it that you accomplish during your break that was more

important than health and well being in the safety and the security of the american people? i am going to florida shortly after this meeting, go to orlando and have meetings related to what happened in orlando two months ago. go to south florida to talk about zika. solutions are there. the evidence and the silence -- science and the data lead us to a place where responsible governance for compromise and for ending the job done are readily available. but the republicans are just saying no. any questions? >> more on the zika virus now the zika virus now is health care and policy specialists talk about its impact on women's health care. discussed later in life health care threats to a normal child born of an affected mother and offered views on current research at the center for

progress host this event. good afternoon, everyone. welcome to the center for american progress. my name is winnie stachelberg and executive vice president of external affairs here at c.a.p. what you think each and every one of you for joining us for a time discussion about the zika virus and women's health. in recent months we've seen because transmission ask like in parts of the developing world and here in the united states. according to the centers for disease control and prevention, the mosquito-borne virus has infected over 6000 people in the united states and united states territories come including more than 800 pregnant women. the pentagon has reported that at least 33 american service

members have contracted zika overseas. just last week florida health authorities reported the first likely cases of mosquito transmission in the continental united states. as cdc director friedan recently declared, zika is now here. these cases are just the beginning and congress can no longer ignore this urgent and dangerous public health crisis your the center for american progress estimates more than 2 million regnant women in the united states are potentially at risk of zika virus this summer and fall. for pregnant women, the zika virus can cause and lead to a serious condition at birth known as microcephaly which can have severe iphone affects on children's physical as well as mental development. it can cost anywhere from 1 billion-$2 million over a lifespan to care for a child

with microcephaly, and there is no vaccine for the condition. nor is there one for zika virus, and that's what makes prevention of zika in the first place so critical. unexpected health issues like zika campus and tremendous challenges for already disadvantaged communities and sink families deeper into poverty. this is a vicious cycle as many of these communities living conditions that can compound the zika transmission. including lack of access to shelter or air-conditioning, living or working near standing water, and inadequate health insurance coverage. these families cannot afford to wait any longer for congress to take action on zika. the good news is we can prevent zika transmission. and zika response efforts we can help ensure access to contraception, family planning

and maternal health care for women at risk. for families of children born with microcephaly we can help ensure access to quality pediatric care and social support services. and we can support research and develop an foreign vaccine and adequate testing. but in order to do all of this, we need congress to abandon political wrangling and allocate adequate emergency funding to combat zika. without harmful restrictions on women's health care here since president obama's request in february of $1.9 billion in emergency zika funding, congress has played political football with the lives of those at risk for zika transmission. in fact the situation has become so desire -- dyer, congress will not approve new funding. once more, senate majority

leader mitch mcconnell, house appropriations chairman hal rogers, representative tom cole and other republican leaders have put partisan politics before the needs of the people they were elected to serve. here we are in august, the day before the olympics in brazil, a place receipt is responsible for over 4600 microcephaly cases alone, and we still have no resolution. no dedicated emergency funding. congress has done a vacation. even after they return senator mcconnell and republican leaders have promised to make sure capitol hill is as an action packed as ever. we can't let that happen. the time for denial and delay has long passed, and every day without this funding puts more women and families at risk. make no mistake, we have the tools to fight zika. what we lack is a congress with

a political courage to do right by the american people. today you would've from a distinguished panel of public health experts and advocates who are fighting to ensure that women and families have access to the services they need in the face of zika. their discussion will examine our efforts to combat this crisis, and why women's health care must be an integral part of any zika, effective zika response. but first we'll hear from someone who has been at the front lines of the crisis, turn 11. as the principal deputy assistant secretary for health at the department of health and human services, dr. mullen is to coordinate the administration's response to zika at home and around the globe, and we are thrilled to hear her insights this afternoon. please join me in welcoming dr. mullen.

[applause] >> good afternoon. i would like to thank you for inviting me to be a part of this important event. and thank you for the introduction. i especially appreciate this convening, because we're discussing an ever important topic, ensuring access to maternal and reproductive health care at a critical time, zika outbreak. the disease, characterized by transmission by both mosquitoes and sex, as associated potentially severe birth outcomes. speaking from my new almost seven month perch as a federal official i want to share that as

a physician and public health practitioner, i'm speaking to you from both of those heads knowing that my words are those of a person who will often see herself as a doctor first. people who only know me as someone who works in government asks me, have you ever been a real doctor? but i assure you from the way in which i approach my work that i still am here so know that i needed and understand when i say that i really appreciate this meeting in your wor work. because what you do is so much closer to the people, the community, and the patients that i am at this point in my career. for the administration, so much of the work in progress of the past several years has been rooted in the belief passed down from generation to generation that we can continue to strive

towards equity. and that we can work together to level the playing field for all americans. that we can give all of our funds -- sons and daughters, our family the opportunity to grow and thrive and succeed is at the heart of that period and the progress is at the foundation of our country's values. we know that health is the bedrock that forms the foundation. you don't have to look far to see the results of that incredible work of the passover years which now includes having more than 20 million more americans who for the first time have access to coverage for themselves and their families. work that has led to a more than 50% decline in the uninsured rate for african-americans, and a 27% decline for latinos. and today women can no longer be denied coverage for a preexisting condition, like

childbirth. but we also know that there's a lot more that we have to do, and even more sometimes when we think about african-american and latino neighbors or less likely to have access to health coverage and access to care. zika challenges us to mobilize around that reality. one women to have -- while women to have improved access we still have work to do for women's health, that women's health is far more than reproductive health but that we can't separate the two. progress on women's health is a comprehensive approach focusing on health and well being for all women. daughters, sisters, mothers and grandmothers. two months ago at the white house united states of women summit where women from all walks of life came together to say that by working today we can change tomorrow. i was fortunate to moderate a

panel on unplanned pregnancy, and in that conversation where many reminders that i wanted to share briefly for today. because in that conversation about unplanned pregnancy, we have to remember that what we can say to women, and sometimes i say women and teens because i don't want us to think about one population that we are addressing. we want to say convey things in a way that really addressed the needs, desires and understand other people that we serve, and that conversation we had was informed by panelists from new york city and sierra leone, among others. so the diversity with which we need to approach that work to achieve equity is key. i've been able to observe in the

work we've been doing on zika what that means to address maternal and reproductive health with equity in mind, and because of the work i've done in puerto rico, to understand that when you are addressing these issues for populations in which the economic conditions can far outweigh the concern about the disease for which four out of five people infected have no symptoms, the conversation requires true information and informed decision-making for an individual are needing to be informed by the insights that everyone of the panelists here today is going to share. i want to stress that because one of the things i understand working at the federal level is that with all of our expertise