tools they could use to identify other plate boundaries that had major ruptures in the past and susceptible to future struck yours such as cass caddia structure in the pacific northwest. hassards caused by movement on secondary fault structures, a better understanding of liquefaction, a better understanding of earthquake hazards in general and tsunami hazards, assessments and warnings. these are all things we learned more about since the great alaskan earthquake. as was evident in the earthquake and others we've experienced in 50 years since, death and destruction from the tsunamis can be greater and more widespread than damage caused by the shaking. the tsunami can happen thousands of miles away from the epicenter of the earthquake. in recent years, massivee and tsunamis have wreaked devastation across indonesia, japan, chile and haiti, but in

each of these massive movements of the earth there are lessons. earthquakes in haiti and chile of nearly the same magnitude have caused massive differences in deaths and damages. much of the differences are the direct results of efforts to establish standards and mitigation of earthquake hazards. in japan the early warning system allowed the japanese transit system to shut down every train so not a single derailment occurred as a hult of the han shu quake. today we're here to remember those that lost their lives in the great alaskan quake. we have to remind ourselves we capital be complacent protecting against hazards and remind ourselves the advancement of science depends on vigilence. i would like to thank our witnesses for being here today. i like to hear their thoughts and what we know about advances in earthquake science over the last 50 years. over the last 50 years.

i would now like to recognize the ranking member. >> thank you, mr. chairman. i would like to thank our distinguished panel for being here on the 50th anniversary of the largest recorded earthquake in north america. it's sobering to think that when the earthquake happened, we weren't even familiar enough with the theory of plate tectonics to understand what was going on. that takes us to the point of this hearing. we need then and still need now significant search and scientific development in geological sciences and earthquake sciences. the past half century has seen some impressive advances, but there is quite a bit more to learn. i'm a little surprised, mr. chairman, that you didn't originally invite the u.s. geological survey to testify at this hearing. i thank you for allowing us to

invite usgs to be here. the usgs is one of the world's leading authorities on the topic. in addition to the general knowledge about usgs earthquakes, i'm interested to hear about other aspects. i'd like to hear about induced earthquakes, connection with hydraulic fracturing, wastewater injection and so forth and earthquakes. so i understand fracking itself doesn't cause earthquakes, at least not large ones, but fracking creates a lot of wastewater. there are now numerous examples of earthquakes that appear to have been enduesed by injection of this water, the wastewater back into the ground. i understand usgs recently reported injection of fracking

related wastewater was the likely cause of the largest earthquake ever recorded in oklahoma, magnitude 5.7. the cause of millions of dollars of property damage. the impacts of quakes induced by fracking related wastewater aren't limited to oklahoma. there have been quakes in ohio, arkansas, texas, kansas, colorado, and elsewhere. and so this is certainly a concern for people who live in these areas who maybe thought fracking was just a mom and pop operation like drilling a water well but it turns out to be a major industrial undertaking. in some cases, i think establishing the link between wastewater and earthquakes to the untrained person might seem obvious. new injection wells start up and

all of a sudden an area that's never had an earthquake might have some of these shakes. and then the injection stops and the quake stops. i understand it's not that simple. so i will be interested to hear what we do know, what we have yet to learn in that area. it's a topic that we might devote an entire hearing to, ranking member defazio previously along with then -- with ranking member waxman of energy and commerce requested just such a hearing on induced seismicity. so i'm pleased they have called for such a hearing. we can touch on the subject, i believe, in this hearing and that might be helpful. i'm glad dr. leaf is here and able to answer questions about

what the u.s. gs has been doing on the subject of induced seismicity. i'm sure there are other points all the witnesses can make about what we have yet to learn. what research we need to sponsor, what studies have to be done to understand earthquakes that continue to happen in usually unpredictable ways and with very important consequences. so thank you. >> all right. as i said earlier, if either the whole committee chairman or ranking member are here, they are invited to make a statement also. i see we have the ranking member, representative peter defazio of oregon and you are now recognized. >> thank you, mr. chairman. thank you for calling this important hearing. as the testimony today points

out the impact of the good friday earthquake was not limited to alaska, those particularly devastated in alaska. the tsunami generated killed four oregonians in part because there is no and was noer early warning system to alert people that a tsunami was bearing down on the oregon coast. a tsunami warning system 50 years ago could have saved lives and given people warning, even a few minutes, can save lives. we can build an earthquake tsunami warning system with the potential to save lives. oregon doesn't just face a threat from tsunamis generated elsewhere, we have our own fault, it turns out, with some of the research that came subsequent to this quake. a rather big one, it turns out, that generatored the quake, 2010 earthquake and indonesia earthquake and according to

geologic history we're about overdue for a major quake in the northwest. it has been fairly quiet for a few hundred years. but, as i said, it is judged to being overdue. someday it's going to wake up and our coastal residents, not only oregon, washington, northern california and potentially we'll be sending a wave north like a wave was sent south from alaska and we need that early warning system finished and deployed in the ocean. and and as needed on land. the doctor and usgs are developing that system. we know we're not going to be able to predict a quake days in advance but just those few minutes. can you stop the trains. people, we have evacuation plans in place everywhere on the coast and warnings on the coast.

we practice drills in schools on the coast. we have measured impacts and we have found safe havens. we would benefit if this was coming. the doctor made an excellent point and i won't belabor it. i have asked for hearing on induced seismicity. i think this should have an individual hearing of its own, although i believe we'll be able to touch on it a bit here today. it is relatively recent phenomenon, which is not well studied or well-known. there have been swarms of quakes in areas there have not been before and it's attributed to reinjection of waste, which includes lubricants, oil, and proprietary chemicals which we're not allowed to know about. this is regulated under safe

drinking act. the thought is we want to protect the water table. it turns out there are other assets that need to be protected. if you have induced seismicity in areas with dams, induced seismicity in an area with a nuclear plant, induced seismicity with other aboveground developments bridges and other things potentially at risk, we need to know about that. we need to know a lot more about that to avoid these problems. i'm going to ask usgs a number of questions about this today, see where budget is adequate to research this and whether or not congress, i believe, should be paying direct attention to it. i don't think safe drinking water act is adequate. some agencies are a bit reluctant to get into this controversy. we're not talking about saying we'll bring a halt to oil, gas, and fracking in the u.s. but we've got to decide whether or not reinjection of the waste is

wise in certain areas and alternatives should be developed. thank you for this hearing and i appreciate the opportunity to hear from the witnesses. >> thank you. i would now like to ask unanimous consent the gentleman from alaska make a statement. see no objection, so ordered. >> i thank the chairman and i think the members. heim not on this committee i want to thank you for holding this hearing. as one who lived through the earthquake in alaska i'm interested in what is testified to today, particularly the warning, tsunami warning. we lost lives none in the earthquake, all because of the tsunami. we had no warning system. that was one of the greatest things. i will tell you it was a 9.2 earthquake. i believe the largest one that's ever occurred in the united states. being on the ground when that occurred was an awesome

experience because the length of the quake -- it wasn't a sharp jolt. i've been through 7.8 and 8 pointers where it was just a jolt and done. this thing lasted ten minutes. it was a puddling effect. that's why all the houses slipped into the ocean from the inlet. not only the tsunami but kodiak, that is a rock island and it won't tip upside down, by the way. it nearly tipped upside down. it dropped eight feet on the south side and raised eight feet on the north side, thus flooding houses and homes before the tsunami on the south side. on the north side any place that had boat landings were prohibited. it stayed that way. it was a massive quake. if we continue, i'm disappointed in congress, frankly, because we lacked the money, we've cut back

on the tsunami warnings, that's the biggest danger. i do think we can identify when earthquakes can occur. have you to buy a pheasant. a pheasant will tell you when an earthquake is going to happen about five seconds. they croak. that's a unique thing before man got involved. i want to thank you for holding this hearing. one living through it is the awesome experience of the power of a quake and how helpless mankind can be. there's nothing you can do. we can be warned ahead of time so we can avoid that tsunami and i think save a lot of lives. thank you, mr. chairman, and thank members of the committee. >> and i thank the gentleman. i would like to introduce four distinguished witnesses. dr. leith, dr. lisa grant

ludwig, president elect of si s irvine. pacific northwest seismic network and professor in the department of earth and zion -- excuse me, earth and space science university of science. dr. desroches, georgia institute of technology. like all witnesses your written testimony will be in the record so ask your onal statement be five minutes. press the button when you are ready to begin. i'd also like to explain how our timing lights work. when you begin to speak our clec will start the timer and a green light will appear. after four minutes a yellow light will appear. you should begin to conclude your statement. at five minutes the red light will come on and i would ask you conclude at that time. dr. leith, thank you for being

here and you may begin. >> mr. chairman, members of the subcommittee, thank you for the opportunity to discuss the significant advances in earthquake science that have been made over the past 50 years. the usgs proud to be a partner with private sector and other colleagues in ongoing research and monitoring needed to strengthen earthquake resilience and hazards. as you mentioned 9.2 great alaska earthquake that struck southern alaska 50 years ago today, it was the largest earthquake in u.s. recorded history and the second largest ever recorded. it's also maybe relevant to understand that the earthquake shaking lasted for five minutes. about the length of time i'll be speaking with you today. so consider that. anchorage sustained heavy damages. tsunamis generated by earthquake caused death and damage as far away as oregon and california as

has been pointed out and the earthquake and subsequent tsunamis resulted in 129 fatalities. >> sir, could i ask you to speak a little closer into the microphone. >> certainly. >> thank you. >> a major leap in scientific understanding followed the 1964 earthquakes, including breakthroughs in earth science research that continued over a half century since. providing evidence for the new theory of plate tectonics. it also had lasting effects on national earthquake safety policy. first it showed how disruptive a major earthquake can be to modern society and its infrastructure. second it showed the complexity of earthquake effects such as landslides and tsunami that need to be addressed in any national mitigation policy. third, through the iconic scenes of houses broken apart by

landsliding in the neighborhood of anchorage, the '64 disaster demonstrated the importance of considering earthquake hazards ineshan planning and development. the usgs national seismic program is the applied science component of the national earthquake hazards reduction program or niherp led by national institute for science and technology the other partners are federal emergency management agency and national science foundation. within this partnership, usgs provides scientific information and assessments necessary to reduce deaths and injuries and economic losses from earthquakes and earthquake induced tsunamis, landslides and liquefaction. usgs is the only agency that routinely and continuously reports on current domestic and worldwide earthquake activity through our advanced national seismic system or anss, usgs and

its university partners monitor and record earthquakes in all 50 states, u.s. territories and around the globe. the program has four components. monitoring and reporting of activity and crustal deformation, conducting and supporting targeted research into earthquake causes and effects and conveying earthquake safety information for loss reduction. all of these components rely heavily on federal state university and private sector partnerships. we're also looking into the future for opportunities to apply science, to reduce earthquake losses. for example, the next system in public safety, earthquake early warning is already under development by usgs and our partners and a test system is successfully operating now in california. another important opportunity we're pursuing is to incorporate into the nasf the earth scope

portable seismic monitors across the eastern u.s. even though it's been two decades since a major earthquake disaster in the united states, the risks are still very real and resilience of the nation will be tested when, not if, the next earthquake disaster strikes. giant earthquakes like the one that struck alaska 50 years ago produced ground shaking of long duration that can trigger landslides and damaging ground failures. these occur in predictable locations. likewise areas of high tsunami run-up can be estimated in advance, so modern earthquake and tsunami planning scenarios give emergency responders and community responders much needed improved visions of what can be expected in a future disaster. such scenarios are being played out today in the alaska shield das ter response exercise. but rapid earthquake loss assessments are still

unacceptably uncertain because of network coverage in many areas. this is only one-third completed. built-in inventory used for damage modeling and uncertainty about how buildings and infrastructure respond to extended, strong, ground shaking. that's the critical engineering problem. if you're keeping time anchorage has just stopped shaking, so i will conclude by saying i appreciate the opportunity to discuss the vital earthquake monitoring and research the usgs and our partners are doing. these efforts over the last 50 years have made the nation and world safer and more resilient to earthquakes. i'll be happy to take any questions you may have. >> thank you. dr. ludwig. chairman and ranking member hole and members of the subcommittee, thank you for inviting me to testify. as a professor at university -- is it not on? >> no, it's not. >> as a professor at university

of california irvine, i live with earthquake risk every day. today, i'm speaking primarily as president elect of the seismological society. >> even a little closer if you could, please. >> the core purpose of ssa is to advance seismology and understanding of earthquakes for the benefit of society. my message today is three-fold. first, in the 50 years since the great alaskan earthquake, there's been a scientific revolution in understanding earthquakes. second, federal investment in science has been directly responsible for those advances. and third, this investment has yielded valuable returns that are helping us become an earthquake resilient nation. i want to start with an account of the great alaska earthquake on good friday in 1964. i've heard the story from extended family many times. donna grant shopping in downtown anchorage as buildings collapsed in front of her and chasms oept opened in the street she grabbed a parking meter and hung on for

dear life. it lasted five minutes. she had time to think it must be the beginning of world war iii and the end of the world as she knew it. her experience is important because it shows donna grant nor no one else knew it was caused by subduction of the plate between pacific north america. 1964 sighs mo graphic networks were monitoring nuclear weapons testing in the cold war and also monitoring earthquakes. this data was critical to the discovery of plate tectonics. donna experienced the most powerful earthquake in u.s. history. the alaskan earthquake was so big that seismologists had to develop a new scale to measure it. the earthquake also caused a tsunami which affected the entire west coast and hawaii. the recent japanese tsunami provides an example of the devastation that can follow such an earthquake. plate tectonics is now a powerful tool for identifying areas that are most susceptible to earthquakes.

the greatest earthquake hazard occurs at the plate boundaries. these boundaries imaged by seismologists and mapped by geologists. data processing allow locations of earthquakes to be precisely determined. the methods and technology are similar to ultrasound commonly used in medical imaging. the earthquake locationing reveal active faults. some faults that reach the surface such as san andreas in california can be investigated by geologists like myself to determine their earthquake history and their potential for future quakes. research on the san andreas fault has shown the average time between large earthquakes is about a century. these findings are a call to action because the last big ones on the san andreas in 1906 and 1857 occurred more than a century ago. it is important to prepare for the next one. i've become so concerned about this problem i joined uc irvine's program in public health to work on protecting health and safety in addition to doing earthquake science research. earthquakes are not just a

california problem. research has shown the potential for large earthquakes in many areas. for example, along the coast of washington, oregon, and california, subduction zone earthquakes have occurred every few centuries and the last one was way back in 1700. the old saying, those who ignore history are condemned to repeat it should not apply to earthquakes in the u.s. because we know as a direct result of federally supported research and seismic monitoring that we have an earthquake problem. we know the areas most likely affected and it is types of earthquake most likely to occur. scientists developing scenarios for preparation, advance modeling for the expected shaking. the 2008 preparedness exercise has expanded into an annual drill throughout the u.s. and other regions of the world with approximately 25 million participants last year. unfortunately, earthquakes cannot be prevented.

we can trigger them, but we cannot stop them. in my opinion, we must protect ourselves from this national terrorist beneath our feet, and congress is our first line of defense. how? through support of realtime early warning system, continued funding of the advanced national seismic system and reauthorization of the national earthquake hazard reduction program or nehrp. earthquake warning is proven technology and these systems developed and deployed in japan and mexico. created by congress in 1977, nehrp led to significant advances for earthquake risk and the best ways to mitigate it. it was reauthorized in 2004 but this authorization expired in 2009 just months before the devastating haiti earthquake. as chairman lamb born said in statement, earthquakes can and do kill people. in haiti a magnitude 7 killed

over 230,000 people of the tragedy in haiti was surprising to many, but not to seismologists who were familiar with the fact haiti is on an active plate boundary. i'm here to tell you federal investment in earthquake science has given us the knowledge we need to protect ourselves from the type of tragedy we saw in haiti. in science as in life, you get what you pay for. it is in the best interest of the american people to invest in earthquake science and to continue working toward becoming an earthquake resilient nation. thank you for inviting me to testify about this important and urgent problem. >> all right. thank you. dr. vidale. >> good morning, members of the subcommittee. i appreciate the opportunity to speak tout about a proposed path forward to forthifies against earthquake. from the university of washington, director of seismic

network. while many earthquakes are magnitude to the public only those bigger than eight receive great. they are discussing one step larger, a magnitude nine in vastly wider reach and nearly unimaginable power. these magnitude nine earthquakes threaten only two places in the u.s., alaska and pacific northwest coast and only the pacific northwest is heavily populated and industrialized. puerto rico prone to smaller but similar earthquakes, hawaii and california, the tsunami from the earthquakes. magnitude nine coming to the pacific northwest might not come for a long time or it might come tomorrow but the cass caddia fault is locked and loaded. when it comes it will extend from northern california up the coast of canada including entire coastlines of washington and oregon. to prepare for this devastation, i'll highlight two opportunities, earthquake early warning and cflar monitoring and

discuss why the cass caddia subduction zone needs to be a focus and why earthquake hazard reduction program must be strengthened. one new advance in earthquake research is the development of earthquake early warning. these eyes sighs mom teres broadcast a warning of shaking coming to vulnerable areas. earthquake early warning would provide advances and mitigate earthquake risks for life safety and early warning will forestall train, car and airplane accidents, halt surgeries, allow for bridges to clear, shut down elevators, open critical doors, warn schools and the population in general. in the private sector, companies can mitigate losses by battening down factories, protecting computer operations and critical life lines. emergency responders can jump-start emergency operations while mass communications still work and maps of predicted devastation can be more quickly

and effectively disseminated. early warning systems ideally suited for impending magnitude nine on the pacific coast we expect one to five minutes of warning time prior to the arrival of severe shaking and gain valuable extra minutes in accuracy and tsunami warnings. many other countries exposed to earthquakes have already built earthquake early warning systems include japan, china, taiwan, mexico, korea and romania. the 2011 magnitude nine earthquake in japan provided clear evidence of the strong benefits of earthquake early warning. the usgs made a detailed implementation plan early warning for west coast finding 16 million a year would build and operate a system. in the meantime regional experts run from cal truck, university of washington experimenting with prototype early warning systems. in the pacific northwest, the performance of the earthquake

early warning system would be bolstered by having seismic instrumentation directly atop magnitude nine earthquake ground rupture. this information would increase warning time and make warnings more accurate. the offshore instruments would also watch for long-term signs of tectonic unrest and accelerate scientific understanding of the risk. the university of oregon, oregon state university, and university of washington have the right scientists and technicians to move forward. the u.s.gs should devote resources to quantify the risk in the pacific northwest. the ample expect a loss from earthquakes in the pacific northwest is a billion dollars a year. a large fraction of the exposure for the entire united states. the realization of this risk that ha come in just the last 25 years. much is hidden under thick forest or miles of ocean or wiped clean by glaciers. our most frequent earthquakes, in 2001, tens of miles deep tied

to no fault at the surface that can be mapped. our problem is not simply an extension of san andreas fault, need more dedicated study in the region. reauthorization of nehrp to characterize poorly understood risks. our cities in america have not been testified since relatively mild earthquake that hit suburbs. funding level should be high to accommodate new developments such as earthquake early warning and cflar monitoring. the pacific northwest, to prepare we should build earthquake early warning system, monitoring, vigorous science and engineering effort and all this requires a reauthorized nehrp program. thank you for the opportunity to speak. >> thank you. dr. desroches.

>> thank you. 50 years following issen an unprecedented period how to build to minimize impact of earthquakes. as a result we are much more prepared, much safer and much more resilient. however, much more can and should be done to protect our infrastructure. let me highlight a few areas where we've made significant progress. building codes will woefully inadequate at the time of the 1964 alaska earthquake. buildings that were designed and built 50 years ago would likely sustain damage in a moderate to large earthquake. although buildings codes are frequently updated significant changes occurred after identified structural deficiencies. 1961 san fernando earthquake and 1964 northridge earthquake were two such landmark events in terms of building codes. vans in structural dynamics by the late 1960s encourage structural engineers to consider not only seismic forces but

movement and ductilitductility, bend, key to design. demonstrated good detailing was critical and could provide sufficient duck tility in concrete structures. a large percentage of the building structure designed and constructed prior to introduction of modern seismic zones introduced early to late 1970s. these are highly to damage and earthquaking. rehabilitation strategies developed to reduce homes, buildings and other infrastructure. focused on developing and testing effective retrofit approaches. these studies have been instrumental in developing new approaches for retrofitting and improving existing approaches. many of the approaches for retrofitting uses today were developed using nehrp resources. we know scientific design and

retrofitting works. the impact of improvements to building codes and retrofitting technologies can be seen in a number of recent earthquakes, namely 1994 northridge earthquake. l.a. city officials say that more than 200,000 people living in retrofitted brick buildings when northridge earthquake struck. not a single death or injury was reported from the more than 30 so 30,000. a stricter code experienced limited damage, although structures that have not been retrofitted suffered greater damage. significant progress has been made in the area of public policy as it relates to earthquakes. policies regarding performance of hospitals, emergency operating centers, city halls, and schools didn't exist 50 years ago. the lack of safety in hospitals became a prominent policy consideration following 1971 san fernando earthquake. several hospitals, including veteran administration and olive view hospitals collapsed in the earthquakes.

44 people died in the v.a. hospital alone. as a result the 1973 california hospital safety act mandated new hospital struck yours have higher seismic safety standards. according to recent legislation, by 2030, all hospitals are to be retrofitted to a level capable of providing services and continued operation to the public after a major disaster. in the area of education and training, in 1964, the only earthquake engineers were primarily located in california, japan, and mexico. now earthquake engineering is taught all over the country including schools and states not traditionally thought of as being in a seismic zone such as my institution georgia tech. in fact, just this week researchers at georgia tech leading one of the largest scientific retro studies ever conducted right in the middle of downtown atlanta to develop and validate cost effective retrofits for unsafe concrete buildings. this project, along with hundreds of others, would not be possible without the continued

support of nehrp and specifically network for engineering simulation or nes. it's made a number of studies a reality. from large scale testing of the california levee system to testing of buried pipelines. the inform es program provided research community with the opportunity to test a range of systems in a fashion we can only dream of 50 years ago. finally i'd like to reiterate that we still have a lot more work to do to prepare for impact of earthquakes, particularly large earthquaking. however, the american people are safer and our cities are more resilient socially and economically than they were 50 years ago. this is a direct result of the nehrp funded research, knowledge transfer and education and outreach programs. thank you again. >> all right, thank you. i want to thank all four of our witnesses for illuminating and enlightening testimony. we appreciate your being here. we're going to go ahead and start with questions now.

i will recognize myself for the first five minutes. this is for any one of you. transatlantic pipeline planned for movements of a major fault. there are many types of infrastructures across san andreas and other structures in the pacific northwest and alaska such as transmission lines, railroads, highways, pipelines and so on, what is the status of efforts to retrofit existing infrastructure and what are we doing to require enhanced protection from earthquakes on future projects in i know you've touched on that some but who can best summarize that for me? or a couple of you, if that would be good. dr. desroches. >> certainly significant effort. i mentioned nes program, a lot of effort not just buildings, buildings have been a focus for many years because the majority

of casualties occur in buildings but recently to look at life line systems, those are highways, buried pipelines, utility systems. i think we've made a significant amount of progress. i think a lot more can be done in this area. >> say a little bit. in the pacific northwest, it's a real mix. we have roads, infrastructure, critical life lines. we saw this week landslides. if there's a big earthquake, we need to be ready for landslides. there's not really a single answer. we're trying. things are very expensive, replacing 520 bridge via duct downtown seattle, $5 billion projects. we've identified a lot of the worst problems but it's going to take a long time to fix them. >> one thing that's important to point out is that underlying all of these efforts to construct

earthquake resistant structures is the scientific understanding. engineers have to design to something, for something. so the more we know, the more we understand scientifically, the more we can help the engineers design to be earthquake resilient. that was something i think we saw in the 2011 japan earthquake that their buildings were very earthquake resistant but they didn't expect the size of the tsunami. so really underlying that is the scientific understanding. >> two comments. first, we just started a project cooperatively with the city of los angeles that's directly focused on identifying solutions to the problems of life lines. that includes the water system, the communication system, power system.

and then just more general problems with older constructions of the type that dr. desroches mentioned. second, usgs operates a system called shake cast that allows any user to quickly get an assessment of potential damage at any site. we run that system, for example, for all the nuclear power plants in the united states and around the world. caltrans in california runs it for every bridge and overpass. so there are ways of also very quickly using the data reported through the networks, analyzed and processed within tens of minutes to get a damage estimate at life line facilities. >> okay. thank you. dr. leith, while you're on deck here, what would you say about

what's been touched on by other witnesses, an earthquake early warning system. how important would it be for the u.s. to have such a policy to institute such a program? >> we've been -- we at usgs had this as an objective since 1959 when we put together plans for national seismic system. we've invested nearly $10 million so far in the research and development and modernization of the network so they can provide earthquake early warnings. we have a test operating system that's working now in california. it's not a public system, doesn't have robustness, resilience 24/7 operations needed for such a system. but it is testing out very well. with further investment can be made public in part of the

statewide and west coast wide. >> thank you. like to recognize ranking member holt. >> thank you. dr. ludwig, you said a moment ago in order to prepare for, set standards for earthquakes, we need to understand the science. i want to first get an understanding of how good the science is. in 1964, geologists had been -- had spent the previous half century either denying or ignoring that continents move and that there's collisions and subduction. let me turn this into a budgetary question for dr. leith. if usgs got additional money for fy '14, how this is induced

seismicity research. if you had more funding for anything, how would you use it? another basic question, how mature is this science? or lots of bits to clean up, bits and pieces. dr. leith first. i want to get to the budget we might be doing in response to any inadequacies in the science. >> i would answer that, you know, i tend to, my style is to focus on opportunities. what i see is a number of opportunities for advancements. we are -- as the science progresses along and we learn

new little pieces about how the earth works, how earthquakes are generated, there are opportunities to move that forward. also get many gaps in our understanding that still need to be addressed. and there are gaps in our reporting on earthquakes that need to be addressed. all that could be addressed by additional resources. for example you brought up, seismicity where we have documented and published very significant increase in earthquakes in the central part of the united states. we need to understand better to map out the hazard posed by those earthquakes and to help inform decisions about land use planning. >> i meant my question to be a softball for you to tell us your needs. let me turn to dr. ludwig and maybe others will have comments in our brief time remaining

here? >> first of all, our understanding is only as good as our data. and with the earthquake problem, it's a little bit different from some of the other sciences because we can't take the earth and put it in the laboratory and run controlled experiments. every earthquake, especially the large ones, is essentially an uncontrolled natural experiment. and we have to kind of chase it. we have to have the infrastructure, physical infrastructure, seismic networks and human infrastructure, human resources, scientists to be able to collect the data. also we have to learn from what's happened in the past. i'm a pallio seismologists, i look at past earthquakes to see if it's happened in the past, it could happen again, to get an idea of what we could expect and to use that data for forecasting. but so you really have to have a pretty robust infrastructure both physical and human to be able to do this kind of science

and to make these sort of breakthroughs. like plate tectonics. it took a long time and a lot of data. and then the alaska earthquake really helped. but we -- that was an opportunity. >> in the remaining less than a minute if either of the other witnesses would like to take a crack at this maturity of the science. >> i have a couple of points from pacific northwest. one is that we don't understand subjections on earthquake, japds had a punch from part of the fall we didn't expect was loaded, a magnitude nine punch. we really would benefit knowing subduction zone, what earthquakes might have better. another issue is how are the base basins under city amplify. ohio, stanford might be factors of two differences we expected. we really need to feed the engineers the right motions so they can build the buildings

strong enough. no, sir areas need research. >> thank you. thank you, mr. chairman. >> i'd now like to recognize ranking member of the full committee, representative defazio. >> thank you, mr. chairman. first professor vidale, i didn't understand the figure? >> the billion a year? a fema estimate from a few years ago. 600, 800 million for washington and oregon annual losses. so i guess maybe i rounded it up to a billion. >> i don't know what you mean annual. in the event of a 9.0 or greater, i assume the losses would far exceed a billion dollars. >> right. i didn't give for magnitude nine. i gave a billion a year, long-term average of expected losses in earthquakes. for a magnitude nine, the estimate is 50 to $100 billion. >> $50 to $100 billion.

okay. so is anybody on this panel think federal government given potential for 50 to $100 billion calamity which could be partially mitigated, we're investigating enough money in research or development. anybody think we're spending enough? anyone? okay. no one. good. i'd be very surprised if you did. the issue seems to me, i think it was dr. leith who talked about it. we spent $10 million, wow, since 1989. we're looking at $50 to $100 billion in the u.s. and we spent a million. talking about countries like i think you said romania, mexico, they have deployed early warning systems and the united states of america hasn't. we have a prototype. did there's not work? do we have to develop new

technology? isn't there technology today that would at least mitigate the loss of life in the northwest with the advent of a tsunami that we could deploy, we might improve it later? >> is it a question? >> it's a question to either of you, one or two of you. >> no, i think we should build the early warning system. the physics is simple. we know how to do it. it's a bit of a challenge to make sure we don't get false alarms. we have to adapt the emergency broadcasting system to react in seconds rather than minutes. >> but if romania can do it, can't the united states of america? i don't know. i've guess we've fallen so far and republicans are disinvesting so much we can't, but this is crazy. >> in these other countries, japan, mexico, turkey, that have either existing systems or developing systems, those decisions were all made after major earthquake disasters. >> so we've got to wait. >> for example, the earthquake that hit japan in 1995, it was

after that disaster that there was a national political will to install an earthquake early warning system and bring up the base of earthquake preparedness countrywide. that paid off heavily in the toho tohoku earthquake from 2011. the tsunami damage was horrendous but the earthquake related shaking damage was much less and as was mentioned, that system performed. so there seems to need to be a national political will in order to make the investment. >> i just wanted to emphasize the magnitude of the investment they're making in japan. it's $1 billion for the seismic monitoring system, probably another billion for the sea floor instrumentation they're putting down now and china has launched into a multihundred million dollar seismic monitoring system and they're planning early warning that's quite sophisticated as well. >> so if the united states could afford as much as japan, that would be $2 billion toward $100

million and thousands of lives potentially lost or saved. thank you. on to another subject, induced sice misity. do you have -- are you getting the data you need? are you getting the resources you need? this is another issue of potential prevention. not to cause these problems in areas that could provide tremendous risk near nuclear plants or other facilities. >> on the data -- on the resources side, congress provided us an extra $1 million this year which is being put to good use and administration has requested an addition in the fiscal '15 buckedget. on the data side, we don't have all the data we need. in particular there's a short coming on the data on the injection activities themselves. the waste water disposal wells are regulated under the safe

drinking water act and earthquakes were not really i don't think considered when that was put together, and so most of the epa and most of the states don't require the kind of precise data that's necessary to both understand that as a national problem or to do the kind of forensics that one would want to do to connect a particular damaging earthquake with a particular injection activity. >> okay. thank you. my time is expired. thank you, mr. chairman. >> yeah, and i want to say to the ranking member, i would like to work with him in finding additional money for these important issues like major earthquake research or to have the agency shift money within its budget from lesser at thise. this is an important issue and i agree with you on how important this is. >> i appreciate that. i had choken to former chairman young.

maybe we can work something out. thank you, mr. chairman. >> okay. now, i'd like to recognize for another five minutes of questions representative huffman of california. >> thank you, mr. chairman. i wanted to be at this hearing because i represent earthquake country, tsunami country, and i think it's a very important subject with some real helpful testimony, so i want to also thank the witnesses for their contributions. mr. chairman, i also wanted to be here to thank you because as a new member of congress, i think this is the first hearing i have attended of any subcommittee in the natural resources committee that wasn't a loaded partisan title full of loaded partisan content with a loaded partisan agenda. this is a really important subject where we can all be interested and engaged and we might actually get something done together that could really help the country. so we need more hearings like this and as much as anything i wanted to be here to express that and to thank you for it, and with that i'll yield the

balance of my time to ranking member holt. >> iative huffman. first, following on the line of our ranking member's comments, the mentality here in washington is a very pessimistic mentality, and mr. defazio points up one aspect of that. i mean, here, the richest country in the world by far undee niund undee deniably doesn't act as if we have a future. one invests, one builds infrastructure, one sponsors research when we believe we have a future, and instead we just talk about cut, cut, cut here. it is a fundamental problem that the chairman says let's look for some money. i'll show him plenty of money. we've got it. we could invest in education. we could invest in research. we could invest in infrastructure, and we should because we have a future, i

believe. the other general comment i wanted to make has to do with the field of geology and seismicity and earthquakes. for generations humans believed that we experienced the happenings on earth, and probably the most important development of recent years is the understanding that humans have the ability to actually change the earthquake, to poison entire oceans, to change the very climate of our globe, and, in fact, to induce earthquakes. most of us would have thought that the energy involved in injecting water into the ground is so minuscule compared to the energy released in a quake that it couldn't possibly happen, but it does. dr. leath, am i right, have there been significant earthquakes tied to human

activity such as waste water injection? >> yes, absolutely. it's been known for decades that deep injection of waste water can induce earthquakes. in the 1970s the usgs conducted an experiment in colorado and found that earthquakes could be turned on and turned off by injecting or not injecting water. >> what are the problems with collecting injection data? what data do we need that, for example, the drilling companies aren't reporting? >> the record keeping for injection wells, and i'm speaking of the uic class 2 wells for the oil and gas industry, the record keeping is minimal. it requires the operator to collect records, report the total volume injected in a month, a monthly average

pressure, monthly average volume, and report that at the end of the year with a grace period. so, for example, i mentioned forensics -- >> just average, general data. it's not specifics about what's injected and when? >> it's not specific enough to when asked tie an earthquake or a series of earthquakes to an injection -- >> and it's the safe water drinking act that is the only regulation that requires reporting, is that correct? >> the base is the safe water drinking act and mostly epa delegates to the states and the states may or may not add additional requirements. >> so we probably need more federal requirements about specific data. and you might address your answer to the majority here. >> in order to really make progress on the research and the hazard assessment of this

phenomenon, either the federal government or the states need to consider that a priority to collect more precise data on the injection activities and to make them available in a more timely manner. >> thank you. i think the chairman observes that my time is up. >> and now as we stated earlier, the full committee chairman is here, representative doc hastings of washington. we'll hear his statement and then we will conclude the hearing at that time. representative hastings. >> thank you, mr. chairman, and thank you for holding this hearing. i apologize for coming in here at the last minute. that happens from time to time with our schedules. mr. leath, i just simply have not a statement but simply a question, and hopefully we can get, you know, be helpful. as you know, the landslide in the state of washington in snohomish county, i think all of

america is listening to the news every day about what is the circumstances of that. will there be a time in the future -- will there be a time we'll be able to examine the circumstances around the slide, but right now the focus should be on the rescue efforts and the cleanup, and we're all well aware of that. but my question is simply this. where can people look to find more information about the slide hazard? is that something that you can be working on? >> so, yes, the usgs has a landslide hazard program. it's hard of our hazard mission area, and we both operate -- we have for the public a website which identifies landslide-prone areas of the country and presents information on research and how the public should deal with questions of landslides.

the responsibility for the land use decisions resides with the state, county, and local decision makers, and our job is to provide the scientific information that supports smart decisions about land use planning. we also map out the locations of landslides, and that includes the landslide that occurred last week in snohomish county. >> well, i appreciate that. i know there's obviously going to be more awareness of that. i have had my colleagues ask if it's in my district, number one, but, you know, the underlying question is, boy, that's a pretty massive landslide and what -- people are going to be interested in that. that's simply my question is to see if there's something that you guys can do to help

facilitate that in the future, and i see if that's the case, i think that's a very positive development. so i just -- i just wanted to ask the question to get it out there, if you will. >> would the chairman yield? >> i'd be more than happy to. >> i wonder if dr. vidale would have any comment, i know in my state we have mapped much more exactly where we see risk and hazards. i wonder if washington state has done that? >> yeah, i know a little bit about that. with the seismic network we actually noticed the landslide within an hour and we've been looking at the seismic signals to look at the chronology but as bill said, the state has -- department of natural resources and they have maps of landslides and they're on the scene managing with the emergency management division supervising this. i know the surveys come out with a lot of people and they're talking about what they can do

to help understand the situation as well. so right now there's a pretty coordinated effort going on to understand the landslide, try to figure out how it happened and the history of how we got to this point. >> well, i'm wondering about predictive or risk zones, that that's i think part of what doc is getting at here. >> right. >> it is a state responsibility, and i frankly couldn't tell you exactly what maps they have -- >> watch this hearing in its entirety at cspan.org. we leave the last few moments to take you live to the kaiser family foundation offices in washington, d.c., for a discussion this afternoon on last month's annual international aids conference held in melbourne, australia. live coverage. >> and to our joint event with the center for strategic and international studies to look at the outcomes of aids 2014, the 20th international aids conference which wrapped up in melbourne a couple weeks ago. we have three distinguished guests with us today who i will

introduce in a moment to discuss this as well, and also a very large audience. thank you. i first want to acknowledge and thank csis and steve morrison specifically for this ongoing collaboration. we have come together, our organizations, for five conferences, the major conferences afterwards to do this kind of gathering with d.c. community to really take stock of the conference and try to understand what we learned from it, what it means for going forward. so thank you so much for doing this. and second, given the large audience that signed up for this and that is actually here, i'm just curious how many people in this room went to the conference this year? raise your hand. so most of you did not. understandably it was far away. so this is good. this is why we were trying to do this, so we could bring you together. but on a more serious note, i just want to say a few words

about the tragedy that befell all of us as we set out to get to the conference and that's the cash ofm h-17 on july 17th, literally the day that most of us were traveling to melbourne. i can't speak to how it felt here on this side of the world but i can say that it can't be separated from the experience and the meaning of the conference itself. we are, all of us, collectively lost six incredible people who devoted their lives to fighting aids. i want to name them all. they were, houp lang, the science director at the amsterdam institute and former president of the international aids society. jacqueline von tu. engrin. pimm dekuzer, martine. lucy von mens who was at the

female health company and glenn thomas of the world health organization. this experience shaped the beginning of the conference which was somber and serious and full of a lot of shock and some pain. it also reminded all of us something really important about our community and the response to hiv, and that is the community. it's a community of scientists, of activists, advocates, of patients, politicians, many times embodied in the same person. so just to remember these individuals, i'd like to quote a friend of mine who worked very closely with huop and jacqueline, dr. kate hankins as a reminder of who they were and what this means for our community. and also, you know, frankly to recognize the act of violence that occurred that took them. these are kate's words. they were a tribute she just gave a few days ago. as she said, it is incomprehensible that people who worked so hard to save the lives of others should be shot down and be collateral damage in

someone else's war. each of us needs to reflect on how to celebrate their memories by taking forward their visions. this world is a better place for them having walked among us. let this be said of each of us, too. so with that i want to just say a few more words about the conference itself which was anticipated to be smaller than prior conferences because of where it was, and it was in terms of the attendance, and not expected to necessarily have scientific breakthroughs. it didn't. but nevertheless, it had an incredible richness that i am not sure was felt here and an incredible depth in what was presented and the coming together of lots of communities. in terms of highlighting what many of us feel is an emerging global consensus on where we need to go from here that's not always been present. on emphasizing the importance of focusing on key populations, those who are marginalized, men who have sex with men,

transgender, drug users, and confronting stigma in all their forms. the emphasis on the need to scale up treatment and what we know how about treatment and how effective it is, but also the power of prevention again, and some exciting new information about prep which i'm sure we'll talk about. among other things. so for now i'd leave it at that. i'd like to ask our three panelists to come up. i'm very pleased we're joined by ambassador debra burkes, ambassador at large and coordinator of the u.s. global aids program. dr. chris beyrer and dr. steve morrison, senior vice president and director of global health policy center at cisi. so please come and join me. [ applause ] that's my most important job today.

okay. so as with usual in our events, i'll ask a few questions of our panelists and we'll pretty quickly get to your questions, and i hope this is a dialogue, especially for those who weren't there who want to get a sense of how things really played out because we know that the media itself didn't cover the conference extensively. that's been a trend we've seen for a long time, and so bringing that information here is really a critical task that we want to help with. so my first question is going to be the same question for each of you but i'll start with ambassador burkes, is just to get a sense of your main impression and takeaways from this year's conference. what are some of the big themes and the ones you hope to continue as we carry forward this work. >> great, thank you, and thank you for having me here again today and thank you for all your information that you put on the kaiser website about hiv aids. and every question i had from every applicant press over the last four days, they all

referenced the site and how much they utilized the site. >> that's good. >> so 8aids 2014, when you star out with that level of heart break it required all of us to be very introspective because many of us came from that time when there were so many unexpected deaths among our friends for an unknown reason back in the early '80s. it was tough to have that reflection at the beginning, but every time i was in a planner or heard something, you were able to think about the history of hiv aids and where we are. to me it was historic content of our 30 years together and where we've been and where we've been together. so what started out as heart break i think came forward as very much as hope when u.n. aids released its global report. hopefully you have all seen it. it is really a return to fundamental data reporting from u.n. aids with clear analysis

that we can all understand. the first time we look at the graphic without a lot of subtext. i really only have to look at the pictures and you get a sense of where we are around the globe. and then i think to me the last thing was renewed commitment, and the sharing of that shared experience at the beginning of the week really -- when things happened and when advocates and activists spoke, there was a true resonating theme through all of us. when they were talking about they want to be undetectable and it's important to be undetectable, we all agree with that and it's so important. so i think there was consensus. i will leave with my final impression. probably the biggest impact on me personally was a session done with individuals who have lived with hiv aids for more than 20 years, and it was really -- i

had somehow in my years of travel lost track of how those days felt and how sick those patient were, and hearing them relive the number of days they spent in the clinics, they spent in the hospitals throughout their 20s, throughout their 30s, throughout their 40s, they were unable to work. they were unable to access effective treatment. we had mono therapy and then bitherapy. form all of them in that room made it to combination heart. hearing their life experiences and what an impact it's having in their 60s and 70s and having lost their most productive work years reminded me why the united states turned to the huge epidemic in sub-saharan africa and said we can't stand boy this. we experienced that and hearing their stories and understanding that their life journey hation

had a tremendous impact and we all need to resonate with that and understand that and understand we have a lot of patients now who have lived successful with hiv but don't have the wherewithal to retire successfully. it renewed my commitment to really understand all of the stages of the life experience from prevention of mother to child transmission all the way up until our decades that they are -- not you, me, are approaching rapidly and understanding and being able to understand people's life experience and respond to them. >> thanks. chris. actually want to thank you, too, because this is i think your third of these that you've done with us. >> yes. >> just put it on your calendar for two years. >> well, two years from now we'll be talking about the durbin conference so we might want to come back to that at the end. i would just add to jen and

debbie's reflexctions that, of course, the mh-17 tragedy had a huge impact. the word that summarized the response of our community was unity. that this really powerfully brought people together, and i think this will be remembered certainly as one of the conferences if not the conference where the divides that we sometimes see between researchers, providers, community, politicians really truly got resolved in some profound ways. it really was a unanimity of purpose and engagement which we all know we're going to need for the next phases of the response. i would say big picture messages that came out of the message were certainly -- and debbie's talks remarked a number of other presentations.

there's a consistent theme of using the resources we have strategically. focusing on better targeting of the response. focusing on the people. u.n. aids report shows about 50% of new infections going forward are predicted to be in key populations. that's an incredibly important thing because they're relatively small proportions of our communities but bearing disproportionate burdens and excluded from services, and that is a combination we have to change. we really have to work on that. so that refinement of the response i think was really a theme that emerged. if i might, if now is the right moment, just go through a couple of the highlights from each of the tracks. of course, we have five tracks now at the conferences, and while there wasn't i would say any one or two single big studies. there were a number of advances in each of the tracks that i

think are important. particularly since so many of you weren't able to attend, hopefully this will be your 10 or 12 minute strip flew the silence. aids 2014 is a great place to go. with track a which is our basic science where there's a lot of focus on cure obviously, the big news in advance of the course was, unfortunately, the freak through after 27 months of functional remission of the mississippi child who is 4 years old and doing well on therapy but unfortunately was not able to stay off anti-vviral therapy. the big focus, of course, is on cure and vaccines and the cure plenary on the opening day is a masterful summary of that science.

she managed to not dumb it down and also keep us appraised the science. le big news is the consent of kick and kill. which is basically you try to get hiv out of whatever latent reservoir it's hiding in and then use other therapies to try and then go after that reactivation virus. so there's quite a lot of data and information on that and there are a couple of early studies that suggest that this may be a way forward. there's clearly a consensus emerging that the best thing from a cure perspective and probably also from a clinical spperspective is earliesterlrli better, and the people who are likely to be the most likely to

benefit are the people who are started on immediate hard or very near to immediately hard, and that, of course, includes this larm number of children worldwide who have been started shortly after birth. that's going to be a very important area. trackb, the clinical track, the great news is the it varies. 13 million people are on viral therapy. with the new w.h.o. guidelines another equal to that guideline are now eligible for therapy. there is an enormous still untreated population out there. but more people were started in the last several years really than at any other time. a lot of that due to the global fund and also country ownership

and that whole effort. in terms of treatment areas that emerge, there was a big focus on tuberculosis. diane's plenary on tv is a great summary and had some very important findings that really looked quite promising. there's an emerging area related to clinical care and smoking and particularly with thinking aboutc opd as a smokers condition but also as a co-more bitity in hiv. and then probably track c which is epidemiology and prevention was the area where there was the most action because there have been the most new studies and trials out. a couple things to highlight there. first of all, the new w.h.o. guidelines on prevention,

treatment, and care for key affected populations were released just before the conference and then we had sessions on them. i should, fum disclosure say, i co-chaired the guideline process with the dean of the medical school university of malaysia in kuala lumpur, a fantastic scientist. and those guidelines really made one of the strong recommendations based on the quality of evidence was for consideration of the use of preexposure profill laxies, so that's prep for many who have sex with sex with men. this got very miscon stewed in the med line. please do read the guidelines. they're a real advance. toud that the guide lens form sm. there's an important recommendation for community distribution to reduce overdose

deaths which have actually in countries where there's good coverage of arvs, overdose deaths have gone to replace hiv as the leading cause of death. a very important change. there was also good news on prep among men who have sex with men and transgender women who have sex with men which was the results released at the conference of the iprex, the clinical trial that came out in 2011. this is the open label extension. this is the question of the effectiveness of pren when it's not a placebo controlled trial. when people know what they're taking and they can choose to take it or not. the good news is the effectiveness was actually a little higher than the trial, 50% everyall. looking at blood levels, it

turns out first of all that the he have efficacy was 100% in people who took it every day. but it was just as good as six times a week, five times a week, and four times a week. while that's a different message to put out there and we're not backing away from daily prep at this point because we don't have the data to do that, the adherence doesn't have fob perfe -- to be perfect for the drug to work. that's a real advance. the other thing that emerged is that people had a good sense of their own risk. so taking the drug daily was much more common among people who actually had high risk ex exposures and less common among men and transgender women who didn't. this isn't surprising. people are smart. the other thing that's critical is there's been all kinds of concern about risk compensation. if people are on this drug,

he'll us a condoms less. the same concern raised in using treatment as prevention. lots of science around this. turns out it's a kre retcle, not a real world concern. condom use is better in couple one of woman is being treated. there was great data on that from zambia and no evidence of behavior disinhibition. there wasn't great condom use to start but it didn't decline. there also was encouraging news on voluntary male medical circumcision. the most important data are the first empirical finding from the french group that did the first trial of the benefits for hiv prevention for women of male circumstance vation. lower 80s of hiv and syphilis for woman whose partners was vishg laysed. it really is very encouraging. i would say track "d," our human

lights policy and the law, there was an enormous amount of work. michael kirby kind of led us off with that theme. there were a number of presentations on human rights policy and the law and also some empirical data from a special issue of the lancet. they have now been happening regularly with these conferences. this one was on hiv and sex work, and sex workers. i would encourage you all to read it. i also edited it, full disclosure but it's a wonderful group of young investigators who led those papers. really excited about the science but there's strong human rights evidence there for for example the potential benefits of reducing police violence onsive incidents. models outkonl and also on decriminalization as an hiv prevention approach. finally in track 8, actually now

has the largest number of be a strukt sufficient lations. for those of you who worked for implmenters out there, you are an enormous sector and doing lots and lots of work. there was great science. some very encouraging outcomes. also one or two warnings. one was good news that earlier disclosure to adolescents turns out to improve their adherence on therapy. that's an important finding because the cohort of kids who were born with hiv is now in adolescence and young adults and happily in africa. earlier disclosure to them matters. a challenging issue with plan b, which is putting all pregnant women with hiv on therapy which looks like their retention and care is not as good as we'd hope postpartum. they do great through the pregnancy and delivery and then they're falling off.

that's going to be an important implementation ahead, particularly around breast-feeding. i would say finally from track e, the thing that emerged is how much more granular we're getting about the data. debbie alluded to this. and the importance of targeting resources to where the virus is, where people need treatment, where transmission is ongoing given what the global funding climate looks like and given the fact that we are beginning now to really bear down on this epidemic. >> i have to thank you because i was at many of those sessions and i read so much of what's come out of the conference but that was such a good summary of what happened. you got the best summary right here. steve. >> thanks, jen, and thanks to kaiser and craig for hosting us and for this partnership. and congratulations, chris, for

your ascent into being the president for this next two years and working and during towards durbin. i, too, was really struck by the convergence of opinion just in sitting and listening to debra burkes, to mark, to tony, to michelle. the decree to which there is a very mature con shen sus is remarkable. this is not a community beset by deep controversy and division. i was at times a little irritated there was not more debate, but this was really a sign of success i think, and there was an -- embedded within that was a palpable realism and focus upon results and implementation. there was a spirit of constructive forward looking

progress to this and a sense of advancement and a sense of realism that all came together around those five or six key things that need to happen, and i didn't fully appreciate the degree to which that convergence had happened, and it's a real testimony, the leadership and the continuity of leadership when you looked at the people that were up and eloquently making the case and you realized how long they have been in leadership positions in pushing this forward. it's a very unusual enterprise i think. i'm going to say just a few words about the implications of the mh-17 because i think this was truly extraordinary and i will explain a bit about that. we've heard some about this, but i think we need to tease out a little bit of the implications from it. first of all, we've never had a

conference in which a geopolitical global crisis sucked the conference in and sucked the host country in. australia suffered the loss of 28 citizens and 8 permanent residents. 18 citizens from victoria state died. this became a geostrategic top priority, pressing, urgent matter for the australian government as it did become a pressing and urgent human matter for the organizers of the international aids conference. there was no escaping the reality that this was going to become a dominant factor going through the week and beyond. and so thinking about what that means in the immediate and longer term i think is important.

one is the mh tragedy will become a signature frame for thinking about this. i think in the future as we talk about this conference. secondly is it triggered a massive spike of media coverage, and bear in mind going off to melbourne was to pushing the aids conference off into the periphery and lowering the numbers and lowering the media presence and in a world in which the global media is shrinking in terms of its willingness to deploy to these kinds of conferences, the media presence was a lot lighter certainly than it was two years ago, but that tragedy spiked the media coverage in a period, but the story line was not the substance of the conference. the storyline was the human tragedy and the impact there and what that meant. far less was their coverage around -- as there has been in the past of the sort of programatic developments that chris and debra have summarized.

i do agree that the immediate impact was a slightly disoriented and dulling effect upon the population for the first couple of days. there was a somberness that hung over the opening ceremony, the delegates themselves individually, and the early panels and events. what was interesting was there was a rebound effect that began soon thereafter in which you saw a community that had an unusual resilience to it. and it had an unusual capacity to absorb and process this tragedy and some of that has to do with the historical legacy of hiv aids. >> it has to do with this is a community that's familiar with loss. it's familiar with irrational violence and cruelty. it has the 1998 precedent of jonathan mann and his wife dying on an aircraft.

so there was a reconciliation of a kind that began to happen slowly and moved people out of this dull and disorient ed initial reaction. and then i think one of the key moments, and i'd like to hear from jen, deb, and chris on this, i thought the key turning point was president clinton on wednesday at midday, and this was not a conference that attracted a lot of big celebrities. it attracted bob geldorff as a faux celebrity but it really only attracted one global personality and that was bill clinton, and clinton came in and the media attention intensified again and he really was quite deft i thought at lifting the spirits of the conference and defining the moment, and he was particularly i thought humble and eloquent in the way he went about doing that. he talked about mh 17 emanating

from the dark forces of our inner dependence. he reminded every one of the 2,000 people there in the room to -- not to weaken their resolve in the face of this. he supported the dutch and the australian and the american positions that there was no excuse, that this was a crime and there was no excuse, and then he segwayed to talking about the vital point of appealing to the assembled community. that it had an obligation to honor the service and lives of those who were lost and the children that were lost. and he said we have to remind people that the people we lost on that airplane guy their lives to the proposition that our common humanity matters ahell of a lot more than our differences. this was a speech that was quite historic and quite unusual and obviously driven by this

tragedy. two other points about the impact. one is the australian government. the australian government was an exceptional host. they were gracious. they were well prepared. they were generous. they were cordial. it was very well organized on their side, but this center. so that was an important thing to remind ourselves, that in the midst of this conference was this other larger drama that was

unfolding. the last thing i will say which chris can add more element to which has to do with putin's actions vis-a-vis hiv aids. this mh-17 tragedy aggravated and further worsened what was already a trend line in which putin's seizure of crimea, the confrontations over ukraine, and the battles to regain dominant shares over central asia and the baltics and elsewhere which has grave public health implications was driven into the next stage, and we need to think about that. we need to think about that. i'm not sure there's any near-term solutions to this, but it was another one of those dark, dark and somewhat implicit implications for this terrible tragedy. thank you. >> thanks. i actually want to pick up on one thing you said and then come to a couple of you as well around some of the turning

points. i agree, that speech that president clinton made was quite extraordinary and i'm not sure everybody -- it got the attention it needed given how extraordinary it was. but the other thing i wanted to say is that the ias itself in the way the ias responded was also pretty phenomenal because there had been a few calls for should we go on with the conference and the ias came out and said immediately we are going on, we have to go on. and that really i think just gave a lot of energy to people that people needed and the way you adjusted to the opening ceremony to address it was very admirable. thank you for that. so there's a lot to pick up on, and i'm just going to go to a couple places. i don't know, chris, if you want to say anything in reaction to am so of the pieces that steve mentioned on the conference but one thing that would be great to hear about is the melbourne declaration so maybe those things. >> maybe just start with the melbourne declaration. one of the kind of core ideas

that we had for australia is, you know, countries now 30 years and more into the epidemic each have their own story and their own kind of national response and what's happened, and part of the story with australia is very early implementation of evidence-based prevention, very early engagement with communities. one of the first countries to really seriously take needles syringe exchange to scale with a big injection drug use problem, and really heading hiv off at the pass in some ways and still having an admirably low rate of infection, although ticking up in the young gay man as is happening virtually everywhere. this was always going to be part of the story, that australia is a place to talk about key affected populations. we are in the asia-pacific region where that is the principal driver of most of the epidemi

epidemics, the poor public health policies around them and the restrictive environment. that's certainly the case with central asia and the increasing russian influence on public health programming in that region. so we focused on the melbourne declaration to say basically nondiscrimination is totally unacceptable at this point and if we cannot do a better job of delivering safe and effective programming with dignity and human rights for everybody who needs it, we're not going to be able to succeed in the hiv response. so the melbourne declaration became all too real and alive during this conference i have to say. vis-a-vis the issue with the russians, we wanted very much to try and have the russians engage in this conference and to have central asian governments as well in the asia-pacific. we tried really an outreach

there. organized a special session on the region which we invited russian participation in. they agreed. the head of their federal aids program was the person they put forward. ten days before that conference, that person pulled out and said, sorry, we're not coming. we invited them to put in a report, they didn't do it. on the day of that session they sent a letter to the international aids society and also all the meter protesting the russian exclusion from participation. so very unhelpful to say the least and put us in a very challenging position. we tried to respond with the evidence. we laid out what actually had transpired, but as steve said, what is really distressing about this is, first of all, that their own public health programs have markedly deteriorated. the quality of the data and evidence is such at this point that i really don't think anyone knows what is happening with new

hiv infections in that enormous country honestly. in addition to that there are also aggressively promoting these policies and practices, pressing hard on anti-homosexuality legislation in their region of influence and the best example of that and i'll stop after this is the occupation of crimea. they announced the cessation of the methadone program. ukraine has methadone substitution therapy. on the first day of their occupation of crimea. so that gives you a feel for where this sits in their priorities, right? you occupy somebody else's country, there's a long list of things you need to do and most people would not put methadone on the day one list, but nevertheless -- so we really do have an enormous challenge ahead. >> thanks. debbie, to come back to you and then we'll open it up, two other

things that have come up. one is around this -- i think we all felt around the global consensus about where we need to go, whether it was the geographic focus, the goals, how we get there, how we use existing resources. i was wondering how you put yourself into that dialogue and then just a follow-up would be related to the africa summit because that's wrapping up and it has consumed all of your time until probably right before you arrived here. what's your read out on that for us? >> well, this particular meeting was really helpful for me personally because it was the intersection of the new gap report really illustrating where we have done well and really recognizing that, but also recognizing where we haven't done well and then immediately be able to go at the posters and see who has something we can bring back and try to implement.

we looked through everything, where do we still have gaps. tb hiv. we have patients coming in and getting dot therapy. being diagnosed with hiv, not getting hiv treatment. so we have a gap there and we have to figure that out. that one should be pretty simple because we already see the patients. and we're paying for them to come to the dots clinic. we need to really redouble that effort and really use, again, data for decision making and understand that situation. the other big gap that was clear is pediatric treatment, and so we really tried to respond to that immediately. we sat down with pete mcdermott. he shares my and everybody else's global concern of the children and the children not accessing treatment. only about a third of the children who should be on treatment are on treatment. this is country by country. even in countries that have been enormously successful in getting adults on treatment where you have adult rates on treatment of

80%, 90%, and children of 30%. they have joined forces with us, and i think it's really an exciting time not only because of what it stands for, but it recognizes that we and the european community are working together on these issues and i think we haven't really had that kind of alliance with europe during this time and, you know, they feel very strongly about the global fund, we do, too. we're the largest contributor but having that technical dialogue helps us to have that broader dialogue. we're very excited about that. that's a gap we all can address. i think the double diagram was important to make it very clear that the vulnerable population in sub-saharan africa is young women. 7,000 women infected every week. if you add up all the other bubbles, they fit within the women's circle completely.

that size of that group that is vulnerable and at risk. if you walk around to the posters, a lot of people have ideas but none of them have been taken to scale. and young women like young men have their own agenda and their own endeavors and their own belief systems that we have to really discuss with young women. it takes us back to we have to understand what's driving young women's decision making. do they feel empowered. are they making correct decisions for them and do they have all the correct information to make their own decisions and are we giving them the correct services in a friendly way where an adolescent feels like they can access a clinic and get advice without someone going why are you here? you mean you're having sex? and we know that happens. it happened in our household. so i think it's happening in others. they're all passed that now. they're 27 and 31, but it was a vulnerable and difficult time. so i think, you know, i

recognize it as a mom. i think all of us struggle with this and struggle to figure out the best way to resonate with young women and we have to figure that out. i think it was a great time to really look where we still need to do better and then see if that can connect with science that gives us a road map. and we're excited about those pieces coming together and we're excited about the opportunity to translate gaps immediately into response. but we want your ideas so you know we have put all of our data up on the website. you can go to pet far govern.go. send information back to us and say, well, i'm there, i have looked at this and this doesn't make sense. you can't -- don't try to hold back. we want to really hear where you think we could do a better job and we're committed to putting additional data as we receive it. we're going down to the site level and site level quality

data so you can really look at our performance and tell us how to do with a a better job. we're all in this together. it's a global panpandemic. i want to leave with one last thing, ebola. it's a very big contrast in how the united states has worked effectively in partnership with countries. the last five or six ebola outbreaks you haven't even heard about. you haven't heard about them because scientists and clinicians in those countries had the immediate infrastructure, the infrastructure, the laboratory infrastructure, the knowledge base so when those patients came in, they were immediately isolated. the lab is xlwas immediately isolated. i think all of us should feel guilty in a way that sierra leone and liberia and guinea did not have the resources to really

identify that -- those cases in the laboratory and i think it speaks to the infrastructure in the laboratories that have been built, have been really critical to the health system. sometimes we ignore the laboratory and we shouldn't because it's absolutely critical. i'm just going to d one more gap. long act two. long acting prep would be amazing because we have vulnerable young women who may not have the ability to take a pillar day regularly. i see a lot of birth control pills on my counters where there are still pills and not all pushed out, so it worries me. yes, it worries me. prep is important and i think a long acting treatment option so that people get monthly injections, long acting prep could be a bridge for young women and vulnerable young women, and i think good tasting pediatric formulations. yon i don't understand this frankly. we made dimetapp taste good.

we have dummy vitamins and we can't figure out how to make pediatric treatments taste good. a mother cannot hold their child down every day to give them a dose of medicine. it's horrifying. if your child is already sick and you're trying to do this, it's horrifying. we have some still technical gaps we need help for in a global way. if you're working in any of those areas, please work harder. please work harder. >> i have one other thing that hasn't come up that was talked about at the conference which is the question of resources going forward and where are they going to come from. part of it, there was a big emphasis on using the existing pool of funding that we have and using it wisely which is incumbent on everybody but also going forward we know there are still these gaps and needs. we released a report showing donor government convictions are going down. that was an issue but there's other sectors that can help. so that's something we can get

into if it comes up. steve, i'll turn to you to see if you want to add anything else. >> a couple quick points. the melbourne declaration, michael kirby, the australian jurist, came across as just remarkably eloquent and powerful at multiple points. at the beginning, then there was a session on criminalization that was a dramatic session, and the u.s. ambassador jon barry showed up at that and kicked that session off, and in his presentation turned the view back upon the united states in terms of the body of law at the state, federal, or local level that impedes a sensible, rationale approach on reaching certain populations that need to be reached, and it was a very i thought refreshing, a very

refreshing self critical way, and it opened the discussion quite nicely. michael bir kirby came in and jd it as well. that was quite amazing. it was less clear to me what was supposed to be done. i mean, it was less clear to me after all of the pronouncements -- i mean, the melbourne declaration was great, the criminalization session was great, the appeals were made, kirby's opening address on opening night, but it hasn't yet gelled into a fairly clear set of priority actions that are supposed to happen to address this surge of homophobia and the proliferation of bad laws that we confront. so i put that out. another problem area that emerged was the fact that there were no serious high level asian lead thaers shers that showed u.

the president of fiji showed up which was nice of him to do and that was great. there were ministers there, there were ministers there, but there was not a surge of -- there -- there was not evidence of a broad gauged high level political interest from the asia pacific region, and i was disappointed to see that. the world bank had a test run, a study of the financing across the asia pacific. a paper that will be published that david wilson's working on. it shows that there -- you know, in this case, the response is overwhelmingly dependent upon government commitments but is very flat and very deficient. so that's something. myanmar, we did a session that chris was very instrumental in helping us organize, a regional session which the deputy minister from myanmar came and presented. this was a bit of a debut. i think the government of myanmar had overcome its sense

of embarrassment or discomfort at talking publicly about its programs. it came forward in a very candid, come proceprehensive, h and forthright way, and that was so refreshing to see. and the response was great. i mean, you have dozens of myanmar folks come and those from the region and you had the indonesians and thai experts join in that effort as well. so i was really delighted to see that. thank you. >> okay. so let's open it up to questions or thoughts. we'll take three at a time. so just introduce yourself. there's mikes on both sides. i'll try to facilitate this. anybody have any -- okay. you have somebody over here, over here and over here. yeah. so just say who you are and -- >> hello. i'm suzanne lacler from usc.

my question is for dr. morrison, you mentioned that there was near consensus on the five or six things that need to be done to turn the tide of hiv. i'm wondering if you could just review those. thanks. >> next question. >> mary lynn, creative associates international. i had the same question for steven. i think consensus at an aids conference is a little frightening. and i wondered what you wanted to see more debate about. but i also wondered what is the explanatory dialogue going on about low treatment for pediatrics. i worked a z a pediatric aids adviser from 2005 to '08. i never felt it was the lack of free agents or formulations. mothers in communities did not know anything about what could be done for their children and the stigma around the discussion

of parents being positive were much more the barrier. so what will be the response of sif. what kind of interventions are being looked for is the question i have. >> last question. >> my name is edward green. i'm the u.n. secretary-general special envoy for hiv in the caribbean. i happen to be at the conference and i share the sentiments of the head table. and in fact, i want to congratulate you for making the content, the context so vivid for the audience. i, however, want to add a more optimistic takeaway. for me, when i reflect on the conference, there was a takeaway which was resolved to end hiv/aids in brackets by 2030.

this is a momentous opportunity for health and development. one reason is i think it was embellished by the u.n. aids executive director, the 90, 90, 90. now i want to ask the panel, are you as optimistic about that 90, 90, 90. and i want to ask where it is the position is in the post 2050 agenda. one of the takeaways and one of the results of the conference is ensuring that aids is positioned in the post 2050 agenda. i think we were all clear on that but less clear was whether or not we embrace it within the conversion of health. that's what i was not sure about. i think we have to discuss that strategy as we move towards the u.n. general assembly in september and beyond.

>> thank you. so we had a few questions here, one on this consensus and what it was about specifically and another on pediatric and low access and what's going on there. and that, thank you very much, were we as optimistic and really hard questions i think about post 2015 agenda, 90, 90, 90, are we really going to get there. so do you want to start? >> sure. we heard from debra in particular about the fundamentals of the consensus. i would say they are really about making full use of an expanding and very promising set of prevention tools including treatment to prevent prep that there's a sense that in the last several years there's been dramatic improvement in expansion of tools and those

become central in moving forward. a sense of the need to systematically retool approaches from the general to more targeted investmentsed a local and sub regional areas. where the epidemic is most intense. and that includes geographic as well as targeted populations. dramatically the need, the imperative to improve the use of empirical data to guide investments and track and prove impacts that will guide our future investments. the shared common view around girls, particularly rural girls in southern africa obviously key populations as high priorities. i would also put as the broad frame of this a shared optimism, a pragmatic approach, a forward looking approach, a data driven approach, and that -- i was being only facetious really in saying that it bothered me there

wasn't a more active debate. there will be more active debates but i found this broad consensus quite reassuring. and the last thing on this is the whole question around criminalization surge in homophobia proliferation of -- that was a prominent portion of all argumentation across -- i think that was the question. >> i want to come back to the community piece because it not only relates to the children. it relates to all of the mothers and fathers in these difficult countries being further stigmatized, being afraid that they'll be -- when the perception is that hiv/aids is only in the vulnerable populations, then it becomes fingerpointing. we had it in the u.s. we have to make sure that our

responses are comprehensive and at the community level, so that the community understands that there's a compassion that needs to go with public health. we talk about a lot of technical details but there has to be a sense that all of us are vulnerable and all of us need access to services and no one should be stigmatized. what has happened in uganda, what's happened in nigeria and isolated cases in tanzania, kenya, the drc, very difficult and will only drive people away from services because no one wants to feel like their life is in danger while you're seeking life-saving services. and people believe their lives are in danger. and they are. they are in danger. so this has to be addressed. so it's a matter of criminalization, but a matter of the community accepting that criminalization and actually even turning each other in. so we can't -- and we need to work in that more comprehensive way. i do believe that there are mothers, both mothers accessing

option b and b plus and mothers who are not bringing their children into the clinic for diagnosis are the very reason that mothers found it so difficult when we only had single dose noverapain and we asked people to come out of their villages when they're hiv positive and save their child when there was nothing for them. we didn't have any other options then, but imagine the break of trust with that mother when there was nothing for the mother. so i think option b and b plus are going to help us there where mothers feel like they're being cared for, where they feel like their children are being cared for, but we have to overcome that 10% or 15% that we know are throwing away their pills on their way home because they can't confront the stigma in the community. and i think involving the churches who are a very important fabric of the community, involving the community leaders, involving the local chiefs to make sure that

no one is turned away from services and becomes more vulnerable to disease because of what we're doing ourselves. so you're absolutely right, the community piece is essential and remains a barrier for both mothers and baby. >> so the last question on -- >> on tptimism. >> and the post 2015 agenda. just to start it off, i am an optimist. i always approach it very optimistically. but that was a feeling at the conference. so if we didn't convey that, most of us felt it. i think what's changed from my perspective is just in the last four or five years we can actually say now we know what to do and the fact that there is more of a -- or is a consensus on those things. so a few years ago we both didn't necessarily have all of the evidence and the tools, we did a lotut