others five, three and two. for those women who have many children, soon they run out of the sticks. because they are not able to provide the food, the clothing, education for their children. and they soon realize, with many children i can't provide everything. so we ask, what are some of the coping mechanisms if you are not able to provide for the education? what do you do? these are real choices for these women. many of them will say, you know, we give the younger children food and the older children go without food. or we take the boys to school and the girls remain home. because we cannot take all the children to school. for those who have run out, they say, well, in my family, we were ten children and i decided to go into prostitution to be able to support our home. so finally they realize that

there is a relationship between family plan -- between having many children and whether you can be able to provide for these children using the sticks. so i asked again, so what have we learned in the few weeks that we have been together? kedra slowly puts up her hand and she says she wants to contribute. okay, tell us. then she says, you know, i have had 11 children in my life. i got married when i was 13 years old. and over time, i give birth to many children. and i continued giving birth because they were dieing. seven of them -- seven i have put in the ground. i have buried seven of my children. i only have four children remaining. and it's because i didn't know about family planning. nobody told me about it. but over the weeks i have learned about family planning. i have an implant and it can

protect me for five years. i'm also telling other women about family planning now. so i realized that actually this program is making an impact on the women that we talk to and the women they are able to relate family planning, child survival and provision to their families and children. so that's the work that i do. and it keeps me awake every night. thank you. [ applause ] >> thank you, jane. amazing and so powerful to see jane up on the opening stage yesterday. so our last speaker -- our last fellow to present to you tonight is an amazing person named bisi

alimi. he is the founder of a consu consultancy. he loves apple products. all right. i think there's actually much more to this amazingly courageous person and you are about to meet him right now. bisi. [ applause ] >> when i was growing up, i wanted to be either a lawyer or an actor. so in 1999, when i got admission into the university to study theater arts, it was a dream come true. three months into my admission, i met ibrahim. he was everything i wanted to be. was tall, handsome, intelligent, witty, with a very wicked sense

of humor. i remember it made me part with my feeding allowance because i dared him. such was the relationship between us that he had such an impactive influence on my life. so it was. after my first year holiday, when i resumed back to school, i got a call. he would like to see me. he's in the hospital. i rushed to see him. the moment i walked into the ward, i saw my best friend. he was lying there on the bed. i could see his ribs through his skin. there was cancer all over his skin. his skin was dark. his eyes was big and was popping out of his skull. his arms were withered, skin

wrinkled. i couldn't help myself. i broke down. and then he turned around and he looked at me and he said, come over here [ bleep ]. even at this particular time, he still had a sense of humor. i walked up to him. he stretched out his very weak hand and he held me and he said, i've got aids. and the doctor said i've only got a few days to live. i would like to talk to you. he looked right into my eyes and through me and he said, bisi, of all my friends, you are the only one that can get the message across to every of our friends about hiv. and i want you to promise me that you will do this.

i was young. i had no idea what he wanted me do.do. in my frustration, i started looking for an answer. then i came across an organization in nigeria called alliance rights. was working with gay men at that time in the area of hiv. i started to volunteer for them. a few months of volunteering, i was given the opportunity to become the program director. that came with the responsibility of lobbying the nigerian government to start an hiv framework that would include men who have sex with men, sex workers and drug users. this was a big challenge for me. in nigeria, a country for public health is defined by religion. it was hard. every day i tried. i hit my head against the wall. then in 2004, i was invited to

the fourth national aids conference to give a talk alongside representatives from sex workers and drug users. and then i told the story of ibrahim. just then, the health minister stood up and he looked at the three of us and he said, it's time for you -- when she was a

week old, our daughter had open heart surgery that saved her life. family and folks prayed with us. they called her a preexifting condition. i know healthcare reform wasn't done right. there's a lot i will do to make it better for west virginia. i won't go back to the days of letting insurance companies deny coverage to our children. i'm natalie and i approved this message. >> sad to say we are seeing politics at its worst. my opponent is tacking my personal integrity and my family with ads that are false. i'm not surprised because she has shown she will say and do anything. misleading voters to get elected is not a good value. i will fight just as hard for my family as i have for all of west virginia. i approved this message.

>> i approved this message. >> what do we know about congresswoman shelley moore capito. on the financial services committee, she helps bankers get rich. there's more, while west virginiians were losing their jobs, she gave her husband a wall street banker insider tips. they made more than $100,000. she keeps getting richer and west virginia pays the price. >> live coverage in the senate race at 7:00 eastern on c-span. live at 7:00 on c-span2, virginia's senate debate. a conversation about vaccinations and why diseases like measles and mumps that were eradicated a generation ago are reappearing. a panel of doctors and other experts participated in this

90-minute discussion. welcome to the national press club and its journalism institute and a special welcome to the vast audience viewing us today via c-span. i am the president of the press club. we are pleased to be hosting this briefing with the pbs show nova and tangled bank studios the producer of the upcoming show on vaccines. from maine to ohio to california, there have been many outbreaks of preventable diseases that many in my generation thought were no longer a threat. measles, mumps, whooping cough and even polio. on a personal note, i was a

foreign correspondent for the associated press for 40 years. when i am asked what was the most important story i ever covered, i respond that it was covering the eradication of smallpox in india. when i went out with a group of world health organization people to a remote area to report on how they isolated areas to ensure that everyone was vaccinated. those vaccines helped make the world smallpox free a few years later. that's why it is essential not to forget the roll of vaccines. no question, this issue of vaccines is being talked about by new s media around the unite states and the world. we will hear from a distinguished panel including journalists who are on the front lines covering the issue, persons like joe lawlor.

and who to better examine the science behind vaccinations, the return of preventable diseases and the risks of opting out than nova, the premiere pbs show on science, health, education and more. i want to welcome paula apso and julia court the producers who are based at wgbh in boston, one of the pbs flagship stations. our moderator today is michael ros rosenfeld. named after darwin's colorful description of a complicated ecosystem. we look to you, julia and michael and other experts on the panel, to help us better

understand the complicated ecosystems of vaccines. thank you so much again for having this important discussion, this very important discussion at the national press club under the auspices of its journalism institute. i'm pleased to turn over the floor to julia. >> thank you. and thank you to the national press club journalism institute for hosting this briefing and thank you for coming this morning. we are here to talk about reporting on vaccinations and outbreaks of vaccine preventable diseases. and to share some insights we have gained while preparing our upcoming program, vaccines calling the shots. vaccination is really a perfect topic for nova to cover. our primary mission is improving the public's understanding of science through accurate and engaging journalism. in fact, today nova and pbs are among a handful of places one

can find good science journalism on television. the need for science journalism has never been greater. science and technology is involved in so many public policy issues today, like vaccination. it's crucial that people not only get the facts, but get clear, accessible explanations, analysis of the facts so they can make informed decisions. yet providing these can be really challenging for journalists, especially on subjects like vaccines, because not only is the science very complicated, but we're presenting this to readers, viewers, our audience who are not just engaging with the facts but are engaging with powerful emotions, like fear, mistrust. so this is a challenge our producer, our editorial team faced putting together this program as we aimed to provide solid scientific understanding

in a field full of misunderstanding and misconception to an audience that includes parents who are confused, who have a lot of questions but are trying very hard to do the right thing for their children. paula, senior executive producer of nova who is here today and i were very fortunate to be working with an extremely talented team of journalists including sonya and michael who took on this really difficult and complicated but extraordinarily important topic. so we hope today's discussion is helpful to you and you report on vaccines and on these outbreaks and wrestle with some of the issues that we have been wrestling with. now i'd like to turn things over to michael rosenfeld, head of television and executive producer. >> thank you for that kind introduction. thank you myron for the opportunity to participate in this briefing. good morning, everyone.

thanks so much for coming. the subject of vaccination is on the minds of many americans right now as we send our kids back to school at a time when vaccine preventable outbreaks are making headlines around the country. the cdc puts the numbers in perspective. measles was declared eradicated in 2000, but there have been 600 cases this year, the highest in the u.s. in almost two decades. whooping cough is also a problem. 2012 was an especially bad year with nearly 50,000 cases and 20 deaths in the u.s. this year the state of california declared it an epidemic. these are diseases that vaccines can and do prevent. so the numbers would make anyone, but especially a journalist, wonder what's going on. at tangle bank studios our mission is to shed light on topics of public health so the

story of vaccines was irresistible to us. we have been fortunate to partner with pbs and nova to explore these issues. the result is a new documentary, vaccines calling the shots which airs on nova september 10, 9:00 p.m. eastern. we hope it will help 5audiences understand the science. we know this is a story that will unfold over the coming weeks and months and years. i think it's safe to say that journalists will have their work cut out for them as they cover the return of vaccine preventable diseases which can't be fully explored from any single beat. this is not just a science story. it's a public health story, a medicine story. it's economics and policies, psychology and history as well. our panelists today reflect that. you have their bios. i won't repeat that information. i would like to add a few things about them. usa see -- as you see when you

watch the film, paul to my left cares passionately about public health. it's not that he was a leader in the development of a vaccine which saves hundreds of thousands it of lives around the world. he has experience from his years on the front line of pediatric medicine at the children's hospital of philadelphia. from public speaking to writing books, he has a lot to say about the role of vaccines and the return of vaccine preventable diseases. the way to make a smart film is to immerse yourself in the topic. sonya really goes deep. when first discussed this with her several years ago, i was impressed by how much she already knew about vaccines. and she has really spent the last 4 1/2 years immersing herself in this topic. but in addition to a quiring a detailed understanding of the subject, sonya has given a lot of thought to how this story should be told. her goal, which we shared, was

to craft a film that would bring clarity to a very complicated science. and be accessible to the general public and to parents who have a lot of conflicting thoughts and emotions about vaccination. brian grapples with one of the hardest suggests to study and communicate risk. as someone who studies how people make decisions, he is adept at explaining tough concepts. those subjects are important for vaccine -- for the vaccine conversation because how you see risk can have a big impact on whether you vaccinate your kids, on schedule, delay shots or even skip their vaccinations entirely. finally, i'm pleased to welcome joe. he is a journalist in maine, joe has firsthand experience covering vaccination. he has written front page stories calling attention to the rise in vaccine exemption rates

as well as potential legislative responses. his coverage generated discussion on the web which tells you something about the appetite for good reporting on this subject. that's the panel. i'm now going to ask each of the panelists to speak for roughly five minutes about the subject of vaccines from their particular vantage point and we will open the floor to questions. paul? >> okay. if we could start actually -- there's a two-minute clip that's going to lead into my five minutes. roll it. >> the 2013 measles outbreak in new york hit hard and fast. but remained within the brooklyn area. why didn't it spread to the other 8 million people in the

city? the virus was in circulation even though it often wasn't openous. it was being carried by people who often had no idea they were infected. but the vast majority of the people who came into contact with the virus had protection. they were vaccinated. >> there's two things that matter for whether or not i'm going to get sick. one is if i bump into somebody who has the disease, am i protected against it or not? but the other piece and the more important piece is the chance i will bump into somebody in the first place who has this disease. you can think of this as the sort of concentric circles of

people and the less the disease exists in my circle or the next circle or the next circle, the safer i am. >> it's known as herd immunity, it protects everyone. and in new york, it worked. >> if we didn't have the high vaccination levels that we do, you know, in new york city and even in this community, i can promise you, we would have had hundreds if not thousands of cases. >> this protection is fragile. for highly infectious diseases like measles, we need 95% of the community vaccinated for immunity to hold. if the rate drops, even just a few percent, it can collapse. >> so we live in a country of about 300 million people.

in that -- among that 300 million, there are 500,000 people that can't be vaccinated because they are getting chemotherapy for their cancer. they can't be vaccinated because they are getting immune suppress receive therapy for diseases or they can't be vaccinated because they are too young. they depend on those around them to protect them. when he arerd immunity breaks d you see this come back. as michael said to introduce they, look at the current measles epidemic. the current measles epidemic has 600 cases. that's the biggest we have seen since two decades ago, since the mid 1990s. 600 cases. now, if you look at this through how that happened, it happened that generally citizens from this country travel to areas where measles is occurring

generally year round. for example, the philippines. in the philippines last year, there were 31,000 cases of measles and 42 deaths. travel unvaccinated goes to the philippines, catches measles and spreads it among a group off of unvaccinated children. tease because the parents had chosen not to vaccinate them. now although it is the biggest epidemic we have seen in two decades -- it's worthwhile looking at what this -- this disease was before we had a measles vaccine, which the first vaccine was introduced in 1963. before the first measles vaccine, there were 3 to 4 million cases, and there were 500 deaths. everybody saw measles. today, although there are 600 cases, i would bet few people if anyone in this room has seen a case of measles. in fact, when measles -- a

suspicion comes into our hospital, a child with fever, rash and there's a question of measles, they bring old people like me down into it the emergency department to see whether or not it really is a measles case because people don't remember what it looks like. for example, on a recent larry king live show, generally mckathy, who is my go-to on healthcare advice, she said, when asked -- when addressing the issue of whether the combination of measles, mumps rebr, rubella could cause an epidemic, she said she will take it every time. she has no recollection of measles. i think we have forgotten what measles looks like. which is remarkable. because i remember when i was an attending at children's hospital of philadelphia in 1991, we were in the midst of a massive

measles epidemic. it centered on two churches in our city. this is 1991. this is 30 years into the development of a measles vaccine. we had 1,400 cases of measles and nine deaths. we had five deaths in a ten-day period in february of 1991. our city was in a panic. so are those of us who understand the power of measles. for example, about 50% of children with measles will have an abnormal chest x-ray, which is to say they will have radiographic evidence of pneumonia. i would like to think what we experienced in 1991 in philadelphia is a lesson from the past and not a pro log to the future. thanks. >> sonya? >> hi. i'm a filmmaker and a science journalist. like many people in this room, i see myself as a conduit between the experts and the public. translating science for the public is kind of what i do and what i focus on.

i started thinking about this film way back in 2009 after i made a different film caused catching cancer. that was about how viruss can trigger cancer and how in a funny way that's good news. if you can find a virus causing a cancer, you can create a vaccine to stop it. it got nice reviews. but then i received a large proportion of nasty mail. what many people might call hate mail and abuse. i was shocked because i spent most of my life growing up in a medical family. i started to study medicine. this is smi area. i was surprised. so i decided that i wanted to understand why people could be so upset and so angry about vaccines that they would take the time to write me these letters. so i began a process really 4 1/2 years of digging really

deep. i really wanted to understand why people would be really frightened of vaccines. bau because to me this was alien. i saw it as life saving. i didn't understand it. so i had to really confront my own bias, my own pro-vaccination stance and try and understand what it felt like to be someone who was fearful of vaccines. that is what led to the film. i thought today what i would try and contribute was five things i have learned about talking to people with hesitancy around vaccines and about communicating vaccination issues. from one journalist to many others, here are my five tips at the moment. first of all, never forget the vaccine is a good news story. we get so used to hearing it pitched as an us versus them debate. about 1% of people in this country don't vaccinate at all. it's a really small number.

can we all just get a grip to start off with? about 90% on average vaccinate most of the time or all of the time on the schedule. it's around about and it depends where you are and 10% who might skip or delay some of the shots some of the time. that group is important because as paul said this can affect herd immunity. it's not an insignificant number. it's an important number. but i think it's important that we all put it in context that it is the norm to vaccinate. we should reinforce good behavior in a sense, positive stuff. so that was one of the first lessons i learned, to this by this as a good news story not a bad news story. the second and really important thing is that people who have concerns around vaccines are not necessarily anti-vaccine. in fact, the number of people that came forward to me -- i'm talking about hundreds of people that i have spoken to over the years who said, i am nervous about vaccines, i have

concerned, i'm scared of this or that vaccine, once i was open to having the conversation with them and didn't shut them down with my kind of personal bias about you should have a vaccine because it's good for you, when i stopped and listened to them, i would discover that most of member were not against vaccines. they just wanted to ask questions. i think we forget that. because the groups that are against vaccines are so vocal that we can lose sight of this very large group of people who just have concerns. we did the first national survey of attitudes to vaccination in our country that 53% of parents have some concerns around vaccines. the vast majority, 47% go on to vaccinate -- fully vaccinate anyway. but what was interesting is they had enough concern to make questions. i thought most useful thing i could do as a filmmaker was speak to the parents. the film is about trying to

speak to parents who have vaccine concerns and to do that respectfully and acknowledging that people are not necessarily outright refusing. they are concerned. also i think the thing that we need to remember is that the internet has changed the vaccination landscape. it is a force to be wreck on the with as we all know. people go to dr. google for all sorts of things, including vaccine information. trying to count they're with calm, sensible and hopefully impartial, in a sense that we're looking at the science and trying to follow what the science has to say. i think that's vitally important. my third point is it's okay to talk about concerns and fear. you don't need to be frightened allowing people or encouraging people to talk about their concerns. in fact, as brian will attest, that many, many studies that show actually acknowledging fear helps people deal with fear. that's how we all process it.

when you don't talk about things or try and push them away or don't allow people to talk about this sort of thing, then we make the problem worse. for me, one of the goals was to help reduce fear. in order to do that, we took a very brave step to actually acknowledge fear and let people in the film talk about their fears and concerns. i think that is the fundamental point of difference of this film. hopefully, the reason why it will speak to many people. the fourth thing i wanted to add was there are a -- there is a spectrum of views around vaccines. it's not a debate. it's not us versus them. that's lazy. that's not the way we should be thinking about this. there are people that with a spectrum of views around vaccine. one study that i like to think of came out of australia was a spectrum of five groups. there's the unquestioning accepter, the questioning accepter, the hesitant, the

delayer or cherry picker and the outright refuser. this is just one way of grouping people. i found it use to think of where people sit on the spectrum and remembering the outright refuser is about 1%. there's a very big in the middle and trying to speak to that group and not -- and treat them with respect and listen to what they have to say was really important. again, it's worth remembering the vast majority do choose to vaccinate. reinforcing that. finally, number five, it's something that paul offit says in the film, and he says, we're all in this together. whenever i struggled with people hitting me with their opinions about vaccines or their fears around vaccines or saying things that i knew were scientifically inaccurate, i had to find a place in myself where i could listen to them and think, we're all in this together, we're all united by the need and the desire to try and protect the ones we love, all of us, no

matter what your position. and if you come from that position, then i think we can find a basis at which we can have a good conversation. the uaustralian broadcast of th original version, hundreds of parents came forward to say the film helped, it opened a conversation that allows those that just had questions to come forward and speak. there was very sane and nice conversation on the internet for about a week, which was really good fun. and people said please and thank you and would you mind answering this question and it was polite for a little while. that was wonderful to see. the people who would normally hit hard had to be quiet because the people who were just hesitant and questions came forward. also, what was really interesting that came out of it was the australian immunization specialists have started training pediatricians in how to speak to vaccine hesitant parents so they can be equipped

with the skills to have the conversations. finally, inwant to say that i think i'm optimistic that there is a way to have this conversation and that we can all do it. and we can all help the situation and help people to talk to one another. i hope you find the film interesting in that regard. thanks. >> thank you, sonya. for a perspective on risk and where that fits into the story, brian. >> thank you. i'm a decision psychologist. my field is trying to think about how people gather information, make sense of data, make sense of risk. in many ways, we ask parents to go through a journey like the one that sonya has gone through, to gather information and figure out how -- what they need to think about, vaccines, what they need to feel about vaccines. and ultimately what they need to do about vaccines. i would like to start with rolling a second clip from the nova episode. i will talk about the implications of it.

>> wants to vaccinate her two children. she's chosen not to follow the recommended vaccine schedule. >> the plan is to be fully vaccinated as soon as possible. but we're doing one at a time. i don't know if that's the right way. i don't know where he came up with that. >> she has a 4-year-old and is expecting another child soon. she delayed vaccinating her oldest until she was 3. >> i was concerned that her immune system couldn't handle it. we waited. my son and -- they're not vaccinated yet. my older ones don't have boosters. >> this woman has four children. she vaccinated at first but then one child had a seizure. >> worried about reaction. i am worried about the diseases. >> in america, children must be vaccinated before they start

kindergarten. but the required shots var friday state to stay. and most allow for exemptions based on personal or religious believes. here in california, almost 3% of children are exempt and in some schools it's more than 30%. >> i have a lot of friends that don't vaccine. if you say vaccine around them, they look at you like you are -- like you were poisoning your child. >> the other hand, you have parents that can't even understand why this is even a question. >> nobody is willing to have a conversation with you and discuss what's the service ever reaction? is it okay to have a seizure? i would like to know what the real risks are. >> one of the things you will notice in the clip is that there's a lot of discussion of risk and not a lot of discussion of benefit. that's the first thing i want to highlight in the conversation,

which is that dr. offit is right. we are facing a point in time in which the benefits of vaccines are harder for parents to understand precisely because it is not part of their experience. 70 years ago, every parent, every grandparent knew personally cases of the kinds of diseases that we now prevent with vaccines. you didn't have to sell vaccines to them. they wanted vaccines because they didn't want to have their children grow up in a world in which those diseases were the threat that they were. today, as dr. offit points out, people don't know that. they don't know what it in an intuitive sense. i have the word that measles is circulating, but unless i know someone with the disease, it doesn't have the same impact. our risk perceptions are about

experience and emotion as about thoughts and facts. the challenge is how do we help people understand the threat of vaccine preventable diseases in a world in which their narrow circle, the people close around them, are not likely to include somebody who has been affected by polio or measles or whooping cough? the challenge here is that in the modern world we are -- our society is mobile. the person who is standing behind me in starbucks could have been in russia, could have been in india, could have been in africa yesterday. we do not know what that person is bringing with them. and precisely because of the mobility of modern society, the intuitive understanding of are the people around me sick, well, if not then maybe i'm safe no longer is an accurate representation of the risks that we potentially face. somehow we have to have the conversation to help people recognize to tell this

possibility story and help them understand that it's that benefit of vaccines that we need to get back in touch with. we do need to talk about safety. and we do need to talk about the questions that parents have. the one woman ends the clip there with two sentences that i want to highlight. she asks, what's a severe reaction? is it okay to have a seizure? i want to point out two things about that. the first is this. she knows that vaccines are not perfect. she knows that she has to at least think about the possibility of a reaction. and that is true, vaccines are not perfect. she wants more information. and as a result, the simple statement of vaccines are safe is not going to feel satisfying to her. from a public health standpoint, they are one of the safest

things that medicine has to offer. that's why we offer it to people because we know the benefits vastly outweigh the risks. on a personal level, that's different. so the challenge is, we have to acknowledge the complicated story in order to gain the trust of parents like gabrielle. if we say vaccines are safe, why should she trust that? we have to go deeper. when she asks, is it okay to have a seizure, what she's asking is, is it okay that this thing i hear has benefits also has risk? how am i supposed to, as a parent, put my child at risk? so the last thing i want to talk about is the parental experience of risk. parents want to do what's right for their children and keep

children safe. part of us always knows that risk is everywhere. i'm a parent. my daughter turned 16. i handed her the keys to the car. unquestionab unquestionably, the most dangerous risky thing i will ever expose her to. i did it anyway. because i knew that the benefits to her, to her development were worth putting her at risk. that doesn't mean i ignore risk. we want to be safe. i give her a safe car. i make sure she trained, she learned how to drive well. just like it's appropriate for parents to say, how can we minimize risk in the contempt of vaccination? we also have to engage with the point that part of what being a parent is is sometimes dealing with risk, because risk is everywhere. vaccines are incredibly safe. most children who are vaccinated have the most trivial symptoms,

if anything. but severe reactions do very occasionally occur. those tend to be very temporary, but they can be scary. so there's a duality of risk that i need to end with. at a population level, public health can say, this is a one in a million risk. we don't need to worry about it. it will outweigh whatever the risks are. from a policy standpoint, that's all right. i have no problem with that. but from a parental standpoint, parents don't care about probability. they care about possibility. it's possible that their child might have something scary happen to them. they will worry about that. we have to acknowledge that reality in order to be heard by them and to be trusted by them. so the conversation of vaccines for me is one of respecting the emotions of parents and helping them realize that, yes, this may not be the easiest thing to do, to watch your child get a shot.

but it may well be the tlihing u need to do for the benefits it will provide. >> thank you, brian. now for a perspective from a journalist who has been actively covering the story. >> thank you for having me here. i guess i just wanted to point out that the folks on this panel here are all -- have lived or studied this issue for their entire careers, many years. myself, i started looking into this in july. but i dare say, many journalists will be approaching this like myself from completely an outside perspective or learning things on the fly. i'm the health reporter at the press herald in portland, maine. i've only been the reporter for

a year. i would say, there be a lot of general assignment report others city hall reporters who may cover these stories based upon the dwindling resources in the media. unfortunately in this day and age. the other thing i -- i want to talk about how i came upon this story. it's really not a very obvious story. there was -- in 2012, there was a whooping cough outbreak in maine. so i started at the newspaper last year. so i wrote about just kind of a straight story about how there's this outbreak and isn't that -- shouldn't we be somewhat concerned and kind of moved on. but then this year, it was pointpoint ed out to me that maine had one of the highest voluntary opt-out rates for parents choosing not

to vaccinate their children. opt-out rate, this is for children entering kindergarten, and the opt-out rate is 3.9%. as a journalist when you see a number like that, you are like, is that really that bad? but as the documentary -- the excellent documentary points out so well is even with small numbers of people opting out, herd immunity, what protects all of us, breaks down even as 95% or less vaccination coverage, depending upon the disease. so you know, it took -- the more i looked into this story, the more i realized, this is really could be a pretty big deal. i mean, it would be better to -- if there was some really tremendous terrible outbreak like what happened in philadelphia in 1991, that would be a tragedy.

i thought it would be better to write about this before. so anyway, we spent a lot of time -- the other thing that really struck me about this topic is that unlike a lot of things, if people -- if say 5% or 10% of the population believes something that's not true, for the most part that doesn't affect me, affect us. if you are at your family reunion and your second cousin talks about area 51 or the aliens, you might just kind of nod your head and move on to the next conversation. it doesn't really affect you. 5% of the population believes that, so be it. with vaccines, in order for them to work properly, you need everybody buying in or almost everybody buying in. so that really struck me. we did a pretty comprehensive story about this.

you know, talking to all different types of parties, including somebody who had contracted polio as a child and people -- we got the side of the people who were -- didn't believe in vaccinations. i do have to and people -- we got the side of the people who were -- didn't believe in vaccinations. but i do have to say, we also made the decision that, for this particular story, you know -- and, as the document ri points out very well, the science is settled. there is to debate amongst scientists whether vaccines work. and there's no proof that's been debunked about the connection between autism and vaccines. there is no connection between autism and vaccines. when approaching the story, you have to look at it, like, okay, these people have concerns, but it's not a scientific debate. they're having a debate in which

they believe to be scientific, but it's not scientific. you can't do the whole, you know, well, this side believes this and this side believes this and let the read eres decide. it's really not that kind of story. i think you are really doing a disservice to the readers if you approach it like that. so, anyway, we put the story together and it ran -- the reaction to it was really -- even though i had been resourcing this topic for about a month and kind of got a sense at how much depth and breadth there is to this topic, it's really quite amazing. we had over 600 comments on our web site. and, for us, that's probably ten times the normal amount of comments we would receive on a story. and, you know, i was really interested in what types of

people were comment on the story and, you know, it was fascinating. it wasn't just the 1% that sonya was talking about. the virulent, absolute antivaccination people who were commenting. there was a lot of people who, i believe, were just mis-informed. they weren't militant about it, but they were just misinformed and didn't believe that, you know, that they felt the cdc was hiding something, maybe or there was just scientists covering up information. and then there was a healthy debate on a lot of people who were patiently debunking the claims that people were making, which i felt was a good service. and, so, you know, we're going to continue to follow the story so we did some follow up stories and there's more to come. i think there's a big topic.

and this is a huge topic. and the other point i want to make is there's also an element of -- it's not just a science story, but it's also a political story, in a way, because this gets to the issue should the government be telling me what i have to do? there's a clear correlation between washington state -- for instance, washington state had one of the highest opt-out rates of children entering kindergarten in the country. they made it harder -- they didn't make it impossible, but they made it harder -- for parents to opt out. and upon doing that, within just a couple years, they've seen a reduction in the percentage of people opting out and also a corresponding reduction in outbreaks. so this is not an easy -- and,

you know, in maine, just last year, they made it through the house, a bill that would have -- i don't want to get into too much detail here x but it was an aent-vaccination bill and it passed in the house. our legislators were playing provaccination legislator. playing defense, in a way. the governor of vermont has gone on the record saying he believes parents should have a choice and should make it harder to opt out and vermont has one of the highest rates of children -- of parents opting out of the vaccine. so, you know bs i suppose if you don't really think about it, in detail and really get into the heart of why vaccinations work, it does sound logical. the government should not force people to do something. but, you know, this is one of those cases where the 5-10% of

the people, you know, it really does matter. so thanks a lot. >> thanks, everyone. i think that probably gave you all a sense of how personal this is for people. and, also, parents who are on the front lines who care most about protecting their patients through vaccination. so, with that, i'm going to turn this over to all of you for questions. there are microphones available that will be coming around in the aisles. if you wouldn't mind just telling us your name and your affiliation, thanks so much. yeah, right up here. >> this is penny star with cns news. some of the people that i mentioned to before this event,

you mentioned the internet and there are sites that people i know go to called the informed parent. and one of the main things they do is use cdc stats to make their arguments, anti-vaccine arguments. and i wondered if you could address that issue as to, in other words, is the government doing enough to actually communicate with parents about the benefits or the risks. >> paul, do you want to take that? >> thank you. so, for example, if you look at the impact of vaccines on diseases like diphtheria, measles, et cetera, and you go back far enough, you go back to the late 1800s, 1900s, you can start to see the incidents of measles or mumps or diphtheria decline when vaccines are introduced. and that's because we chaked

things like sanitation in this country, hygiene at home, this had impact on these diseases. obviously, purifying drinking water had an impact. but the slope of that curve dramatically declines. and then you see there's a dramatic reduction because of the introduction of vaccines. that particular cdc statistic will be used by those who oppose vaccines and people say see, we didn't need vaccines because the rate was going down anyway. but certainly, these diseases would still exist if we didn't have vaccines. and we have abundant evidence in that. for example, when the soviet union was dissolving, the incidents of diphtheria vaccine dramatically declined. we saw 50,000 cases and then there was an introduction of vaccine and then the rate dropped again. we do these experiments over and over again. there's no reason to believe

anything other than what the data show, which is vaccines clearly make a difference. don't use them, the disease goes up. use them and the disease goes down. that's one example. in terms of how the cdy or others try to communicate, i think a lot of groups, the american academy of pediatrics, the autism science foundation, there are a lot of groups out there that really try to communicate good science to the public. i think they do it compellingly, cogently and kpaush gnatly. i think if you look at this story now compared to the way it was covered 15 years ago, it's much better. are there those groups that consistently hold on to the vaccine and doing more harm than good? yes. i think we are making a difference because i think, really, a lot of people are trying to create good science for the public. >> do you have thoughts from the science communication point of view? >> i think the one thing i would

add is to acknowledge the character of the internet and the role it plays in the discussion of vaccines. the internet is not just making information more available to people. it's enabling us to share stories. to share individual cases. if you believe your child was harmed by a vaccine, that's the kind of story we want to share. the stories that don't get shared as much, of fk, i want's a story that's the most common story. i went, i got my child vaccinated. it hurt a little bit. it didn't bother them that much. nothing happened. he doesn't get sick. this is boring. but it is the fundamental story of vaccines. it is the story that is the most common story of vaccines. and, precisely because in a web 2.0 environment, the shared

content comes from users, what we tend to see when we go looking is a disproportionate share of the people who want to share information. and this's not a fair representation. it's not even close to a proportionate representation of the lived experience of vaccines. so that's the challenge that we face. how do we help people understand that what gets shared is not a fair representation. it's the story that people want to share. and the voice. the child who is in a classroom and has measles. and what is she feeling at the point that yes, she did vaccinate. and does that make her feel safe? that is the emotion. and somehow, i wish we would be able to make that story more common. >> you're probably going the talk about what i was going to suggest. there's a story in the film

which is the per vase story. >> i was going to say this issue about telling the boring story is very interesting. one of the scientists i approached very early on said poi just point a camera at a regular family eating dinner and run it for an hour. they're not thinking about disease. they're not worrying about disease. that's the story of vaccination. and i went, yeah, sure, i can't turn that into an hour of television. but it is the challenge as communicators, you know, how we tell the stories effectively and accurately. so we took a bit of a gamble in this film because it was scary to tell a classic story you see on the internet of my child was a healthy, beautiful, fabulous little baby and six months of age, everything was fine. and hours after the vaccine,

everything went termblely wrong. you can find those stories on the internet. i chased a lot of those stories. i tried to talk to a lot of parents. it was very hard to verify those stories. i found one family who had their medical records and ready to share their story. the child was six months of age and decided to have seizures. they were on going and devastating and resulted in this child having brain damage over time. and for the first year of that child's life, they believed it was the vaccines. and then testing was done and they discovered the child had a form of epilepsy. epilepsy caused by a fever.

the first-ever seizure usually occurs around six months of age. for another little girl we interviewed who is not in the film, hers was caused by flu. they both have it and she got it from her first fever from flu and he got it from having a spike in fever after his vaccines. the vaccines were not the cause. they were a trigger. like bouncing on a trampoline is a trigger for him now. because he has epilepsy. the parents truly believed the vaccine had done that to their child. so putting them on the film was the way to explore the child and putting a face to it and putting some science to it. one thing i did want to say is if we can try to tell the stories where nothing goes wrong, that's really helpful. this's really, really helpful.

it is the norm for all of us. and we don't question it. i think we have an obligation to try and share that safe story. >> just briefly, to follow up on one thing that sonya said in terms of the relation between causal associations. my wife is in prak tigs and she came and was helping a nurse and there was a four-month-old sitting on her mother's lap on the wall. and while my wife was drawing one of thoo ez vaccines into the syrin syringe, the child had a seizure. if she would have given that five minutes earlier, there would have been no evidence in the world that would have been able to convince her that that vaccine didn't do that. i think you're always going against the power of the

emotional anecdote as compared to the power of statistics, which i think is a hard fight. >> if i can make one quick point, a lot of the fears and opposition come about in maine that might be a good example, you know, people take into movemented, you know. for instance, the organic food, natural movement which, you know, it's good to eat your vegetables and things that come out of the ground or processed food. i believe that sentiment is out there. and there's trace amounts of

things like formaldehyde and other -- that absolutely would not make you sick. but people see that and they get scared and that was actually the bill that was introduced in the main legislature last year that passed the house, got killed in the senate and was just to inform parents of every single ingredient that was in each vaccine without any context behind it. a scare tactic, actually. >> they're derived from parts of viruss or parts of bacteria. we've been making formaldehyde every since we crawled out of the ocean on to the land. and the quantity of formaldehyde we have in our bodies is logarithmically greater than anything you receive in the vaccine. penn and teller did something once, they were able to get about 300 people in california.

california maybe doesn't count, but they were able to get 300 people in california to sign a petition to ban dry hydroxymonoxide. they were able to get people by giving it its chemical name. and they never lied, which was a great part of this video that they did. they said it's in our tears, it's in our streams, that works. chemical names sound bad. >> context is everything. >> i could have said that one of the things that we have in the film is we showed that vaccines go back at least a thousand years. it was a traditional form of therapy that people used to do. and we explain where that comes from. and i found that astounding. i didn't know that. so if you're introthings that have traditional focus, i think that's interesting. i also think there's another false polarity here.

that's an artificial divide. thoef all of these posters saying they don't have to be it at all. that's the conversation. we're unofficially making that a divide. >> question over here. >> i'm allen kotock with science and enterprise. welated la related to this discussion that you just had, do you see any correlation between the fears of

genetically modified organisms and food? and some of the engineer ed molecules you find in vaccines? >> i think that's the point. yes, is the answer. so for example, the hepatitis b vaccine is used with dna technology. i think it's great for that reason. you take a single protein from the virus. you basically use, in this case, a yeast cell to sort of serve as a little factory to make that protein. and then you purify that protein. it's virtually a hundred percent purely one single surface protein. it can't possibly reproduce

itself. it's not the virus, it's just that one part of the virus. what could be better? foods are genetically modified all the time. they're just genetically modified in the wild. what you're going to do is create a situation where you're going to get the best fen fit from the harm. use the following terms. they use the term vaccine virus. but for the fach ral virus, they don't say natural virus. they say wild-type virus. what it says that in the wild, it could do anything. wild-type viruss reproduce themselves thou saps thousands of times in your body.

it's this sort of notion that it's man against nature and nature is all good. i don't know what planet people are living on. mother nature can kill you and you want to make sure that that doesn't happen. >> good morning. i want to know what works as we move forward. how do we make -- how do we get to a place where we reinforce positive behavior or a way to move forward with this. my hopes is that we can jump start getting more children vaccinated and healthy. could you comment on that and give it some positive stories as

you move forward after your film? >> yeah, look, i wish i had the absolute answer to that, of course. i think through our film being released last year, and obviously, the american version is next week. the australian version taught us a few things. there were many, many people who want to talk about this. we had one million facebook hits. nod one anticipated the level of response. secondly, to open that conversation with the point of difference. it was the point of difference. that we were not going to tell you what we could do,

necessarily, but we were going to invite the conversation to begin. now, that can sound like a trite statement, but it wasn't. it was very genuine. it was difficult because people came to you with stories that are difficult to hear, especially if they're scientifically not sound, you know. it's very high to leave it. you just have to engage. i'm not qualified to answer the ally complicated questions, so don't try to speak beyond your area of expertise is really pompbt. we found we got hit by a lot of the negative stuff and that was a bit depressing. after a few days, there was so much spaming going on, it

stopped the real conversation. by spaming, people dumping endless anti-vaccine messages into the mix. and what we found, they were actually miscalculating, which was depressing. we tried to keep it open as long as we could. open it up. let it run. try not to control it too much. most people just want to have the conversation and provide them with some good information. i think there's some important

parallels that we no longer exist in a society in which the situation is paternalistic, we're going to do surgery and you have no other choice. that evolution is important. they need to respect the data and understand when their doctor is saying this is really a good choice. why their doctor is saying that. that there is, in fact, a reason behind that. and to respect the fact the reason they want to know, at least in some form, where they're going to nod their head and say yes, this is a good idea.

recognizing that we need to empower them to face that process. most patients when faced with difficult treatments, like what breast cancer surgery to have, they're not saying i know everything. they're coming in with questions in mind. they're k078ing in knowing i'm not an expert and want to figure it out. we open the door for people to say here's what i want to know. >> we were also really surprised and astounded by the amount of action that we got to the story. there's some evidence out there

that show a lot of people are delaying vaccines, not spacing them out because of fears. and i think what we've all run into people, or many people have run into people who have at least heard from somebody who is concerned about the safety of vaccines. i think it's a topic that many people are interested in. if someone comes into yur office and says i've done my research and i've chosen not to do the chickenpox vaccine, they haven't done their research. so what does doing the research mean? it means they've raed people's opinions on the internet.

but what you need to do is real the several hundred articles about the vaccine. you need to understand how that vaccine is made and what are the differences between that virus and say the wild-type virus, what's the safety and efficacy. to do that, frankly, you need, at some level, a background in virology or microbiology. so what they really do is rely on panels of experts and advise as to whether that vaccine should be given and why. but that's extremely hard. it's an impossible message to sell in the 21st century. trust us, we're experts. so that just doesn't work.

what imformed means is a tough one. >> paternalism meant you would have surgery. in today's world, even if we don't do that, medical professionals do have a responsibility to help guide someone through the process of thinking about something. i's not just it's your choice, go away.

we need to draw upon our own knowledge and our own expertise to guide them through that process. even if ultimately, you're going to turn around and say it's your choice to do. it's not that you're going to read whatever you want and think that that is a full understanding. >> one thing that gets forgotten is doing nothing is a choice. the choice not to vaccinate is a choice to do nothing. and it has its own risks. i think one of the messages is that doing nothing is a risky choice. by enlarge, one thing parents didn't often understand is if your child gets one of these diseases, for the most part, there is no cure. there are treatments and lots of

interventions we can do today, but there's no cure. modern medicine, i met one family from switzerland whose 17-year-old daughter got measles. they didn't agree to be in the film. they were quite a wealthy family in switzerland and their daughter got severe measles and long story short, she was taken to one of the most fancy hospitals in europe. and she died at 17 from measles in 2011. there's nothing this family could do to save her. nothing. the best medical technology in the world could not save her.

>> i have to say that that understanding is clearly one of the things that drives the medical professionals in the film. i think we have time for two more questions. >> do you see a. >> do you see any difference in perception between aadulthood children vaccines or shingles and influenza?

>> i think as a general rule, pediatricians are much better about making vaccinations a part of routine care. for adults, certainly influenza rates have gotten much better over time. >> as a general rule, the uptake among adid you wants is pretty whoaful. we're not as good for adultss as we are for children. for whatever reason, we're less passionate about it. >> for an adult vaccine, you're doing it to yourself. right? if you hear information about risks, you're taking it on for yourself. we all protect our children more than we protect ourselves.

and that's part of the reality here is that we will look at our children as vulnerable as people who need special protection for very good and appropriate reasons. but that means just simple side effects of your arms are going to hurt, has a different emotional meaning than when we're talking about ourselves. that makes the conversation more difficult. it has to come to the surface. >> hi, linda cramer with "glamour" magazine. all the story telling focuses on mothers. so what does the research show about the father's input and have you noticed any generational trends, millenials

parents, more or less likely. >> i admit, i don't know a whole lot on the gender issues that you know about. i certainly know about childhood medical decision-making in general. it is more often the mother who is involved. but that is, to some degree, an issue of availability with generations and i do believe that that's evolving over time as more fathers become the primary care giver of their children. the generational issues are important for many reasons. the experience issue, in terms of what have parents actually seen in their lived experience. but, also, in terms of the way in which parents gather information, right?

my generation uses the internet different than my daughter's generation does. gli'd like to say from personal experience, my wife is the one that -- i'm the one bringing them in because she doesn't like to see them suffer. they tried to pgive my son a sht and he ran out into the parking lot and i had to chase him down. i just want to say, a little bit more seriously, from a generational standpoint, this is touched upon before, this is really unquestioning.

it was close enough to the gem ration that they saw the effects. so, you know, if you look back at the media coverage from the time of when jonas alk was a hero, really. and it was in michigan where they made the announcement and there was a famous quote from him. ole mean, really, it was viewed as heroic from, you know, people that i've interviewed. and i do often just quick ly -- i've never seen a problem in the documentary that hilts home.

my experience was it did impact on a negative way when the human papaloma virus in 2006, i actually spoke at my daughter's high school, she was in eighth grade at the time. it was the most harrowing talk of the time. i asked them how many had gotten the hpv vaccine. act half raised their hands, and i asked the other half why it was that you didn't get it. i personally said they didn't see the same thing. the notion was that this would then increase their likelihood of having sexual activity. my daughter was 8 years old, i told her she could date whoever she wanted whenever she wanted, she just had to wait until i was dead three days. >> can we go to 11. so that reminds me of something that i actual hi wanted to ask sonya.

so you made this film, initially, for the australian market. and then we brought you over here and you essentially remade it for the united states. so i guess i'd like to ask you what did you discover coming here and beginning to cover the story and the american context about what's different and which stories were perhaps more important than the u.s. and perhaps less important elsewhere. it covered a lot of stories in europe in ukraine and india and we had a very different kind of stunt. so the view that we took in the original was to keep it very global even though there was about 30% australian stories. we do keep it very globally focused in the ease in which debris spreads. the american context is quite different.

you can choose to vaccinate. as we put it, we have the carrot, not the stick. so you get the child benefits and so forth and you can get child baby bonuses and things. and, in our country, our vaccination rate is sitting at about 93 pnt. so it's higher than here. there are different issues. what i learned about the american situation was that it's more passionately debated here. it's more devicive in some ways. i think the issues, in our country, the issue of autism and mmr, the measles, mumps, rue bell la vaccine is over. it doesn't really warrant big discussion. most parents have made the decision that that's been put to bed. we had to explore that in more detail for the american audience because that's still a live subt here. hpv is very high.

i think it's 80%. which is it? hpv? >> hpv, for girl who is have completed the series is 38%. for boys who have completed the series it's 14%. so for girls, it's around 80%. so it's much higher. there are different forces at play. i think the distrust of authority is greater here in some ways. and this ability -- this idea that you can trust your own opinions and your own research is more dominant in terms of psychology here. so that's all been very interesting to explore that. at the same time, you know, the vaccine-he has tent moms are very brave and great. i said we won't ridicule you, we just want to show your story. they were so frank and so forthcoming and i'm very grateful to them. i'm not sure we got quite the same thing in australia.

i think, most importantly, though, is we can't affect beyond sort of the emotional issues and the scientific issuings, there's also the sort of issues of convenience and realities of how easy it is for parents to get vaccines or not. medical coverage in our country is free, so we've got completely different kind of forces at play. i do think somebody in europe once said to me, there are the three cs of vaccination. and it was confidence, complacency and convenience. if you're very complacent about the disease and it you think it's in the a threat, that's going to play a role. your government, your medical

system sets up in a way to make it easy for you to go and have your children vaccinated, then all of those things influence whether or not you will. so it's not enough just to blame things on parents, there are systems in place that also inform that. does that answer your question? >> yes. >> one more question and then we'll have to wrap up. one more question that's quite self of serving on my part. i understand you have mentioned that milva will have some pieces around what other states have done as far as legislation. if you could speak to that or if joe has a sense of that, i'd appreciate it.

>> there's the broadcast goes out in a week on the tenth. but, in addition, there are extensive materials on the web site. they infer articles on a range of topics. there's an extensive effort to keep the story going and create resources for parents and others who are interested. >> one of the things i would encourage people, if you're interested in this subject, if you've got members of your family or community who are nervous around vaccines, i think it would be really useful to have networks to sort of have that confers during this time. there's a window where you can suddenly talk about things that you can suddenly sidestep.

one of the things i was surprised by is there are people who just avoid the issue and don't talk about it. here comes a window to talk about it. if you use your networks to open that up, that would be really terrific. >> let me just ask the panelists if they have any concluding thoughts or things that we'd just like to add before we have to wrap up. >> it's a choice to take a different and more serious risk. and the time has come actually where we need to explain ourselves better. for my parents' generation, vaccines were not something you had to convince people nor people in my generation. i think you need to explain to them what it means to not get a vaccine.

and you have to be willing to step back and realize this is not something that easily sells itself anymore. i think you have to make it clear why it's so important to use this. we have to be patient about making it clear. >> so i hope someone says the next time i don't believe in vaccines saying it's not about faith, it's about science. i now ask why. and it opens a whole different conversation so i'd encourage people just to ask why if you hear that. >> my last message, we tend to focus in health education about providing facts. but, in my line of work, context is everything. we need to help parents -- we need to help the policy discussions understand the context of vaccination.

the context we were just reminded of is helping people to imagine life without vaccines will be different than life as it is now with vaccines. 70 years ago, parents said things like, no, son, you can't go to the pool today because of the epidemic. if we move forward and do not as a society maintain vaccination rates, we open the door to a different kind of life. to a return back to a life in which parents have to fear, parents have to think about these types of questions in their day-to-day life. and it's that kind 06 choice that we need to remind people of as they're considering weighing all the elements of the vaccine picture. >> i was just going to reiterate

the point about what can be done. there have been state legislatures in dichbt parts of the country that simply just make it more difficult to opt out and it's not only a matter of making it more difficult. but most of that, from what i understand, most of the ways this is done is if you want to opt out instead of just signing a form and giving it to the school principal, you have to sign a form and give it to a med can professional and then they sign it after you have the confers and then just that extra step makes it more comfortable. they would rather just go ahead and get the shots. so that does seem like it's

working in some states, according to early returns. >> i'd like to thank you all for coming. i'd like to thank the panel igss for an interesting discussion. and i'd like to thank the club for sponsoring this bereaving with us. as a reminder, you'll be able to see a web cast of this session in the next few days and you can follow the conversation about the film on twitter with a hash tag at vaccines nova. and, again, thank you so much for coming. >> our campaign 2014 coverage continues with a week full of debates. live coverage for the u.s. senate debate with republican

shelly moore capido and its secretary of state.

well, thank you, kevin. it is a huge privilege to address this conference as foreign secretary of our united kingdom. [ applause ] >> and, to be frank with you, with everything else that's going on at the moment, the foreign office is rather relieved not having to add scotland to its list of responsibleties.

let me start by introducing my fantastic foreign office ministerialty. the house of lords, joyce endly and whip anne milton. our inday penceble damien collins. please, give them a big round of applause. [ applause ] >> and i can tell you that i have inherited a foreign office in great shape. ministers visiting countries from australia to somalia that labor had forgotten even existed. the language school reopened and their invidious culture of immediate i don't careerty replaced once again by diplomatic excellence. and all of that is due in no

small part to the commitment and the determination of the man who will surely go down as one of the truly great british foreign secretaries, william hague. [ applause ] [ applause ] >> people rightly credit william with many exceptional qualities. i have to say looking back over this summer, i'm beginning to wonder if he's collar voirnt, too. he's a very hard act to follow. and i have to tell you, i take some small comfort in the knowledge that there's just one thing i have that william doesn't. [ laughter ] [ applause ]

>> he has left in our country a fantastic legacy and i am determined that i will build on it. it might be called the foreign office rgs but i want them to think of it as the british office. their job is to back for britain, protecting our security, standing up for our values and pursuing our prosperity, playing a vital role in the conservative plan to secure a better future for britain. and, by the way, by the way, that includes securing the future of britain's overseas territories. with a conservative government, there will be no sell-outs, no back room deals, no betrayals of jill bratter or the faukland islands. we will defend their right to

remain proudly british for as long as that is their wish. in this uncertain and dangerous world, conservatives never forget that the first duty of government is securing our nation from external threats. and, over the course of this summer, we have seen our national security challenge on multiple fronts. russia's aggression in ukraine, the bar barty of isil, civil war in syria, crisis in libya, conflict in ga sa and ebola in west africa. we know we cannot turn our backs on the world. when disaster strikes, we have the comepassion to act. when our values are threatened, we have the confident to stand firm. and when evil rears its head, we have the courage to con front it. [ applause ]

nowhere is that courage going to be needed more than confronting isil. they are the antithesis of everything we stand for. and left unchecked, they would transform suedes of territory into a haven for international terrorism. a threat to millions of people in the middle east. muslims, christians as well as our own citizens at home and abroad. an affront to humanity that we must defeat. and britain is one of the world's major military powers. and we could not in all conscience standby as others confronted this menace while we looked the other way.

it is right that britain burdens its share and we should be proud that we are doing so. so let us salute the bravery of our armed forces who once again are putting themselves in harm's way in the interest of the nation. [ applause ] of course, it's about more than air strikes. our strategy is comprehensive. political reform in iraq, humanitarian aid for the displaced, weapons for the kurds and a concerted international effort to cut off isil's funding, disrupt the flow of foreign fighters and deal with jihad attempting to return to these shores.

isil must and can be driven out of iraq. in syria, we will continue to support the modern opposition who have bravely taken on isil as well as the south. but they cannot win this fight alone. so we are backing the coalitions air strikes in syria. clear that the way to peace in syria lies in the defeat of isil, the removal of aaad and the negotiation of a political settlement. and those who say to defeat isil we must do a deal with asad, i say you are mistaken. it was asad's brutal war against his own people that allowed isil to take root. he is the root of the problem and cannot be part of the solution. [ applause ] a few hundred miles to the north, we face a very different challenge. for decades, britain stood firm

in the face of the neurocollar threat from the soviet union. shoulder-to-shoulder with our american allies until we achieved freedom over communism. and in the 25 years since that . offering investments, trade, and partnership. but by his illegal annexation of crimea, by supplying the missile that murdered 298 innocent people on flight mh-17, and by sending russian troops into eastern ukraine, putin has torn up the rulebook and chosen the path of confrontation. we should be proud that britain has led the way in securing far-reaching sanctions, sending the message that russia's illegal behavior will not be tolerated. [ applause ] and neither will we allow our

nato allies in eastern europe to be bullied. let me remind mr. putin that a threat to any nato member will get a response from us all. that's why we sent our fighter jets to the baltic earlier this year, and we will do it again if we need to. [ applause ] because nato and its principal of collective self-defense protected us through the dark years of the cold war, and it will remain the cornerstone of our defense policy today and going forward. [ applause ] serious though these challenges are, and right that it is that our national security should be the number one priority, our foreign policy must also support our long-term economic plan, and protect our national sovereignty. under this government, our embassies around the world have

a clear mission, to break open markets, attract new investments, boost british business, create british jobs. and it's working. our worldwide exports are up 28% since 2009. but nowhere is the need to secure our future prosperity and to protect our national sovereignty clearer than in negotiating a new settlement for britain in europe. [ applause ] nearly four decades ago, like millions of others in britain, i cast my vote, my first-ever vote, in favor of our membership of the common market. and like millions of others in britain, i have watched aghast as that common market has morphed into an institution with the aspirations of a super state, pushing ever closer union, imposing red tape and

regulations, giving powers that properly belong to the nation states. that is not what i voted for in 1975. it's not what the british people signed up to. and it's not the way to build a competitive europe in a nation of nation states. [ applause ] reform there must be. and i'll be perfectly frank with you, i've always been prepared for the possibility that britain would be alone in arguing for it. margaret thatcher used to say, there's no shame in being in a minority of one. so long as you're right and all the others are wrong. [ laughter ] [ applause ] but the fact is, we're not on our own anymore.

slowly, but surely, the others are coming around to the need for change. and to those who say it will never happen, i say, under this government, it has already started. after 13 years of labor surrendering sovereignty to brussels, signing away power after power and treaty after treaty, casually giving up 7 million pounds of the rebate so hard won by mrs. thatcher, for the first time, by standing firm and making the arguments, we started to reverse that trend. david cameron secured the first-ever cut in the eu budget. we've got britain out of the bailouts, delivered the biggest reform ever of the common fisheries policy. and a referendum to the powers going to brussels. we've done all that, all that, in coalition with the most

brussels-loving bunch of europhiles you could ever wish to meet. [ applause ] just think what a proper conservative government could do. [ applause ] i've met my european counterparts, reform has to happen, because the current system quite simply has run out of road. they know that the eu will be weaker without britain. and so they understand that reform must address the british demands set out in the prime minister's bloomberg speech. because our referendum pledge means that reform has to be substantial, it has to be irreversible, and it has to satisfy the british people. so my political priority between now and next may is to lay the

groundwork, to marshal our forces and build up our battle plan, to cajole and convince every eu member of the need for change, and change that works for britain, so that when we wake up with a conservative government on may the 8th next year, we will already be in the best position to get the best deal for britain in europe. our goal is clear, a europe where powers flow from brussels back to nation states, not the other way around. a europe of free movement, not free loading. a free europe of cooperating nations, not a european superstate. a europe of open markets and free trade agreements with the world beyond. a europe that can outcompete the best in the world without red tape and regulation weighing it down. but most of all, most of all, a europe on which the british people have had their say. [ applause ]

because when it comes to the election next year, there will be a clear choice. an in-out referendum in 2017 with david cameron, or no say under labor. we conservatives trust the people, and only we the conservatives will deliver that referendum. no ifs, no buts. [ applause ] so whether it's european bureaucracy, russian aggression, islamic extremism or syria's civil war, we have a plan in place to deal with the threats to our competitiveness, our security and sovereignty today, and to build a better future for britain tomorrow. after four years of conservative government, we have a success story which we should tell with pride. britain is once again an outward

looking, self-confident nation, building economic success at home, and walking tall abroad. with our partners around the world, we will defeat the threat from isil. we will stand up to democracy in ukraine. and as a conservative government, we will deliver that referendum. so when it comes to may the 7th next year, the choice will be stark. ed and labor, offering a bigger deficit, a weaker economy, a shrinking international presence, and no say on europe, or david cameron and the conservatives delivering growth, jobs, a stronger britain, and that vital in-out referendum. conference, our message is clear, britain cannot afford five more minutes, let alone five more years of labor. only the conservatives will secure a better future for britain. thank you.

[ applause ] c-span's campaign 2014 coverage continues in just a moment. with live debates across all three of our networks. beginning at 7:00 eastern over on cnn sparks, the senate race between natalie tennapt and representative shelley capito. on c-span2, we'll bring you virginia's debate between mark warner and the former chair of the rnc ed gillespie. here on c-span3, live, next, the governor's debate in massachusetts. the battle for the open seat there, including state attorney general martha cokeley and

businessman charlie baker. also independent candidates, evan falchuk, scott lively and jeff mccormick. patrick decided not to seek reelection. from springfield, massachusetts, this debate is courtesy of wbez tv. good evening. welcome to the wbez gun nor tor yal debate. i'm jon keller for webz. welcoming our listeners, and