it was the exact same thing that georgia did in 2005 and that congress said in the house report when it reauthorized section 5 in 2006 -- >> if that turns out to be wrong, i guess you're still not guilty of using race. you're still trying to comply with section 5 as opposed to being racist, right? >> that's exactly right. they did make intentional discrimination claims -- >> if the district court said that race was not the purposes, in the district court's view, what was the plan? >> i don't think there's a need for a district court to identify any one -- >> i'm asking in this case what did they say? wasn't it the assumption they wanted to assure preclearance under section 5 and for that reason used race. so when you say the district court said, well, race was not the purpose, it was close to the purpose because they were trying to use section 5 and use race

for that reason. >> well, it was certainly -- >> that's a very fine distinction. >> well, it was certainly a purpose that went into the majority district but it was not the predominant motive. >> i understand that. don't you have to use race to comply with section 5? >> that's right. >> is there any way to comply with section 5 without using race? >> there is not. >> but you don't have to use race in this way, mr. brasher. nobody would say that section 5 required you to maintain a 78% district and a 78% district was no longer needed with respect to a group's ability to elect a candidate of choice. >> i respectfully disagree with that. once again, we followed the same preclearance strategy that georgia followed in 2005. congress made a record in 2006 to try to reauthorize section 5. georgia's plan from 2005 which kept all their majority black districts all the same was a good thing. we did the same thing in this redistricting cycle that other states did, we did the same thing that the plaintiffs did

when they were in charge of the legislature in 2001. there's been some inconsistency on that. the only difference is that they tried to hit targets from the 1993 plan as they were in 1993 and with simply tried to keep the districts the same from 2010 to 2012. >> could i follow up on justice briar's exploration of what would happen if this was done over. i assume that section 5 would not be a consideration, so long as a new coverage formula is not adopted by congress. is that correct? >> if the legislature were to pass new plans, i don't think they would have to comply. >> the legislature could do whatever it wants if it relies purely on partisanship rather than on race. >> that's correct. >> to what degree would the legislature be justified in doing and to what degree would it be required to take into account the degree, if any, to which section 2 imposes something like a retrogretion

requirement? do you know what that might be? >> i really honestly don't know how section 2 would necessary apply in this circumstance. by it complying with section 5, we necessarily complied with section 2 because it's a lesser standard. i do think -- the fact that we could have done -- if the plans were vacated, they're very likely to be the same planned reauthorized -- >> what would happen if on a do-over, the objective was to produce maximum republican representation in both houses of the legislature. and the way -- and in doing that, there was a drastic reduction in the number of african-american senators and representatives. would that be a violation of section 2? >> not necessarily. obviously be a lot more that would go into that analysis whether that violated section 2. you would have to look at each district. this plan actually gives

proportional representation to black voters in alabama. they're 25% and they have about 25 majority black districts in the house and about 25% majority black districts in the house and about 25% black districts in the senate. this plan meets section 2 in that regard in the sense that it gives proportional representation. i do not know what happens if the court were to vacate these plans. to go back to the 2% deviation, these are very sophisticated parties on the other side of this case with very sophisticated counsel. the reason they never proposed to do this is because they know 2% deviation here prevents them from changing districts. it would be very simple the 2% deviation was adopted at the very beginning of this redistricting process. so the plaintiffs had a year while they were on the committee, the reaporschement committee to come up with a new plan and they came up with a new

plan. then we had a year of litigation to come up with their own 2% plan and they didn't do that. that's what the district was getting at when the district court said -- race did not predominate because we followed race neutral redistricting criter criteria. you fwhee this case is really about, it's about the 2% population -- >> you're suggesting there's some necessity for a 2% plan but there is none for 2% plan. states are routinely gone up to 10% without getting into trouble under reynolds. that can't insulate your plan from this challenge, can it? >> i think it is for this reason, we're in charge of adopting a race redistricting cry tear many. if they want to prove that race predominated in the plan the first step of that and certainly the easiest way to propose some other way. and they haven't proposed any way to do that and the plans they did propose, even though

they're 10% plans are very, very similar in many of these majority black districts. not only have they not proposed a 2% plan, that's our criteria, the plans they did propose are not that different. at the very least, the fact that the plaintiffs have never proposed any way to do this redistricting that meets the state's, underscores you cannot find that the fact finding here was erroneous. i think the court should affirm on that basis. let me address the issue of remand for a second here. united states has said that the court should remand this case, but the united states position on that is internally inconsistent because the united states agrees that the population percentages alone in the districts are not sufficient for the plaintiffs to met their burden of proof. but that's the only evidence they introduced about these districts. that's why the district court said, the best i can tell, these are state-wide challenges. the only evidence in the record, whatever they may have said, the only evidence in the record about these districts was just

population statistics. >> you would look at the complaint, when i look at the complaint, i suspect i'll find something about districts. it is certainly true that taking the u.s. point of view, it's quite clear to me that the court decided on the basis of the state-wide plan. so if it's wrong about that, then they ought to have a chance to go back and make their claim district by district and have a decision on that basis. >> well, once again, i don't think they may have brought claims with respect to their own individual district. i don't think they do. if you look at the complaint, i don't think you'll find that. even if they did the only evidence they introduced about any of these districts are the statistics alone. the united states agrees with me that that's insufficient for them to meet their burden of proof. i don't see how you can reverse the fact finding as erroneous that race didn't predominate. all they introduced was statistics. it would affirm. unless the court has any other

questions, that is mine. thank you. >> thank you, counsel. you have two minutes remaining. >> thank you very much, chief justice. >> on that last point, earlier one of the two of you said that if you looked at the division of precincts, it was done on the basis of this policy. in almost every district, was that shown? >> we introduced all that precinct splitting information below. in document 196, some of which is reproduced in the briefs, we made exactly this point, yes, your honor. >> what other evidence did you present? >> your honor, the key fact we presented, i think, that hasn't been discussed here is that the alabama constitution prohibits the splitting of counties.

and they say they had a supremacy clause obligation to meet these racial targets. that meant they could override the alabama constitution's protection of county boundaries and all other state traditional districting principles. the 2% rule works the same way. if that's actually a federal constitution requirement, they can also override the key protections against partisan. the county boundaries or political subdivision boundaries and it means they can manipulate the all-important county delegations in the alabama legislature by breaking them into multiple districts and deciding who runs the county by putting their district in there. now, a second question we answered that i think has been very important in this discussion and by the way, i don't want to lose track of the fact that on remand, the alabama legislature will have to comply

with the whole county provisions or at least they can't use this federal excuse to split them. the way most states do this is they either start with traditional districting principles in the core of redistricts districts and look to see at the end, have we maintained the same majority/minority districts. or if they start with a number at the beginning, which they're not required to, they ask what's necessary in current conditions to preserve the ability to elect today. that's what alabama did in its 2001 submissions. it actually said that the number for the ability to elect was a 55% black voting age population. that's in its official submissions to the united states. >> thank you, counsel. the case is submitted. >> as director of the national institute of allergy and infectious diseases, dr. anthony fauci heads the effort to

prevent the spread of ebola. he talked about development of a vaccine. this is an hour. good afternoon and welcome. my name is myron belkind. i'm an adjunct professor, a former international bureau chief for the associated press and the 107th president of the national press club. the national press club is the world's leading professional organization for journalists committed to our profession's future through our programming with events such as this while fostering a free press worldwide. for more information about the national press club, please go to our website at press.org. on behalf of your members worldwide, i would like to welcome our speaker and those of

you attending today's event. our head table includes guests of our speaker as well as working journalists who are club members. and so if you hear applause in our audience, i note that members of the general public are attending, so it's not necessarily evidence of a lack of journalistic objectivity. i would also like to welcome our c-span and public radio audiences. you the follow the action on twitter using the #npclunch. after our guest's speech concludes, we'll have a question and answer period. i'll ask as many questions as time permits. now it's time to introduce our head table guests. i would like each of you to stand briefly as i call your name. and then i will begin by saying, from your right, adam spencer, washington, d.c. corespondent for news beat social and new national press club member. jared rizi, white house corespondent for sere yus xm satellite radio.

marilyn thompson, washington bureau chief for thompson rotors. paul shingman, national reporter third generation member of the national press club. virgil dickson, reporter for modern health care and another new member of the national press club. david evans, executive districter of the national science teacher's association. jerry, washington bureau chief of buffalo news, chair of the speaker's committee and former national press club president. skipping over our speaker for a moment, doris, president of editorial associates and the national press club member who arranged today's luncheon. thank you, doris. diena, editor of health and medicine, scientific american. todd gillban, washington bureau chief for the washington morning news.

care row lin block. vince. combat news chief for air force. [ applause ]. dr. anthony fauci is an authority on ebola. the health crisis that has devastated parts of west africa, sickened or killed many health workers and called into question america's preparation for an epidemic. dr. fauci is director of infectious diseases part of the national institutes of health where he has spent his career. he became a public figure for his role in understanding hiv and aids and for his involvement in developmenting an hiv vaccine. he received a presidential medal of freedom for his work on hiv.

of late, development fauci has been swamped with requests from the medical community, media, legislatures and the public for his guidance regarding the ebola outbreak. typically he does not sugar coat his assessment. last week he said, quote, the war against ebola is far from over, unquote and cautioned that outbreaks can come in waves, receding and then resurging. the virus continues to make headlines, such as nurses strike to demand better training and safer clothing for dealing with ebola patients. congress is considering a multi-billion dollar boost for ebola prevention and treatment. scientists and governments debate the development and testing of vaccines. infected health care workers in africa are being flown to the u.s. for treatment. public disputes about mandatory isolation rules. we've had dr. fauci to address

these and other issues of the ebola outbreak. ladies and gentlemen, please join me in a warm, national press club welcome, for dr. anthony fauci, director of the national institute of allergy and infectious diseases. [ applause ]. thank you very much, myron. it's a great pleasure to be with you here this afternoon to discuss this extraordinarily important global health topic that has captured the imagination, fear, concern and mobilization of people throughout the world. i want to spend our time -- and i'll be relatively brief because i know one of the best things about all of this is giving you the opportunity to ask me questions -- so i want to break up my remarks into four major areas. first of all, some background on

ebola. i know you've heard a lot about it. i want to point out of sail yan features. the status of the current outbreak in west africa, ebola in the united states and finally what we're doing in the form of countermeasures for the development of therapeutics and potentially and hopefully a vaccine. so let's start off first with some background on ebola. as some of you may know, ebola was first isolated and recognized in 1976 in the former sigh year, current democratic republic of the congo. very soon there after, within days of sudan, since 1976 there have been 24 outbreaks not including the current outbreak. these have been of varying sizes with the totality of the outbreaks put together about 2,400 people, which means that the current outbreak in west africa is more than all of the

other 24 outbreaks combined. and we can talk about why that's the case. these outbreaks have been anywhere from two people to several hundred people all of whom have been contained and eliminated and suppressed by public health measures of identification, isolation and contact tracing. i'll get back to that in a moment and why the situation now in west africa is very different from those previous outbreaks. so, what is ebola? ebola is a virus member of the a family called fee low viruss. f-i-l-o. if you look at it in a micro scope, it's an ugly looking virus. they have these filaments that look rather intimidating from someone who has looked in the micro scopes for viruses over so many years. it's one of the ugliest ones that i've ever seen. the transmission cycle, we know

what happens from human to human, but there are still some unanswered questions. it exists in fruit bats and certainly infects non-human primates. it kills off these non-human primates intermittently. it jumps species as some, if not most of emerging microbes do. it's fundamentally an animal virus. it's not fundamentally a human virus that stays in the human population. it bleeps up in these outbreaks that i told you 24 of them and we're in the middle of a massive one right now. and the way it gets there is really not clear. eating animals, touching them, slaughtering them, preparing them for food. but once it gets into a human, it's transmitted only by direct contact with the bodily fluids

of an individual that is sick. we'll get back to this. this is all the concern, the argument, the debate about who can and cannot transmit ebola and why health care workers are the people who are at the absolute most risk as are people in a family who take care of an individual as are people who handled bodies because the actual burial ceremonies when people touch bodies are one of the most important ways it's transmitted. so, we want to keep in mind unlike influenza, which is transmitted across parts of rooms by air sol, that you can't even see, ebola is transmitted by direct contact. when you say bodily fluids, it's a uf michl, diarrhea, vomit, blood when people cough up, that's what we talk about when we say bodily fluids. it's incubation period is

anywhere from 2 to 21 days. the mean is right around 8 to 10 days. and by incubation period means that if i get infected now by working with a person, somewhere between 2 and 21 days i'm going to get sick, very likely around 8 to 10 days. once i get sick, i start to feel flu-like symptoms. at that point, it is unlikely that i'm infected. 90-plus percent of the times you get a fever, then you start vomiting, coughing, bleeding, diarrhea and it's that that causes the trance misability. that's the background of ebola. it's a very serious disease. the mortality depending on the strain, there are five separate strains. the one we're dealing with now is ebola zier. there are other names to them, sudan, et cetera, et cetera, not

important for the purposes of our discussion. if you get infected with one and you recover the fact is that you are protected against that strain forever. so let's focus in on the outbreak in west africa. it started likely from contact with an infected animal. if you do molecular tracing, the first case was probably in a child in beginny in late december of 2013. we started to notice it as an outbreak in march of 2014. now, the thing about this that makes it different and why we had the explosion of cases -- i wrote a paper a few months ago in the -- actually last month in the "new england journal of medicine" and the title of the paper was "ebola in 2014, a perfect storm" and a good example of the discrepancy and the disparity of health care capability in these countries.

you wouldn't get an outbreak in a country if you could do good contract tracing, if you could isolate people. what happened is somehow this child infected people in a cluster of countries that was very different from the far out geographically isolated areas of the previous 24 epidemics where you can actually isolate very easily. if you look at a map of west africa, beginny wraps itself around liberia and sierra leone. the tribal relationships are very close, so people go across the borders. the borders are very easy to go across because people work in one country and live in another. also, it got into the big cities. and when that happens, you have a problem. so we had an explosion. they were about 14,000 cases, 5,700 deaths.

that's probably an underestimate. when we were talking about the changing demography of it the number of cases are going down in liberia, but they may actually flair up in the outskirts because monroe vi is where most of the cases were. as that's happening, the cases are going up in sierra leone. so when you look at the epidemic as a whole, one can say, without a doubt, the cases particularly in mon robe ya are going down. likely because of the effort that has been put into that. however, i have said and was quoted by myron is the fact is that it is not over and we should be very careful to think that we are going in the direction of it being over. there's still a long way to go. so, that's where we are at that. something that comes up in questions, is this virus changing. all viruss that are a virus tend

to mu tate. most mutations have no functional relevance. it doesn't change anything about the virus. potentially, however, there are rare mutations that do change the function, namly, make it little bit more vary lent, or little bit less. however, in the history of viology, it's unprecedented that a virus will mutate so much to change the way it's transmitted. is it possible? yes. is it likely? extremely unlikely. yet you probably read in the papers about the concern that it's going to change into a respiratory virus, spread over and destroy the world. now, as a scientist and as a physician, i cannot say that's impossible, but i can say it's very, very unlikely that that would happen.

it may change a bit, but unlikely to change so much. now, when you talk about how it's transmitted and the proof of trance misability, when you look at the history, we don't want to say we know everything about the virus, but when you look at household contacts of people during outbreaks, for example, a famous one in 1995, in the households of people who were infected, the only people who got secondarily infected were people who actually touched the person who was very sick. everybody else in the household, they didn't get infected. now, that is strong evidence that you don't get it by casual contact in the sense of being in the same room with someone without necessarily touching them and coming into contact. now, is that 100%?

nothing is 100% in biology, but the evidence is pretty strong. okay. so now let's talk about ebola in the united states. when you think about ebola in the united states, you should think about it in five separate issues because it gets very confused and i believe strongly that's the reason for the concern and what i have called the epidemic of fear in the united states. the first situation where you can have ebola in the united states is when you deliberately air evacuate someone to take care of them in the united states. and we've done that with dr. brantly, with salia and unidentified person. we put them on a plane and brought them to a hospital here. it was either at emory or it was at nebraska or other places. the second is the inadvertent

importation of someone who gets sick some place else, doesn't know they're sick, and comes here and the illness is manifested here. we have two examples of that. thomas duncan who went to dallas and craig spencer, the new york physician from columbia who got sick over there, came back here and when he realized he was sick, he got admitted to bell view. the third is secondary spread from an inadvertent case. there isn't any. so craig spencer didn't spread it to any, so there's no cases. the other, health care workers in the united states who have taken care of patients. and we have two of those. nancy fam who i had the privilege of taking care of myself at the nih and amber vinson who was also infected and taken care of first at dallas

and then at emory. and then lastly is the secondary spread from those health care workers. and there's been none. nina pham did not spread it to anymore nor did amber vinson. you have to be careful when you talk about ebola in the united states. you have to be talking about do you bring it in or is it spreading insidiously, and it's not. i would be happy to discus that in the questions that we have. so, what about the issues of how do you protect america? do you ban travel? do you do airport screening? do you quarantine people who are over there? or do you quarantine all health workers who have come into contact? that's a debate that's going on. as we've said and i've said publicly decisions are made based on scientific evidence and experience. let me tell you what's going on.

there's both exit screening from west africa. someone comes up to get on a plane in liberia, sierra leone or beginny, they are questioned as to whether or not they feel sick, their temperature is taken and then they are asked if they've come into contact with anyone who has had ebola. when they get on the plane and they get off the plane at one of the five airports which are the only airports that people from that part of the country can come to, they have what's called entry screening, same thing. temperature taken, questioned if they have any symptoms. if there's any question, they get put in a separate facility. watched. let me give you an idea of some of the numbers. is there a large influx of ebola people infected with ebola who are trying to get in the united states? the answer is no. if you look at august and

september of 2014, 36,000 people went to the airport in one of those three countries to get out. of those, 77 were denied because of a health reason. of those 77, none had ebola. most had malaria. so, yes, duncan got into the country, but that was a very rare event because of what we know now when we do screening. so the question is, how do you balance the issue of keeping america safe at the same time as you don't do something that might be so draconian, for example, as to cut off a nation from help, namely isolate them which we know from talking to the leaders in those countries, that to them would be devastating to do that. what do you do about the many, many health care workers that we need to volunteer to go over there to help? what do you do when they want to

come back? do you quarantine them or do you institute a system where, as we've discussed it publicly many times, where you stratsfy the risk of that person having gotten infected with the way you monitor and/or restrict their free movement? so let me explain what we've done. we being the government in the sense of the cdc, nih, fda, the department of homeland security, et cetera, are all working together. you divide it into four levels of risk -- high risk, some risk, low but not zero risk, or no risk. an example of a high risk, health care worker is one who accidentally sticks themselves with a needle that was contaminated. that's a high risk. or someone who was working with an ebola patient, didn't have the right equipment.

that's a high risk. if you're a high risk, you are directly monitored. someone will take your temperature every day for 21 days. someone will question you how you feel and your activity is restricted. you can't get on a plane. you can't get on a subway. so we're already implementing some form of quarantine on certain people who are high risk. i don't think many people appreciate that. what happens if you have some risk? namely you took care of a person, you had the proper equipment, but you still can make some mistakes. the same thing, direct, active monitoring. someone takes your temperature, records it, questions you and your restriction will be made on a case by case basis. not everybody gets restricted. the next one is a low but not zero risk. i used to be now but i'm past 21

days, i took care of nina pham. what did i do for 21 days? i took my temperature in front of someone. i showed them the thermometer. they recorded it. if i felt well, then i could go out into society, which i did. low risk, there's obviously nothing there to do. so, let me now just move to the last part and we'll open it up for questions because i want to stay on time. what are we going about it? there are no therapies that have been approved and there are no vaccines for ebola. the reasons for that are complicated. we haven't had good industrial partners who would be willing to invest in developing a vaccine or a drug that barely exists. remember, from 1976 until this epidemic, there were less than 2,500 cases in the entire history. so there's not a lot of

companies that want to invest hundreds of millions of dollars to develop a vaccine or a drug. but we do have some important advances. what's happened is that we started a phase one trial with a vaccine at the nih up in bethesda on september 2nd. we enrolled the full component of people. it looks good. there aren't any adverse events. we've shown the immune response looks good. we're now planning that some time at the end of december the beginning of january we will expand that into what's called an ethicacy trial in west africa, in other words, to determine if it works. and that's in the process. i can't guarantee you it will work because you never can guarantee that a vaccine will work. but at least we have one that's ready to go into advanced trial. in addition, finally, we have drugs that are still

experimental. you read about all these people that had these experimental drug. there isn't a single drug that's been proven to be effective. i hope that one or more of them will turn out the be effective, but we don't know that yet unless you do the clinical trials. that's, in fact what we're doing. so let me just close by saying looking ahead, what do we need to do? what we need to do is first, make sure we keep our eye on the problem. and the problem is west africa. they are the ones that are suffering. they are the ones that have the disease. the best way to protect americans is to completely suppress the epidemic in west africa so there isn't any risk of it going anywhere else. prepare for future outbreaks. we're trying to build up the infrastructure in other

countries so that they can identify these outbreaks much earlier before they wind up getting out of control. then again the last is what i said i wrote about in the "new england journal of medicine ""where we spoke about the disparity of the health care systems in developing nations. as a rich country, as one of many rich countries, i feel we have the responsibility as a global community to help those countries build sustainable infrastructures that not only are beneficial to their own health but actually have an indirect benefit for the rest of the world to frechbt outbreaks that then wind up having a dispersion throughout the world leading to the kinds of fear and kinds of situations that ebola has brought to the united states here. i'll close with that and be happy to answer any questions. thank you. [ applause ].

>> thank you, dr. fauci. if containment of any communicable disease is isolation with the use of stringent medical treatment and protocols, why is ebola not contained and treated in the african locals? >> when you say not contained and treated, you mean it is? >> the question is why is a highly communicable disease not contained and treated in african locals. >> i'm not sure what they were -- what point they were trying to make. i'll give you a couple of versions of that. i think they were trying to say if you want to live in africa, why would you want to bring someone over here? is that what they're saying. >> i think so. >> the people we brought over, if you're an american citizen and you get sick, you have the right as an american citizen to return to your country of origin

and that's what we've done with those individuals. >> nigeria in particular was quickly able to put a halt to the spread of ebola. why was nigeria so successful in its containment efforts when neighboring countries were not? >> very good question. that relates exactly what i told to you about the infrastructure to be able to handle an epidemic. and nigeria, as a country, as a relatively good infrastructure to deal do that. much better than gunny, see yar ya leon and liberia. what happened in nigeria when a case accidentally, eric sawer, mr. sawyer went from liberia to nigeria and inadvertently, unfortunately infected a number of health care workers, several of whom died. what they did in nigeria was very effect ive contract tracin

and isolation when someone is shown to have ebola. so the whole mark of containment is identify, isolate, and contact trace. and when you do that, you can suppress an outbreak. nigeria did it very well. the other countries were unable because of their resources to do that. >> what is your assessment of the weakest points in the u.s. health care infrastructure to deal with ebola and to deal with other future outbreaks or b biological weapons? >> well, what we've learned, first of all, is you need awareness. remember, when duncan first came, he was not recognized as being a person with ebola, even though he was from liberia and he was sick. that should not have happened. but what we do need is we have to have the capability of education, equipment and a health care system -- which is actually pretty good -- to be able to handle outbreaks.

that's the reason why we started this officially and in earnest it was after the 9/11 attacks followed by the anthrax attacks, we developed a system of trying to be able to have better surveillance and better capability to respond to emerging microbes. that was to a deliberate attack. but we expanded that to say, nature itself is probably the worst bio terrorist when you think of it about the emergence of influenza so we expanded our capabilities to be able to respond in the united states to outbreaks of emerging infections. since we live in a global community, the weakest link global limb is the weakest link that might be some place else. that's why we need to build a global health security agenda so that hopefully all the other countries would have the capability of doing that.

>> you said that president ebola's response coordinator is excellent. how has he changed the united states fighting it in the united states in the in west africa? >> ron clan is the official ebola response coordinator. he's terrific. i work with him daily. the reason it was important to have a coordinator is that there are multiple agencies involved in the ebola response. there's hhs, there's the department of defense, there's homeland security, there's the state department with usaid, among others. when you have multiple agencies involved, you need some sort coordination at the white house level. doing that prior to the appointment of ron clan was lisa monaco and to some extent, suzanne rice.

both of whom have very, very important day jobs to do in addition to that. so it was felt that you needed a person who was devoting their time to nothing else but coordinating the ebola response. that's exactly what mr. clan is doing an excellent job at right now. >> the president is asking for $6.5 billion for the fight with ebola. what are the u.s. medical priorities and what will the spending on ebola do to those american medical priorities? >> the president is asking for 6.18 billion, not 6.5. let's not get carried away here. so, actually i had the opportunity with my colleagues from other agencies to defend that budget before the full senate appropriations committee chaired by senator mccull ski from maryland. the nih and i just mentioned our

work with vaccines and therapeutics, our share of that was $238 million. the cdc, which has a much broader role in surveillance and trying to get the hospital up, they had a much larger. the defense department was smaller. they moved money around, the department of homeland security had some and others had some. so it was a combination of multiple agencies, each of which had a line item request. >> now that the estimates for the potential number infected, loss of life and financial burden have been revised downward by the world bank, will the response effort from niaid decrease as well? if so, do you think this is a wise decision in trying to get the united states prepared for any type of biological outbreak? >> well, this gets back to what i had said during my formal presentation, just because numbers are going down in a particular country there's no

reason to think that we have won this battle. so we have not nor has the cdc or any of the other agencieslessened our efforts to try to contain this. we're going full speed ahead with our vaccine work and our work to develop therapeutics, everyone as the numbers go down in lie beer yarberiliberia, remg up in sierra leone. >> a few weeks ago there was a sense of fear bordering on panic about ebola among some americans. why do you think that was? and was the fear justified? >> well, i always respect fear and concern on the part of the american public. that's us, the american public. so you can't just disparage it and say, well, it was crazy to be afraid. but you can understand why. ebola is a very dramatic

cataclysmic disease as it occurs. and when you look at what's happened in west africa and particularly not so much now because things have toned down a little bit over the last couple of weeks, but remember, it was every single day that ebola was on the front page of the major newspapers throughout the country. and what the american public saw and what they saw on television was this terrible situation as it existed in west africa. so, when we had the first case here with duncan and then we had our two nurses getting infected, there was this understandable but not justified extrapolation of this is what's going to happen in the united states exactly what happened in west africa. it's an understandable extrapolation but there's no evidence that that would or could happen for the simple reason i get back to something i said just a few minutes ago, the

reason you have an outbreak in the three countries were that they did not have the medical or health care infrastructure to be able to do the identification, isolation and contact tracing. someone asked the question about nigeria. nigeria did. there was no outbreak in nigeria. so even though you can think that this might happen in the united states, it is extremely unlikely that you would have that outbreak, yet the american public understandably made that extrapolation and connection. now that we have a case in the hospital and two nurses got infected, therefore we're going to be like west africa, and that's just not the case. >> you mentioned the media -- this is a media-related question. liberal groups like media matters have criticize what had they say has been overblown television news coverage of ebola, but this week, this past

tuesday, president obama noted that the news coverage has subsided. even though the epidemic rages on in parts of africa. we believe he thinks it's still a very important story. what's your assessment of the media coverage? >> well, you know, in general i think the media coverage has been commensurate with the interest in the american people in this. and people get very interested in this and they hear it, so the media cover it. i think the media coverage was actually quite good. there are sometimes when you have -- i think the problem is we all know -- people interested in media know it better than i do, when you have 24-hour news coverage, you can make something look much bigger than what it actually is. i didn't say that's bad. that's just an effect of the 24-hour media coverage. >> thank you.

>> what are your suggestions for education and training, best practices for the u.s. health care system as a result of the ebola outbreak? many health care workers are required to take a basic ppe and blood born pathogen training as part of their employment. beyond that, what do you expect? >> that's a very good question. one of the, i think, positive things that will come about of all the attention that's been paid to ebola in the united states is that we really need to have regional capability of being able to handle outbreaks that require special kinds of medical attention, like ppes. i mean, ppe stands for personal protective equipment. you don't just put on ppe. you have to learn how to do it. and importantly, you have to learn how to take it off. because if you look at people getting infected, it is more likely that when people take off ppes that if you get something

on you with ebola, that that's how you do it. you inadvertently are very careful when you put it on and you're taking care of a patient, you're doing it for an hour, hour and a half, at the most, two hours. you're very tired. when this stuff off, and you take it off and you may not take it off properly. in fact, there is a terminology called a wattsan named after water sanitation historical issue that when i took off my material i had a trained person watching me to make sure i did it correctly an they have the authority to stop you when you do it and say, oops, you're making a mistake. stop. so those are the kind of things to train. it's not just take care of a patient. you got to be trained. bottom line answer, you have to train people. >> what can local laboratories, ie clinics, hospital labs,

physician office labs do to prepare for processing any samples from suspected ebola patients? the cdc revised guidelines to say all suspected samples to cdc but in preparing samples for transport, are there suggestions for the phases of testing for the local lab? >> right. so, that's a good question. and it isn't like suggestions that i have. there are clear protocols about how to do that. the cdc spells out very clearly how you have to handle specimens that you are suspected are infected and how you would handle that and the testing. there are preliminary tests that do not need necessarily to go to cdc. the first ones and then the second level when you really want to confirm it have to be sent to the cdc. >> there's been a good deal of public concern regarding risks associated with ebola related

waste. including medical waste as well as the belongings of the individuals afflicted. with high-ranking officials across the country stumping politically against this transport and even taking legal action to stop it, is there any merit in fearing infection of the treated medical waste and how do we alleviate mass public concerns if not? >> so i have to be careful on this answer. and the reason is i'm not making policy. i can just tell you from a scientific standpoint that when you do the kinds of contaminations that we do with waste it kills the ebola. if you do decontamination and then incinerate, it kills ebola. what you do with waste after that is a matter of contention. but from a scientific standpoint, the kinds of decontamination that is are done in hospitals like my own and the kinds of things that you do when you autoclave, decontaminate or

incinerate are really enough to essentially kill all the ebola. >> you have had extensive experience in the research of aids. has that experience been applicable to your work with the recent ebola crisis? >> scientifically, not because they're different diseases. i mean, you learn about viralology and things so there's some experience there, but i think the thing that's the real lesson is how to make sure that you make policy and you make recommendations based on the science. and to get the american public to understand the relationship and difference between probability and risk. the american public understandably and this is not a criticism, really wants to live in a completely risk free life.

yet, every day we live a life that's full of risks. the issue is, the risks have been with us for so long we don't pay attention to it very much. when a new risk comes in, no matter how small that risk is, it captures the attention of the public and they worry more about a risk that's very, very, very low than they do about a risk they've been living with forever that's much higher. so i give an example that's out of the situation of ebola. and i think you could understand it. so years and years ago in the 1980s, i think it was on ted koppel's "nightline" show when

he was on and i was asked by someone who said, we should ban gay waiters from waiting in greenich village because the infection rate is so high there and what if a waiter has a cut on their finger and brings to your table your dish of call mary and you happen to have a cut on your finger and pick up the plate that he puts in front of you, is it possible that you could get hiv? and the answer is, biologically, yeah. it's possible. but what is the likelihood of it happening? well, i can say with confidence that the likelihood of it happening is n that greenwich village rest vaaurant less thanu walking out of the restaurant getting hit by a bus. so it's a probability and risk.

you can't be 100% risk free. >> do you worry that the growing human population combined with climate change will create an environment where outbreaks of ebola or other deadly pathogens will be more common in the future? >> theoretically, yes. probably the only thing that significant climate change might impact is the range of certain mosquitos, for example. there may be malaria, for example, if you take kenya as a nation, there are parts of kenya with high elevations and when you get above a certain elevation because of the temperature you don't have mosquitos so you don't have malaria there. you could imagine if you get a 1-degree increase the malaria range would increase so much. but i don't think that that's that important because if you really have so much of a climate

change that would have mosquitos be all over the place through every season then there will be enough melting of the icecaps you won't have any coastal cities anymore so that's what you should really worry about. >> beyond the ebola epidemic, there is growing concern among many scientists that the overuse of antibiotics in farm animals could lead to the development of infections that are immune to antibiotics and therefore dangerous to humans. how do you feel about this issue and what should the federal government do about it? i realize you are not the policymaker but if you could. >> no, no. i have no problem addressing that. antibiotic resistance is a real and present danger as it gets worse and worse in the situation of having microbes that could be resistant to all antibiotics. we have examples of that right now. one of the things, there are about four or five major factors that are involved in the evolution of antibiotic resistance. someone our inappropriate use of

antibiotics among humans when people take antibiotics when they don't need them or they take antibiotics without the full course giving the opportunity for emergence of resistance but another is the inappropriate use of antibiotics in animals for the purpose of growth as opposed to the purpose of treating a sick animal f. you just imper cli give it for growth, you absolutely have a danger, i don't know exactly how that gets transmitted to the reality but there certainly is the danger there of propagating resistance when you do that and the fda already taken steps to try and diminish that. they did that last year, actually. >> is the use of public health monitoring proving to be an effective way to track specific drug resistant medical situations? >> well, certainly, hospitals now have a much more sophisticated tracking system

for resistance and sampling people who come in particularly hospital that is have problems with things like mersa or c-difacil and others. for example, i know in my hospital we do tracking and isolation as soon as we have a patient with a resistant microbe. we isolate them and we have strict protocols about washing hands, putting on gowns, gloves. i do it all the time when i make rounds on our patients. >> move away from ebola for a second and then i have more questions to come back to it. but peanut allergy, nobody had it when we were kids. now it is very prevalent. do you foresee a cure or a turnaround in the spread of this allergy? >> we are working on this very intensively. my institute is the national institute of allergy and infectious diseases. infectious diseases are much more dramatic and cataclysmic

and generally identify me with infectious diseases and we do allergies and you're right. it is growing in numbers. we're doing a considerable amount of research on it and one of the approaches is to try and essentially desensitize children before they develop the full allergy. and there's a big study going on now to see if you could actually prevent the emergence of peanut allergy in children in which it's a relatively high percentage. >> thank you. as i mentioned before we had lunch we could go on for a couple of hours and trying to succinctly get the best questions and more keep coming in. the ebola outbreak highlighted the danger of all sorts of infectious diseases. that being the case, what do you recommend as a regimen for every american to avoid common and dangerous infections? >> wash your hands.

[ applause ] >> you touched on this and one of the questioner wants clarification. can ebola be spread by cough or sneezes? both of which contain small particles. >> that's a good question and a source of confusion. so, ebola is spread in bodily fluids when the level of virus is very high. in order for the virus to get into a cough it has to replicate in the lungs. by the time ebola replicates in the lung, a person is so sick and we know that and that's the reason why when you have someone who's very sick with ebola and they're in extremendous misand want to intubate them, when you intubate someone, i hate to say this after lunch, you intubate and stick in a tube, a bunch of stuff comes out.

that's dangerous if you don't have the personal protective equipment. but that happens when someone has very advanced disease. someone who might be infected with ebola, that feels well enough to walk around town and goes like that, that's not ebola in the spew tell. it gets in the sputum with it in the lung and then you have advanced disease. now, is there the possibility that a 1 out of a million situation will occur when someone -- of course. there's nothing that's 100% risk free but from our extensive experience with ebola, it is not spread unless someone gets into direct contact with those body fluids. >> how did the initial treatment of eric duncan go so wrong? was it just lack of preparation and staff training at the hospital or was he too advanced

to be treated? and what was learned about treating ebola in the united states from that case? >> well, the situation with mr. duncan was very unfortunate because it was blasted all over the media and it was true that he came to the emergency room on a certain day saying that he felt sick. and mentioned that he had come from liberia. and mistakes happen. that was a tragic mistake that it wasn't -- the dots were not connected. sick, african man, just got back from liberia where there's a major ebola epidemic that, you know, you would think you would want to put the person in the hospital, at least isolate them. he went home for two days and then came back to the hospital in an ambulance very, very sick. could that have impacted his ultimate course? of course. we know that the sooner you treat someone and sooner under care the better but again those things happen.

it's unfortunate and perhaps hopefully that would be a lesson learned right now. we learned that in medical school as part of your physical diagnosis course. one of the important things you ask somebody is a travel history. have you traveled out of the country lately or where have you been lately? it's just the natural part of asking them if they smoke or if they are on any medications. travel history is a very important part of the physical diagnosis. >> japan has received inquiries about the influenza known. some scientists think that the drug could be helpful against ebola. do you think that the drug will prove to be helpful against blool and if so are there plans to move forward with testing the drug? >> i have no idea whether it's going to be effective. it's put up as a potential ebola drug and as i mentioned during my formal remarks, there are at least five and maybe more

therapy that is have been tested 'em per cli under compassionate use by the fda. we do not know if, a, any of them are effective, or b, if any of them are really quite toxic. so i can't tell you right now until we put it into clinical trial and ask the question in an appropriate way. >> has the presence of u.s. military troops changed the atmosphere on the ground in west africa? >> certainly. the department of defense has been extraordinarily helpful. they have sent over teams of engineers, logistics, command and control, engineering and they have set up their -- the plans of 17 100-bed hospitals. they have already put several of these up and have been very helpful in making availability the capability of taking care of patients in what's called ebola treatment units for etus so the

military has been extremely helpful. >> we're going to switch to malaria for a question. there are report that is genetic data can be obtained from bar codes. can the data obtained be used to locate the origins for malaria if a malaria is active in a number of countries and regions in the world? >> a bar code for malaria? i'm sorry. >> that's what it says. >> okay. all right. to locate the geographical origins -- well, i don't know if it's a -- i will have to change the question. i have never dunbar code with malaria. >> please rephrase the question. >> can you make a bar code be an analysis? yes. we have capabilities right now that have been developed over last several years of ability to

sequence microbes, even big parasites like malaria. it's big compared to a bacteria or a virus. and you can actually track the evolution and location of where things come by tracking the genetic evolution of a microbe. so if that's what the questioner was asking about, that's what you can do. >> a quick pinultimate question. where did you get your interest in science? was it a chemistry gift early in your youth or was it some educational experience? i teach my students at gw doing profiles to try to find that spark that led to a person's profession. what was that spark for you? >> i don't -- i'm not sure i can pinpoint the spark but i can tell you how i was interested in science and medicine. i was interested in people and dealing with people as science as an abstract discipline. i went to probably my first year

in high school i realized that i liked science and good at it but i didn't want to divorce myself from a profession that on a daily basis interacted with people so to me the most natural thing was science and the form of people is medicine. so i went into medicine. >> if you could wait here for a moment, doctor. we are almost out of time but before asking the last question, we have a couple of housekeeping matters to take care of. first of all, i'd like to remind you about two upcoming lunches. monday, december 1st, teresa sullivan, president of the university of virginia, will discuss trends in higher education. and friday, december 5th, gary betman, commissioner of the national hockey league and ted leonis ceo of monumental sports and entertainment will discuss the growth of the ahl and 2015 winter classic and i believe, jerry, they might even bring the stanley cup.

that's the plan. next, i'd like to present our guest with the traditional national press club mug. dr. fauci, you might have other ones. please add this to the collection with our deep appreciation. >> thank you, thank you. >> for the last question, i'm just struck here as you have dealt with so many crises over your outstanding professional life and i know in october you must have gone weeks with minimal sleep. how do you remain so calm? >> the alternative doesn't work. well, i learned a long time ago that when you're dealing with crises that if you be consistent in making your policies, your statements, how you deal with situations based on facts, be consistent, don't be afraid of saying that you don't know

something when you don't know something because otherwise you get yourself into trouble, and all of that leads to i think a calm approach towards crisis situations. >> thank you so much. [ applause ] thank you all for coming today. i'd alike to thank national press club staff including the journalism institute and broadcast center for organizing today's event. finally, a final thank you. we are adjourned.

questioned officials and representatives of honda and chrysler about the recalls. we also hear from the acting head of the national highway traffic safety -- >> good morning. good morning. we are extremely excited about today's conference and i have a very special honor this morning. on behalf of friends of cancer research and brookings to introduce you to chairman fred upton. he likes to be called fred. it is hard because, you know, he is the chairman but he -- i'm going to tell you very briefly about him. very briefly. first of all, he's a true bipartisan player in washington. he gets things done. and he's done already so much for this community and all of our communities so just very briefly. he is the chairman of the energy and commerce committee. representative of michigan 6th district. he is served six 2011 as the

head of energy and commerce but he is played a major role for fda and for nih. he was part of the bipartisan crowd that did the doubling of the nih. he's already done things for drug quality and the most important thing that he's doing now in a bipartisan effort is with diana degette on 21st century cures and change the way we do business, the way we really deal with drugs and development and nih. and he's doing it in a very bipartisan way and also by listening. by really listening. they have been all over the country talking and getting feedback from people and i have no doubt that what will happen through this legislation will profoundly change the way we really deal with noin vags and really be very, very, very positive so, again, i want to

take my time, not -- you don't want to hear from me. you want to hear from fred upton and tell you about the cures. he is going to take questions. we are on c-span so please be sure to give your name and your affiliation. there won't be a lot of time but mostly i just want you to help me welcome chairman fred upton. >> well, thanks. good morning, everybody. it is, it is really delight to be here and what i thought is i would take not a lot of time and overview of where we are, we are going, i'm going to the airport to go to the warm state of michigan. and spend the rest of the week there. so i'm fred upton. and i got to say that when i was

elected i can remember going to these orientation meetings of which i did this week to help the new fresh men in, republicans and democrats, and i remember well one of our leaders in our -- republican leaders was wonderful woman by the name of lynn martin. from chicago. she said, to the republicans, for 40 years, you know, we have been in the minority. it's going to be that way for the next 40 probably. it wasn't. she was wrong. but if you have a good idea, two things are going to happen. it's either going to be defeated or stolen. so just, you know, stay true. i said then, i said, you know what? that's not going to happen to me. i want to -- i came here to make a difference. and i'm going to partner with somebody on the other side of the aisle on virtually every bill that i work on. and we did it.

i can remember a story i like to tell. we had a fellow in the class, great guy, represented my mother in baltimore of mfume and as different as you could find with different districts and the two of us worked on legislation that ended up being enacted that was hailed as the most important legislation in that congress helping small businesses. provided tax assistance, tax credits for structural changes to small businesses to comply with the american with disabilities act. and i can remember him coming up to me, grabbing my lapel and say, fred, what have you done to my reputation? i used to be a zero with the chamber of commerce which is a good thing in his district of inner city baltimore and now i'm like hailed as a hero. you have ruined me for life.

he later headed the naacp. so as many of you are familiar with we have spent the last actually a year just about listening to folks around the country about what we can do to expedite the approval of drugs and devices and we're getting close to actually coming up with legislation. ellen, in fact, was one of our very first participants in our formal process at a roundtable we had back in may. not at the normal committee hearing where we're sort of at this big dias and, you know, q & a and literally a table we're all sitting at and -- we're asking questions but it's a very positive experience as we listened to a dialogue between different parties on what we can do in terms of, you know, what

we can do to work together. and we're going to continue to have those ideas. i was up in new york with diana degette. long-time friend. democrat of colorado. the two of us have teamed together. and participated in these roundtables and hearings really throughout the year. and our plan now is to release a discussion draft early next year, probably the second or third week or so in january. ellen in her normal way, she's worked me out here in the doughnut line, we are going to have a -- i don't want to say a private meeting but we are going to have a meeting with a number of you all. she is going to get a group together of all the, you know, important -- some of the important groups and where we can really sit down and you can look at what our discussion

draft does. because we want to continue to get that input. we're looking for ideas. you know? maybe we missed something. maybe we did -- went too far or whatever. really sit down and have a constructive discussion for considerable amount of time before we actually move that bill into the next stage which is to introduce it. we have an ambitious goal. but there is no more important issue to me in our committee than moving quickly and to expedite the approval of these drugs and devices. 7,000 diseases. we have cures for only 500. not a republican or democratic idea. i look at my family. my wife has lupus. my uncle had parkinson's disease. my mom's a survivor of cancer. no different than any other family that's out there. and i know that we can really

make a difference for every family as we move on this legislation. i personally have been so impressed with the advances in technology and likely of medicine achieved over the last couple of decades and in fact i took my health team -- i call them my dream team, to different places around the country to actually kick the tires and see what they're doing to listen and figure out what we can do to help in even a better way. but if we want to save more lives and keep the u.s. the leader in medical innovation, we have to make sure that there is not a major gap between the science of cures and the way that we regulate those therapies. that is our goal. so, we're taking the first comprehensive look held by the congress at looking at the full arc of accelerating the cures from the discovery of clues in basic science to streamlining the drug development process to

unleashing the power of digital science and media at the treatment delivery phase. bipartisan. one of the first things we did then with the majority leader eric cantor who tragically lost his election but i got to tell you kevin mccarthy when's taken his place as the republican majority leader now has filled those shoes and fully supportive of what we are trying to do. steny hoyer, former majority leader, now the democratic whip, number two in the democratic leadership, also very involved, testified with ellen that first day at that first roundtable. very, very interested in making sure that the democratic support is there, too, because our goal is to absolutely keep this a bipartisan way. we know that the cycle of discovery, development and delivery is what saves lives. and we want to work it faster and more efficiently so that patients have better access to

treatments. needs to be collaborative which is why our first step has been listening to experts like you so that together we can achieve the common goal of axccelerating th pace of cures and keeping america at the forefront of medicine and discovery. we learned that half of the venture capitalists have left the u.s. they're investing now overseas. we want to bring them back. we want that investment to be here. we've got to maintain that leadership role in research and health care that not only produces jobs but also saves lives which is why it was so important back in the '90s when henry waxman and i teamed up as the lead republican and democratic authors of the along with john mccain and paul wellstone to double the money for the n 4i that president clinton lined into law. we have been working very closely with the secretary of

hhs sylvia burwell. she's been terrific. participated. fully engaged but whether it's working with francis collins or margaret hamberg, we have welcomed their support. they're fully participants and in the hearings and roundtables all over the country. we're working with researchers and innovators in the private sector who are investing in the future of cures and i'm sure that our colleagues particularly our new colleagues to the congress and to our committee they're going to be fully engaged in what we're trying to do and we want to obviously work continue to work well with you at our committee. we have held four or five dc-based roundtables in the last couple of months. we have had eight committee hearings, francis collins has been all over the country with us. he's been terrific. dean kayman. michael milliken, commissioner hamburg and others, secretary burwell, andy beshen back. all of them truly helpful to try

to encourage us to do the right thing. we have done more than a dozen across the u.s. from philadelphia -- from pennsylvania to out west to the south. even in this great town called call ma zoo, michigan. happens to be where my plane will land a little bit later this morning. we have had a number of white papers. i would encourage you to go to our website at our committee to look at them. we have done i want to say four or five pretty extensive white paper generating thoughts and ideas. we want input on how we can better utilize digital medicine, asking patients about their diseases so we know how we can help. the basic framework pillars of what we want to see our goals are these, five. keep patients at the center of the decisionmaking process. two, modernize clinical trials.

three, foster 21st century digital medicine facilitating data sharing and the use of medical apps. encourage, four, encourage young scientists to enter the research world. the reduction, inflation and everything else, younger scientists aren't getting into that queue. losing interest. we've got to bring that back up. and we want to -- fifth, incentivize for unmet medical needs. those are our five goals. we've seen most recently with the ebola outbreak that there's a lot of work that needs to be done to develop vaccines and drugs and treatments for thousands of diseases. it's got to be -- we have to have an ongoing and collaborative effort. it has to be all hands on deck. and we're going to need your help. we really are.

because after we sit down in january our goal is to then introduce legislation within a couple weeks. i'm a regular order guy which means i'm actually changed the rules of our committee to encourage more bipartisanship. and we have seen that happen. and i'm delighted that frank pa loan is my ranking member. he and i have already had a couple of good chats since he was selected by the democratic caucus and he actually told me, he said on the floor when i congratulated him earlier this week, he said, you actually helped me get this job. you know, there their circle, our circle the same, different. he said because i was asked by my colleagues that were voting, can you work with fred upton? and he said, absolutely, i can. and then they came to you and said, can you work with frank

palone and you confirmed what i told them. he said, i got a couple of votes that way. well, it was pretty close vote on third side of the aisle if you watch that. but i'm anxious to work in a bipartisan way with frank and obviously diane is the lead dem sponsor there. but our goal is, again, have a discussion draft by mid-january or so, not too late after that. then after we sit down with ellen, introduce the bill. our idea is to move it through the committee before the end of march and to have it on the floor before memorial day. we're reaching out to the senate. i had a meeting, a great meeting with senator hatch yesterday. we've got more meetings that are scheduled, the first week in december to really line up bipartisan support over there, as well.

we expect to formally announce that when that happens. but we're going to need particularly the patient groups and all of the stakeholders that we have been working with to really help us because there are some -- there are some bumps out there. and we also know that the political season gets into high energy particularly with 2016 right around the horizon, we want to get this bill enacted next year. that is our goal. and that means we need a big vote in the house. to help with the senate. they have different rules over there. be able to work out our differences, hopefully there are not all that many. i don't expect real problems but to get it to the president's desk before the end of next year. where you all can look at what we have done directly, we have got a website and it's cure

cures@mail.house.gov. and there's a link there that actually take you to our white papers that we have done so it's for anyone that's watching now on c-span, but many of our hearings held on c-span but obviously this group in particular we look forward to that input, that constructive ideas, and we're very excited about what we're going to be able to do to be able to change the process and save a lot of lives and, you know, secondary effect is to bring a lot of jobs back to america. that's not a bad thing. so, i think i can take a couple of questions before i run to the airport. yeah? >> two things. i just failed to mention diana degette, the co-spohfco-sponsor please be brief. mention your name and affiliate. >> do they need an mic? >> we have mic around, people with mics.

okay. sorry. >> thank you. you can stay up here. >> i thank you so much, chairman upton. i'm nancy goodman of kids v cancer and worked on the pediatric priority review voucher. which as many of you may have heard a priority review voucher in the tropical disease space sold for $125 million this week. my question to you is about your concern of the priorities that you have for drug development for children. even when drugs are developed for adults that could potentially benefit kids, pediatric drug development is oftentimes delayed by many, many years or may not really get to kids at all if the drug is not appropriately ef kay house is on the adult side. >> you raise a very good point. one of the highlights that we did earlier this year in this congress was passing a bipartisan pediatric research bill.

lois caps of california was very engaged in that. i was involved. joe pitts my chairman on the subcommittee, eric cantor and others, we were able to get it done, signed by the president. and i think it ought to be part of where we want to go. you know, that's -- pulls on our heart strings probably more than about any other group and your success story, $125 million in nontaxpayer dollars, right? yes, the answer's right. that's outstanding. congratulations to you and what you all do and we want to work very closely with you to make sure that we're on the right page. >> good morning, chairman upton. >> you can call me fred. >> good morning, fred. >> the first rule. >> so my name is josh summer. i'm a survivor of a rare form of

bone cancer and executive director of the foundation. so my question relates to the role that hippa plays in the research and development process in addition to funding research one of the things our foundation does is has patients and researchers and ask what are the challenges you face and what can we do to help alleviate those challenges and one of the consistent themes that comes up is the impediment of hippa to learning from the experience that the patients have and advancing research. and so i wonder if given that patient-centeredness is one of the key tenets of your proposal to what extent have you considered patients' desires to actually enable researchers to use their data and use from their experience opposed to simply protect the privacy. >> this is -- i don't want to call it delicate, but it is something that we, you know,

firsthand we know about your story is not unusual. my guess is that if we had a chance to have a longer conversation you would be among the many that say, use me. not only do i want to find a cure for myself, but i want to make sure that there's not someone down, you know, we can prevent this to happening to somebody else down the road. is there a way that you can use, you know, my input in a much better way that hippa doesn't prohibit us from doing so? and i -- we're looking to have the right balance i guess you could say on this. and to perhaps make some changes and that will be something that we look forward to unveiling. i know that -- so we're out of session this week. or next week, i should say. diana degette and myself are getting together the first week we're back, week of december 1st. we are going to be looking at where we are so far as we begin

to write up our draft and that's an element we'll try to consider. and again, if you can include more numbers as part of those trials and everything else, we're much better off and, you know, to reducing the cost of what that ultimate cure may be. by utilizing the greater groups of folks so i look forward to your input on that. make sure that you're tied in with ellen. she is going to have everyone here is her best friend, right, by the end of the afternoon? but we look forward to your thoughts on this, too. but we're very aware of that and, again, as we try to keep patients at the very center of the decisionmaking process, what is it that we can do that perhaps makes some changes that aren't too terribly controversial but, in fact, move the ball down the field. thank you. some question in the back?

>> so michael sider, excellent idea to incorporate incentiviz incentivizing young scientists to stay in the field and not going into other fields. the challenge for young scientists as we know is the challenging level of early stage funding opportunities, given the challenging budget climate, how do you reconcile trying to incentivize these folks with the challenging budget climate? >> a couple of things. we got to -- this is one of the issues that michael milliken, michael had a major conference earlier this week up in new york that diana and i went to as we did last year, as well. first of all, we probably do nih

will agree with this big time, we need more money for research. we're looking for a way to figure that out. with a budget constraint that is we have today and -- [ applause ] it is what it is and i have always been a big supporter of the nih and dr. collins has done some good work, working with us to figure out what makes their job easier and i think find some more money. the second thing is, so i took our team. i'm a wol reveen, right? i know we're playing maryland on tomorrow but i'm a lot better -- i'm a happier guy when we win than not. but i took our team to the university of michigan a couple of weeks ago and spent a whole day at the medical school looking at the research they're doing. really it was just outstanding. i can remember going there back in the '90s, as well, and talked

to the scientists who identified the breast cancer gene and cell to -- i mean, just blew people away in terms of what he was able to do. we have got to have those gentlemen. we have got to have the researchers and they're low 30s and others to be part of this process and so whether it's set aside, whatever it is, we're -- diane and i are aware of that and i think you will see changes to encourage that young research to be involved and stay involved rather than looking at just the folks that had been getting two or three grants and now in their 60s or whatever. that will be part and parcel of this, too. some of the other ideas that kicking around irks michael milliken was talking about this,

one of our events earlier this week was, you know, what can -- these student loans. they're so high. is there some way if they participate in something, you know, can there be some way for some forgiveness or different -- so, a lot of ideas that are out there that we're going to take a look at. i hope you have your fitbit on. you're doing all these steps. she does. all right. i have to create more memory for mine. >> good morning. rachel sherman of greenleaf health and i'm a 25-year veteran of fda. you have talked about the nih and doubling the budget. i joined fda in '89 at a very exciting time when fda able to attract young scientists and foster them and my fda former colleagues can't say this but

what about fda? what about -- what about retention, recruitment, loan forgiveness which was dropped? the continuing need for -- the crucial need to make sure that the scientists, young and not so young, are able to interact with their scientific peers in other realms? what about the fda? >> yeah. well, i put them in the same bucket. okay? in terms of needing -- this is on our bucket list, too. all right? margaret, again, hamberger -- first-name basis, margaret and i have had some conversations about we want to be very helpful and to her credit she has been very constructive working with us on this so i think you will see some very positive changes.

you know, we have learned what things they don't like and we're going to fix them. there's a couple of good things that will be right up front so i think she'll be very happy with where we are. but it's -- i do have to run to the airport. and i just want to say thanks. thanks for all you do. we are -- this is not over. we are going to need you. okay? for this to get to the finish line we're going to need all of you there so, you know, we want you to eyeball our document when we release it. we're going to want on a fairly rapid pace your ideas as we turn this thing around. because we are pushing this end button as quick as we can and ellen, again, has really been a remarkable leader for this. this effort from the very beginning. not only the roundtables but our travel, the relationship that she has with our staff, i mean, she's really good. thank you. [ applause ]

millions of vehicles in the u.s. were recalled this year because of defective air bags made by the takata corporation of japan that were linked to at least five deaths. the senate commerce committee questioned takata officials and representatives of honda and chrysler about the recalls. we also hear from the acting head of the national highway traffic safety administration and the first witness at the hearing talks about her injuries that were caused by a defective air bag. this is just you should three hours. >> good morning. may i ask everyone if they would take their seats?

good morning, everyone. senator thune and i have been looking forward to this. we want to thank the witnesses for coming. we're here to investigate the link between defective airbags and the numerous injuries and deaths across the country, indeed across the globe. more than 7.8 million vehicles in the u.s. have been recalled because of defective airbags. just this week, the national

highway traffic safety administration announced that it was calling on all automakers to expand that recall from a few states, what they called a regional recall, to the entire country. well, the first thing that needs to be done is to take care of consumers. automakers need to get a replacement part so that the airbags can be replaced that needs to be sent to the dealers. they need, because of people potentially driving around with a defective airbag in their steering wheel and dashboard, the dealers, automobile makers, need to provide a loaner vehicle

or a rental car for those whose cars cannot be immediately fixed. general motors recently took that kind of step for certain models with faulty ignition switches. there's no reason why the automakers covered by this notice should not be required to take the same kind. i think it is absolutely imperative in view of the fear that has gripped the public by virtue of what has already been said and what will be stated in this hearing today that a loaner or rental car would be provided for someone if they cannot get their replacement of their defective airbag on the list done immediately. the owners should have a right

to expect the cars they drive are as safe as possible. that's going to be what we're going to be facing in the next immediate future as we dig into the question of what, in fact, is the problem. i've written to secretary fox urging him to impose civil penalties up to the full extent of his law on any company that refuses to provide drivers with an alternative form of transportation if they're going to have to wait to have their car repaired. the american people have a right to know about the story behind this airbag recall. that's why we're here today.

now let me just show you some of the items. this is part of the steering mechanism. it would be facing the driver like this. it would look like this in the wheel of the steering column. of course, the chemicals inside this mechanism upon impact, the chemical reaction causes an inflation of the airbag. upon close examination you'll see the little holes around the

mechanism that the gas that is created by the chemical reaction comes out, inflates the airbag, and it's a device that has saved many, many people's lives. this compound, ammonium nitrate, seems to have a problem. long about the turn of the year 2000 when it was changed as the compound, perhaps some of the met call, as well, and when the explosions occur, instead of the gases form to fill the airbag, additionally, it explodes with such force that this metal shreds.

as a result, what you see in this particular case of an airbag, metal has shredded it. here's a big hole. here's another hole. the very device that is supposed to save lives becomes a device that is taking lives. so that's absolutely unacceptable. now, after the opening statements of the respective chairman and ranking members, i have asked an air force active duty first lieutenant who

happens to be stationed at the large eggland air force base at ft. walton beach, florida, to be our first witness. she will give you a firsthand account as to what her encounter has been with the defective airbag. so, let me turn to our ranking member, senator thune, our future chairman of this committee. senator thune, thank you for participating. >> thank you, senator nelson, serving as chairman of this morning's hearing to examine the alarming takata airbag recalls and actions of the national highway traffic safety administration. these are currently issues that belong on the commerce committee's agenda. i appreciate you calling this hearing to examine these issues in greater detail. i first want to thank stephanie

erdman for being here today. thank you, also, for your service to our country. we appreciate you coming here to tell your story and help inform this committee. this hearing is an important one. and our discussion today explores matters of public safety and accountable. ensuring the safety of america's motorists is a priority and the public's trust is shaken due to the record number of recalls this year and the beliefs many have about problems in the industry and at nitsa. this year, record fines levies against ford, toy to that and hyundai and now we're faced with examining an apparent failure of serious safety consequences. today, we'll ask asking takata, nitsa and others familiar questions of how the faulty products made it into consumers' vehicles when the problem was first discovered and what steps if any could have been taken sooner to save lives or prevent

injurie injuries. in this case especially many would like to know if the allegations reported in the "the new york times" that takata knew of and hid risks years ago are true. questions also exist about the approach to the recalls and the wisdom of the agency's initial decision to request regional rather than national recalls, a decision that should be a wake up call. i believe we can do a better job of addressing issues as they a rise and holding auto makers and companies accountable to their mission of insuring safety on n. recent years, congress america's roadways. in recent years, congress

enacted and they have sought to implement a robust reporting regime. the major auto makers and other manufactures have instituted or sought to improve safety reporting systems that encourage employees to report safety problems. reports of employees who's concerns may have been ignored, silenced or possibly cover upper i believe we can do more to insure they're informed of potential defects as a quick as a possible. later today, i along with senator nelson will introduce the motor safety whistle blower act. i'm pleased senators on the forefront of recalls are also sponsors of this legislation. this bill will incentivize employees to voluntarily provide information to the department of transportation. if such information leads to d.o.t. or department of justice enforcement actions that a total more than a million in penalties, the whistle blower would share in a portion of total penalties collected this. bill will protect whistle blower's identities. other programs have similar to report to securities and exchange commission and irs.

if there are potential whistle blowers with information to help, identify more defects, we want them to come forward to that these problems can be identified earlier in the process. i think we would all agree that it's better to address a problem before injuries and deaths occur if at all a possible rather than fines imposed after the fact. i look forward to working with stakeholders and colleagues. as we continue oversight safety on these matters. we'll undoubtedly revisit these issues. and consider the present nominees. having written president obama twice in the last eight months urging him to to swiftly fill the administrator position that

has now been vacant 343 days, i'm pleased the president announced intention to nominate dr. mark rose kind on the eve of this hearing. this nomination is long overdue. i look forward to reviewing this in a timely manner. i urge all of my constituents watching this hearing, i urge you to pay attention to recalls and field actions. if you determine your vehicle is subject to recall get it repaired quickly. i want to thank the witnesses for being here today. i look forward to your testimony. thank you mr. chairman. >> thank you senator. >> we want our two leaders in the subcommittee to make a short opening statement. the chair of the subcommittee senator mccaskel. >> thank you. i find it troubling but more importantly i am sad i am not surprised that we find ourselves examining another example of manufacture's failure to fulfill safety obligations that could have saved lives. honda is under investigation for

failure to provide early warning reports related to deaths the company linked to takata air bags. takata itself is under investigation by nhtsa and federal prosecutors over troubling claims it might have known a long time before it notified the auto manufacture customers of the public safety defects associated with millions of its air bags. ten auto makers have now recalled at least 7.8 million vehicles in the united states. under either safety recall or service campaigns related to defective air bags. what i want to try to get to the bottom of is what is the difference? isn't that difference important? a safety recall versus a service campaign. there seems to be confusion among the driving public about the scope and severity of these recalls. part of that is because not all manufactures are treating this

the same, using the same language, and we have failed to have clarity from nhtsa in this regard. in this committee's consumer protection subcommittee, we have held three auto safety hearings where gm recalled 2.6 million vehicles earlier for a defective ignition switch largely ignored by the company and federal regulators more than ten years. sadly i think today we will hear many of the same themes we heard in the gm investigation. an industry that fears no consequences from the law, a regulator that lacks the resources and technical expertise to effectively do its job. i am pleased the president has finally nominated a candidate to serve as administrator, a position that has been vacant nearly a year, a critical year.

i look forward to hearing from him particularly in regards to his plans to strengthen the agency's over sight of the industry. dr. mark rosekind has z has been nominated and has a resume with years of work in the z has been nominated and has a resume with years of work in th has been nominated and has a resume with years of work in the has been nominated and has a resume with years of work in thas been nominated and has a resume with years of work in ths been nominated and has a resume with years of work in th been nominated and has a resume with years of work in the transportation safety. i have a lot of questions as we head to a new session of congress. this committee should make legislation reauthorizing nit sa a priority. we aren't going to agree on everything. i think there's common ground needed to act without delay. i look forward to working with the chairman in that regard and all members of this committee in the next congress. thank you senator nelson. >> thank you, senator. senator heller, the ranking member. >> chairman, thank you. i'll keep my statement brief. before i begin, i want to acknowledge the lives lost due to the takata air bags and would like to thank lieutenant for being here today. thank you for your service to this country and for sharing your story with this committee

today. mr. chairman, i think this is the year of the air bags. gm had defects with air bags that would not deploy. now we have takata air bags that send shrapnel into the face of those that are driving. as this committee know, i know a little bit about cars. i race them, build them, break them, and i fix them. probably break them more than a race them. that seems to be the way it works out. i will tell you the most terrifying thing a driver experiences is a crash. at that a moment the only thing that matters in their lives is that air bag. we have common themes emerging from all of our hearings this year from this committee and our subcommittee. it's taken far too long for information found within the company that there is a defect and then getting these cars off

the road. today i'm proud to stand with senators nelson, mccaskell and introduce legislation to bring this forward faster by rewarding whistle blowers. it's my hope and our hope the whistle blower's act will solve the problems we're seeing time and again with recalls and employees in these companies that have raised concerns about defects and warnings have not been properly vetted. it's my hope a significant monetary payout will get this information to the public faster. faster means saving lives. today this committee has takata here. we need to know what they knew and when they knew it. i'm troubled by the new york times article that alleges there may have been a cover up. i'm glad to have them here. the president submitted the nomination to the senate

yesterday. i have called on the president to do this for months now. we'll review this nominee. i'm hopeful we'll be able to process accordingly. they need an administrator. it's been almost a year. i feel the trust in this agency has been eroded. one of my concerns is they're not able to recognize defects fast enough. they're far too important for that to happen. i want to work with them and colleagues on solutions to that. a as you know, nevada will be producing cars very soon with the new tesla giga center. we need to make sure nhtsa can handle cars of the future as well as cars that we have here today. thank you mr. chairman. look forward to testimonies and this hearing. >> with the indulgence of the committee, we want to get on into the testimony. after the lieutenant, we will have the next panel, the chairman will defer his questions so we can get the members plenty of time to have their questions and then we have

a third panel which is the administration, nhtsa. let's get right to it. we are appreciative lieutenant you'd be willing to step forward. first lieutenant united states air force stephanie erdman. graduate of university of texas, rotc graduate. one of her first duty stations of which she is a compliance and testing officer in the air force testing and evaluation command at the air force base. if you all can turn the posters, you can start to see something of the impact.