captioning performed by vitac pepfar, that's one little virus, $60 billion spent, more than anybody in history. the global fund, the sort of side fund at the exact same time and president bush and he played a bill role in that, but we were the largest single -- we were the first gift, the largest gift to the global fund. that expanded it to hiv, aids, malaria and tuberculosis, other infectious diseases, at the time hiv was killing 3 million a year.

now for hiv/aids we cut aids-related deaths down to 50% of what it was. what happened, michael, you hit it right, when you come in and are going to have an anti-retro viral or mivarapin because it's a dollar to save a baby, you have to set up a system, you have to set up a system of delivery and compliance. you don't take it one time and go away. of compliance, of surveillance, of people coming back in. the whole testing of it was revolutionized in tests which would cost $300 down to about $2. you had to set up an infrastructure, 11 million orphans, a mom who has hiv/aids would give birth to a baby that has hiv. somebody has to set up the mom, set up the infrastructure, go into the community and while you are there you have other issues of maternal and child health and it might be breast-feeding, it might be early detection of other diseases, it might come into a clinic. so all of a sudden this huge

infrastructure gets built on the single little virus expanded to other infectious diseases that an infrastructure broadly set which ultimately saves countless other lives. if we save maybe 20 million lives have been saved so far by this investment and that's conservative, probably five to six times that have been saved because of this broad infrastructure that has to be set for the diagnosis, delivery and treatment of that initial therapy. >> it's amazing to go to hospitals in rwanda that used to be overwhelmed with aids cases and now can do diabetes and heart disease. >> and cancer. even cancer. >> exactly. we've seen from the 2019 house and senate appropriations bill that there is still strong bipartisan support for pepfar and other critical health efforts. let me read you a quote from your former colleague, u.s. senator lindsey graham who is chair of the senate state and foreign operations appropriations subcommittee. he said of the 2019 bill, this

bill makes america safer by supporting critical diplomatic efforts around the world, providing security assistance for our allies, directing stabilization assistance for areas in chaos through the conflict and supporting lifesaving health and humanitarian assistance to people in dire need. now is not the time for retreat. this bill signals to the world that america is not backing away from its role as leader of the free world. in an era of america first, why does that leadership remain important? >> i would say it remains even more important perhaps now than ever, in part because the world is in such chaos. you've got 25 failed countries, you've got an enormous challenge on virtually every continent and i think american leadership especially in this context has never been more critical. secretary mattis said it

succinctly once. he said you cut back on funding for programs like this i'm going to have to buy more ammunition. i think that's a succinct way of saying there is a direct correlation between the stability we can create through good health and good economic growth and support at the local level and what ultimately we have to look at from our national security perspective, regardless of the continent. so small investment, big results. we've seen that now for 15 years. this arguably could be the single most important investment we can make to overall stability worldwide, especially in parts of the world that we don't have a very strong military or diplomatic presence today. >> i'd say you opened with it, that this has been bipartisan from day one. from day one. didn't start -- actually, in our early years it didn't -- it was very partisan, and as tom mentioned it was hugely stigma advertised, it was an entity of

condition that was pushed off to the side. i remember jesse helms writing an article, i think it was for the "new york times" basically saying this is something we don't need to be dealing about initially. about four months later after the american people spoke, after republicans and democrats spoke, after the faith-based community came on board and said 3 million people dying of a single virus every year, 11 million orphans out there, we've got to act. bono from u2 was at a concert the other night and i talked to him afterwards, again, he played a huge role in saying america is great, america is leading. he can be critical of america, too, and this is the single greatest thing this country has ever done. that kind of image from the outside. to put in perspective we are talking about this is the budget. we are talking about everything we just talked about being this much. all global health is about one quarter of 1% of our nation's budget. one quarter of 1%.

we talked about gdp, reputation, national security, america first, which in our document if you read it you will see the four principles of america first that are outlined and maybe the next panel will get into it of president trump, we meet every one of those principles. different language, but we meet every one of those principles of coming forward. one quarter -- but the issue does boil down to this, which we point out in the report, if it's only one quarter of 1% that goes to all global health, not just hiv/aids but all global health and if it really is a currency for peace and if it really is a national security issue and an issue of individual well being where people can provide for their children and give them hope for the first time in 20 and 30 years, if it is all that, why is it that our administration right now comes back and says let's cut that global fund by 30%? why is it that the administration right now says let's cut it by 12%? now, luckily the congress has

come back and essentially given it level funding for the last four years, which is good in this environment overall, it's about flat so we've come back every time, but now is not the time to step back. now is not the time to have an administration cut global health when we had this 15-year history of positive, constructive, broad, yes, global benefit of being able to cut the deaths related to hiv/aids in half in 15 years. >> we have time for a few questions, but we only ask that you ask your questions in the form of a question. >> there is a microphone coming. >> hi. first of all, thank you for being here. my name is olivia landau, i'm with the senate foreign relations committee. i'm wondering how pepfar and the bush administration dealt with

south african former president's opposition to hiv denialism. >> yes, so the question is at the time we had countries and recipient countries with high hiv/aids who basically from a -- i can't say from what standpoint. the narrative was that anti-retro virals don't work. that hiv aids is not caused by a single virus. didn't really say what it was -- it was called wasting disease at the time. nobody knew what it was, everybody was dying, they called it wasting disease because you were wasted. what we did at the time is -- and this is a pretty part of the story -- michael garsen is the expert up here now, he wrote a lot with the president to articulate this, but what the president did before was send

tony fauci our head scientist in the united states of america for infectious disease. before the announcement he sent tony fauci to africa. he came back -- again, this is before the state of the union -- and basically said, mr. president, this can be done. the naysayers out there, including the leaders in africa, are wrong. it is caused by a virus. if we mobilize american industry, if we make it a public/private partnership, if we put -- at that time it was about $15 billion over five years into i can promise you based on science -- he didn't say promise -- i can pledge to you based on science that we can diminish the cost and reduce the burden on this disease and cut it in half. it came back to science. so plowed straight ahead. but remember you had recipient countries that said, america, the west, stay out of our business, it's not caused by a virus and anti-retro virals don't work. we relied on science and our industry and creativity and drove straight through it. >> i was just going to say just to complete that thought i would

say it's the results. he became convinced once he saw the results and the results were happening all around him. and it took a while, but i think to bill's point once you had the science and then you had the results, it was hard to deny how you could do the same in your own country. >> what do you remember of those times? >> i would only add, though, that i remember sitting at a lunch next to a health -- south african health official who told me that aids could be cured with garlic. >> okay. >> and you had this element, but beneath that there were a lot of really good health people in south africa that knew what was going on. >> okay. >> you had the leadership problem, but you had a real health bureaucracy that was -- that didn't hold -- >> and then you have countries like uganda, uganda came forward with the first lady of uganda went on the equivalent of television at the exact same

time and said our country -- and that was before we had really good treatment, through voluntary counseling and testing hiv plummeted there, people began to live. so you had countering countries with that voice and uganda was on the forefront at that time and the president and the first lady were out front. >> let's get another question. >> i was curious about the connection between condoms or prevention method and the political issues around family planning and condoms from perhaps religious groups and others, how you dealt with that. >> i will jump in. first of all, i don't know the answer historically or present, but what it was at the time is this, we knew people were dying

so we had to give -- not just dying, but suffering around the world and had to give voice to the reality of what that was. the answer, remember, at the time we didn't know very much about anti-retro virals. we through they cost $100,000 and this whole idea of applying t what we our scientists and industry told us is if we came together we could get the price down. so the therapy end of it everybody can rally behind, but therapy with five people, you know, walking in with hiv every day, there's no way to be able to give enough therapy to all of them with the number of people who are dying. so the only real answer was the prevention end of it. even to this day. right now we've cut it way down, but it's prevention. prevention. we know abstinence works, number two would be we know that birth control condoms protection work. so what we did, because you had

democrats and you had republicans, you had evangelical, you had faith-based. why did the faith-based community come on board even though some of them were very much against condoms, an element of birth control. basically from a government policy standpoint we didn't get that involved with that. we basically had -- certain parts had to be watered down just a little bit to get the coalition that was there and we basically went to the faith-based community and said you go about it the way you want. if you want the abcs, you push that forward, but support that legislation. if you want us to add some kind of -- i don't want to say abc, but you can say you're for condoms or against condoms as part of it. at that point in time people didn't realize we were distributing at that point in time more condoms than any country in the world already at that point in time. that's how it was handled. the people came on board. if people didn't believe in anti-retro viral therapy, they could still come on board.

if people didn't believe in using condoms, just the ab, just the faith and abstinence part of it, just the belief and the abstinence part of it still come on board and that's how that coalition was developed. >> one more question, maybe in the back. >> i'm with malaria no more. i was wondering what you thought of the future in u.s. investments in relation to global health security and the reemergence of polio in venezuela and the upturn in malaria cases in america. >> i will jump in real quick. tom and mike, you ought to comment. the reason this funding has to be -- this isn't a thing that's cured and goes away. we have two issues and you brought up one that we should have mentioned really earlier and that is -- which is one of the big ones, the reason why we have to continue to invest or this will come back. we do not have a cure. we do not have a cure for hiv/aids. malaria a little bit different,

malaria mainly kills children and, again, just so people will know, but it was very much part of the global fund and malaria no more coming -- the thing that you brought up is the resistance to current their piey ar therap. you would be given an anti-retroviral or anti-malaria drugs and all of a sudden malaria evolved and it no longer works. so we have to have the continued research coming in. the other big issue that we talk about in the report is this resurgence of young people in africa today and as that resurgence of young people they need to be -- they need to both receive that education, because culturally if you are not receiving that education in some way, again, those same sort of behaviors with that virus for which there is no cure yet will come right back. >> i think we've mentioned a couple times now the importance

of the infrastructure that we've created. and that infrastructure is so vital as we go forward and take the lessons learned. there is a new concept that is oftentimes referred to as data diplomacy. using data for purposes of applying what we now know. the infrastructure that we now have to address the challenges that we now face. i don't think anyone can fully appreciate the magnitude of that contribution because it's hard to document in a macro economic fashion, but it's there, it's real, and data diplomacy and transparency and the kind of qualities and values and tools that we brought to this challenge are very applicable as we look to the next 15 years. we have to apply them just as effectively as we've done in the past. >> we have to conclude there, but i want to thank senator daschle and senator frist for 15 years of leadership in the cause of compassion and american

leadership. so, please, join me in thanking them. [ applause ] >> allow me to echo mr. gerson in thanks senators daschle and frist for their contributions in this report. thank you, mr. gerson for helping guide us through not just the history of pepfar, not just the description of its infrastructure and how it works but really a touching and impactful story of the change that has been brought on the continent and how it has changed the lives of millions. so talk a little more about what pepfar does today and the impact it can continue to have i'd like to call up our second panel. ambassador deborah birx, u.s.

global aids coordinator for global health diplomacy. general charles wald, the co-chair of the national security program and ambassador mark storella, former u.s. ambassador to zambia and current deputy assistant secretary of state at the bureau of population, refugees and migration. our moderator today is dr. charles holmes who in addition to consulting on this report is the faculty co-director of the center for global health and quality and a visiting associate professor in the department of medicine at georgetown university. prior to joining georgetown charles served for found years as the ceo at the center for infectious disease research? zambia and prior to that served as the chief medical officer for pepfar. he was their founding director of the office of research and science. charles? >> thank you, blaise. it's a real pleasure to be here this morning and given the range of diplomatic and public health

as well as security concerns and issues that we've talked about already, we really couldn't ask for a better panel here today. i won't go into bios but i will introduce of course ambassador birx, general wald and ambassador storella. i have had the great honor of working with both ambassador storella and ambassador birx in various settings over the years so this is really a special occasion. i'd like to start with you, general wald. as referenced earlier, prior to pepfar societies as we've heard about, particularly those hardest hit in sub saharan africa were being truly ravaged by the hiv epidemic, with sharp declines with life expectancy, rapid rises in orphanhood and faltering economies. the new report finds that pepfar has been successful and other health aids investments have

been successful in impacting health, socioeconomic development and also reducing fragility. because of these effects we've heard about parallels between the pepfar program and the marshall plan. given your become ground with the european central command, can you remind us of some of the objectives in the marshall plan and the advantages that that had in rebuilding europe as well as for the united states and do you see parallels with the pepfar program? >> yeah, i do. i mean, i was asked to prepare for this question so i've looked it up a little bit. for those that don't remember the marshall plan i think it was at the time somewhere around $13 billion for all of europe after post world war ii which today sounds like not a lot of money, but at the time was quite a bit.

i've read where there is some revisionist history that is saying that the marshall plan was implemented by the u.s. government to give us a better global market and increase the market of the united states, which is kind of cynical meaning there was not a benevolence there, it was mainly for self improvement of our economy. i suppose there is some of that, but i think there was also the reality that europe -- i mean, if you think back on t and i kind of think of in today's context why would we -- you know, president trump is getting ready to go to the nato summit this week, i just talked to jim jones this morning he is going over there, too, and there's probably not a more supportive person in the world than jim jones on nato, but you have to say to yourself why are we involved in europe or later we will talk a little more about africa, but what is in our interest there other than maybe historical relationships with --

from generational relationships, whatever the case may be. it's in our interest to have a group of nations around the world that are stable that we can depend on to help solve some of our security problems. i mean, we are going to hear from two really significant people here as far as our diplomacy and our government goes, which is really the primary, but there's a military aspect and there was a little bit alluded to by senator frist and senator daschle earlier, but my feeling is as a military person has always been the best thing you can do as a military person is avoid conflict, avoid involvement, so prevention is number one. you know, i think that most military people would say idealistically if you could do away with the military it would be a good thing. i'd rather not be in combat. so the marshall plan had a couple things going, in one is there was a certain amount of i think benevolence and just sincere concern for our european

frien friends. i mean, i don't think any of us could imagine world war ii and the devastation. so there was a certain amount of just kindness involved. two, there was a serious -- i mean, george marshall probably the smartest thinking military person we have ever had in our nation and he was smart enough to know that the tools of security and national security are multi-facetted, like mike mullin said one time, our former chairman of the jcs, the number one national security issue for the united states of america is our economy, which is ironic for a military guy to say that. if we don't have an economy we can forget about national security. so marshall saw that. i think the third part was he saw the future that it's kind of repetitious and that security in europe is not necessarily guaranteed and we are going to

need a partnership there of people that could actually purchase their own military capability, train with us and be there as a partner. so if you look at hiv/aids which we are going to talk about now, i felt the same way when i was in uranium command. at that time european command for those that don't know or probably don't care, we had africa in european command, most of it, and our responsibilities were about 92 countries, 50 some were in africa. we spent a lot of time there. and it was kind of a nascent area. it was a little more thought of today because of some of the -- what we consider extremism or potential terrorists that are being grown there, but at the time it was an area that was not very well known, there was not a lot of involvement from the ambassadors which was great for us, but there wasn't any real

strategy involved in africa. the strategy that evolved was basically driven by the fact that china was investing quite a bit in africa and was kind of replacing us as what we wanted to be influential. but the hiv portion of it became a huge issue for us from the standpoint of kind of rebuilding capacity in africa, and the more capacity our friends, wherever they are, have to take care of their own problems the better it is for us, so that's basically the marshall plan comparison. >> thank you. as you know and as we talked about in the first panel, africa is experiencing rapid growth in its younger populations, such that by 2030 it's estimated that about 50% of people living in sub saharan africa will be under the age of 20. in a study that was referenced in the new report the cia called it a destabilizing force.

general wald, i will stick with you and then we will move on to ambassador birx. why is the growing youth population while being a positive on one hand a concern from a security perspective, and what are some of the ways you see pepfar and other health and development programs as being essential to contributing to a brighter future for that influential population? >> yeah, i mean, i said it to mike gerson earlier, which i've never had a chance to talk to him about this before, but one of the sadness -- sad parts about president george w. bush's administration is he should have taken big credit for this. he is not the kind of person that would, but when we first started in european command 2003, again, it was fairly nascent, not a lot of people were very ver sanity in it, there was a growing instability in the continent already as was

alluded to by senator frist. osama bin laden had been in sudan, there was a lot of activity in north africa, we had a group of europeans that were kidnapped in north africa, about 40 of them that became the big issue and this group that kidnapped them became al qaeda. we had issues in mali, in timbuktu, as a matter of fact, we had issues -- libya obviously going bad. and much of it had to do with the reality of social media with the arab spring, but also the youth bulge, but probably most of it was because there was communication amongst young people that started for them to -- they became -- there was a realization of what kind of a government they had, what kind of society they were growing up in and there was a disenfranchisement of young people becoming pretty apparent. we had a fantastic intelligence officer in ucom, rick zayner,

who became head of army intelligence, that coined the word in our -- i think he did, but disenfranchisement of the youth in africa. his concern was unless something is done, this youth bulge i think as it is referred to in the report, is going to be looking for things to do. first of all, they don't feel supported by the government, number one, and number two, they really have no relief for what their life is all about, they're looking for some kind of involvement somehow in some kind of relationship. and the whole issue about paying attention to the young folks in africa was, again, this is the right thing to do but primarily it was a security issue for us. number two is, you know, youthful transmission of hiv/aids process was really a growing issue and the mobility of the society there was

growing, so it became real apparent to us in ucom, i think, that the hiv/aids program was going to be a big deal for us. and, again, i pick senator hagel to became the secdef later to africa that realized the amount of money that was being put into this program was going to pay big dividends and we will talk about it a little bit later but the impact of the fact that our interest in european command was for something africans take care of their own security and stability. it was not in our best interest to have to do that. we'd like to help them. but the hiv/aids program may have turned around much of what's happening in africa today that probably would have been ten times worse if we hadn't had the pepfar program. theres no doubt about it. >> ambassador birx, but u.s. global aids coordinator you've

made the collection in more effective use of data, really one of the hallmarks of pepfar. one of the major issues that's come out of this data is as general wald referenced, we have the youth bulge, but also the adolescent girls and young women who are now accounting for 74% of the new infections in subsaharan africa in that age group. given the rapid growth of this population in africa it's been suggested that these high rates of infection in that age group could actually lead to a reversal of some of pepfar's hard fought wins and gains over the years. what are -- why are these rates so high in adolescent girls in the region and what is pepfar doing to protect them from hiv infection? also recognizing that hiv prevention is not just a health issue but really has multiple societal determinants. >> well, that's a lot of

questions. but thank you. i think we were very excited about data and the use of data because it let's us see down to the communities and the individuals and i think when you heard that discussion about where pepfar was grounded in transparency and knowledge and translation of science to action, we had to be able to see everything, not just an average -- i always call it the tyranny of averages. you can't look at a country on an average and say that's how you're serving everyone. when we started looking geographically and started doing these surveys that were down to the community sites, that's when we found everybody that we were missing. you can understand how this happened because when pepfar started it really was an emergency to save lives and to save parents. so a lot of our treatment went to the very sick. we had forgotten, i think, at some times that you have a disease for eight to ten years

before you're sick at all, but it's silently destroying your immune system. so when you think about it that way you have to realize that you had a lot of 15 and 20 year olds that were probably infected then, but weren't visible to the healthcare delivery system. what these surveys has allowed us to do is to see everyone. so it's not that the -- we have these things we call incidence rates and then we call absolute number of new infections. so the incident rate as was described in the prior panel is actually dropping in all of the different age groups, but when you have twice as many 15 to 24 year olds than you did at the beginning of the epidemic, you see that you have to, again, have those incidence rates just to tread water. so we really noticed then that young women -- and this really was a study done by a doctor who showed us five years ago the risk to young women. so we saw a lot of infection but

we didn't understand the risk and there was a lot of sense that it was cross generational, sexual activity, we really found that it was men six to seven years older with women and younger -- and adolescence that were 16 with a 22-year-old. people always say to me that's so shocking and i'm like, well, weren't you in high school? i mean, didn't you want to date a college kid who had the car and some disposable income? i mean, this is universal everywhere. so we started really listening to young women to understand what was putting them at risk and that's why we launched dreams and that stands for determined resilient and empower in safe young women. that understands that women are in a community with multiple facetted risks. we had to bring together just like pepfar has always led in bringing people together bipartisan and then interagency, we had to bring the ministry of

education with the ministries of finance with the ministries of health and the ministry of gender to work together in a new way. to really look at every aspect of a young girl's life and address the issues that they're faced with. i think one of the biggest issues we've uncovered through our violence against children surveys is about a third of young girls first sexual experience in rape. so these are difficult questions and that's where you use the diplomacy of data. when you have that objective evidence and you can take that to these ministries and work together to address an issue that crosses young women's lives, and that's -- i think you've seen our recent report, we saw between 25 to 40% decline in new infections in women, the absolute number of new inspections, that's what's going to drive costs, absolute number of new fekss in many of these communities. like all data it also points out where you're failing. i think part of this bipartisan

support and the bipartisan report that just came out is for us to understand where are we doing great and where do we need to do better? i think with the young women we can clearly see that we probably don't have programs that are optimized for young women in highly urban areas. so if you look at johannesburg, if you look at nairobi and lusaka we have a 10 to 15% decline in absolute new infections when in many of the other areas we had a 60% decline. what data is useful for is to point out where you're doing well but also point out where you're not doing well and fix it. i think that's how we want to use data. we want to use data to help us understand where we're doing well but also where we need to fix things. data drives change. so people say to me all the time when will pepfar stop changing all the time? never until the epidemic is controlled. because the virus as senator frist said is tricky and it constantly evolves and changes

and effects people in different walks of life. so you constantly have to be looking and changing to keep up with it. >> so in the came way that you've worked to make data more available and to use data you've also opened up the country operational planning process, which is the annual planning process for pepfar and made it more transparent, but you've also involved partner governments as well as civil societies and as we heard on the previous panel that that kind of transparency is really one of the hallmarks of strategic health diplomacy. what prompted your move to -- for that greater transparency and the involvement of both governments and civil society, and what are some of the benefits and challenges that you've experienced from that? >> well, you heard from the previous panel where pepfar was grounded. so we went through and looked at -- and i want to thank many of the people in the audience who wrote really comprehensive

reports on how pepfar could be better and still do that and we read them all the time and work this those areas, but one of the reports and several of the reports said, you know, you talk about transparency but you are not transparent. you write these things in secret in rooms and then you tell everybody this is what you're going to do and the data is not available and we don't know what's going on. so we felt like we had to be more transparent. now, that made everybody nervous from the agencies down to the implementing partners that all this data was going to be up and available, and it is. if you go to pepfar.gov, every data of every site, 55 or 50,000 sites that pepfar works in has that data on the website so that everybody can see it. the communities that we are serving can see it, the governments can see it, civil society can see it. part of what we do in the planning process is to bring together communities that are affected and impacted by hiv

with the government who is providing services and often with pepfar funding and bringing that together so we are both listening. so we are listening to each other. and i think that's the big difference. through listening to each other we have been able to double the number of people on treatment in a flat budget in the last four years, just by listening of how we could do things better, and we've quadrupled the number of prevention impacts by increasing the circumcision number. flat budget. how do you do that? you do that by listening to the communities telling you you're doing it this way, you would be very much more effective if you did it that way. and these communities and governments are doing this when there's really no funding often going directly to them. people are al truist clee telling us and helping us be better without paying them to help us do better. that's really been the spirit of pepfar and raises our spirits when we're constantly doing

change management is to listen to people talk about and help us -- i've seen many of you in the audience who came and helped us on the dreams program for young women. you weren't receiving pepfar funding but you want that had program to have impact because you cared about young women around the world. that's what we still see in this program every day is people coming forward to help us and really bringing their intellect and their spirit and their wisdom to us every day to make us better. and that is so powerful. so keep writing your reports and keep helping us get better because we are in this until we get control of this epidemic. you heard there wasn't a cure. there is a cure for malaria and tb. so we are working against something difficult and there is not a vaccine. so those are being developed and worked on right now by nih and scientific institutions around the world so they need to continue to be funded to do that, but in the meantime there should be no excuse to not move forward as fast and as effectively as we can.

>> can i follow on for a second? going back to kind of the point about data, kind of the irony here is that probably 100% of you in here already know the issue, you are already supportive of more pepfar, you understand the problems with hiv/aids and the security part and all that, but the narrative has to be better. i mean, first of all, people like yourself or people who understand totally i think what you're saying, i had dinner or lunch with a european parliamentarian when we were back in african command or u.s. ucom and we talked about the benefit of stability operations or putting money into what some people would refer to as soft far and the benefit security wise. he said i agree with you 100%. my constituency doesn't get it,

they don't understand why europe and the united states why senator thune would tell me my people in rapid city don't understand why we're spending money on africa when i have a pothole out in, you know, 16th street or something. and the problem is you've got to start developing the narrative. so i asked our gao at the time, the general accounting office, what do you estimate the amount of money that we save by actually investing in prevention of soft power and they came back with a number that for every dollar you spend on prevention which i would consider hiv/aids pepfar money as a prevention of the instability issue, every dollar you spend on prevention you save $10 in response, in other words, for every dollar you spend on prevention you save $10 in military spending. now, we should have more of those stories because that's exactly what's happening to us. even if you are the most heartless person in the world and don't care about human kind