says we continue to become more and more involved in another middle east war with no military solution. congress must debate and vote on all the options. darrell issa, major thanks to the men and women of our armed forces who are taking the fight to our enemies. some reaction for you from congress. asking all of you. should congress vote on syrian air strikes. let's go to patty in alexandria, republican caller. hi, good morning to you. >> good. thank you. thank you for c-span. i guess i'm a little confused about the vote. when they we want to war with iraq, we had a vote and we agreed, everyone agreed to do it or most people did. and then there was a whole lot of flack about bush took us into the war and it was like nobody knew that we were spokee supposed to do it but congress did vote on it and all everybody forgot

that congress agreed to do this and now we didn't leave any residual forces in iraq and it's become a mess and now they're going to say we can go back and do the war because -- well, it was under the other agreement. but that went away when they pulled everybody out so why won't they do at least a vote on syria and say, yes or no, you should go in or you shouldn't go in? i mean, because we get these residual forces from the other countrieses which is great and i do believe they do need to be -- we do need to protect our country and stop this big massacres but i find it disingenuous that they talk out of both sides of their mouth and they won't let congress say what their real thoughts are.

>> host: okay. we have to leave it there. this conversation will continue on the "washington journal" but today we're going to switch gears. we're going to go to the national institute of health coming here. talking to director francis collins and later joined by patricia grady of the national institute for nursing research. we'll get to that right after this break.

>> price, whatever you do, do not take c-span 3 off. it's a very educational show. i listen to it mostly every day. and i'm finding out more and more about my government. and also, books and history. please do not take it off the air. >> caller: why is c-span favoring republicans over democrat caller katrina. republican call in and demonize the president and not get cut off but democrat say something about republicans, they are cut off. c-span is not fair. >> continue to let us know

what you think. call us, email us or send us a tweet. join the c-span conversation. like us on facebook. follow us on twitter. "washington journal" continues. >> host: this morning here at the "washington journal" we are going over to the national institute of health in the washington area to talk to the institute and director about what this national institute of health does. research facilities and as well as news that has been made about ebola and what they are doing over there to fight that and bio terror and lab security. joining us is dr. francis collins, the director of the nih. i want to begin with breaking news yesterday. cnn tweeted this out saying if there are no additional interventions, the ebola death toll could rise.

this according to the cdc. dr. collins, what is the role of nih in fighting ebola? >> guest: good morning. yes, nih is deeply engaged in thest to try to turn back a frightening outbreak of ebola in west africa and yesterday, tom freeden did make this projection that if nothing happens, we could look at more than a million cases of ebola over the next few months. a frightening number. but we want to make sure everything is don't to keep that from happening. what is our role? largest supporter of research in the world including research on infectious diseases led by the best known infectious disease expert in the world,

tony fauche. partly the development of vaccines and developments of new treatments for people infected. vaccines moving forward at unprecedented rate and this is an effort we started 13 years ago anticipating there might be a need for a vaccine because ebola has been around since 1976. albeit small outbreaks. this is the 5th generation ebola vaccine. looks very good in the animal models. you don't know until you try it out in human patients whether it will be safe or work. we did start three weeks ago what is called a phase one trial of this vaccine. 20 individuals have now been injected with that. they are volunteers here at the nih clinical center. so far, all is going well. no red flags to indicate there is a problem with the vaccine but it will take a couple of months to see whether or not those

individuals mount an immune response that you would think would be protective against acquiring the disease. once we have the data, we need to move quickly to get this into what you call a phase two trial in west africa in individuals that are at risk. all of that is very complicated in a circumstance where in liberia and sierra leone and guinea, a great deal of stress as you can imagine on the health care systems but we're determined to figure out a way. >> host: what is the time line? >> guest: november before we have the evidence about whether the vaccine is looking promise in this phase one trial. if it looks good, shortly after that, meetings are going on today and every day exactly about how to do the design, we would try to then set up this more extensive trial in west africa that would determine whether the vaccine is actually effective or not. there's a second vaccine we also played a role in, developed in canada. that is also getting tested

sort of parallel and we have partners in england in the welcome trust tufting one of our vaccines in a different population, all hands on deck here. everybody is trying to do everything possible to speed up a process desperately needed. >> you said this is unprecedented. so, describe what it has been like to ramp up this vaccine research and effort. >> guest: well, we've been working hard on this for 13 years. we didn't know when this outbreak might happen but many were fearful it would. nobody anticipated it would be as bad as it is where the disease spread into the cities making it difficult to follow. frankly, if nih had been in a better position as far as research support over the last 10 years, we would be further along. this is a consequence that we're not in a position to already have this vaccine ready to distribute. but we pulled out all the

stops. colleagues at fda have been hep full speeding up the process of approval but i wish we were a little further along. i promise you that working with cdc and other partners, we're trying to make this our highest priority. people's lives are at risk. >> host: did you get more money. congress voted for a continuing resolution that funds the government. extra money in there to fight ebola. >> guest: for c tv and organization trying to speed up the therapeutic development. let me say a word of that. vaccines are preventive but for people already infected, vaccines will not help so there you need a treatment. people have heard about zmapp. cocktail of antibiotics shown in animal model to be protective against dying from this disease. we want to be able to see

how that works. a total of seven people have received zmapp as part of a come passionate use effort inclusion the two individuals we first heard about that were air lifted to emory hospital in georgia. we don't know with seven individuals whether this work in humans or not. the problem is those were the only seven does that's existed. nobody expected a big push so barta is pushing forward with dollars from the cr, a scaleup of thattest. for technical reasons, that is not trivial. acts are developed in a tobacco leaf program. and that doesn't necessarily turn into something where you just turn the crank and have lots of it. it is taking a while to do that scaleup. two or three other therapeutics are promising but none in human trials. we have a big push there as well. as far as nih, we did not

receive additional dollars in the continuing resolution. that goes through to december 11th. clearlily, whatever happens after that, we hope norad additional dollars because this is going to cost a lot of money. >> host: all right. we're talking about ebola with the director francis collins. join us for that conversation. the nih funding for 2013 is about $30 billion, $29.2 billion. and the 2015 request from the white house is $30.4 billion. founded in 1887. located in bethesda, maryland in sprawling campus. 37 separate institutes and centers. world's largest hospital dedicated to clinical research. a little over 23,000 unique patience in 2013. your questions, your comments for the director of

nih. get your thoughts in a minute. william is up first. vicksburg, michigan. democrat, thanks for hanging on the line. go ahead. >> caller: actually i'm from mississippi. >> host: sorry about that. go ahead. >> caller: first of all, thank you to c-span for allowing me to comment on this subject. first of all, first of all, i shouldn't say this but i'm a free mason and i don't want you guys to lie about health and thing like this because one thing about it is i love to help other people. it's one of the things that i love to do. if you guys are funded for this ebola operation, then

you can put forth the most earth to it and i understand that what you're saying and everything but if you reach out to the other cities, countries, states and ask them for funding, if they won't give you funding, ask the other people will they fund you to help the ebola. because first is the country of america needs to survive and if anything happens to america, then i believe the whole world is just out of hand. >> host: dr. collins, are you preparing for ebola outbreak in the united states? >> guest: i think the chance is low. on the other hand, it would not be shocking if someone with ebola got off a plane at some point in the next few months in the united states because this is such a large outbreak in west africa though efforts are being made to do screening at airports, that is possible but our public health system is excellent

and such an individual would be rapidly identified, isolated, we would make sure that kind of quarantining took place. i think the chances therefore that you would have a widespread outbreak in this country are low. a testimony to the public health system that has been built up over many decades to make it possible for me to say that. the caller is also suggesting that we do need to lean on other countries and i agree with that. the world health organization is a major convener of all of those countries trying to help. lots of ngos involved and particularly to doctors without borders carrying a great deal of the load in the early parts of this outbreak. we've all got to work together. greet that, you mentioned the statistics about nih. also important for callers to know most of our money is not spent in bethesda. goes out in grants. 85% to our best and finest universities and research

institutions. when you hear about a break through that happened at stanford or the university of chicago or the university of mississippi or wherever, it's very likely if it's by a medical research, it was funded by nih. >> host: let's go back to the situation with ebola in the news that was broken yesterday, the wall street journal has these numbers, 1 .4 million. cdc worst case easy mat by mid january. 2,811 the latest death toll. this 1.4 million is if nothing were to happen and doesn't take into calculation what the president announced recently with more money and sending soldiers, sending the u.s. military down to liberia. >> well, exactly. that projection, we have many miami doing this kind of modeling and they come up with somewhat different answers but it does look quite frightening when you're on a exponential

curve which is what is happening now in liberia, then over time, you can see numbers very fast into this kind of category of over a million but we want to stop that. so the president's announcement which i was heartened by and involved lots of input from different parts of the government including nih was to make a bold step here to try to put in place efforts to stop this outbreak in going further including asking the department of defense to set up in rapid fashion here 1700 beds in liberia so those individuals who aren infected or thought potentially to have been exposed can get the kind of treatment and isolation they decurvee serve but that won't be enough. we also have to have a plan actively pursued about how do you handle individuals who are potentially exposed outside of these treatment units because we won't have enough space for all of them to come in. lots of work being done on that. obviously the countries where this is all happening,

liberia, sierra leone, guinea, with the leaders increasingly effective in engaging with communities, this has to be a full bore effort on the part of efficient everybody involved. the u.s. of course has an i want worldwide in trying not just to be sol injuries to the world but doctors to the world. i think we're pulling out all the stops to do what we can. >> larry in alexandria, independent call you are. yes. >> caller: good morning. i want to thank you first for putting himself in harm's way in dealing with these issues because we have some things out there that i know they just haven't yet spoke of but what noters me is it is taking so long for them to get a handle on potential answers to questions like they said, they've had since 1976.

is there any way to cut down, anything we can do to cut down the time lag in fighting these? we have to analyze them after so many deaths before we get the idea that maybe this is important? >> guest: very sobering question. one we all struggle with. no one anticipated when the first case of ebola appeared in new guinea in march of this year that there was the potential for this kind of explosive outbreak and for the first couple of months looked like it was under control and then by the summer things started to happen that were alarming. it is very challenging given the already difficult circumstances in these west africa countries as far as public health systems which are in many cases quite rude men try to mount effective effort. that made this difficult. the fact that the outbreak

han in the cities has made this much harder than previous since 1976 mostly in rural a areas, more easily contained. it was sort of the perfect storm. i share the caller's sense of urgency and frustration about how hard it has been to get on the ground every resource we think is needed but i'm heartened by the steps taken in the last couple of weeks especially by the u.s. government. we do need more partners on the international stage and i'm hoping more of them will step up to the plate as well. this is an international worldwide public health emergency. no one should hang back if they have resources to contribute. >> host: i want to introduce another topic, dr. collins. that is security at labs. it's a story in the news recently with lab agencies, not just your own but cdc and others, here's u.s.a.

today yesterday. what has nih done since reports have come out about mice being infected with the ebola. what has nih done? >> guest: we're taking this very seriously greta, an issue we really need to attend to maintain public trust. important to point out that though there have been surprise discoveries of agents around for a long time, decades in some instances that have been lost track of, no individuals were hurt as a result of it. no risk to the public. at the same time, recognizing that it is possible for things to slip through after many years of people coming and going from an institution like nih or cdc. we are in the midst of doing a thorough sweep of every

freezer, refrigerator, shelf, drawer, to make sure that everything is where it should be and we're well along with that and by the end of this month will have a full reporting of what we have found here at nih and likewise, we have asked all our granting institutions, most of the people in the u.s. that do medical research to do the same. a good opportunity to take a full inventory. again, i will not want anyone to be alarmed that there is a serious risk to public health as a result of this, but it is prudent for us to be sure our house is in order and that's what we're doing. >> host: is there enough money for the nih and laboratories at universities, enough money separated out for security? >> guest: i think so. we will put in place today a new sort of recommendation that will be announced later on today about how they should pay attention to

biosecurity issues in relation to research that might potentially be used for nefarious purposes by those that have malintent about what they want to do with certain types of research, dual use research of concern. universities are struggling now. nih is struggling. frankly in answer to your question, maybe i should point out that nih and all granting institutions have lost about 25% of our purchasing power for research over the last 10 years. putting a stress on the system and a lot of great science that we'd like to do is slowed down or stopped as a result of this ten year decline. it's rather ironic when america has led the world in biomedical research for about 50 years that we are now slipping in that regard when other countries are coming up fast. that is bad for the potential here of medical sad vanses, bad for our economy. i'm hoping that over the course of time and very soon, in fact, decision makers in the congress will

figure out a way to turn this corner and bring us back into a stable support for this remarkable engine of discovery, biomedical research in the united states. >> host: who has oversight over the university labs? is it the federal government? >> guest: yes. every one of our granting institutions as part of the contract they sign on with us in order to receive taxpayer money to do research have certain obligations they have to follow and institutional biosafety committees that oversee this issue of biosafety in place for a long time. those are activity involved in this current business of looking for any evidence that their are agents in places that shouldn't be. they are strongly in a place i think which ought to provide a lot of confidence that these institutions are very much taking care of the issue. >> host: we go do michael, north carolina, independent

caller. good morning. >> caller: hi. how are you today? >> good morning. go ahead. >> caller: dr. collins, with all the good help we do around the world, that's what america is about, when are we going to remember the three million people here that have help tie at this time b. add450 coming out. fda is real slow on letting that out. they let everything else out. commercials that you wouldn't want to be stuck with the disease you have before you try the side effects. this is no side effects. for three million nonresponders. $120,000 for a 90 day course of steadily funded technology. they use federal money to come up with this drug. my tax money and right now, i'm dying. i'm in stage 3. the insurance companies with the no caps are turning me down. on getting this medication. yet you have three million people in the country that are nonresponders.

you are a cure, a proven cure for this disease yet i have no problems with helping the rest of the world, doctor, but three million people, out of the three million, how many people are not going to be able to afford this with insurance companies turning them down to buy the medication and the next step is a liver transplant. i'm 258 years old. i will not take a liver transplant because a 4-year-old deserves a new liver before a 58-year-old. >> guest: that's a troubling story from our caller from north carolina but there is a lot of excitement right now about the ability to cure hepatitis c with the new come points just pushed through and approved by the fda. i'm deeply troubled that the caller is not able to get access to that because of the cost and there is a lot of discussion about the cost. point out however that even though the drugs are expensive, it is very expensive also not to be cured of help tie at this

time c an such things as transplants cost more than the drug. i don't know exactly the caller's situation but i would think in this circumstance tans, there oughted to be a plan by the drug manufacturer to make this available to those that can't find the resources or don't have the insurance to cover it and i don't know how to handle this on the air but i would encourage the caller certainly to get in touch with the company and ask if there is some way to get access if the insurance is not providing coverage. >> host: okay. fred in florida. democrat. >> caller: good morning. i'm confines are fused. about 10 or 12 years ago, you made a movie about the ebola virus in africa, dustin hoffman, morgan freeman. all these people was in the movie and another question, why is it you got the white doctors out and two of them but left a few behind

causing all of these illnesses. doesn't make sense. at. >> guest: i'm not sure about the relationship to the movie. halves an opportunity to raise consciousness about the facts there are these new viruses emerging all the time that place potentially a worldwide community at risk and something we should be working hard to anticipate, develop therapeutics and vaccines for. what we've been talking about. the two individuals that were air lifted from liberia, that was something that their organizations, samaritan's purse wanted to put in the resources to do. that was not. money that was responsible for their traveling to the u.s. and being cared for. but in fact, u.s. citizens, as they were, are entitled to ask to come back into the country if they need medical care. there was no reason to refuse that. happily, both of them recovered with the care they

got at emory university hospital. of course, there are now thousands of people in west africa who are infected. there is no practical way to move them out of the space where they current are so the big effort now has to be to provide care for them there in country. and that would apply also to health care providers. many of whom sadly have always been infected and hundreds of them have died as a result of ebola. but the big push has to be to get things on the ground in liberia, in sierra leone, in guinea, to make it possible to treat those who become infected and reduce the number of new infections. that's what this is all about. >> john, independent, good morning. >> caller: good morning. my question is about the z pack. are you guy making more? is that what theater using to treat the people that came back? they ran out. is there more and all the

troops that they're sending, are they going to get the vaccines before they go? >> guest: so the vaccine is not ready yet to be delivered to anybody right now. it is just this face one trial in healthy volunteers to see if it is safe and generates an antibiotic. the troops going now to set up the 1700 beds are not able to have access to that because it's happening right away. in terms of zmapp, as i mentioned, this is a biotechnology advance where these are antibiotics directed against the ebola virus but they're generated using a recome bin national airport dna factory which happens to be tobacco plants. tobacco plants have increasingly been used for that purpose because they have the machinery to turn out proteins. but it doesn't scale easily. and the production of zmapp was not anticipated to be needed on this kind of scale any time this year and so at

the moment, we're in a bind. what barta is trying to do is pull out all the stops to scale that up or find other ways to make the zmapp abilities in a different system such haas been used in biotechnology for other purposes. unfortunately, there is no solution that is going to provide large numbers of doses of this in the next few months. it will take time. taxpayer. [please stand by]

the containment, how much trust show the public have in vaccines developed? can we see things going to legislation like the patriot act that protects eli lilly from possible litigation if they fail safe vaccinations and cures and treatments, and what do we have in terms of backup to prevent this from becoming a worldwide epidemic? worried about avian flu, many

people have been discussing. thank you. a lot of questions. let me try to take them quickly. in terms of confidence we ought to have in containment, a huge challenge in the circumstances inflict west africa. the department of defense is sending resources to put in place 1700 beds. but it is very challenging to come up with a strategy which requires a so it is an public education so people know what to do. critical issues about people affected, burials of people who died whose bodies turn out to be infected. do not touch and do not wash. a huge effort is underway to achieve those kinds of strict public health measures. it is challenging indeed. in terms of what we're doing in

terms of other parts of outreach, this is a huge priority. you mentioned the possibility of a flu outbreak. we worried about that about age five and one, which has been there for south east asia. it could potentially turn out to be a worldwide effort. we're working on a universal flu vaccine which would be effective against all vaccine strains and we believe we are in a pathway to get there. we would be further along if nih had not been in a circumstance of losing more purchasing power. this takes a lot of time and effort but we have not been able to move up the pace we would really like to. a wake-up call about the consequences of having those limitations when there is really a serious risk of worldwide illness. much of your work is focused on preventing illness and how much is focused on treating illnesses?

>> it of course has to be both. vaccines are an incredible contribution to the world. that hasok at the way prevented countless deaths, from childhood illnesses and such things as influenza, it is worth every penny. sick.ople still get we want to have something to offer them, whatever the illnesses. we put a huge amount of effort into therapeutic spirit we work as part of the ecosystem, basic science researchers funded by the government, doing things that would not get done by the private sector, but we work with our partners in biotech and industry. this vaccine for ebola, we would not be able to promise we could scale that up and have thousands or maybe tens of thousands of doses without that kind of partnership. full-page ad in the washington times this morning from peta with the picture of an

infant monkey, and it says, nih, millions spent scarring monkeys and making them depressed and drug. stop it now. what is the policy about using animals for the research you do? >> a good question. animals are essential for many of the things we are trying to learn about how to prevent and treat human diseases. with humano things patients ethically nor would we necessarily ask them to be involved in some of the studies that can be done on animals, which give us great insights, whether it is diabetes or heart disease or heart -- or alzheimer's. there are particular concerns i think when those animals are close relatives of ours. i want to point out we recently pretty much to scale back or maybe even stop altogether research on chimpanzees.

after extensive debate, we have the potential of small colony chance we would be for the kind of research that can only be done with chance. when it comes to peta concerns, they are also pointing to other monkeys where they are concerned about the way in which animals are handled. i want to reassure people this is done with intense oversight by a variety of groups that look at protocols to make decisions about whether the results of the research are justifying the kinds of studies being done. there is a great deal of attention to avoid pain and suffering. but reasonable people will still disagree about whether we have the balance right here it >> let's go to harriet, a miami beach republican caller. >> two questions. first, there was a study not the ago that showed possibility that ebola was

airborne. have you done any follow-up research to see whether that is true? is, there is aon magazine put out and sent to i believe everybody, every nih and ibout the wonder how much money the taxpayers are paying for the nih pr magazine. guest: to take the second question, i am not familiar with any. there is a small publication published by the national library of medicine that highlights things happening in research that you might find in a doctor's office. it is a modest budget and an opportunity to inform people about wings that are happening they might want to know about medical research

and implications for health care there has been a lot of discussion about, is it possible the virus could become transmissible by the airborne route, which would be a dangerous development. one animal study was actually quite different than anything you could imagine happening in thens that suggests possibility of that. frankly, i think the experts looking at that say that is not likely to happen in the current circumstance for humans with any serious possibility. the other concern is the ebola's mutating,la virus is as many viruses do. a lot of copies of the virus have a chance to change properties. we think it is unlikely those changes would make a big difference in transmit ability. it deserves close watching and the best solution for the risk is to end the outbreak at the present time, we think airborne transmission is extremely unlikely to develop. that is good there it you do not

want that to happen. >> a lot of questions this morning about ebola in the news. before we let you go, remind our viewers the role nih plays in the medical research community. >> it is the largest supporter of biomedical research and the world. the research is funded by grants we give to institutions all over the country, as well as what is done here at the is the campus has been over the course of many decades the reason why lifespan have been increasing and deaths like heart attacks and strokes -- we're making great strides against cancer and all kinds of conditions. this is a noble institution with a noble enterprise. privilege for me to serve as its director. i wish it was more widely known about in the public. anybody who looks at the mission of the accomplishments, the trains, the vision of what can happen next, if we really pulled out all the

stops and applied all the resources we need, would be truly excited about the promise for dealing with a whole host of diseases that currently cause a great deal of suffering. host: dr. collins come up next we will talk to patricia grady, the head of nursing research there. why is this important, to focus on nursing and having the research there? , as theatricia grady director, can no doubt tell you a lot of exciting work they are supporting. we have 27 institutes and centers at nih and we're trying to cover the entire landscape of biomedical needs. nursing is a critical part of our health care system. they also have great ideas about the way the system could work better. she will tell you more about that. that is part of the integrated whole that covers the waterfront from basic science to translational science to clinical trials and everything

in between. we're doing everything we can to against world safer disease, to come up with strategies for treatment that people just really need. host: a big thanks to your and your team for letting "washington journal" to come out to nih. we will continue this conversation and we will talk with patricia grady. we will talk about what her team does and what sort of research they're doing in the role of nurses. later, we will talk with dr. griffin rodgers in the national institute of diabetes and digestive and kidney diseases. that will be our conversation coming up. we will keep taking your calls until we get to patricia grady. a republican caller, kimberly. we do not have a guest right now but what are your thoughts on nih and pacific lee what they do

there? >> i was thinking a lot of the vaccinations they do our greed driven. i take care of a lot of senior citizen friends at 75 bus. despite the fact they have never whatever, ibox or noticed they're pushing the shingles vaccine, for $200. even though i am there with the person and they're telling the it, theyey do not want still try to do the shingles vaccine. that is crazy. havethe fact that i myself taken my daughters to the doctors, upper respiratory problems, and they wanted to give her a vaccine while she was sick. not supposedu're

to do that, you know? but if you tell these people, they get an attitude and you're not as smart as they are. the truth of it is, if somebody is already sick, you're not supposed to give them a vaccine. i wonder how much of this not sd to do that, you know? is money driven. host: you're wondering about the profits of vaccines. caller: physicians and nurses are pushing even though the patient is not qualified at the time when they are sick, or the person never had chickenpox to justify it. why would they push that? ok.: new york, democratic caller. help me with your name. in westborough, new york. caller, go ahead. one last call for a westborough, new york. host:democratic caller. caller: hello. host: clifton, new jersey, democratic caller, go ahead, curt. caller: when ebola comes up and the ice bucket challenge and

everything, i have to wonder who will do the research? what happened in new jersey is the biotechnology and pharmaceutical research has been decimated. most of biologists do not have anywhere to work. pfizer came into south andswick, fired everyone, the plow was bought, they got rid of all the chemist there. they closed a, site. i am wondering who will do the research, because all the people i know do not have jobs in chemistry and i do not know where the people in seton hall and princeton and russert -- and rutgers will find jobs. known will do the research after this. >> ok. back to the national institute of health, were patricia grady is joining us. she is the director of the national institute of nursing research. , what is they

institute and what do you do? >> we provide information for clinical practice and also for promoting wellness and health across the nation for individuals regarding their stage of life. because of nursing research, teams are better able to manage diabetes, young minority women are able to increase -- we have a better understanding of how men and women respond differently to certain pain medications, and we have provided tools for helping end-of-lifeiscuss with family members and patients, and also to try to approach the issues regarding that difficult time of life. >> why is that an out you know it? what contribution is nursing research making? >> nursing research does studies tot address chronic illness help us identify the issues, and

how better to identify interventions to help make that better. we engage in studies to determine how to change toaviors in individuals , and we determine what is important for these patients to want to know around the time of their end-of-life. we have an effort on the patient's and what their symptoms are and how to make their symptoms -- their conditions better. we also focus on the family's of those individuals there we know the caregivers require well.ance from us as the area of end-of-life is particularly important. as the population ages, people develop more chronic illnesses with age and develop serious illnesses.

we know that it is really important to focus on the symptoms, pain and suffering, at any stage of serious illness, and also family members. there is awhat we found out is great deal we do not know about pain management, communication among the health providers, and also patients and families, so we have identified ways to strategize communications systems to improve that and better address what patients need at the very serious time of illness. another area is incorporating the patient in planning their own care so they get the type of care they want and do not get the type of care they do not want. we also have, and studies have shown this, that is very important to the patients but also to families. if the condition has a serious and negative outcome, if a person does die, that the time after breeze meant -- grieving

is improved by someone understanding they did with their loved one wanted. and can rest assured of that. there is a great deal we do not know about painhost: we are talking with patricia grady, a trained nurse with a masters in nursing and a doctorate in physiology from georgetown university. our topic this morning is research and the role nurses play in health care. we have four nurses and we want to hear from you. get to joshua in rockville, maryland, and independent caller. good morning. we lost joshua. let's go to joy. independent caller, missouri. aller: i would like to see program on exactly what the nih does to monkeys and other animals. i bet the average person would be shocked at the cruelty involved.

ok.: right. patricia grady, is the use of monkeys part of your institute? a small amount of rescission animals, but not monkeys. but nih does. we did have -- we did hear france's college, the director of nih, speak about that type of research. >> christine, buffalo, new york, democratic caller and a nurse. caller: good morning. i have been a nurse for 48 years and have seen tremendous from the old to the new. i started out in the diploma program and got my bsn degree when i could afford it. i'm just wondering, have you done any research about what the impact of the 2020 resolution before a lot of the nursing board as to having a bsm for all willes and what impact

that have on obama care? >> we have not done any research in that area. we have done studies that show that the more education and background and experience nurses have is associated with debtor outcomes for patients with serious illness. but we have not done studies on specifically the 2020 proposition. >> susan is next, a republican caller in waldorf, maryland. >> i have been an outpatient for the past six years after having brain cancer. i am currently an inpatient watching myt here tv in the neurological research division. i cannot say enough about nih, the nursing staff, the doctors, everybody. i have been so impressed and in love with nih. >> specifically, what is it about the care you are receiving? >> i am receiving excellent

attention and care. i do not have to push that call button more than once. i cannot give enough love to this place. i wish i could give some way back to it. all right. that is a patient right there at nih right now. -- you watching, nursing, nurses interact with patients for best practices? guest: we are in most of the research we do is directed toward improving best practices for the over 3 million nurses across the country. i would like to thank the caller to -- for her contributions to nursing. i am pleased that as a practitioner and someone who has been so much a part of the health-care system, that she is feeling very positive about nursing and its contribution. the clinical center is a specific example of nursing at its best.

nurses there are involved in research protocols and really where there is state-of-the-art care being given. it is good to hear that you're there and that you are watching this morning from your bedside. nationaldget for the institute of nursing and research, the request for 2015, 100 40.5 million. in 1986 atblished the national center for nursing research, elevated to an institute in 1993 and more than 80% of the budget goes to researchers and trainees. registered nurses in the united states. in 2012, nearly 3 million registered nurses. the estimate for 2002, 3 .2 million. what does the health care system need to do to prepare for that increase? -health-care system desperately needs additional nurses. that, thecause of

nurses who are graduating, the increased number of nurses will be welcome and the environments will be prepared to take them in and make certain they become part of the new system seamlessly. our graduates are well prepared and very excited to be part of as new health care system our country moves into the 21st century. we have so many more opportunities for taking care of people well and for helping keep them healthier. we spend a lot of time in difference that test different settings. we have a number of studies that help teenagers and manage their diabetes, for example. problemss health across the spectrum of life, from helping premature infants leave the natal intensive care unit earlier and healthier, two managing theirns diets any health problems they

have, and also the older population who are living with chronic illnesses, to help them manage and be part of their own management of care. most people now are living older and healthier at that age. they really want to be a part of their health and care. studiesve a number of that are helping us assess that and develop strategies for helping people to dissipate in their own health. we're working with technology that helps people age at home, as it were, and it also helps them be active while we are monitoring the situation. if their activity level increases or decreases according to it ever chronic illness they manage, that will be noted and if help is needed, that will be sent so if all of these technologies are becoming much more technology for these people to help monitor their own health, and also to be able to be as active as possible for as

long as possible. press we will go to george next. independent caller. .> thank you so much i was there with the ebola situation and i'm also a clinical researcher. my question is, we in the medical community have been trying to reach out to nih and cdc and the body that are actually trying to help the situation in west africa right now. we have not had success with regards to national. that is involved in trying to help stem this disease. my question is, we know there are training programs that have been organized by cdc by obama and we know there are links your sending in your resume's, but we are finding it extremely

difficult for us to actually be contacted at with regards to helping. for me, i am a clinical researcher associate. that lincoln health, directly, given that link. is there a way that there may be so that can actually directly contact cdc or nih or any other body so we can have a direct impact from the get-go? -do not have a specific contact information for you on the ground in africa, but i do know we are excited people want to help and are trying to help. we are going through the process of trying to get active people. there is a great deal of preparation that takes place even for people who are already involved in clinical care and clinical research, so that the process of going through the identifying and devising

training programs to help people, when they are on the ground, is in the process. checkd suggest that you our website. we have a special link on the nih website related to ebola and will help you get from there to hopefully wherever it is you need to be very -- be. host: vicki is a nurse, democratic caller in oregon. i have been a registered nurse since 1966. i was wondering, i'm still working because i was called back by my organization to do teaching. wondering about the trend for the 12 hour shifts, how that across the country, the trend is that nurses work 12 hour shifts. there at the workplace, 12.5 hours. i hear in many situations, they

do not have rest rakes and breaks for lunch. how does that impact our 100,000 lives campaign and is there any association with increased errors with medications and other types of errors? when somebody is working maybe 3, 12 hour shifts in a row, and their commuting and they have a 14 hour day or whatever, and maybe there's lead to private and not getting the rest they need at work on any research being done on that or has there been any research in the past? are funding a fair amount of research on sleep and sleep disturbances and sleep patterns. it has been shown that decreased associated with impaired thinking and the ability to function. we have noted that in particular with soldiers and shift workers. it is important that everyone needs rest, but particularly important to have proper sleep and have rest so you are better

able to function and and effectively. >> caffe, democratic caller, berlin, illinois. click yes. patricia, i've a question for you. how do you determine your criteria when you are given money to these medical students in the university's? what is the criteria that is required for giving money for research? how do you know they are being upfront and telling the truth, actually, and not just getting the money for kickback money? that,ctually a victim of being used as a human guinea pig . a university in the chicagoland i am not quite, sure yet if it was funded by the government or the nih, but i did

contact the nih and they would not help me with it. they were very rude to me. that wasrocedure done an idea in a peer-based journal. i am disabled and now. -- disabled now. when i spoke to nih, they could not answer me any questions. >> patricia grady, could you answer the criteria question? >> that is a difficult story and i am sorry to hear that you had that unfortunate outcome. the money he have for research, about 80% of our budget goes out to research studies and for trainees across the country. we keep very close monitoring of those funds. they are given to the university on behalf of of researchers for studies. there is a fairly brisk surveillance of how that money

is spent and to make sure the goals of the research projects are met as outlined. we also have very strict oversight for human subjects. anyone who participates in a clinical study. because we understand how important that is and how they are helping us to make lies that are for future generations. there are very strict oversight for inclusion of patients in studies. i would think -- and that is that a local site as well. those are usually our oversight plus the institutional oversight, it tends to be very strict. inwe will go to paul next hollywood, florida. an independent color. hello, paul. >> good morning. i have a question regarding research in the area of pain management and the emergency room for patients with sickle cell disease. , the healthitute

institute, have they done any particular research in the area, and have you dispersed the information out to local regions and local hospitals to make use of that? i have seen some research in the area at duke university that seems to be pretty the successful. north carolina as well, and chicago. does notinformation seem to be reaching the rest of the nation. >> what is your experience with sickle cell? experience as a survivor, i am 65 years old now, has been slowthe treatment is very as the patient comes in. the area of fluid administered right away can decrease some of that a patient will have to wait for as the doctors

at emergency rooms are very crowded and doctors cannot always get to you right away. but there is very little protocol, like immediately given fluids, as opposed to saying, wait over there and we will get to you. that type of thing. and the patient remains in pain. >> describe the pain. for as the doctors at emergency rooms are very crowded and doctors cannot always get to you right away. sickle cell pain is rated in the emergency room from 1-10. anything of eight and better is considered to be crucial. the pain is in the joints. many times, in the chest, and the head as well. though, if i could describe it, it is as though somebody is squeezing your joints or squeezing your chest. your breathing is restricted. excruciating as a result of oxygen being denied or the blood lay let's, the blood cells clogging in ottery's

-- arteries and joints. but his not being supplied to areas of the body, especially organs. oxygen and blood is not reaching organs. this is producing pain. it can be disruptive to organs sickle cellwithin the body. >> ok. patricia. >> all is a good example of great deal knows a about his condition, sickle cell, and is able to describe it to us and also to his care providers, if you do go to the emergency room. in our institute, we do not focus on specific diseases. we do focus on symptoms. so we do have a fair amount of research directed toward the pain related to sickle cell. it is acute and serious. part of what we do in addition to getting information is for how toategies improve it. some of the ones paul has

mentioned are some of the ones we have been able to identify. we also, his question about getting information out, we also have a responsibility to get the information that we generate, new information from the research, out to patients and their families. we make a concerted effort to do that through our website and messaging, as well as publishing in not just scientific journals, but also lay journals and publications that are more available to the general public. that is an important part of what we do. we have, for example, at the end of life, we have a brochure on the website available in spanish and english and we also have written a chapter on the senior health website for how to stay healthy related to end-of-life and end-of-life issues. in we have a campaign pediatric care that discusses issues related to conversations.

it is called "conversations matter." those are very important because we have information about how to manage systems and how to communicate with the health care system, and, in general, they are intended to help health care providers work more effectively with patient populations. and also, for the patients and families. >> we will go to our line for republicans, naomi, republican and a nurse. ask how going to say or are actively active nurses. i am retired 45 years. license current because i volunteer for the american red cross now. and they really make it hard for you keep your nursing license

up. you have to attend so many classes for so many credits. wondering, what is your comment on that? >> we do recognize that as the population is aging, that the nursing population is also aging. we are facing a serious issue of retirement in the upcoming years. licensure ande the requirement to taking further education classes is important. there is so much new information. much of it, we are generating in our research. so much new information does affect our clinical practice for health team members. , and i know it is inconvenient for the person, sometimes but it is very important for patients and their safety at the people providing

that clinical care are up to date on the latest research and the latest findings to improve clinical care. those requirements for continuing education are likely to continue. about nursingng with the director of the national institute of nursing research. patricia grady. a couple of minutes left. our last call, christopher, in alabama, a democratic caller. go ahead. caller: i have a general comment on nursing. i pay out-of-pocket and i do not have insurance. i have a great doctor. to a clinic for things like blood tests. i have diabetes and i am treated for anxiety. what i have downed is that the nurse, because we have more time to talk, if i am at the doctor, it costs more to -- more the longer i am with them.

i found in talking to the nurse, i have gotten more information of how to treat my medical problems. christopher, i will leave it there and have patricia grady jump in. guest: so much of having a known as are the symptoms that bother us. that is the focus of our research, on symptoms and symptom management. determining what causes the symptoms and how to intervene and how to create comfort and relieve systems. a great deal of what we do in research and what nurses do in practice is related to that. it makes sense the nurse will be the community. we have people who are very mobile dealing with chronic illnesses and symptoms related. it does make them. i would say, talk to the nurses,

find out the variety of approaches that can be used to relieve symptoms and make you feel better so you can feel as healthy as possible. is about wellness, preventing illness, and increasing quality of life, so that every individual, regardless of the stage or age or background, will have as high a quality of life as possible. that is our goal. to work with you, the public, to make that happen. >> for more information, you can go online to the national isn't it of nursing research's website. thank you very much for your time, patricia grady. our conversation continues here about the role the national institutes of health plays in medical research today. up next, we will focus on diabetes, digestive, and kidney

diseases with dr. griffin rodgers. towardbut they tend continues with a stop at northwestern university. we will talk with the president there. we will keep getting your calls until we are joined by our next doctor. let me go to marjorie, a nurse and independent in missouri. what are your thoughts on the nursing field? i am retired but it brought back some of the things they're it i was a missionary nurse and i taught research. i have a masters, also. 1989, when i encountered the ebola virus in south sudan, we dealt with it and we were able to do some things that contained it a little. had to keep off people and burn them and keep -- give the

ashes away. i did want to answer a question with epidemics. why they sendnder out the american missionaries -- the missionaries to america. it is common. you always save the people who can save others first. you want those alive who could help more other -- help other people. the other question that i think he did not come up but perhaps it is relevant, we, in iran then intaught, and sudan, it was totaled as -- total denial. you get anybody working overseas. the health service will not admit it. epidemic.huge cholera no one would admit it. our students would lose family members and we were not allowed to call it that.

the third problem i might mention that might be relevant, it is a different type of epidemic but i was wanted to bring it up. a research problem -- project because he always thought a home there were 10 times as many physical and medical of underage mothers that give birth. infants would have mental status and things. you cannot i just for the social conditions but in iran, you could. there were many early mauger is -- marriages. we get a research study and it had to and when we were kicked out clutch or years later. but before, children and mothers, as ashley under 14, but under 16, were still mentally about four years below in doing it is aasks, and problem today here in america.

i think we need to do some research here. sri. on that, i will jump in. we want to go back to the national institute of health and here in bethesda, maryland, a sprawling campus close to the capital in bethesda, maryland. the budget overall for 2013 was $29.2 billion. about 30.2ey got billion. the white house requested 30.4 billion. this institute founded in 1887 and comprised of 27 separate institutes and centers. theof those institutes is national institute of diabetes and digestive and kidney diseases. we are joined by its director, dr. griffin rodgers. just tell our viewers what sort of research you do at the institute. >> the national institute of diabetes and digestive and kidney diseases is responsible for some of the most common and chronic, costly, and consequent so diseases affecting americans

today. we have research in diabetes and related endocrine disorders and metabolic diseases. we funded studies of digestive diseases, liver disease, as well as in kidney disease. the nine neurologic diseases. a vast see it is spectrum of disorders we are responsible for. your budget is 1.7 billion dollars. how is that money allocated out and for what? componentse are two of our funding scheme. inter-more -- inter-murrell -- a program here in bethesda that funds a number of laboratories and branches. we have had a laboratory in near the rivera reservation, where we study obesity and diabetes among the indians, who have among the highest prevalence of diabetes

of any population in the world. roughly 10% or slightly less of our budget goes to our program. about 85% of that budget funds research at universities, medical schools, hospitals, around the united states and, to a limited extent, internationally. >> let's focus on diabetes first. in 2012, according to nih, the effect is -- the affected is about 30 million people. aged 20 and older have prediabetes. 200-8000 under the age of 20 estimated to have diagnosed diabetes. how big of a problem is this? is a huge problem. the fact that there are 29 million americans with diabetes, perhaps a quarter of them are unaware they have diabetes, but that is just the tip of the iceberg. 89 million you described

that have prediabetes, a condition in which the blood sugars are high, but not quite high enough to designate them as frank diabetes, that is a major problem. no these patients, however, are at high risk for developing diabetes sometime within the next 1-5 years. i think we all agree that prevention of diabetes is certainly a goal that is critical. we want to prevent the high risk group from developing, preventing the development of diabetes as long as possible. host: the wall street journal this morning has this headline. a sign of progress. certainly, that is some positive news. notuld say that that is seen in all populations. although overall, the numbers may be trending and finding out, a higherroups have proportion.

certain racial ethnic groups. people over the age it -- as they age, the baby boomers increasing the numbers of our population, this is a risk factor for diabetes. family historya is certainly another risk factor. ,nd so, putting that altogether while it is somewhat comforting the numbers may be leveling off, that trend is not apparent in all populations. >> dr. rogers, where are we with treatment of diabetes? what is new? >> the two forms of diabetes, the major forms of diabetes that i should mention, first, there is type one diabetes, which we used to refer to as juvenile diabetes. this exists in individuals who have a genetic priebus a bit ash predisposition -- a genetic pancreasition -- their

inducing the insulin. these individuals are not able to produce sufficient insulin and that is required to sustain life. about 95% ofrity, individuals, have type 2 diabetes, or what we previously called adult onset diabetes. then, their body produces a sufficient amount of insulin and it does not work very well. they consist -- a condition called insulin resistance exists. it really drives the epidemic we're seeing in type two diabetes. is directly related to the obesity epidemic we see in the country. just read isne i this one in the wall street journal. pledged by 2005 5. coca-cola, pepsi company, dr pepper, snapple, will work to cut calories in the american diet 20% by 2025 by promoting

bottled water and low drinks and smaller portions. treatment is one thing, but the treatment combined with a bad diet does what? you offset the positive effects one receives. i have to say we are really gratified that a number of these companies are taking the effort to actually reduce the calories. one of the things we know is att in those individuals high risk for diabetes, those our nih fundeds, research for diabetes prevention program showed that in that high risk group, losing about five or 7% of one's body weight through exercise and calorie restriction can greatly reduce the risk of going on to develop type 2 diabetes. the fact that you are seeing companies now making this effort

really is gratifying. host: 83 -- a tweet -- to smoke toe needs live, but you have to eat to live. the types of strategies effective in the antismoking orpaign do not exactly match can be utilized in the obesity campaign. these really require important efforts in behavioral research and usually, people respond to different ways to rewards. a lot of the research we are actually funding now are really efforts in behavioral research, or the science of behavioral

research, to understand why people do certain things and not others, and how one can best and or makeectively explain certain that the recommendations given are carried out. >> according to your institute, obesity in the united states, approximately one third of u.s. adults and nearly 17% of children and teens. let's get to call. conrad is up first, independent. hi, conrad. >> good morning. i recently had a kidney transplant, after a few years of being on dialysis here. concerns is aest billf bills, a bipartisan with a beautiful name, the comprehensive immunosuppressive drug coverage for kidney transplant patient acts of 2013.

in 2009 and 2007, going back a decade. , byas bipartisan support subtest bipartisan cosponsors in both houses, and yet, after a decade, it has never even gotten out of committee. i was just wondering if you knew about the bill, and if so, if your organization had any public support for it. i am not certain of the details. i suspect the caller is referring to an effort to make certain that after patients who have in stage kidney disease were either required dialysis is a semi-for a kidney transplant, and the situation in which individuals receive a transplant, of course, they are receiving an organ generally or otherose relative donor. of course, one has to take

immunosuppression regimen or drugs to make sure the body does not reject the transplanted organ. i suspect, but i am not certain, that the bill you are referring to allows for ongoing coverage for those medications and that is an area in which, we really provide the research to understand what drugs might be more effective, how long one needs to be on the drugs, but specifically, for the legislation, we are not a part of that area of governance. immunogen z's in past 20 million americans. what are you doing on the research front and where are you with treatment? wewe have a number of things are undergoing. just like diabetes, what is inving the diabetes epidemic this country is obesity. in turn, the leading cause of

chronic kidnedisease in the country are diabetes and secondly hypertension. if one can effectively mitigate or prevent people from developing diabetes, which is our effort, then in turn, one could prevent complications associated with diabetes, such as chronic kidney disease. we have a host of efforts underway to see whether, in fact, one can first identify people at high risk for developing chronic kidney disease, again, there are genetics associated with this. people with kidney disease, it runs in families. we want to make sure people who have a family history or a history of high pressure and diabetes, are aware of that, so they can go to their doctors to be tested. because if one has been found to have early kidney disease, one can introduce therapy that can

gradually slow down the rate it progresses to in stage disease, requiring a kidney put chet -- a kidney transplant or dialysis. currently, we are involved in a number of studies to understand what it is about the kidney that could potentially lead to the damage, either acutely or chronically. and whether some of those, that damage, can actually be reversed inside kidneys. for people who already have in stage kidney disease, there are a number of efforts underway. when -- when we typically do a clinical trial, it involves recruiting individual patients versus the treatment other, a standard treatment, for example. oftentimes, those are very costly and it takes a long time before one can obtain the results of those trials. we are trying in addition to that effort more pragmatic

trials. one trial currently underway is a timed trial. the patient being the unit of randomization, it is actually the location or the center providing care. in this country, we have verylly teamed up with two large dialysis care providers in the unit of randomization, actually the center. there, one center can prepare a standard treatment to another center, who can make very modest adjustments in the dialysis regiment and now, instead of talking about 400 patients, we are talking about 4000 or 40,000 patients. you get a result much more rapidly. if that result is positive, that can gradually improve the standard of care. leslie will go to michael in massachusetts, democratic caller. thank you for hanging on the line. >> good morning. i am a type one diabetic dr..

i am 43 years old. i've had diabetes since i was four. apparently, according to my mom and dad, i did not really have a chance against it. i had gotten sick with a virus that happened to a pack -- to attack my pancreas. i was four, i was fine. after, i was always a type one diabetic. my mom is in her late 60's, and i'm getting concerned because she is on the line of diabetes type two. an excellent group of physicians, i am pleased with the care i get and i'm pleased with everything that has been going on with my care, except for the fact that our stem search -- stem cell research development got stopped when our last president was in office. i want to know if we can do anything to bring that back in what we need to do to bring that

back. --t is very them written very important for the cure of this disease. host: dr. rogers, do you believe it is important for the care of this disease? guest: i think we need to examine all areas of research, including stem cells, both in humans and also other models. one introduction of a new , which we fund this type of research, is giving us clues to how one could actually take an individual with type one diabetes, take their skin cells, and then put them in a test tube with a combination of agents, reprogram those cells back to pancreatic cells reducing insulin. in this regard, one can begin to test a variety of therapies that might be more effective in making certain those cells survive for much longer times.

that research is very important. we funded studies to really understand everything that is necessary in terms of the development and progression of cells that we funded. now the knowledge learned from that has really developed in number of tools that might be applied in the future to expand, even in people who have only a relatively small pancreatic functioning this type of research is an area that we are actively involved in. your color really highlighted a very important point. these individuals live with type one diabetes for over 30 years. he mentioned he was doing fine until the age of four and then

he developed a virus. something about that virus that .riggered his immune system more --ally became much ultimately required insulin because he had type one diabetes b. because we no so much about the genetic predisposition of diabetes, 85% of the genetic risk factors are understood. we think it's time to now study patients at high genetic risk and understand what in the environment is triggering this. it could be a virus. there are camps that believe that it's something in the night. we have a study just an ambitious study looking at the environmental triggers of diabetes in youth. we screened half a million

individuals to find 8000 at were following-- we are from the time of birth to 15 years of age. we are doing very careful follow-ups with them and their positions. we are collecting samples of stool and saliva and blood and other factors. we are determining what types of vaccines they are receiving care be collected millions of samples so far. what we will learn from this study is what are those triggers to people with high genetic risk for developing diabetes. if it turns out to be a virus, a vaccine can be developed to soat this successfully patients never develop. ,f it's something in the diet some sort of dietary restriction will be important. this is a bold effort and we really think that because of this combination of a genetic risk and and environmental

interaction, this study will set a gold standard for understanding other diseases and which genes and environments come and apply. host: canton, georgia. don, republican. caller: my mother had triggered diabetes. i don't recall what type it was. i have a brother and sister that are 10 years older than i am. shots andtake insulin have had difficulties with this disease. life, am so far in my i've been disease-free of sugar diabetes. -- if theyc makeup have the gene and i don't, i would like to know why i succeeded in life without becoming a victim of that illness. our genetic makeup says a

lot about what we are likely to become. you may or may not have the same risk because we have two parents and you inherit half of your genes from one parent and half from the other. , thatld be that susceptibility gene, you may have been lucky to not inherit. a lot has to do with our environment. how much we are exposed to, what we eat. as it turns out, and diabetes, our environment begins even earlier. bothtudies we have funded, in our phoenix branch and other sites nationally, determines that our environment begins in utero. a mother who develops type 2 diabetes or who has diabetes , theg pregnancy

infant born to that mother when they have diabetes is more likely to develop diabetes later on in life then an infant born to that same mother who was not affected with just a small diabetes -- gestational diabetes. there is something in our environment we are trying to understand. that's another factor to be considered. of course, if it runs in your family, that does put you at higher risk. it sounds like you're doing the right thing and you are being checked periodically to determine whether you have any signs of it. good prescription, however, is exercise and maintaining your weight at a level that your doctor recommends. we are talkingt: with dr. griffin rodgers. dk.nih.gov.

you can follow nih on twitter. they are like tweeting right now. a conversation we've been having here with several doctors at nih. to see if you qualify for a clinical trial, go to clinical trials.gov. steve in manchester, new hampshire. democratic caller. caller: hi. rogers, i have a brother who worked in the diabetes research project. a prominent diabetes research clinic. .e was laid off some time back they told him the project had come to an end. it coincided directly with the , what theion

government did. how much of this research has been affected by the sequestration and other types of budget cuts? the sequestration you are referring to is something that occurred back in fiscal year 2012. that had a direct effect on funding in that year until 13. or fiscal year 14 and 15, the funding is at a level approaching where we were back in 12. obviously, the more funds we have to fund research, the more research we can fund. it is axiomatic. i understand the concern the caller has and i've heard from -- had important

projects moving on when they had to cut their budget by a certain amount. they have very little choice. i'm hopeful that some of those positions are now opening up because this research is so vital. especially given the numbers that were cited early on in this program. host: jacksonville, florida. jack. independent caller. caller: my wife was diagnosed disease thatmmune attacks your lungs and kidneys. i would like the doctor, if he the lungs andts the kidneys. she's been on dialysis since 2007. right now, she's in a nursing home getting good care.

, nobody was diagnosed had ever heard of this syndrome. when she was in the hospital, the doctor took an educated guess and he diagnosed her right. guest: i'm really sorry to hear that your wife suffered from goodpasture's disease. that is an area that we actively are involved in researching. this is a disease that can affect both the lungs and the kidney. like type one diabetes in which the body is producing antibodies directed at the pancreatic cells . here's a condition in which the body is producing antibodies directed at the cells within the kidney. cause scar tissue to the kidney and overtime, as the kidney loses its function, patients will require dialysis. we are making a substantial

benefit to understanding the underlying cause of this. people in the pharmaceutical company are looking at potential a conditionreat such as goodpasture's disease. you were seeing drugs in the pharmaceutical companies which are called biologics. rather than a pill, these are treatment center directed at antibodies or neutralizing in the interaction that are occurring. goodpasture will be an example in which there are better therapies that will become available. host: edgewater, maryland. angelica is watching us there. republican. caller: good morning. i wanted to thank you for your important work and all the good that you do. have a question for you.

i feel the root of the problem is not being addressed by the fda. see and hear is that there are so many things now in the food, especially processed food, from sugar to antibiotics to chemicals from gmo produced food that are having all kinds of impacts on the human body. i feel there is a failure on the de of the government because the sugar, in particular, is a huge issue. i used to buy organic orange juice. i don't do it anymore. i was not aware that 24 grams of sugar per cup meant six teaspoons of sugar. guest: i think the caller raises an important point. we are beginning to understand causeme of these products

disease or contribute to health. for example, the food labeling suggests it's better to have more fruits and vegetables, more grains, lessre sugar. chemicals that she is suggesting may have direct negative effects. what we're learning now is that a number of these sub lenses me,ually affect the microbio a combination of bacteria and viruses that live within us. variousocesses these nutrients or additives, it changes our own chemistry in a actuallyit can contribute to the number of

conditions. this is an area of active research by investigators that we fund. basis or some of these adverse effects that we are seeing with the specific nutrients that we are ingesting? host: silver spring, maryland. independent caller. acua, cohead could -- go ahead. caller: i've heard you on our local radio stations providing really great information about combating diabetes and related diseases. thinkman's terms that i are very effective. i only hear it periodically. i'm wondering if there is any major campaign to get that information out on multiple radio stations into the schools. the way you say it makes so much sense. people will understand how to address the issue.

guest: thank you for giving a plug to our radio stations. you can go on our website. 85 series archived and readily available for your listeners. this on a daily basis in the baltimore-washington area and richmond and chicago and norfolk, virginia. four times during the year, we air this nationwide on about 50 stations. coming up on the first of december, this national airing in observance of world aids day in which we are talking about the importance of aids is an issue -- as an issue.

there is a wealth of information that we did not have time to cover that if you visit our you can not only get reference to that healthy moments, but also things for kidney education, diabetes education, weight control and a host of other things that are extremely important. support andte this come up with observations on publicly funded research, we have to make this available to both patients, families and the providers. host: dr. griffin rodgers, we want to thank you. everybody over at nih for talking to our viewers and letting us go over to your campus there. we appreciate your time. coming up next, we are going to continue c-span's big tour.

the president of northwestern university, morton schapiro. time here15 eastern to threats of terrorism by isis are affecting the political landscape. the associated press reports that in one of the latest republican campaign ads, a lone militant is featured walking across a barren land with a black banner. the once back burner issue of national security is suddenly at the forefront. polls show americans trust the gop more to deal with foreign policy and terrorism. ahead of the november elections, candidates have spent more than a quarter billion dollars on television ads. is survived by the center for public integrity says the bulk of the political ads are yet to come.

heavy spending on state-level raises almost $280 million and counting tops what candidates and their friends are paying for ads in u.s. senate races. the group puts senate specific television spending at $196 million. the campaign has been one of the most closely watched nationally and is also excited to be one of the most expensive is the virginia congressional contest between john faust and barbara comstock. mr. faust has been the first to mount a large-scale television ad campaign in the district. are running for the seat vacated by frank wolf. the chamber of commerce is hosting a midday debate today. on c-spansten to it radio lab at 12:30 p.m. eastern time. c-span campaign 2014. more than 100 debates for the control of congress. c-span campaign 2014 debate

coverage continues thursday night at 9:00. between lee terry and brad ashford. sunday, the iowa u.s. senate debate between bruce braley and joni ernst. c-span campaign 2014. more than 100 debates for the control of congress. the 2015 student cam video competition is underway. opentable middle and high school students to create a five-seven minute documentary on on the three branches and you. showing how a policy, law or action by the executive, legislative or judicial branch is affected you or your community. fore are 200 cash prizes students and teachers totaling $100,000. for a list of rules, go to student cam.org. >> "washington journal" continues. we are doing a,

month-long series of interviews with university presidents in conjunction with c-span's big 10 college tour. this morning, the c-span buses on the campus of northwestern university in chicago. now joining us is morton schapiro. mr. schapiro, let's begin with challenges that you see to higher education as the president of northwestern university. guest: thank you and welcome to you. i wish you were here in person. it's a beautiful day in chicago. -- we are to funding a big research university. we get 600 million dollars a year in sponsored research. the nih was on as a major funder. we always worry about keeping the lapse going and keeping affordability for the most

talented students in the country and the world, regardless of family circumstances. host: the tuition for northwestern university is $46,000. room and board comes in at 14300 -- $14,389.lars why is the price tag over $46,000? guest: as you said, the sticker price is 46. you add in room and board and it goes up to 60. we have about 8000 full-time undergrads paying the sticker price. come from families sufficiently wealthy that they can afford it. why do we charge a fair number of students as much as $60,000? you look at the data, we spend

about $80,000 to educate each undergrad each year. the two thirds who pay on average less than half of the sticker price get a much larger subsidy. host: the northwestern university is the only private university in the big ten conference. what is the difference between them? our viewers have been watching us do these interviews. it seems to be the price tag. much more expensive than the public universities we talk to. guest: we are not subsidized by the taxpayers of illinois. money a little bit of from the state to do new construction and keep research labs going. generally, we have to pay for ourselves. we have a very large endowment and we get a lot of money through philanthropy. host: your annual budget is $2 million -- $2 billion. endowment makes up $9.8 billion.

parents, students look for in deciding between a public university and private university like yours? host: there are a lot of great public's out there. we are proud to be in the big ten. there are 14 universities in the big ten. public.em are they are great flagship publics. many of them we call the public ivy's. we are a lot smaller. we have 8000 full-time undergrads. if you look at the larger ones, penn state, the ohio state, they have almost 40,000 undergrads. it's a bit of difference once you get on campus. it's more of a skull college -- small college feel. host: what about outcomes? are the outcomes the same?

graduation rates, job placement? anti-communist -- i'm an economist. i can say a few things about northwestern. our graduation rate is 95%. ofinst a national average 60%. we did a survey of the graduating class of 2013 and found most of them within a year of when they graduated and everyone was 20% -- and 22% were in graduate programs. we had a large group of the journalism program in theater and so on. it's not that surprising that they all got full-time jobs. we are proud of those educational outcomes. guest: how many students do you get a blank northwestern university for their freshman year?

how many do you accept? guest: last year, we had 43,000 applicants. it's about 13.0%. is, you get many more highly qualified people who could contribute greatly to life on campus then you're able to admit. that is clearly the case here. host: what is your criteria? guest: we do look at standardized test scores. we try not to make that the preeminent qualification knowing people could take review courses and take it many times. you care a lot about high school grade point average and we read the essays and we care deeply .bout teacher evaluations try to think about who can out only succeed in the classroom, oadlyho could more brad

added to an energetic campus. host: how do you maintain diversely? guest: it's expensive for the people from the top income brackets. it's not expensive for people at the bottom half of the american income distribution. you take 60,000 below, some of the people pay $15,000 and some pay nothing. you have to be careful when you say to expensive. expensive for the people for who come from wealthy families. host: what are you were thoughts on your neighboring state, michigan. the top court recently here upheld the michigan ban on college affirmative action. what is your take on affirmative action for colleges and universities? guest: we have, as you alluded

, a diverse campus. we have a lot of international students and members of underrepresented minorities. applications -- we have 34,000 applicants. we look at them in the context in which they were able to succeed. there are some people who come from lower income backgrounds, for example, who did not have the access to the standardized test score reviews. or have a family specific high school specific and you look at the record this person has produced. is it good enough to justify being admitted to northwestern? with texas and michigan, we are able to look at people in the context in which they had to succeed. host: we are talking with morton schapiro.

our big ten c-span for roles on today. -- our big ten c-span tour ls on today. we want to get your thoughts on higher education this morning. divided the lines like this. students, (202) 585-3880. parents, (202) 585-3881. educators, (202) 585-3882. illinois residents, (202) 585-3883. , what sort ofo majors does northwestern -- is northwestern university known for? guest: we have a very big and very large engineering program. this year, about 21% of the freshmen are in that.

we are very famous for the school of music eared one of the preeminent territory/liberal arts experiences in the world. and the school of journalism. we are very famous for that undergraduate and graduate program. -- preeminent conservatory/ liberal arts experiences in the world. our school of education. we are known as a large, fairly large research university with expertise and excellence across the body. host: you said earlier you are an economist. do you ever hear from companies about what sort of job skills they need from workers that are graduating from northwestern university? guest: yes, we do. more so in the preprofessional

majors. journalism and engineering and the like. we do. the data speaks or itself. -- for itself. students who graduated in june of 2013, we found almost everyone who wanted full-time employment basically had it. host: east brunswick, new jersey. go ahead. caller: i am a lawyer in new jersey. her little brother was a student at manhattan college and was short $11,000. his tuition for the was $54,000. the family does not have a lot of bread and they are distraught. i'm not sure that he will be able to continue this year. even though he is not published athlete.

he was not very limber about getting signed up on an athletic scholarship. i'm fine, but it's complicated. i'm not sure exactly what options a family like them -- they can't get a loan. what can they do on an emergency basis? first of all, in general, it's a sad story. i'm from new jersey myself. it's even sadder to hear from somebody from new jersey to tell that story. i mentioned before, we are in full need. that situation would not happen here. higher education typically is the best financial investment anyone is going to make in his or her lifetime. the rates of return are at

record levels. generally, for most people who do take out those loans, the economic evidence is clear that's a good investment. i can't comment on that particular case. sometimes imperfections in capital markets. you can get a great return, but you can always get the access to capital. would you say college is worth it across every major? guest: i love the way you added across every major. , the data are pretty clear that federal reserve bank of new york just released a study two weeks ago talking about how long it takes in your work experience to make up for the cost of college. not just the money you spend in tuition, but also the foregone earnings when you're in college as opposed to in the labor force. they look at the differential earnings you get because you

have a college degree. when i graduated in 1975, it took 23 years to make up for all those costs. now come it takes less than 10. it's not only a great investment , it's a better investment than it ever worse. -- than it ever was. there is a myth out there that if you major in business, accounting, you're going to make more money over your lifetime than classics. if you looked, about 15 years after entry into the labor force, classics majors make even more than accounting majors. keep that in mind. host: we go to sean in cambridge. he student up there. caller: thank you for taking my call. i am a graduate student. i am blind. i was interested in asking a question related to accessible materials for students with disabilities.

i was wondering if you could speak to efforts underway to make sure that technologies that are developed, course management interfaces, electronic textbooks of tablets -- electronic textbooks, tablets are accessible to students with his abilities. i was interested in commenting on a bill that's in congress called the teach act that would set out voluntary guidelines to achieve that. the american council on education has come out in opposition of that bill. i was wondering if you could speak about your stance on that. guest: i did not know about bill, but i am going to reach out. i feel very strongly about this. in many cases, as you know, there already is a really cooperation -- a legal obligation, but also a moral

obligation. , it'shanges in technology much more cost-efficient and much more practical to do so. sometimes, people worry about the legal aspects. i think we ought to do a better job worrying about the moral aspects as well. taking your questions and concerns about higher education. students, (202) 585-3880. parents, (202) 585-3881. educators, (202) 585-3882. illinois residents, (202) 585-3883. we continue our conversation the morton schapiro, president of northwestern university. roger green on twitter says this -- mr. schapiro? we are private, but not a

proprietary school. have accesse should to loans and pell grants and everything. if you look at default rates on loans, northwestern is less than 2%. if you are thinking about public policy, what's the best investment the federal government can make, the theuation rates are in 90's. publics are in the 50's. it would be terrible public policy to exclude the private not-for-profit sector. it's different for the private for-profit sector. host: what about the effect of udent loan debt in general on the economy? guest: there's a lot of attention to the fact that when student loan debt crossed the

trillion dollars, a lot of reporters got very excited about that large number. debt. exceeds credit card that's the more sensationalistic headline. credit card debt, for example, is basically paying the price of consumption goods. investment --mic onre is enormous literature this. it's the best economic decision one can make. you don't want to inflate -- conflate credit card debt in student loan debt. illinois. in a parent. caller: good morning. thanks for taking my call. regardinguestion student admission. currently inunior

district 204. he is averaging approximately a 3.75 gpa. he is really not involved in sports or outside interests. if he was interested in , whating northwestern would he need to do to increase potential chances to get in? guest: we get a lot of good kids from their. -- from there. congratulations to you and your son. it sounds like he's very successful. to get into any single selective private or selective public, it's a bit of a crapshoot.

when you are only admitting 13% of the applicants, you never know. that's why i tell children to apply to a lot of different places. generally, if you apply early, it increases your percentages. we have empirical data that shows that. to find all him passion. i would also tell him to enjoy high school. i just spoke to 2000 and during shman and i apologized to them -- in some cases, the to aess of getting in prestigious school sometimes ruins their love of learning. maybe they take too many advanced placement courses or to many a ct review courses. many act review courses.

for your son to get into a highly selective public or private is to ruin his childhood, it's not worth it. host: what about legacies? is that a factor in admissions and northwestern -- into northwestern? guest: it is. we don't have the same percentage. it's slightly south of 10%. there are others where it's funny percent. -- wendy percent. -- 20%. there are 34,000 applicants and 10,000 of them are really not ready to prosper and contribute widely to the campus here. of the rest come you are taking about half of them. if they have the equivalent gpa and act, if one of their

parents went to northwestern is a way to break ties. the moral obligation is to make sure that everyone who we admit can really prosper here and feel good about himself or herself. just because your parents or grandparents went here, my responsibility is to the kid, not to anybody else. host: mary in pennsylvania. a parent caller:. i'm the mother of eight children. they all went to college to a marine biologists. i'm very upset about the moral decline in colleges. children going to college and drinking. i don't want them to have to have a job on the side so they can go to these places and have

and all thise drinking. why aren't you having more formal relationships between men and women? important ass education. that's why our moral ethics and values are declining because we as parents are putting all of this money into our children to be corrupted. guest: god bless you with your a children. 8 children. i take issue with the premise of the question. i don't think anything is declining. i showed up on campus in 1971. i'm pretty close to it. i have lived more or less on campus for 15 years. his generation -- this are a lot more

impressive than my generation of baby boomers. their moral character is probably better. drinking and other aspects of student life is a problem. is it greater than when i was in college? absolutely not. host: campus safety is an issue in the news lately. here's the headline from fox. a suspect in the case of the university of virginia student is charged with abduction. what is northwestern doing about campus safety? are blessed to be here. a wonderful suburban location. it's a fantastic city. a city of 75,000 or so. we are blessed to be here. you can look at one of the nice things that the government has forced everybody to do is disclose your crime statistics.

schoola sensational intros bill. terrible things to happen. -- he is a sensational school in charlottesville. terrible things do happen. there was a time when we swept about under the rug drinking and sexual assault and other aspects of safety and now we don't. we try to deal with it. recognizing problems and dealing with it, we are much more successful. host: you are one of the primary founders of the big ten. there are actually 14 schools in the big ten. what is the significance of this conference? guest: it stands for academics and athletics. is a bit unusual

given that we are so much smaller than the other 13 universities and we are the only private. we are proud to be there. it's doubts for something. it stands for the student athlete and excellence in everything we do. one thing i really love is just -- we tell our theater people that they should win emmys. we tell our athletes that they should compete at the highest national level. their student athletes. -- they are student athletes. host: what is the value to the members of the big ten? guest: we have an academic -- people focus on the athletic side. we are also an academic conference. we have consortium -- a consortium of academics.

we have tremendous cooperative research operations and even some teaching. both the athletic side and the academic side. is as, northwestern relatively small, private university. we are on national tv constantly. we're plain football this week at penn state. we are going to be on national tv again. we have nebraska coming in and michigan coming in. you pick up the paper and there's a big thing about northwestern. it gives us nice exposure. it's exposure about the academic excellence as well as a athletic excellence. host: we are talking education with the president of northwestern university, morton schapiro. we want to get your thoughts, your comments and concerns about iran education -- about higher

education. students (202) 585-3880. parents (202) 585-3881. educators (202) 585-3882. illinois residents, (202) 628-0183. do you come down on football players turn to unionize -- trying to unionize? that they surprised me. -- that day surprised me. if you go back to when our student athletes came out and said we should try to think about unionizing, they quickly pointed out that we have a graduation rate for football players of 97%. it would be good to do it for everyone. for safety concerns and the

like. sense -- i'm proud this happened at northwestern. we train people to become leaders. -- a was a history that class on the history of union leaders. i feel strongly our football players another 492 varsity --letes here at northwestern their students. we don't have special majors or dorms. we lead the nation year after year and student graduation rates. guest: does northwestern -- host: does northwestern profit off these athletes? no, we don't profit. our budget is $2.1 billion. our total athletics is $64 million. it generates $64 million.

we spend it on the students. we make some much extra money like some schools might be able to do. we spend it with the netflix and recreation and our students who -- we spend its within athletics and recreation and our students get scholarships. virginia in illinois. you're on the air. caller: i don't have a student in college at this time. i have had. i was very disappointed that a university with the standing the northwestern has and university of illinois chicago would have people on their staff that have been very subversive in the past and broken laws.

if they a parent do don't want their children being taught by this type of person? a lot of the listeners are aware -- we have 3000 people or so in the faculty. they are generally proud members of the community and excellent teachers. there are a lot of schools. if you want to say because there is one professor who might have done something in the past that you don't like, you are not going to send the kid to that school, there are other schools to syndicate. if you look at that, you're going to find out there are many people. what happens in the classroom? does this professor bring his or her political ideology to the classroom? i'm proud of the faculty here at northwestern.

a parent in illinois. you're on the air. caller: i have a grandson who was an excellent student. he is in all advanced classes. i would like to know if there is any advantage of his going to or plant- eths northwestern. -- applying to northwestern. guest: it's a wonderful school. a sensational public institution. have 13 eths students. the answer is, yes. created the good neighbor university programs. anybody that graduates at a high school in chicago gets a special financial aid package.

no loan expectations. it is not taxed in financial aid. .e love the kids from eths i had the great pleasure of teaching a number of them over the past five years. host: this is a story from the chicago tribune back in march. northwestern university to launch area's largest fundraising campaign. $3.75 billion. what does it take to raise that kind of money and why is it necessary? it's necessary because you want to keep those laboratories going. earth shattering scientific discoveries. you want to make sure that all the students who get in have the same experience regardless of family circumstance and you want to stay within the lines. all of that takes money and we are in a campaign. so far, it's going extremely well.

some people believe in our vision, some people want to associate with the excellence of northwestern university and some people are very loyal this many people are very loyal because manyhad transported -- people are very loyal because they had transformative experiences. the 10t would be among largest fundraising efforts by university in the united states. how close are you to your goal? guest: we ended the quiet phase six months ago. $1.5d already raised over billion. the numbers are daunting. we have a number of zeros on it. people love northwestern and they are very generous to support us. host: what is the donor process like? we spend a lot of time.

we have a large alumni relations and development operations. of time onlot fundraising activities. a pretty sophisticated operation. the success speaks for itself. host: how much time do you spend fundraising? guest: i'm a little unusual because i still teach and still publish. i do a lot of travel. i'm on the road almost every week. . will be teaching next quarter a large course with a lot of freshmen. i teach tuesday and thursday. i almost never fly thursday arning because, if there is delay, there will be a lot of students who will notice i'm not there. i'm usually gone tuesday and most of the day on wednesday and

quite often i leave again for the weekends. i spend a fair amount of time fundraising. my faculty colleagues don't understand how gratifying it is. you you have something really care about any raise the money to support it, it's as good as teaching a great class or publishing a great article. host: what is the tenure rate percentage? how is that achieved? guest: we have about two thirds or so of our faculty in the tenure line positions. it's a standard sort of thing. the prevalence of tenure in american higher education has changed over the course of my career. i began my faculty career teaching at the university of pennsylvania and two thirds of

the full-time faculty were in the tenure system. now, it's below 30%. that has changed. the way to get tenure has not really changed. host: do you think reduction has impacted higher education negative way? -- negatively? guest: that's a really good issue. i continue to do some publishing. i had an article that came out one year ago and it got a lot of coverage. it looked at contingent faculty. they teach your full-time, for a long period of time. but they are not on the tenure system. we look at their teaching effectiveness versus that of a tenure track faculty. we found that they are teaching their teaching excellence is supported by the imperial data. if you treat those people like and you recognize their value,

it's a little less worrying than the numbers going from two thirds to under 30% tenure track. host: what do you think about the future of harrier education -- higher education and technology? getting a degree without having to pay for the room and board. guest: i think it's overblown in the media, frankly. faculty member for 35 years. technology really helped. certaine places where vehicles are very effective. it doesn't change the magic of what happens in a classroom and it certainly doesn't change the experience of what happened outside the classroom. before i came in administrator 20 years ago, i was blissfully unaware that a lot of a college education that we provide takes place in the dorms. what happens in a student

involvement group or public service group were a cappella group or saturday night in a dorm. that's a lot of the education and that doesn't happen when .ou're sitting in a bedroom you, as we wrap up your mentioned the greatest challenges to education, one of them being affordability. what else do you see happening in higher education that concerns you? guest: we want to create well-rounded individuals. a certain extent, it goes back to the question before about what it takes to get into one of our places. there is an undue specialization for young people in order to get into the most selective colleges and universities. the studentsid were involved when i apologized

for the process. -- you want tos imbue a love of learning so they educate themselves. i think about how little i knew when i graduated college in 1975. you want to imbue in them a love of learning and you want to imbue in them a real respect for others and for difference. se're leaving the millennial with a difficult world. isrican higher education really part of the solution. is theorton schapiro president of northwestern university. we want to thank you and your staff for joining us for this conversation. we appreciate it. guest: it's an honor to be here. host: the c-span bus big ten

tour continues this week on tuesday. we spoke with mitch daniels. will beday, we traveling on to michigan state university and talking to their president there. that is tomorrow here on the washington journal. that does it for today. we want to bring you to the united nations. obama is addressing the general assembly shortly. talking about the threat of isis. right now, the president of brazil. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2014] and countless cases of humanitarian plight. barbaric accept the lawlessness that it violates our ethical, moral, and civilizational values. nor can we remain indifferent to the spread of the ebola virus in

western africa. accordingly, we support the proposal put forth by the secretary-general to establish the united nations mission for ebola emergency response. brazil will be utterly in favor of that mission. mr. president, the united nations security council has had some faculty and promoting peaceful resolutions of these conflicts, and to overcome such a stalemate a true reform of the security council will be required, a process which has been dragging on for quite some time. the 70th anniversary of the 2015 appearss in to be a conducive occasion for achieving the progress the situation currently calls for. i am quite c