requires having three deals. it is a deal between the u.s. negotiators and the iranian negotiators, the easiest of the three. the deal between the president and the foreign minister. there is a deal that has to be struck between our president and our congress, that is an equally tough deal. so -- the 24th is a fascinating marker and i'm sorry michael won't be around to have it in his books. i think we have a long way to go. >> thank you, david. nuclear negotiations are playing out against the backdrop of war in syria and iraq which threaten

the viability in the states, the campaign against isis to explore how this regional tunnel is affecting the negotiations. we turn now to mark. >> thanks for depressing everyone thoroughly by comparing it to the middle east peace process. it is a real honor to be here. when rob asked me to be on the panel and said they were doing it in honor of michael, of course i said yes, although i said the iran nuclear negotiation and the details and intricacies are not a primary topic of my coverage, and there are people far more expert who could be with us today. he said, there are other aspects

of this that you are more familiar with, so at the risk of violating, we will let you get up and talk even though you don't know what you're talking about. i figured i would definitely stick to what i was more familiar with, which i think is a critical part of everything we have just discussed, which is how what is happening now in the middle east really is central to these negotiations. i just want to say that i spent 15 months at the wilson center. some of the 15 of the best months i have had professionally, working on my book. i can't think of my time at the wilson center without also eating of michael. he is an integral part of my memories of this place. we started out sharing offices close by, and then we would meet for lunch, and then we also shared a terrific research assistant, who is here. we fought over her time. she was that good.

and just the conversations i had with him about these ongoing, endless negotiations -- how to incorporate them into his book, and the memories i have would be there would be another round of negotiation that was announced, whether it be in vienna or moscow, and michael was so torn. he would say, i have to stay and finish this book -- but i really want to be there. i think i can go, i think i can go. michael, you could really get access -- he said no, they're not going to talk to anybody -- we are going to be shut out. but he realized that being there was important. he was a reporter. that is, i think, the first rule of being a reporter -- you have to be there to find the story.

michael truly believed that and he couldn't imagine -- this was a topic that was so central to his coverage. not being there for whatever was happening critically at that time -- he just felt like he always had to be where the action was. that is a really strong memory for me. on the issue of isis, iran, how all of the recent events in the middle east play into what they just discussed -- i think the last six months, to put it mildly, just made everything a lot more complicated. rob said at the outset that it would be hard to imagine months ago or year ago having a discussion on this topic without the prospect of a possible airstrike or a military action

in iran. i think, equally implausible, was the idea that we could have a discussion on this topic and one central part of it would be that iran and the united states are working fundamentally close with very common interest on a critical issue in the middle east, isis. if you backup for a second, you had before the last six months, before this summer, you have this calcified set of issues on iran, iraq, syria. things were pretty intractable and weren't going to move. you had a bloody civil war in syria that went on and on with abhorrent loss of life. iran was directly invested in it. but clearly, the obama

administration was not. the obama administration -- president obama said time and time again that this was not a fight that the united states could make an appreciable difference in. it was his role to keep the united states out of it. we heard in so many interviews that he would compare the syrian conflict to an african civil war or something that was really marginal win the u.s. looked at its own interests. that was the civil war against assad. we wrote however many stories

about how there was this debate within the administration, but fundamentally president obama never really believed it. he didn't believe that it was that important. on the other hand, you had iran, which was clearly heavily invested in supporting the assad regime. flowing money, personnel, troops, weapons to the assad regime, because it was about keeping the assad regime, central to iran's interest. there was this real mismatch of interest. in some ways, that allowed, at least from the united states point of view, to compartmentalize the issue stop you could compartmentalize the nuclear negotiations from the broader issue of syria, the violence in the middle east, because the united states was not all that invested. the priority of the administration was getting a deal with iran.

it was going to be part of president obama's legacy, maybe the linchpin of his foreign-policy legacy, dealing with the iranian program. the lack of interest in other aspects of the middle east, i think, allowed the administration to be so singularly focused. but then june and july happened and what we saw was the push by isis to go into northern iraq, to take over mosul, to make a march on baghdad. already they had carved out large parts of syria, but that was not really on the radar and the senior levels of the administration, because it was all part of the messy syrian civil war that the united states was determined to stay out of. but then it became an iraqi problem, and it became a question of isis threats in baghdad? we now see the united states once again militarily involved in iraq and also with airstrikes in syria. this has totally changed the landscape of how we deal with

these various partners. you now have instead of assad being the enemy, you now have a common enemy that everyone is lined up against. it is the one enemy that you ran, israel, saudi arabia, the pope, the united states -- it sounds like a joke -- they had all come out against isis because isis as seen -- is seen by so many as a significant threat. that is a scrambled picture. it changed the calculus for the various parties. it is no longer as simple as it was. for that reason, i think it is going to have at least a tangential impact on the negotiations that rob and david

talked about, because the u.s. interests have shifted. the u.s. now has as much of an interest in the perception of the obama administration, as much of an interest in beating back isis, as it does in denuclearizing iran. there was very little attention comparatively compared to what it is today. so how does iran interpret that? it could be interpreted in a couple different ways. jay solomon wrote a great story last week about obama's letter.

a discussion about how the war against isis would impact the ongoing negotiations. iranians have indicated -- this is leverage. ok, the united states is now invested in this region in a way it wasn't before. it now needs iran. it considers isis such a fundamental threat to the region, it knows that it would need iran toss help in order to beat back isis. the united states does need them to some degree. i don't see any direct military cooperation between the united states and iran, but i would certainly guess that there would be some indirect intelligence discussions going on. because that is what intelligence officials do.

they tried to figure out what the other side is up to, especially when there is some common ground. a little bit of speculation on my part but it wouldn't be surprised at all. there is this common interest that iran might interpret as leverage and could overplay. they could think -- this is their chance to get the most of what they can get because the united states needs them against isis. but there is a risk here as well. the danger that faces iran, completely misplaying its own strength. not only do they have a regime in syria to prop up, they now have to deal with the isis threat in iraq.

there have been reports that they don't have the manpower to do what they do in iraq, and they are relying on conventional military activity to fight isis. iran does not have limitless military resources and they had already got this regime in syria to support. they presumably do not see the prospects of having to fight a years long war against isis as something that they relish because of their own limitation. the other reason that time is not necessarily on the side of iran is the price of oil. the price of oil is sinking. this is putting pressure on iran. that would be another reason why

iran shouldn't take it just because the united states need them for isis -- they could play out the clock longer and longer. just a couple points to close. as president obama has indicated, this war against isis is going to be long. it is going to be something that will be low-grade for some period of time. on the bright side, it looks like the united states and iran may have common interests on a very significant subject for a long time to come, as long as this war is fighting to stop as long as isis is a threat, the united states and iran will have common interests. i don't think anyone is dealing with this had on because we don't know the future of assad.

it that wants to train rebel forces in syria to fight and somewhere down the road we will deal with the assad problem. whenever that happens, that is what will put the united states and iran on a collision course, because once again their interests will come head-on. hopefully before that happens there will be a nuclear deal. >> thank you. i wanted to thread the discussion. einstein famously said that politics is more difficult than physics. in the case of the iranian nuclear challenges, how do you view the leakage issue? i argued that compartmentalizing the agreement may be the way of

finessing this gap. there is space on the technological continuing to region nuclear agreement. that workout does suggest a political narrative that is not unattractive for both sides. iran could say they stood up to bullying and got sanctions relief, we have preserved iran's rights. america could say they are not a screwdriver turn away. do you see that coming to some sort of resolution? >> i do think that is a narrative that will bring to some kind of resolution. whether it will be by november 24 is another question. i thought it was interesting at

the united nations in september that both foreign minister an secretary kerry were saying these issues are not linked. we are not going to do a trade-off of the nuclear deal for cooperation on isis. i think that was the right approach. it was the right approach for the united states because a deal in dealing with isis is a temporary thing. but the half-life of a deal on isis is a lot shorter than a half-life on uranium or plutonium. they need something that is long-lasting on the nuclear side. that doesn't mean they are completely unrelated, but to trade-off the nuclear for uncertain gains elsewhere i think would have been unwise for

the u.s. i think it would have been unwise for the iranians. they are stretched extremely thin. oil prices are dropping. if you believe the projections they will drop some more. it is dropping fast enough that you even wonder whether the russians want this deal to happen because the last thing they might want to happen is for the iranians to come back on the market with more oil and bring the price down. even faster. if you are the supreme leader and you are playing this out, i think that you want to keep possibility of a cooperation against isis out there in the hopes that it will give you some advantage. but you don't want that to be

explicit. if you had a model here, think of president kennedy removing the missiles in turkey. they were separate announcements, six months apart, complete deniability. if i was the united states or the iranians i would want to keep it that way. >> mark, in your presentation you mentioned that in iraq and the united states and iran are kind of tacitly in alignment supporting the central government, perceived as a broader shiite government. in syria the interests begin to diverge over the future of assad. how do you see that tension playing out over time, particularly when you have u.s. forces in iraq where you also have iranian forces.

some inadvertent action that run up against each other -- how do you see these issues getting worked out over time? >> he makes this intriguing prospect of american forces in iraq somehow not fighting alongside but in some kind of coordination with whatever iran is doing against a common enemy. the current debate in iraq is to what extent the u.s. advisers there are going to be engaged in

combat. that is very much a disagreement depending on whether you talk to someone at the pentagon are at the white house. certainly the chairman of the joint chiefs of staff have indicated that the pentagon envisions they will be working with iraqi forces on the ground, calling in airstrikes. that raises some very interesting prospects for whatever they are doing to beat back isis in iraq. i think the real question that we can't answer at this point is to what extent does the syria -- what is the ground picture in syria? obama has ruled out boots on the ground. it is hard to imagine that he is going to go back on that. but a lot can happen in two years.

the question is if there was a military presence in syria, who will they be fighting and to what extent does this issue of a collision course -- assad remains at the center of the picture. it is in my mind in the reporting i've seen -- i still haven't quite figured out how whatever force that has been trained to be the boots on the ground, what they are going to do, and you they are going to fight, and how that is going to be worked out with either an american presence or the presence of another arab nation. if you can imagine -- iraq is actually an easier thing to envision in syria, which is a far more complicated prospect. >> thank you. let's open to the floor for questions and comments. if the speakers could please identify themselves.

>> thank you. it was announced earlier this week that they have agreed to construct eight new nuclear reactors in iran. what are the impacts of that announcement? >> david, you broke the story earlier this week about the possibility of fissile material going to russia, and now this new development that they could build reactors, because one of the issues has been iran -- this opens the door to the possibility there might be some

practical needs for the fuel cycle program. what's your take? >> it's an excellent question and i think that the upside of this for the iranians has been we're enriching fuel for a set of reactors that do not exist. the russian supply it and will be supplying it through 2021. now the agreement that was announced was a bit vague. it talked initially about two reactors, the possibility of moving up to eight. we know from our own experience here in the united states, we know from the japanese experience and the european experience it's a lot easier to announce reactors than to build

reactors, although it would be interesting to see if a not in my backyard movement crops up in iran. that would be an interesting story. it creates a rational of sorts under which the iranians could justify going up to the supreme leaders 190,000 centrifuges as a rational for fueling these when they get built. it takes so long to build them, they would have plenty of time to do this. to that degree it helps. the other side is the iranians are inefficient producers of uranium. if they wanted to do this at a cheaper price they would buy the nuclear fuel on the open market. there is a glut oist, particularly after the japanese closed down so many of their reactors. but there was a glut before that

time. and so it doesn't make a lot of sense for the iranians to be producing this inefficiently, shipping it to russia, having it fabricated into this specialty fuel to fuel these reactors. but if, in fact, it is a way of maintaining control and people can see what they are producing, if it's regularly leaving the country, we have a high confidence level the russians are doing this correctly, then it's a potential solution. and there is no reason that the iranians shouldn't be allowed to produce this assuming there is an understanding about what happens to the spent fuel so it doesn't turn into plutonium fuel. >> may i add my sympathies about michael. he was a member of our iran task

force and very helpful in that regard. to david, how important is it that this declarified are you surprised that obviously nothing would happen until november 24, is it necessary for the findings to be publicized at some point? could they be kept quietly? could this be a long process that does not lose face for the iranians who insist they never intended to build nuclear weapons? >> very good question. this is i think in many ways the toughest issue for the iranians, because if you believe the intelligence, and there is a big if there, prior to 2004 there was something that resembled the manhattan project, if you

believe the intelligence and we won't know that until you get that amount of data. there are three levels to answer your question. one is should they have to respond to this because it's an i.a.e.a. investigation and they've said they would answer the questions. secondly, and i think for my own personal view and as a reporter not that it makes a difference, if you are going to enforce those norms in the future against other states, i think giving somebody a pass is problematic because then you have to justify it the next time and the time after that. the second question is do you make it public? that adds to the embarrassment question. in a post wick ki leaks, post snowden world operating with an

organization that has 180 some odd members whose own control over information has been bless them, a little bit he has than full. it's been the mark and david employment act over the years and you too when you were a full time reporter. it is a very important source of information whether they intend to be at times or not, i can't imagine that information would stay secret forever. it boggles the mind to imagine that. and the third question is even if you don't reveal the history, do you want to make sure that

the iaea is constantly interviewing the scientists who worked on those programs to make sure they are gainfully employed on something other than a nuclear weapons projects. and so far they have not been able to interview any of them and the iranians have made the point when their scientists show up in public some place the sticky bomb ends up on the side of their car. they have some good reasons to not want to reveal who their scientists are. >> we have an overflow room. let me take a question from there. we talked about the muddle through scenarios. let's talk about the politics of that both here and in iran f. there is an interim deal that pockets whatever progress has been made and opens the door to future negotiations on outstanding issues, how will that play here and potentially there? it would be a delicate balancing act because on one hand you'd want to maintain the sanction structure to maintain the

pressure on iran but there would have to be something in it for iran to go along with it. and the politics here particularly with the changing congress are complicated on the iranian side. it's the politically loaded question we've discussed it to be. how do you see an interim option sort of playing out if that's the outcome on november 24? >> i think this would be tough with congress because a partial deal by necessity will not have a lot of specificity about time lines and sharp measures so you are in the position of lifting some sanctions without complete clarity unless some complete clarity is announced about what the iranians do in return. for them it would be difficult as well because presumably the

u.s. position and the p 5 plus 1 position would be we can't discuss permanent lifting of sanctions until you have a permanent deal. i'm not sure they want to live with a temporary lifting of sanctions that could be easily reversed. i don't know how the rest of the region would feel but i think they would be nervous. >> i think they would be very nervous. any attempt by iran to read the u.s. political situation would be quite difficult, like what it means for them, the republican takeover of the senate just as it is for our own political analyst to read the political situation. i think whether iran sees benefit or risk of the new congress, i think that they -- i think once again it goes to rob's point of it's important for them to realize the opportunity when they have it.

>> i think we'll close it there. i'll turn to my colleague, the director of the middle east program for closing remarks. and i should add it was the middle east program that sponsored today's event and we thank holly for that. >> thank you. thank you to our speakers. you couldn't have done a better job. i wish michael had been with us to have shared his views. i know he would have loved the discussions. in the last piece he authored for breaking defense on may 19 of this year, he thought the two sides faced intractable differences and had run into a brick wall.

when i read this the next day, i started arguing with him and i told him i think it's a mud wall and not a brick wall. and neither i was able to convince him nor he was able to convince me. he was not 100% pessimistic but he was not hopeful about the possibilities of a deal by november 24. he was still a skeptic when rob and i and our colleague saw him shortly before he passed away. he was not interested at all to talk about his health. he was interested in talking about the nuclear negotiations and what was happening.

michael was intimately familiar with the details of the negotiations. he was present at almost all the meetings of the negotiators in europe. he knew and had talked to most of the principles. and i remember when he went there to talk to the foreign minister, i argued with him and i said you don't have to go just because he wants to talk to you. he said no, this is an opportunity i don't want to miss. every time there was a negotiators meeting, he wanted to be there and was there and in the last six, seven months, i tried to talk him out of attending the meeting, especially the one in geneva which i think was his last meeting in july of this year but

he went. i'm certain if he were still with us he would be finding stories over the weekend. michael was working on a book on the history of the iran nuclear negotiations at the time of his death. he showed me the first 60 pages because i constantly nagged him and i said i want you to show me something. so one day he walked in and gave me 60 pages. and he opened the book with his one and only visit to iran charting the difficult road that lay ahead. and he was hoping to complete the book by december. we at the wilson center, his colleagues will get hold of the man knew script, we will make sure to finish it for him.

but book or no book, we at the center, his colleagues, friends and editors will always remember michael's measured insightful observations as the negotiations with iran go forward. so we are very thankful that you are all here. we are very thankful to the family who joined us this afternoon and please join us for a reception which is in the dining room. thank you. \[applause]

we will have live coverage of the keystone pipeline. >> whether it will take six hours and 60 votes but the senate tuesday will vote on keystone x.l. pipeline legislation. lauren gardner is covering the he debate in the senate. what's behind the senate taking up the keystone measure? >> well, obviously some political implications here on the line. senator landrieu of louisiana is in a very heated runoff race with congressman bill cassidy, a republican who is currently serving the house. and for senator landrieu, this is key to demonstrate she can

legislate and hold her own on the floor of the senate even when they are leaders are not necessarily behind her and she wants another legislative win to take back home to louisiana and show voters she can get things done. >> what would the keystone bill do? >> the keystone bill would basically take the approval process away from the president and give it to congress. and it would just be in the pipeline approved and consider the environmental impact statement the statement department already issued as having fulfilled the requirements under an environmental policy law that has to be followed in order for a cross-border permit to be considered. >> let's look at the 60 votes needed in the senate to pass the measure. you said i am confident we will have the 60 votes to pass it . where does it stand now?

>> as it stands it appears he has 59 votes. last week senator carper and bennett pledged support for the bill. as of right now we have not found that 60th vote yet. but landrieu said they don't think she would have pushed this hard if she didn't have 60 votes. we will have to wait to see going into tonight and tomorrow. >> seems like a fair a pressure out there. you retweeted a modified tweet from the environmental activist saying a warning shot fired -- your words -- democratic leadership saying senator schumer marched in the climate march. if he votes for the kxl, he's never invited again. tell us what democrats are feeling. >> democrats in particular are feeling pressure from environmentalists who want to tie keystone to climate change and make the argument by allowing this pipeline to go forward it would exacerbate the level of greenhouse gas emissions the earth is already

experiencing. for any democrat to want to be taken seriously on climate change now and in the future, there's a lot of pressure there. for senator schumer's part, his office said he's voting no against the pipeline. >> bill cassidy in the house last week got 31 democrats to vote for his measure. what happens to congressman cassidy's keystone measure if senator landrieu's passes? >> if senator landrieu's bill passes, the house bill by congressman cassidy will be considered passed. that's the actual bill that be will be sent to the president's desk. senator landrieu said it doesn't matter to her as long as the bill reaches the president's desk. >> back to the politics of this. you mentioned how this is playing in louisiana. here's the headline in "roll call" -- keystone dominates the senator runoff but does louisiana care? what's the story line behind that. >> there's been a lot made about this keystone vote for both

candidates they want to be able to take home some kind of victory, however they're going to get it to the voters. but the question is do louisiana voters actually think this is a wedge? for senator landrieu in particular, a lot of her legislative victories she's touted on the campaign trail have had pretty direct impacts on louisiana citizens, for example, earlier this year when she successfully negotiated a delay to flood insurance premium increases, for example. >> it's a big issue to president obama as has the white house said whether or not the president will sign or veto the bill? >> they have been very -- they have not wanted say directly one way or another but president obama has repeatedly said while he's on foreign travel he wants the state department process and the separate supreme court process in nebraska to play out. so if he had his druthers, he wouldn't have a bell at his desk but they have not said one way or another if the state would issue a definitive veto threat. >> readers can read more at rolecall.com and follow laura

gardner at twitter. gardner-lm. >> thank you for having me. >> the death of a doctor in nebraska to ebola will be discussed next. journal" will discuss things congress is working on before thanksgiving. >> here are some comments we have recently received. to see these people in person and hear them have handled discussions or congressional important tois so

understand the context and to listen to the statement in its entirety. >> i have been watching book tv for a few years. this is the greatest program on tv. i like how these authors take the time to present what they write. does a great job of stimulating the conversation. i think it is fabulous and i look forward to it on the weekends. i watch it as much as i can up. the timehed c-span all when i am home. i think it is excellent. i watch the debates around the country. thank you for the book talks in the history.

i like all of it. i use it in my classroom. i teach at a community college in connecticut. thank you very much. >> continue to let us know what you think of other programs you are watching. you can e-mail us. or, you can send us a tweet. join the c-span conversation. like us on facebook and follow us on twitter. a couple of congressional hearings today. in the morning, the head of doctors of that orders and the president of effort care talk about more trained health care professionals. this will be on c-span3. in the afternoon it, the cdc director and the acting surgeon general take questions about the u.s. and international response

to the ebola virus. we will have live coverage at 1:00 a.m. eastern on c-span3. up next, the head of the center for disease control talks about the ebola out rake and the ways of protecting the u.s. from another viruses. we will also hear from kathleen sebelius. >> i would ask folks to take a seat as we get started. good afternoon and welcome. i am the executive director of the health medicine and society program. i am delighted that you have joined us for our second session. we could not have asked for a more timely talk.

before i introduce the session, let me take a moment to tell you about the series. clinicians are kept up-to-date about scientific medical advances and to promote excellence in research and practice. public health rounds is a partnership between two aspen programs, one i worked for, which has a domestic focus, and global health and development which works on international health issues.

this series is made possible with funding from the aspen innovation fund for which we are most grateful. we expect to schedule it for the six times a year, taking advantage of our prime location here in washington, to engage individual thinkers and doers in the field. this is an invitation-only event and we ask you to join us because we believe you can take the focus ideas and spread them further. we are live streaming this event and a video will be up on our website within the next 24 hours. feel free to share it with colleagues are to watch it again. now it is my great pleasure to introduce the man who actually need little or no introduction, dr. thomas frieden. his talk on ebola will take us into the heart of the most recent infectious disease scare. i know he will be reminding us that microbes have no respect for national borders, which means that this is an act of self interest to respond to outbreaks around the world. he has directed the cdc since june, 2009, and in those years he has dealt with h1n1, avian

flu, mrsa, and many other infectious agents that have never reached the front pages. he has also been involved in global efforts to eradicate polio and to control multidrug-resistant tuberculosis. he has also played a role in obesity prevention. he spent his early career as a disease detective in the cdc's eis service, and later as the commissioner of the new york city health department will stop he cut teen smoking in half and helped the city become the first in the u.s. to eliminate trans fats from restaurant menus. somewhere the middle of all that he has managed to publish 200 scientific articles. he earned his medical degree and a masters degree from columbia university and completed his

infectious disease trading at yale. thanks for being here, especially at this busy time. [applause] >> thank you. thanks to the aspen institute for bringing us together. i'm going to go through a large number of slides because i want to get a lot of information out there but i also want to do to other things. one, leave plenty of time for questions and discussion, and two, remember to leave you with what i think is the single most important concept that i will be sharing. that is that infectious diseases are here to stay, but we can make a difference, we can control them and push them back if we focus on three fundamental principles. first, finding threats when they first emerge. second, responding effectively. third, having learned from those activities, preventing them wherever possible.

that key formulation of finding, stopping, and preventing, is going to be essential to every aspect of our infectious disease control measures. the cdc works 24/7 to save lives, protects people, and save money through prevention. we have more than 12,000 health professionals who work to find, stop, and prevent health threats. we analyze information around the world and most of the data you will see comes from the cdc. but we also work with individuals and communities and health care workers to implement strategies to respond and prevent. we also serve as the de facto reference laboratory for the world, and the cdc has more than 150 different laboratories, 2000

scientists working on a broad range of areas. and we have important partnerships all around the world. the cdc has staff in 60 countries. we also have a variety of programs that work around the world. that basic concept of finding, stopping, and preventing is how you can think about the different programs. we have programs in influenza so we can track how strands spread around the world and what is the best choice for our vaccine

here. we have programs and immunization where we work closely with the world health organization. immunization over the past decade has saved more than 10 million lives and is responsible in and of itself for more than a quarter of all the increase and decrease in infant mortality. they are best buys in this country. we also work on malaria control, and we embed back into ministries of health where that program is operational. not dissimilar from what we do in this country. we put our staff and to state and local departments. we don't establish large offices, rather we strengthen the systems in place and hospitals, hospital systems, to support them for better infection control. we do the same thing globally. is the program, the largest bilateral global health program that has ever been, and which has been remarkably successful,

the cdc provides about half of the treatments. the infrastructure established has been very important in helping to enable to respond quickly and effectively. perhaps the single most important thing we do in global health is a program called the field epidemiology training program. this is based on the cdc epidemic intelligence service program, a two-year program where you take a highly trained physician or veterinarian or dentist or nurse or pharmacist, and over the next two years, you train them to do a very specific style of field epidemiology. you train them to identify an outbreak and stop it. you embed them with a local entity and help them respond to urgent threats. that program has been the backbone of the cdc for more than 60 years and for decades we have been helping other countries do a similar type of

epidemiology. we have now trained over 3000 epidemiologists from around the world. 80% of the graduates stay in countries generally working in positions of leadership. this is a program that allows the cdc to strengthen governments, public health systems, health care systems around the world, for their sake and for ours. we have had to respond to a large number of emergencies, natural events, infectious diseases, potential

environmental contamination, and war. and for the past two years we have been discussing the issue of global health security. we are truly connected by airplanes, food supply, air, water. to a very great extend our vulnerability depends on how vulnerable other parts of the world are. we have three major risks that we face. the first are emerging organisms, as ebola emerged in west africa for the first time ever. the second are resistant organisms. the third are intentionally created organisms. the same advancements that allow us to do more faster would allow someone with malicious intent to create organisms that may be difficult to deal with. we had three opportunities that really give us a lot of hope and momentum. the first is that there is a public health framework for responding to health security threats. that framework works. it is committed to by every country. there is an evaluation system to accept it. second, there are real technological advances. now we are able to do rapid testing for the plague bacteria.

in just 20 minutes, with a dipstick. that test is in africa today and has already been used to rapidly detect, and as a result, treat and prevent, outbreaks. not just a laboratory work but also in communications technology. there are success stories, whether it is china's successful containment of h1n9. setting up a system by which they can track and stop flow. for the global collaboration in response to a variety of threats. that leads us to the goal of prevention, detection, and response. the global air network is quite

striking, and we are ever more connected. interestingly, west africa is closer to europe than it is to east africa or southern africa, but in many quarters there is a little bit of a conflation of what is africa and what is west africa. the west african countries that have been heavily affected by ebola are struggling and beginning to show proof of countries that have been heavily affected by ebola are struggling and beginning to show proof of principle, that we can stop it. global health security is something that we have committed to for several years. we implemented pilot programs in 2013. those programs showed real success and promise. the one in uganda was able to result in very rapid detection of outbreaks and meningitis, cholera, marburg virus and allow a very rapid response.

our goal in 2014 has been to implement together with the department of defense. to begin tohope tose some of the blind spots address some of the weekly links that make vulnerabilities around theorld our vnerabities. -- commme ihy 2020 that b20 we wi he countries tht ast 4 milln op eectively preventi a ptecting against otr tbreak .t is a preventn-detection in preveioweta securitynd biofe, ki sure laboratoriearsad that organisms don' unintentionally or ientionly t out. munization program wchre a tremdously effective w n ly of oming healthutf dungeah riskth m spread more oadly.

nothing could make that mo apparent than what we veee aling with measles oveth past couple of years. ere outbres ywren e rlreltften in outbreaks here. measleis highly infectious. a ao cung on sueillan f zoonotic dias ihumans- out the arrsf l wl emerging infecons come from some part of t amakingdo anwetill don'ha aandle on the natur reservoirf ebola. studs e underayowo we caunrstand thaat a prenfutureves er eba coulbe intdud into our ciy. t pventiofront there is anmiobl sian evtion, and at means tibiotic swash a also enfying and opnghe reing of restant ornisms. detti, its poan th w monitor threats early

at a differentor wwod be in today if tse bas sts d enn acin we aica argo doesn't keuctodeif a clteofeoe with hemohac lns,t is a very usu dease. it ds't kehat mu lararyesng it does take lot tst i even if it ive small, and it kean enormous amnto stop epidemiece whh s ppedow that meansavg foation sts,avg sease tectives who he enhrgh traingikthie enomic aingealed epemiolocarainli i ntne anreon capacy. responseapity mes vi iident maname ste th emergency operations centers. th is fundamtay w orni to respond to an emgency. d for e obal hlt

seri nwo whave t metric, the kemetricth evy uny ould bab to acva their emeen opatnsenr d spd th t hrso threat. ifouan do that, yocacu time outf epanyoca reonmuch more fectively d evt in from ttg o of controasbola h tt n talk oueba r mite --e okt fferen feio dease teats and ebola is sry it is arbeusof its fali rateswhh geray in t 5-7 rge wehi tt withetulous clic ce sulbeble toethado ssttily, addrsi hraonndlu nament, t istl a ve ddly dias mpe atitthingsike rsarnd0%, orvethe 19 pdec icisbout 1%-2%. thca faly teisig

t atoe't me ihas ytng likthepem pontl iluza e of t fdant fts abt ebolishafrom everythi wha sn,t ly res omomne whos l d oy reads omirt ntt thodflds of soonwhisll or s ed e re h bn primilby the o rout, sa revi ithho oin cities a iafcaunfe bual bualractic m pmo t widere tnsssion. e tt le thbola i and th dpi renprre

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e veme sd, we nnot, wereoousy. ey sai o we will dit ourselves. they talked to doctors without borders. they were able to stop the spread of ebola for their population of 55,000 people. livingn t lge rbe pltaonn e rl th ionofhe survivo. soinhe.s trere ri othgshawere intotrgtn r praredne again ela. streinanmotongf avelerwh ty av afct cntesndheth ri ithu.s. eiteerurak. foatn tenbo tir nttso heldertntca motohe ica ty co il they are pvid ca cke. chk and port ela. at carpaage haa thmote aev l, al foatn, nbetoalif eyet sic erheascolef ek lstoupeleavgotten

si. th he kethr teerur ty veald atumr. thste al darenha rangedoraf tnsrtf thinvial frowhe they arto hpil adan itg r em. l urf emerrud t r ebol. t eyercad r fe tt st. stda wnofi ppl attaintoday, we ll be inth same ndf ti niri f erye o ring froma. t cae bie tres dere tnsmissn t beusthe e my nttshe a warno t nfenth they e l beg enfi a mited daily. ifneom he,e n'wa toakthri tt eyay co i a t hltcare syemou not bawe of i d'kn tt he e perft sponseutike erhi ipuiceah, erhi f cnil dineevytngn iee, weseattoonnusl

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n deta wtsapni wi tt feio d'kn wt gngo meutf is wehi wcageorrad dinoicofnfti, ug restae,erps idti t sains tt e reinmo. ayhae e y unrsndurnt inftis. the y cinctionsf ltlergis. esstinharo rll we ithe loror mhtot heakg mee e onsies at is l testg eotill itea tt c se ve moy,ime. c c te t obrk teioanma outbrea smle th ia ome t nd coin tinstn . wawainthugh a sessn dchee d zens o grps thiinthrough hoto ply this to their work.

perhaps there are cases considered to be unrelated that are part of a cluster. for another disease where we assumed it was one outbreak. it turns out there was multiple different. each had different sources and needed different interventions. combining epidemiology with genetic sequencing a be formats ats crib porf tacevthis iortid le bioformatics atre credibly perl to hie is on sequeinmainca crtenoh datao erload 0 mper thamntf tas ndogin we thi tt erheiv yes,his iniave wil anorthwaweo genec idemiogyoromof our condio a we arable to idti tngsoerfiing, agnostics atanaka

dinos ahoerim helping at ilentg suaible syeman velopi more edti dengeasures. netenogi d'ta the ple of cef alyc rk eyayoint ia reio whe we can be mo fit inurnalyti work t we d't ke thela oth real tugfucolited rk th will ad tetr dection and rvllance. one of thehings nd look at ianmicrobl sistance. in t u.,nd globall w ise sengnd ixobl in dg sistance. stear, the c d aept onrurestce. 2deifd re tn llion drugesista feion e s., even

coertily eimed more tn 23,0 dth the re 14,0 op w rat t cplation antibtius iss serioueah oblem. as ahyci, i ha tated paen f wm ere arno de medices its hoib and helpls feelg r ysia, patitsanfofali. it refctthe fa tt r me patntand some ganism ware not in the pranbiicra, weren a stntioc a. le we ta uenacona grteproron of feio lle ffult if not imssleo eawi mern dine its t stbout treatnt ofnfectis. ute feio like pneuni una tct infectnsig bomve ffult to tre. were tracking onpaicar gasm

thatrgiscan be resista a aibti a crely mostly in hosta. ispads out tohe commte tn route inary tract infectio m bom trely diicult treat trtmt ieconha bemen tegralarof morn medicalar whetheit is canc, chotra, e eaent of thti jointeplacent, complex surger dlysis. l these this pe o e ily to rescupaen whenheir iune systems w. wi eecventibiocs. reha60000 americans ll gecaerhethapth year. abou6000f em will be fected, wi bhoitiz with aerus infecti tt coliti of their chemotra. one of4 may e. the more resta organms we t,heigr the opti,

thgreatethe risk ocaer eaen th is ju o emple. we have idtiedev particular threa .entioned t there e he. tnk thaweanctuall bsntlly reduceheurn ofhe rks yowill s ts is qte miliar. teio respoe, innatn r w agnostics and new eaen. weava propaln 25 toccere e tection and reon tdr ristant infectnsndo impre preventionn tiot escribing. we think beten a trdnd a lff antibiotic u ith uny eher unceary in e first ple or are

inapprriely brd ecum. weava longayo . weaneg to address thga thataneverserug resistan. in fact,e inweanake significanprre, tnk we can cut this by 5 tou five-year piod. th inoju aue, that is what the sterrmg stems have don that iwh other couri ha de. we kw w dit eime at if have this kind omulti ct inrvention, erivyears n evt 600,0 ltdr sianinfections andve 37,0 dth ansave nrl$8ilon i health care st the e two les. if we keep going wh he onlws gone th oerf ilent gressilyndntsily anbioticterdship it reir cmient, leadershi trki. we nowecomme tt er hoit has an anmiobl stewardsp progm.

tnk it has tremendo netsor theacities. it is a wiint ves moy , d ses liv. e national heahce fe twk eredy cdcow inudes vtuly eve hoit in thcotry, plu ndysis filities outpatient sgil faciti. he had a ve pduiv coabatn withhe cenr for medicare and micd services to use th iorti fdback to hospils and enure rapid progress. timicriaresistance is a ti bb d he got to opt fo ige too late d before the routi inctions that weou a g tomorrow are n eil trtae. 've got to prerve the antibioticweavbe using r r ds and ourrakids. the pipenes t full of new drs. we hope yodrs willom out thatnless irove ste of using t antibiotiagts da wcould se those a

qukly ase haveost these. i think wi that, will stop and i look forrdo taki a qutis you have [alae] >'m e head of peglal heal a develme. were honedoureitus. weave a packed houseothe and ouid we wou love te e me to have lile bitf gang with the audnc weavmiophone it until the micphe me y. a quesoner >> youavgothmiophone iork inenator cas' fi.

i had a quick esonbout hospit prepadns amic i remember, th ithla brfi, you discussep's and ma pduion as welas ju hospital epedss and affing can yorieflyescribe how rey y tnk these invial hospita a a overmeca? >> think you have to dive hospalin several diffent groups. there is a hhly spiaze group atee tbeble to care for seone wh ol ts,dcense a ela reir - and ebola praredne tm s ithey arready and to hp themet as rea apoib. any timehe wlde suspected seweena team to deal wi the situaon at the teamctllwent to

bellevue before . enr s agnosewhen he fit s admitted a was ill. era eclized group o hospitals thatig be ready to de with serious infectio see ch as ola. mo broadly the a hpils , thateed toe adto se patients if they men and may ve an fectio disee ch ebola. weo pect that traverfr pas t worldhahave h eboloutbreaks t ckthey will g f, they didotak eialariaroylis ty might get maria. everhoit ndso be ready and thinngbo wt do i do f someone mes in andhere might beonrn forbola. th iwhy the cdc issued guidin f emergcy departntonhatoo if someone cos a that why there sh prrie intestn suring that we veraing, drills, formation for heal ce

rks the front lines. >>ete coize secretary sebelius, anyofojoining us. i wonder if yowant tmake any comment at this int? we are really gref y' he. >> im ergency physici in maryland. ebola s chand e way we do buness. i rkn vel hospitalan one thing attruck me is the variety of arohethat each hospital hasaken ohoto prepare the employs r ol i have ge throh protecti equipment traingt ffent facilies inhe equipnt i use, how apply it how i remove it, how clnsafterwords is entirely diffent depending on e city it is surprising to me that the is n me consistency.

the second thingi've bn surprised by how avaab the cdhabeen. e's 24ouhoinand no infrequeny we call it with e tit th fever in the dd of the night and how aiblthey are. with t hrshe ia respse andeople omhe cdc willominnd screen these paen. thats ry impresse. >> iope it does not surprise people that cdc is the4/7. weant be everywher we can prodenfmaon consulti. not just for ebo butor health threa. foris notufcient ppe er hospitatoavin unlimited quantity tay. that iwhwe have aow for differt tions.

differenot -- ffen facilities useifre p. thprcies of the guidines are clear. thats at eve hospital ould ensure. one ishat heth care woer shldraice, and practe, d actice so theyre coorble putting onnd taki o the protective equipment. thsends e puttg on and takingffpaicar taking off of proteiveqpmt eds to be protocoloiz and zed in aery standa wa so that a trained obseers watching, guidg,nd providing a ecklisas each step is unrtaken so thatt de with consistencynobeus ola iso terriblynftis becae the stakes are so high. it iserimrtant to have a site manager if there a ebola patient. say you aree

monitoring every aect of care from beginning to enri the treatmt area and as you leave the eaenar. are critical ntl points. placeshere we want tenre there is evethg neo minize theisof infection. >> thank you very ch. 'm a professor of medical ethics and pliheth law bo of my fields are very cited about this. skou a question the eic field. followg on hospital prarness. cter 20th, a ver prominent bioethici publied an aicle questioni whether didu hospital ould rfm cpr on ela patients. and remmending tt when ebola patients, and to a hospital that eyerhaps automatical b

tegorized do not resuscitate patients. i'm wondering if you have any comments? obviously, individual hospitals are struggling with this. >> you sometimes have to go back to first principles. we can want to get the risk of ebola to zero in the u.s. the only way we are going to do that is by controlling it at the source in africa. we coroit at e urce infra,e llotave to cehaki ove dfilt lea. we d't ntl ath sour a ispadtoth cotries,eay he re chlee in thfuture. that iwhweantoaksu that wn patitsho may hav eba are mitted, wean rapiy se tm d tn eath aroiately hhe.s wha paents sery l th ol

y kw,wof emav edontoy,espiteaximal eaen weavhapaen w suiv wh ryntsi suor inudg dn rlame ery,ncdi mhacal veilio ilung ver bsntl ppt. wt pvi that st poible care t ses ssleay. aueioov he. >> thank you. two questions. as you know, medical countermeasure development and odti iiniggear. wh re y s a suesulandas atre fideplininheurnt oure odooueeny outbakinlyeesoed thugthtritnaheth asesouesib? 'm veriri a im inreedn urpionn an

issuth tsef wre li mdeetinia a scsi n wchs e laveacofttti bng paid to th penalooti naref olnotoenon heinctusisse dnote tthk ou hain preparednesplni. ites of technological henovaoni inweav teiatoavso tt e poaninheurnt outbreak. cnopristhat, we can' cot on them,e veo su th w't behe a mime r rrt ols. there arewo or three thgs atig bque omising. the onth m be closes th reach although yocan't prict the future are rapid dinoic erarateast a half-don mpaniefalyarlo. e navy has a pdu tt enuraging.

we might bab tdo test in africa in the field atheoi of care anha resul within a half hour to an hour. that would make a really b dierce we have a good test for ebola buits a real-te pcr. is easy to cross ntine . ruires a laboratory thais gh specialized. weavbe vy eave with moleab th is a r y omeing ab to hike four hours to a dionmi and take out methinfr yr pocket they could determine it is ebo. th wld mak kind of tbaketecti and contr measures that we need si. am guardedly optimistic that in f mthwe may hav something at wor wl ough to bused in the fid. m n bas sensiti aa realime pcr, but even if it haa ightly lower o moraly low sentivity it would vy ef. to rule in ebola. it would be helpful foth manament ooutbreaks.

diagnoices for sptomatic infection t pntf re i think can be brought to ar in the current outbreak. second is a vaccine. we have twvaccincandidates, both of emorwell ianimal models. we are now assessing implemention of two differt clinic trials of vaccine. nih s the lead on one,ost like tbesed iniberia, whicwill be a ndized clinic trial. the cdc has the lead on the other, most lily used in sierraeo, aptive ial. call a steed wedesn. getpped wedge desns can the answer quicker. a randomized controlled trl may be mordifficult to d i thk ese are two very complemeary approaches and i hope we lle able to find efctiveness of one of the vaccines by the milef next year.

that mig still, im afraid, ben time to ud ts outbreak. we are also oking at therapti and what e some thgshat cabe done to imove outcom. i think its important to think of therapeuts the setting where st of the patients are ead. tting ossettings upgraded and provedit efftive care rapidly apoib. >> let me ke a momento ask queson- i see one in the ck >>'m curioutoiggyback on th question. if andhen weo t a viable vaccin wt actions d thgh ithgornment puinino tulyetng atanacri o aa largscale so ican ha a impact? mae ts idicnd

ture os as well. ar, the agen rpoib for bringingewacne and tenogil vaag tth field, is rking ryctivel on this issue,s is the den department. if we had a vacce,f it were effective, we woulcoid usg it in at lea two ffencontex. one would be providingor al ce workers so ty ulhave a reducedisk of infeio the co wlde ccatg clr ere a cluer to stothspadn didu ars. oustf s en worng for many months in ler. in many ways, the respse rends them of other outbreak reons eryoare seeing noa wildfireutany bufis. th he tgetoaconof th a cool down and coroitndavlis and evt he.

there may aolfor a cce erbut weo't know at early on ivaccinwo, e thgshaare prisg we just do't knowhat ro vainwi have and that is why the trials a scrically poan are ting to get them of e ou afa ahunly sslende veeeve encoaged bthreptn we e getting in both srra lee anliri thecountrs e mmteto vi ft d rwd st as icy psie. >> let me ke mento ask yoabt al wkfce e atena al threat ywre is a heal tea evywre perhapmany a sck bthe la ocaci in cotries likeibiandiea leon secrety beuss arof the praccerod al woerigrati. systshafrkly, ty are verynd roued tony biras working in sier lee r mo senea

veryntsilyith the nistry of al tbud capacityhe. yet e patys t ther e levelnd density of al workeriso ofnd do youhi ts cris h won up t worldo e ed me more resrc tar th, d ats e c in inharerd iopit wak t wldp. ho wget commitntro ngss ovethe congons spo t kd of eor thate nto athcd - have pymidal mode atheosbac leve wca t y al wketo

regne and po inees feio, ol oother d itilgemo aur inrmioin me me wa athe middle veweanra er ser montherd. pelehoerwoinat the diri ocotyevel sthey can deta tseepts th a comininndak ti bas othhies lel. chf e threcotrs esafcapaicar srr lee d bea,ot onl stteouwi fewereah rerossnals p cita anitery underdeled puiceah st, t h al sfed roh e at of hundrs of dto a nurs fm ebola. eyrerely challend d th a rpoin detainth ware no intoavasandoors and nuess wh. we a gngo ntinueo eate tm d aith and ppt emute e into ne tusa widean o couny al wke, l heal wkers, midves an upadthr il sth c reonatheomni lel >>ectaebiu

woulyomi sndg? >> aprptg u tk abt otr yr vote pi. u mighta aite bit about aolw- wt u fe authenoed t yby s ouinoury paty andowelul ghbeo veomso o glaleasurent so thats meinhaenfr ar,t aye worl bank w cld atourysqupean rey a tsourylely n. >> wh glob hlth sury therara easeof paciti. n cotrfi tos seouthatin0%f e uny? es cnt he ndmi sueian? r thin le ra mohac ve do iha o tin

idiogi f ery0000 peop? doheha aemgey eratioceer thaca ere thin t hrs there kwae in b th a not crelyno syemicly weavnowoed with coitn me an0 untrieonhelol al cuty agea aeen a t actiopaag iea ofhere of prenon teioanreon. toaksu warpuinin place sian tt n jeivy nir them dendtl whheth ithe world al orniti onoovnmta orniti inoye tein, but thk e rlderv tkn i unies ha syste iple. e worlhealthrgizion haesblhethsyembu h n y de isn e inteationaheth regatn eawhh sinmately retetolol al cutyor e tsere isn nen

oonoc see. arweeay ackinghe eba mero th ioncoont t glaleah cutyor recing t rk sller evtsrothanalinom hanopatns ueranngetr os evts. as is area in wchsa e ad th he d r nyea ndg omonesto study isn deta ts beer weo someorinhiarea thurabaty rk sent peopleo ca i ugda clepythonav i veeethe. itasn orusytn i it has tenofhoanf ba. weno5%o % tm e feeditthmaurvis. ili ela but it d't ha aov me out. oustf ntntth ce

mp the bs d y deta t elo o maurvis und sa tth, ren't you ar? yoha g ts hugeytn, 10,000at a lotf emav rbg. e y id theatdino arusecse weadoo sus o thpyondinosce u at didca uwe t br. [lghter] erwe craatheot the ce. wwo lth cpsp rai sife d coa strikee uldn'be kild. mef isoris ltl alngg,utt very impoan nd ueranthcye ofowisseprdsnde ne tha se accawa ofddssg . i okwi t fstadof guean ta abouthi shisrothfostegn guea, whh s beenhe

icteofheutea ere the'a t of restce. whe e see rsemge problyitr omonct th bat weo tavprf r ol, he oofor mbu, om e udiusderid. fm shmeatfr ama lingn e re a ppl whhu a kl shatay get feed nosoucinheonmpon bhmt t t hti d eang weti d'kn wt e soceaser en if spped ts ole tbakt ulhaenga ne wk wd't ndut w hped isim th ive iornt wor usd s e adorha its e of t ctil coontsf e ob hlt seri wk d iwhit simrtt atones

fus l recoontsn e qut. t lyheomti prarne, notnlstoppi aic b t ob healtsecurity wk re oay. >>e llakonmo question rael >> i w sucwh y sd athe a aotf c rkers who reei ple away from otheprec t fit ol wawoerg etr se veyosath aa loss, fothe heinctious dias tt e ppin becae teioisei taken away orheer pha tres crse hltinasucre cae ts. >>t bh,ctll i te ual he ou 2030eoe rkg on ela c. daweav85 thotr 0 reoi oer thgsefore.

ats otr as t ppmealequests imrtt,o ate n ke su tt c dot tt icweave toorllf al. etr iflor ms, ju had aeagoo ud ariar heinctus dias thloerhigo o t mo cllgi iiso ep alpas t c pteing e bl t w war mmtetooi t se methloert esn,heorwereblto bud e pati iwe ri a u. d he unieth wl ufu t lyorbo, t r e ne elar e xtaror thne ms en v. to lea y wh e out inofhaa ffenpl the rlwould tayf cas o h h bic sueian ste iple, if we d coiz hiv wn first emerged in africa and

stopped it. even without a vaccine or treatment, contaedt,nde wod't vead0 lln deat wldotavha30ilon op infecd. he mh ate n befifr ts. e stems atou he founanstpeth obrk inesafcaosa ny frti owh t rpoe gog ct. itould bve uorna i dn'athimontotto st ela andrenthi uny omavg vuerily. al pting iple e lararythdias dectesthip'- e spse cacy atil fi, spanprenthne hethhrt. anyo ppuse] tnkou. a sgratef for all y

e in uresgeaserhefu lemeiva out outohe ndfuhethedinan ciy am we wl havintwmore i e ri a wwi l y kn as so ath a anund. thk u ryuch fojoing tayndha y, . frien,oroings. aponcoright tional blsalle rp20] apong rfmebyhe tialapong stut whh rpoib f i caiocoenanacra. sincap.org c direcr .omrin wi bonapolill. he wilta qstnsbo the u. a iertialesns tohe eboir. feovagfr t hse er a comrcubmmte at:0p. ete o cpa re haisapni tay

cit hl. e usis bacn rtemr eees. hailwo oa ase wod ke cng tth presfochsi mbe o th epa'cicedvor ar th iailthoba mistti h threateneo ve. li cover oc-ant :0 eaer on-sn2he satdetea ase atou aro t pele. otis expteat. cpa, eeaofocrs tht rds llestify fo aou pelbo t ne f me an hltca woertore ela pies. we wl vehat lit 100 stn. mi uonwainonoual ." rilvabtl few iuethla-dk ngsss rkg o -he

ysneipin geren fuin a eitmes. eplin lt jonesiljo utoisss esidenoba'fuin reestoomt is. wak [ctiinpeord tialapong stut [ctis pyghnaon blsalle rp. 20] apong rfmebyhe tialapong stut whh rpoib f i caiocoenanacra. sincaprg ♪ ho: goomoin eveon re wt' hpengp pil ll tay th c.cdict wl sty foheouney d coer scoite is teooonhe.s rpoe tobo. soestifyg t hd e brka mic cte whe s. dtodi fm olyeery. we'lha le vegef at -sn3 a1: p.asrn anthhoeil te vel lleangitth e.p. wlehe satis