[inaib] are y jlo? [iudle wh a gre tm, the roys. naib] stnoabt oschiefs on nday?

are you up to ten your or? [iudle gatons were >> it waa rlseesha wi b rembed, downo e wd-rdea in thehaionship. iwas almostika mie [inaib] twwi-cd aminheor ri.

congtutis. >> tnkou [iudle >>omgp,enoron

hnn of wcoin disss thisesefore cgrs ait nddo a what he wi t n cgrs i jaar saurillanc bill late stlhtn mazes feurg chl hsconis opridtece a's tionalecitte. li eryorngn sp. jo tonrsio members t bti hse of comms tu f qstionime weesyhepre nister vicarowi awe qutis by mbe o parliant h awer, .

>>ha you.i thk gd ie. >>hawapa of thsty. destic osri a glalreomctpoored b myoodriend ryarer inges it from plien if you' er seenhe procdis t hse and, th s setngenr at meing sil. it ia inly veileapoa toryg to bpoteo medyouo't re for. aouseitthe hure30 fivmeera t of the n d womedon't en owhoacotr e en ey say mgo fen its sienus the ion hure eyrobably kn eh he it might n le chth but e's a betr an oth beg least acqintanc.

>> t wldf litical terminogsuayight on c-an q&a. al dd ndn athe nebraskmecaceer erheasei tat f the diase. esy mbs of the inrniol medical cmuty testified outhreon and thne f trained healtca woer th hringf the us foigafirs subcomtt on afca and globalealth is 9 minute >>heubcommtee will ce to order. role couny s own of e olvis disse since s firspprae ind st eba, since itirstppeared in a remo rionear t decric republic ofongo i 1976.

in pvis outea, eolaas been cfined rra aas in which the s ttontact tse e ilgeofhi it apared. founely, this teak n anpimi sea fromillage ton inteatnal center f reon tradnd sprento urn eanin, sierra leone an bea,hare owd th mid dical servesandimed resent trt chovnment. the unprecented westfran ebolapimias not onl killed more tn5,00eoe, wi mreth 1400 oers knn be affected. is sitti h ewhe plni f h to deal wh e tbak in ou treou hrings o theba idic a ergency heinweel o august 7th, and then flow-up on seemr17h,e hrd aout the worseng rates of infection d chlenges in reonngo th forum fmgovernment enesuc a usaidndcd an mata perso

toy'heinis teed to takeesmo from noovernmtal ornizatis, oving servic ohe grnd rrtl itheafct counie eecllliberia, so we can tt derneho opedctions are being plemented. in itseay sgeseba f fes e meymptom as ls immediately deadlydisse ch as malari wch mean itial health care woerha bn unpraror thdely tu the sseha they ve be aed to eat. thiseant tt o many health ca rrs, naonal a inteational, he en risk rein patients who emlves may n kw ey have ela ndredsf alth corkers ve beefeedand mny ha e inclungome t top mecaleonlin t the feed countries what wound qte quily wa th the healtcare systems in these counies, despe hea instnt by the uned state and heno, remain ak

itappens er ar- tse are the cntries eth coming out of ver disive cil confli, oexrici ris licadivisions. nsequelycizens have not enidely preparedo aep recommentions from the o governmes. r itso m many people a thrcotrs uld not acpthat th ol epidec s al ev now iis belied at deitthrelee burial tes rohout liri for exame,ome families a reluantodentiftheir suffergsndea loved es for safeburials. which pleshefaly mbe dhe neibors at hehted ris o contractin th oftenfataliseasehen tientsre most coagus. theporousoer ofthese recotrs ve alod people to cross twn cotrs will. this may filat mmerce, which is gdi, but al aow fsees toe transmitted gial. a rest, t prevence o eba these the cntes

ha eed d fwe wh e gratioofeoe omne cotrtoheth. bea remains hade-h t tee countries th more th 650 ebola cas oicially rerd. prab asiifan detament. e number o ifeed andea omboou beas much ree me ower, t ofci furdue to unrrorng ornitionperating ohe ou have tolds or the stive mt tateste thencasg ac teatnaannation efforts to conta tse feedith ebol tre mains ny remotere where its sti dfficul tin sintorain sufficnt ustobtain eir coerio coequent, e ebban fw innftis ntue even wheitos ke the baleseingon inne ace, i ireesn a igorg untry, egn, anthregnes in the ar atook to be scesses the unitedtas ocin on liri thuks focin onira

lee,ndrae d the roan uni asuppos to beocing onuinea. both sierra lne anduea tibo eor a bendhe pace o os bea. is epemuebrgh under ntl in athreef r fos ato suesul last wk,loit corewon rebass, and congremama mdoof this subcmieentduced -5710 e ela ergcyesnse t. thisill laysout ststh are edor the us. veme t eecve h ghthweafca ela idicspiay bia e wot-t hehr cotrs. isruseuingnd aingeah reersonnel, esblhi fly futial eaenceers, cnducting ucatio camig on populaonin affect cotrs, d dveping agstics, tremes d vacces -50 confms us. polyin e teba fht,nd pridecsaauthorie fo ednistraono

ntinue or eandntiped aconinhi gd. e llncras u. llaboriowith oer dons. migate ti o eonomic collapse ail unrest ith the feedouries. rtherme eeslion auoresunngfhe ternatnaiste sianacunt e hgh -2014 ve t eective suor es tibo efforts. i'li toow rn to my frndndoeae missas aalways, anyochrm smitfor yourldershi a soorakg e leadn e legislion th who tha maedp on i soanto tnk toy's diinisd winesses, an print o organizaon pridgrical medil, nuitna a evopnt asstcen eo adverly afct nations iwe afric lo fwa earingou dates on h your rpeivy ornitis ntueo mb th ddloure,h

trends you're seioth sivend egiv awh adtialuprts nd a youooinewiththe gornment- e govemes th imct cntesndhe inrnational commit apecteou eor a ouea the keep cgrs infoed of is evoing cris thcuen crisis, asaseen stedhabe thearstnd moidesprd tbak the see isryreating particarurn t unieth a iolved. ncth giingof t oureak, .s.-base ngs he ma aigfintndsustai effo to suorthhr unieashey fohthe dias thunedtates s commitd ar ilon to bld eaencents,train heth ca orrs a bia tes, supplyostawi potti ge, dnse e sfety an mataan uprt iul arcur,ikto he fm e tss what y inabt e assistancth s enoved. anth i hava rtul testn urhoht aou ene apath cris

whathe u.s c lven ple. ando thgh h we ve rwd. wkn thatheean wh thisito adlyis cause of thweak hethnfstcture tsehree unie soutofhierblecris, ishe a w f u bgi tohinkonte authe futureho we pptth infrasucre of unies? anyohohtonhawod areciated. dniraonas aed ngssor over biion in erncfus in orde t suaithprress at h enadan t ense nd tohe csi iseqst wi expd siance t cta t epidem, afuard tmic blic fmuherprea of thsee, a suppoh deloenofrements. stneu.inci ppt d involvemt ssenti to pporthetaeovnae the natis icis opdid by t cre

cris i soon't tnkhaweav ven mu te t - mh time anattentn t ft at wee algit countes atouctllye mov que bi bkward, eecll countrs atavrent, u no gotten ptivil wars. so i lookorrdo your teimies, and i intest inhein fro you aout what c do tasstou effort thk u. tnkou. d likeo w wco o three very dtiuished tnsewh a extrrdary feivan inrm a wl ovidehi suommitt ihi aea sit t watha bn haeng d at nds t be ne. benngith mr. rabih tory, o is aseor vce preside foth iernatial oerio anorss iertional mecacos,lolrograms 31countries and fur contints anitstf dheta lueeumbergell oer 00pele he hernay serse t pansion ofi's humanarn

andevelopment pgrs to some othrld's ugst workinenroen,ncdi sira l yn, irq,rf, bea, lean, kian ghisn,ai,libyand st rectl syia t orniti'sen reprenti iasngn, d.c., heerves asc'liso with t utestes gornnt 'lthen hear omr.re sedgicwho is tenil vir ro scuty and liveliods foglal communie he pevus sve ce presenfo the nasco founti fhomebu akolr laonwith vemeenties, nond ng a oversawune development. prior to that seed as liriscotryirecto for f internaonhe ovsarra signed, imementaonnd monitorg r a rgeofdoor hel serv as tchnica adviser -on a sil bas. we'lthen hr omr.dari

ma w ith preside o africa wheree rpoib fothleeripnd groh th oanation. previolyefuild a nb ros t emienum challee orraon incdi acng chief exute fir and ve esent of plementi a manin rector for africa. in tseositisrns w responsiblfovandivse ogm prtli inc,xa unie helsha experncmagi countprrarondhe world, as director ofheo nkstutorngs onis tching conomics, an svingas aonltanton inastructureroctin lin amera. 'rjoed by . be ve chairm othcoite. tnkou forei he. t's go. >>ha you. thk u i tu tmrtoay cirn smh, ranking mber bass, a distguished memberofhe bmmittee, on

belffntnaonmeca rp i would likeoha y r inviting m to tti today to describ t gng fight agnstth ela vis outbak om theround leve ha already bmted a lengy writn stimontohe bcmiee rar tis morng wi ghght ke servation d ofr necommendatns for oueba response experiee. internatnameca rpss a ob manitaannorofit ornizati deditetosang lives,nd reliinsuerg through al care aingnd li a delopme progrs. we worin31ouri around thwod, ande've b working wt africa sce 1999. oureon to the ebola oure heobt in bth lirindiea leone. mo than o thir o a ol cases andov three arters of l ela lad at have merothese two counie byhe e o tmoh, we anciteaving a total aut

80stf tsewo cotries,ndy yr'end,e pect ts number to eeed 000oin in fur ebol eaenunits, two in libia d twon er lne iouikoakhis pouny to knowlee dedicated d ureo inteatnal anfran national sfforng iur eatmentceters. ey areromiberiand sr leone wl as many prt o thunedtates, europe d her stes. r aff isomomedf docts, nues, tenicians, specialis water sitio an hie, logistician nt health professial custodial worker aual teams. indditio to therement uns,e ve estabshed seral sercefo gupus norrivi tcoathe oure. one example is araining cenr onhe grou ileria. it ll tch a trainta from a ogazaonsngaged the fht tocoaibo

anshow tm how toreat titsndtasan a teially dangous wople. we are ao respondingo the surge of ela csesnmali. weilbeetng un ela eaenun andeloping heth worker tingroam hp the untry fight th outbre. our bueono thebo tbreakasneerridi objecte. contn e rr uteaat its soce in westfra. to suced ser k fto muste plce. e tseis bilding and fepatg ebola eaen ittaedy weltrned hethrossiona. otr key ct i using traingroam torsf in lal han esklsnd knledge cessary to rpo efcteltohebo tbak wemu al assure effecve ornaon amo a acto inlved in thfit contn e virunudgheu. inrniol d tial gornnt a ns.

tourthe tideof tis idice musall work toth tmami t rethf l voed filly we need cdu paivdaollecon a gorousata analyso bil anccurate picrefbola contnmt,ndpo ay ed fonereons. ce succeed contain the cuenutea we mst rema ginto auh tere's resurncofhiepemic. thfito ctainbo a ture -- and peventfure oures willeqre substaiainstnt. iouikeothk t u. agen finrniol vepmt,arcularlits ofce of forgn disasr siance f t nding ha pvido ternatna mecal cos r r ebola spseasell ashesuort ofhe us. liry paicularly ietting a boto nearurba eaenunit in nncot we welce t pridt's emgency request congss to

mbat ela west fra. an bed on oonherod exrice fghng thi epem, ouecomme thathe 4ilonalcad for inrniolisaster sian b ireedyn dion $200 mllno taof$1.6 biion. d remmd tha a additial48 milln aded t enomicsuor fnd for tol $0 lln. . aian, i ncdey te oerg ten romndio r feivtrtmt and adatn eba r. e, suhevaabity eqteumber of well-tin, llrocted healtorrs e tost itical lso learned fr t respse h be t iornc ofhang suicntumreurs prared to drs outea nctious dea. o, eurthonruioof w oltrtmt its f

e cas. thwo mtee coditeanwe aid staff ad to i each city. weeeto malebl a nimb and adt icyo chgi ran to rpoef brksn ruraareas. the,nrehe nesry antitynd qualityf rsonal ottive eipnthas aibl four, pre taolctn. sueian at wilelp diduals recee eaen faer fi,enre atea d deta t les of mmicatio a disnsf responsiliesrestlied unrsodndmataedmo ornangods eratinin e gi. smt andfcit codition steathe tialev isricafor anffti rpoe. si we welce the aans deveth past wee i establhiroduso evua a tea eatat heal wkers w mht contra ela. rcoenthat thesyeme

t ace w,be institutiolized and dear ofhelol rerees annguture -or tu idic sen,e remmh coeral airpaceverbo cotries ma openth personl and reurs n ve icy. eit, acceleratend sport e odti o cces. ni, ve i ergcy praredne iwe arican gis nre thathe cotrs have the nde reur, op tining d sts lao rpo emselv to possib fur oures iecouisease antenay,mrhairma sic health rves nd to be restlied wtafca pelereotju in om eba. ey're dying frmalaria. th'rdyg from teborne diases. meare ing fm t lckof citi wrehey couldo r fe liry and theedsoe de ons osbl antwa ti the ela

tbaks neefe rearthe tiviti. thk u,r. chairman, d nkg mb bs,or the pouny to psehis teimy the comiee i ul gdtonsrny qutis you y hae. >>hank y very much, mrtorbay mrseewick,f u ul pree >>hamasmthanng member basemrs he bcmieethk you r t pouny to tti tayn the wa we a wki to sop th ebola epidec i wst afca the folwiis an abbrevte version of therienestimony provid tthe coite. ameisrteewkand i'm tchca vir global counies formly chf teatnal and i'cueny t ola tsk orce. from 01to 21 iord glalomniesiria uny reornd rurd t. t ysgo aer spennghree iniria lpg to ld r spse on the ou. glalommuniesas wk in lirisie 04. in 20 ben a s. aid

nd ter andanitaon oject rkg osely withhe mistry of hethnd scial lfe. roh isroam we bega to mb eola pry providing mmitucio protti eipntand hyenmarials to cmmits at rk. in gust prtre wth usaid's ofcef fren dist aisnc to he been ceen partners h fht tocap our snse. dawearels workg sa bia aody nament, ntttrin a aulance seic. fe by maagen if t highestriorityn oppinghe spre oeba. thods of ebola victims a trelcoagious libert isofnusma for th filfhe seed s od-byehrough traditio tt involve tohing andasng tbody. e c estimates atupto70% ofba ifeio a origininfr t - from ntt th theecse

glob cmuti iorng i er cn o liri suppti 47 bual teams and 32isfection teams. weor in cse panehi with the minisy hlt einistry elo thebual te persoelnd we pvi trni, vehle liscal ppt and uien the wo o burial teamsisbo ckbrki and hearteang i have accompaniedbual tams -an enhe incredible presoniswith whichhe ere. theseen ando were vered in iermeableateria inig teerur, king hours through thk jungle,tang no o assemblingmakhift brids er bdi of war. theyntercommunies sicken thrief andea and rry t iredibly sensitivta wi t greates refo eir al, d r at of hers. esmen and wom are heroe ts cris tatderve our gratude, a f auming greari and socialsolati inrd to stop ts idic

whe is, is worcabe do safely. not ce o our more tn 50 am members, have ctracte thvirus. this wk not who challenges ma risidentiinthr deads feed th fr theyill no able to mournheirovos, a they themsvewi b stmaze thiss y t workofsafe burialoesa in ndit mmity engent. ny bualitre fe and th tea letommunities salynd respectfully y go-b to thr loved os. anotr alnge isremati. in montserto count which ntnsmooviaremation bemeffial picdung the heht ofhe obreak. wever israice iscote to aditiol practices andas mewi songresistce e ea of a deceaseo o beinburnein tei veacarupset many,nd incrsethstma a corites toodiesei unsafe burd t sick inhien

toombat this,lol mmunits,usdnd the beanovnment,re exploring sa bia in moseato through identiin land that n coode lae mb o bia dha space for fmies to safe th a mrn. despe e chlenges, safe rial is pring gh feiv weeg ri team support i gu f bg, lo andmba coti. by t fsteeof oober w panded to pport ams i every cotyf liber and lst montth wreab to colle 96of di whi24 hours. we were also ae t rely reh over1500 commits thugmeetinandiog ssns brinngogether seor gornmentofcials, county hethteams tadional ie, ligiouears, mmunity health voltes,nd othelol ads. ined is n ing de rerted that we are seei the te ofinctn slow

througutibia which is use fo optimi. howeveit oteti for celeatn. we mt intain theev o gilancth is pven effective in beginninto corol the spadf e ru gnificant lgete investnts mu bma ith healthysmsf e couny. inosing, obommunities would liketo exe pround gratitude r ngss, paicarlyeerofhi coite for urontinu pport of ts rk. the worst ela obrk in historcan be stopped, and ll spp. i lo forwa tyo eson >> m sedgewick anyove mu f yr stimony anyo recommendaon and al se o t good ne lst somewhat opmisticerspectivehayo have pvid e mmte dr. mans, ea pce. >> tha y mr.chrm. lemeta bhankin yo a mbs ofoiteorou ro cmient tohiise. i soally wto ala colleagu he r e tiless wo tt eyreoingnhe grnd. i'horetoe reit

th. if i ma i like t ar b scbi wfrare is doing onherod t fight agait ol and th dcre toou wt w rire believe aheost poansts that edo be keinrd twith war. itilbeoby aicsn thgroundho mendga haveemstted tt tey can ovco dea an adversit anfill i lke toonud thha w bieve the uned at c dtotoeba s ac. wh teba crisieg rlier isye, ricare immedielswg to ti. obiz re tha $2 lln private donatns he bakheha of trsmsi. we spp psol potti eqpmt dssenti hl ppeso all reeaffect countrs roh rerip thirtelfnd hs. adti, we' beelp ing frt line al rks cnttci. thugut the is,we h

be vyoced ommuni bizaonnd bavior chge. that'st e hearofwh africa ds ro t nten weelvehi a om foren vements dfr ganizaonli os tay imrtt, will b afca apting chge in havior tt ulmately wil win e r t gun againseba. f, haveraedor th 300 lcal cmutyeth rks. eyintun, ve ecad re than 15000ibia out eba prenon detectio a ce. inadti, te ar 100 sta thegrod, a liri, joined at e h th ler's minis of al tke heal filie op, tat neba lad sees d that incdeaf liri of baes are takininoou mteal iting homes wom w he been tneawrstals, atreus ereld t eba is.

d ncweelveh asemt abluly cric, a aoorng wi thnogartnertoi ysobed daapre th o divy stems. soha we cprideoo trs ggeur rfmae,nd alme inrmioabt ate're doingto cntribu tthwa agnseba. ani ou tll ou we'r doing l of thisitut any nding from the.sgornnt f but let me dcreha we lieve, in aitn, neds done in t fe ts alleng ogsss being made, b mu, much more ne be done. ctaly trgl spport e prsint's ergcy requesanho t rof t 20ouri wl ep up to e atand door buit not jus memoy atsed. 'smporta how t mey i us. ers nd f betr coditi a pnng esemergency treaen center bie we lely don'te

as manetcs wremorngay and ler fexamp. rymrtan ke e efrttoonol ela to the couny ve th's whe tul care i ovedyam membe,y nehbs,y ca hl woer w alarth rsreonrs in isris. welso hpethat usidil b vethlebity t lotetsresoceasneed ensur treilbe agi spseo ate' sn as piy evolng epimi in adition, very poan w beevthat is eenalha visocietinheffte cotries gi tuprt anspe nde helpnre the stse f,an countabili for ela fuin nay,r. hairma le m y feor about wt mre belie t utestesan . e t bessons of tis criss at dor ndto mo beyontholpproach o vertal prgrmi,

rgin resoueso scific dias, ke malaria, a hiv/aids, as imporntsho are. need iesin strengeng bl hlth sts, eecll mmitbad maname o diseas welsne to take vaage tsrisiso bild aealth infrtrtu thats aecd countrs lleefothe fure thinesen beingade n dung the cis ned t hp thbud mo rusnd sienheth sysms. ashe libean preside h said, musnse t everythi wdo nisotust th the aimf ending th oureak, but ensureth w meut wit aronger efcit,eah careysm. d nay, m. chairm, 's myop at s.ovnmt will com to suprto-term onicrowth t rio i pe youi jnme i urnghe mlenniu calleng cooriotouily fnaze itrograms in libea dn sira leone.

s gnict vement i the ke dvers forgrth wl be what'sneedo hpth uniegeba othe hgh ow ph athey we o fore the ebolaris. anyo m chairn. >> doctora tnkou vy chga f yo tme vaab wk you' dng but sohesightsou provide committe lemesk you a cple of qutions,ll three oyo yomentioned . mans, at you ha0ocolteer mmunithealth wrkshat u' tin whin rn haduted se5000 beanabt ebol prenondection d ca. y stentmrtorbou talkbo tonsureth avlabili o equate, wl trned, w otte health re worke. w oss liber, gne a sira leo to hangan optim number o healt re rks who eeately

trne what is thdecit? i anhiisexcellent inrmioand very enurin inrmio aryofiinpeopleavbe scedwabeuse of theear of conacngitthmselves? i yo couldrode tt information us colymr. dgewic whic i woulpot outrehecay, 're both fm w rs. lce. t me jst- wch is where i'm fr t me syou taedbo thsafe bdymaagement is of th higheriit ttoing thspad of ela aou poind o thedc nbe o u 7 ocas origating from coacfrom t deceased. i think aot o ppl a t awe t tey have n ow w ark ttransmsi a th pioofime when medyasassed ay and yeyo he very gd informion aboutyour teams rehi 9 of bodies witn 24

hos overhe last month. homa o t flk that shld be rehe e n bin acd? just to fry g a sse o thunet need? and whatishe re thlergy and chchre ang? visly when somebodyaes aw, l turn to r fah. u know, e curplays a k le, obviolyin nals. atole are they pyiro e pulp? d y heway ttg atesge o abou the coagus nature seo w dead frombo? i also, wi rards terna prective equipme, mr. toay at'syo trd pot at you made, h availabl it especially to the ltes, andhose indigens invials who mit t have accessoit li se of thengsit going ? if you cldust speak to that. arwe wher w should be?

anywherelo to ? cavus that' o way precting anth dr. ms, you had mentioned, andgfuy so, theep cce . president rlf po, her ncn hereod aboutther diseases that ctie to ke a devastinpac pele in the feedcounie incling ler,nd congratulatis d odor on the saeler asct to hp other and baby he a vue whereh c give rth fe asosbl dasouknow,f you mit wanto expandpo that, how many wen a tainabt oaotten he throu yr work? i have ohequtis t i'll asthose rst anth my frnd andolleaguend en come bacfoa w he.

tnkour. chairm for yoqutis. i wi startithe heth woer p. ate're doing at inrnatiol dil rpis cung traineath rks atilbe wrkg in oltrtmentunit. and tt traings14da intensive trainghainud ndontraining, acuay eangatien in anbo treatmeni anasourabknow, when yowo i an elareme itou nnot wkfo more th aho oamutw bereouetout,euse of e at becaeofhe pressu, cae t stress. and wtoa re tat thoswoergo t beforehe ge tirednd ehrated cae this iwh skes haen soe'eremelyrel abt th. in tms of the healthargap, 'rodinating with aencies that are dng cmuty work, su as, y know,lol communitiefricare ath oups a samatas prs a othegrpss ll. d e ea is toomnend

coorna t commutyas proachitthe eaenbased approh. becae e cnn wor prer, befctive, wiouthother. asoukn, leria and srr leonevefore olaad vy w cteratientrio. wee tkingbout one f 100,000 leria. one door for 10000n beria. d atbere 32 al woers ha dd omela soouanusimine the ga one thinth'srical to the hethp,e cannotenl acve. anti tre aobrk, iss en cio rain. weeeto ilstng hetharystem. we nd bld a stnger preparednesssyte analofhe unie a weee fus o rkrc al rkforc vepment. beus ain is n jst the iecou diseases it t mar. 'sheafdeve. 'see e 's vaceen prevtable dias tt chilenreyi

om i inween tckiner of traingethar rks fotheba spse. bu wt 're doing our eba eaenor ela traini filieis tt w wi b turnitn tex cole of nt toan feio dea acem th cve muchoreend ebol anth i auainabity ascthat wee enurin l ooeaesoook . atomes boneba. thank youorouquti. to addss ur sco quti uet eed,i'd li to pin outh t%foes that e cllte wthin 24hours, at whi24 hou oth deh ofhe didu. t t pneal souch th4% egds a dey beeethdeh d e phone ca anthasgnntf e am dso tt's at a big

fo that 'r rking n tes ur simobilizati d t soal milatn at l t oerane a doing ensureth tatphone ca hpe vy erl on eay 'r har aut the atus othe indivuawe fo -we beforth pass. and a ch posie,ur ccs is me signifany esi b o colleaesikec rnng es and hvi t lu ahe bevailab tathose indiduals. 'sucbetterorhe invialo to the etu, t t rscounity care, d th g t ttu ah mas atlls ou tms t a l ss wrk ic a great tuiotoe in. termsf e lgeueion

unt ne, 's vy diict to uerstand. weo a loofwo with the mmits yi to deta trereeople dng tt e gettg hidden. d 's -- 'sllneotal. i knowhath african uon and e c ve beeworking o inso studi on th. and theye unlite lus ppl idg. buany ardestin wre realwoin o ki se at the ig go downhi wld encoure evyone to ll,ano rede thatme ed. in tms o vomee e compte milized

and we are ablo rpo ry qukl wee mobilizene tms wth a day. soe' able mke sureth as h stscoup, theea e sion available, anreondingmmialy on yr seco pt tha esonregardingley,nd faith sedleadersh'ra rearof how we tect wi the cmuniti. r nd histic tectnsn libiaha be focused ond mimba coti. have real ro laonipnot ju wh e ligiouleader butith the aditiol leaders andea leers. th made our itl tr wth buri teamsairly stigfoar you can't ivonof r hicleshroughho countie thout gett sppnd havi tm k w so and s d at t- s sond so'sba.

and eye -- they're so engethere. att de itvey, vy strahtrwd. ene ved toth uie peal ithsoheast erweav lss o a historic pren,we very quicy rlide hadto do teivnteraconwi the regis alth and tritnal ads. ey've ennediblyelpful inakg rehat t mmits ow y we'r er th wre the f aoo reasonth wre helping and thate're aetoo or work resptfly andloselynd radl sohas been corepart. e lious lders hee relyelul. anth tradioleerwho so serve vymrttol in-theomnity lel, have beee imrtt r mangure that ourea are able to opere piy d safe. >>n rsonal potti

eqpment,owree a whe ar whe w nee to be. erarshortes of l kind of equipment. includin gves for mic rsonnel tose whafraris din is rkg thhe prate sector herein the uit states. the big supplief uipmen like j and so many hers, to beurethwe c get ea pp ofcoumle intoll al filieinler, rking th all o t ngo paners, becae a aig believer in llaborati. at no e of us cadohi alone. and sendnafthho, yoknow kwvenbere t olcrisis, libeaadne of theigst res o maternal moality the wor. an hdedn the on direction. creasi. so a big focus forus has ben develong more anmo o es materlainghomes, workinwi the priva secr

in bea,toai the money too . and so far i think we'up ou20ndhe these facilitieshapoint to in ceommits, cause women whwexpting we n ae to gohe healcilits,hweso feanfabeeen. and th's sothing intend d ctie d po-csis. >>isba? ill agn,a to than all yoor yur tesmo. think 's en extremely helpfu and i haveutis forea ofou. mr. torbay, pronounceha rrt? inou recommendations, e second one ss waed to keurthat theonruio of t etu are appropriate f the nes oa cntryndo i s wonring you fnd wt is goi on nowis not apopat are you sanghi iesns toomhing tt eds toe improved

>>ha y f your eson th'sctll very ipoan esonnde've been diussing it erheast we. the d enlans t bil rtn numbof etsn ery uny seonindingof- th a aut two mths old. the situiois evolng rapiy. d we need to meu that a itvoes w d n stickto the old anthattuall apanwe'relexible eugh toifhe'so ndor an etu, let's not en budha et ifhe's a nd forole tes atould goutnd g paen tan ela trtmen it hat thha eptbeds, let's do that cause 've seen-- weeeen we hve treatmtnihat he overflow of ptits and some that haveempty be. nd toakesure weanc that >> hardbo at,too. thoughone ofhe rso was beusthpopulation was ra tco forward. the best case ishathey e no eded. th wn' the ise. whdo y haveth

sppay? guess you e sayg maybe uss t thewato goight w. i will go ckoyo. >> fir o al t vus movi. is nottaying in one conty. u ila tatntniin e coun a g iunr ntl withheoretween th cmunity bas aroh d trtmt prch its ttg der ctr a ent isnoerunty. soth's whyhere a lrge nuers iceain ea osneed tbe oined tndf e y ol arted at t cmuty lev anth iwh hld e. weeeo ke sure th t couny cenrsar ll eqpp a sff a well aid tend iolate ey defefo furth trtmt. th iwh edtrengtni

dhis is t rk inon you kw w saidas intested in the tng r buildi need a treny val tth etu th webeg blt bnge ere for ehe he inctusiases o her hethneds somere t blt last whicisaiengh. eyreuiltiteory mari t wouldasor a femonths andh is god engh. onofheppacs we a foowg we arying to buila reermane struur atoue turned io sothg else. clde rnin aining center in. th ithe sinableasct ofit the eenouging. ere wie ane for oliowas in wefca ateetoemtheven afr we onin olaecaus ances e tremight he

diseesr elaig suace. eris a nd f t facit wl aequipmt d taid af ter >>ot w rsti i hrd soonbt e only ti heth carwoer cane with a patienis one two ur. i ha sn e euien and sties tat tlk authe heat, t atmpes lrg mb oheth care woke. ifoure ly with thpaen for anou orwoan y lve th doou hereef o -- youndersndhai' sayin >>bsuty. >> howoestwo? >> iur elartmtunit it i70ed treme city we hav23stf meers. >> wow. we wrk au the clk. 'sy shft wh t docr gout anhe onwi binto replac m >> enheern leav aer be ter anortw tey kere oow lon d en iage tey go ck

>> itepdsonth level of hati a hraon th nd recover before we bring themba in w. ay. d yb y nesndto isnef ywaed to add ytng autheetus. i know th tre wasnissue arndhe hltcaorrs o pntnd thebeg pa anthemanng hza y i s woerg wathe tuionas whtt,if tat s imov. >>ha u ree compte out the etcs. emgey tatnt center dh aceainly chlengesrodplni a ornaon foexaleweave senhe ited stategovernnt cotrt 1-bemgey eatment ceerhr miles

from where sfis oerinne echese gvemeasui one ineten a yet couniewhe er e h spotnovearawut not ceib eil by ad can get tony the. e chalngof panng h ds tthappen fdantlyshe reonbity ovnment. d i tin fdi ws, ai makinu thathe i a re mobile reon t b able tge ppl into th faciliti wreheye ppt. because what rrsme i ts t gap that ee in talki tolirien aouthe big mbers atheyearha h beomtt tobo and th actu respoe ki ace o the grnd so tnk it eremely poant b re tathe

plni is ne effectily, th ttomniti is o ersohacize these unie eectionsan b ttmanaged. e othe tng i just wanted d ou tin which s diusd rlier whici in is etrelimportt,e in a lot about we wkit mmunitheth woer ofcose, as a bighaeno fe doors in bea. kene exame, mli op, 5 doctors,ts abig challee,thi, to ove no justo tingor mecaernnut se of is preerce aingt e tenil leveis dpetely ed andcan b done etty qukly. anihith there are institutions here tnited at tt can provide the k spo tat edto rp

uppre-servic ting well as spoing in-serce traini b ititutis the feed unie both u o maybe a o you made rerceo need ta ito t cmunity d ha the cmunityeinvold. i wte tknf maeou cod be scific aut th. i certaiy deta the commit pce i terms ntt acg and idenfying the ople feed if tre areotetcs thenwht? yoar kit the mmunity. u enfi psth at u followinmein >> ianry toner that. >> the roleis critil. inrmg the athoritie is so very imptand rming burialea an alsove

imrtt tducatehe mmity abt what t d if eyeeomne esenting wh sympmshotoisat tt rs and me reth ey have lst gles tn prote heels,uto ke sur tt they ilate and fothiffere authorie bet health woer iss ctical caehais haening is that there are pele that ha ela th are staying in t se roomi vether peopl d at cannothappen. so the iolioisriticalan th iwher the eduti at e mmitlel beom very importt cae ats the ly way we c contai . >>hould ere be sll etc unrstand isoti t peon if yousote the peon witht eaenthpeon is just gng to s there a ie. thenou sid that th esre maybe ininprrie pcr mae tneed. inhepleshey are n need wt pps tohe person >> thas veryal

estion. the are mmunityarenters being establish wch are like mi ela trement nts. the eas those paents wl be ten er isotednd refor unti the teis done. iould justi to add o thing,s wellhatyo mentionenitiay abouth u.s.ovnmt d e etc. in o dscsion th the.s mitary wellsbo the edorbola tatnt units and whe eyhod be, w have en tha they veee tremely exle. ifeel them theresno need tota tsoneto i erthey h beextremely responveocommendations. >>ou might wato rspond but i wte sk y ri of questions around ctul prtis t go ahead a spd. >> i wldike tocap a lilebi wod ke to iterate that flibitonot th

signation whereheu aran genera that flexibily atin ptilay e u.s. aid,araneneral sponse has been rely fantastic. it alloweus te sure w a ab to positionsoces icy spsie. on e iuef the mmity, snt lot im gog er wat testay ito intectith thcommuny. that'sot of these dialo sessions that i heeen lkg aut it rll cused onmang sure that re no tdo, a not stbuting aets and justoi radio ow but rely makingureits a coerti wh the communit out wh elas and wt it is not. and ving tem cmepi eiownsotisheor

throh. that'seeab talw u makeure thheomnies wh ty ve speed case, at theyut t cmuty meern sare caon atheomniesre din lot of theowmotongnd makingurth emangha phe ll ca really that phone clishe stmrtt thg, makingurthh viims oruscted vctis olatedndheaking tat onca irely huge. in t lg rmberewe ard, befe is vir hi we were doing tse wer a sanition titi wi t gornnt and weer scessfuln woinwith over 3 mmunits proper anat d propgiene. andha effort w irebly

succsful. in l 350 couniewhh are meofhehardesthit counties, noneof tm have en effected b ol it rllo tsh tt i u maketh lg trm veme, y prere e mmits fo iit ey ve he it h a he pa and preventsha fom pping. on wh w re ableto t all e counie i lbea fore wwe le- fo e rut. >>waed to a iyo would expa ailer i uderstandit w smein u id 70%f e anisonwe d to coacwith pplwho ha ssed ay. holong ia bodycotaous? cleueassng ou e lef e itmmunit i wa wdeng i ithaders sie e aditions a a part

ppls it theere ki t lead in getti peop tdeatend de fr tditionalractic? u id ty veomupit ys saflyay od bye. thought yoai the dha thll oth pteive gr . i was wonriifh hat u met i nto ow what hpened t u. did ey hd y i t aiort? w d u sea bk in tnkou th is aeriesf great estion winer eas e rs as t at therrt ere wn oypieof par. >> rious? thatuled overo e de so cnducte interewith thcd >>ha rpt? >>ll. >>nd they weelygrt

and th tmelidhe press as qck apoib, askee abt tentialel exsurewhh s vy lited d took tempature. ncth i vee iai ntt withheertnt of healt live in dc. am in cntact wit tm ery y. weisss- iself-nir, ta mteerurtwe a d and mitan mpmsof whh have no. wodlito itate tat eythcnddceptmt of health are realocuse on the partrsp pef it a the fctth iis a-ha we are wki tetron tisnd that theunrsndhy i'm erandhy i wntnd tat 's n aantanistic

relatiship. we wk geer th alwse a erybod mi bk feel eend ppy discs r hlth wh th deptmtfeahnd withhecdc. thateape u at aluend mesthamu moreimct in rmof monitoring ol. your esonbo safely sangoobye,wedotll thcouny membs don ppss rention tol beusit requirea tf training. , tuly alo emo dosopps t ma theme beer bause t burialea e aring full pe. itairly tidin ifit mes themeebeer toeasomeppswe aoy em to do tt. weon't aowhem narhe

dy. >>heurteams >> the ri tms are wring fu pes thcouny mbe a alwed tottd the ri. if they w toth c wr mid ppes b al they ar no alod clos but atllowsth t undetahas haeng, wherthe rial is t watch the processhichs irebly poantoaksureth they eengagean mak sureth ne tehes avictim, thatheyake that phone ca. sohatectn rltas e buf ete, e w th bri ams intacit the cmuti and make sure theurl don respectf and dnied way is a geart o the ti. the re a cple other small- e hesmall item nted to spdo w the haza yhichs arely poant pe ot spse

acal bau the are real bravepele dng rlly importanwk, but tey want to make sre tey a bein coensated. that i a part ofur eor toake se that tat pays haening on tend really rkgto ensethat. 's a sll ount moneyby r stanrdbu it's inedlymptant to ke rehe uerandth are valued and t wkthat tey ar dngis imrtt. >> just quilyo ewola eson whichwereho long i a body - and then if somebod cod drs the abandoned chdr, wre a ey? wh's haeng? >>ure. onheleth ofime th a body icoagus, d't exactlkn. thecdc andw.o. are lki

atts. th'shy are jt focuseon 's a ng te. it's on e de of weeks. and so that' w we keur athe bodis cvered in lorine, pacnodyb, core in coreain 'slternating soil and chlorine it is very l skto the water bl te also keu thathe bris pp above that table to make ur >> tnk u. just a few follow qstns in ourepmb 17hein d nt bralypoke at ng abt a nberf this havg

lid through it a havin surv survived. e inth he made w tt the 120-besoti u at his hpilwaturningway as many as30infectis invialeach y. i' wondering wh ets, has that chged? is the cacitgrowing? th milar is i t process and creatin ttpaty me atrong pnt about those whoilltainhr mendil beare fory lod on,husbands,ives, ch chdren. he sd wl condemni cotls numbers of otrs, faths,o to dth bause th choseno let the loveon ealone. m wondin sncsoti is e theeyto breing t

anison chain imany of the infeedeople ll syt ho, is tutach to the individualarivs robust ast should e? lemelso asat our heang the seconhri d fouchy usedthe woxponeiati d mega dinhis ston we d aroup of to people inudinghe head of aid aa hearg st weeofhe fll coite. ator wasn uer once and i ke themabt e we eing a turn? c had saidha if e tef inease connu t pac ineptember thereou be nys 4 milli cesy la january whe ewe in yo viin rmof thestatns ohow laethidemic may grw?

let mlso askou o ot ten poisth y have ggtetosishe poanf aapable bulancnetwork ncsoan peopl cn' t anetu eah facilit er ibea? thinkounow mo ou liberiin terfapacit and al, icold, a of u ghao uch onthi drralyay veeehelped by matt. the e he drugstillin e pili, ccines and raveotti dru. i s amze and psitive ocd enouaid tt rate ofal atobo

un in liberi isppxite %. th ifa lweth t averagtaty rte ith ree efct ouri. ats in done theo acevthe remkae rults inerofitigatgtit sof you ul spk t those ises >> thank y,r. chama would leotalk with e st qution out thow fatalityatfhebo treaenunit we are usgny maculou ugr any stg dru he. wh we ardog wki thheomnio make sur that paties e feedo the eba eaenni sn ssle th has enne t maj cts in lweng mortality ras. asou hav sn ren e s.hose tt were ught rlon ase to the hoiturvive a tseha

we le d t keit, founel r eatments si lae erotes, min sure people are healy eug f em to fighthe vus otheir n. onvecritical cpontf suesishe. navy b t up nt the tatmentni sed to ta us five tsen daefore we g the test sult f spect se. noit ke uivtosen hos. so bicallyeoe e mi in, we areesng th. ifhere pit teyre put in thereme wd. ifheare netive ty e nt home. th cs down the penal exporeasel th h bn ctil for , asel >>th wou f peole mafestinso mom

>> coect. thisacalie into yur eson abo t ebola treaenni pity. e b citi a pying iticalro. thebo tatntnitscct suect cas. theyertuina lof se ayecausehey d tave thcacioeshe tits. soitthe ditionuer bshaar bng estaisd ler atshelpinou a t. its noongerhe se hdl ynitisusng pies ay thsiation beria and this isomethinghata ntione hee, is looki beerhait loed a couple of mthago. e mbs e we e was a loht sbefore. is muceterhan wate

titetwmohs ago we contie o e rit trac and wa tontinu wi t se momentumwe caot slow do, weill get i unr onol d e sam appliedorhe heuntrie weee theumberscrsit u ftera than libea. we nedotogether mmunit treatmentth goveme, e stovernment asel aons and oer gornntinheilary to contn . liricod reall good ccs story. wehodn sart celebrang t. itstill nnr coro it ioong sive wcoin w wll gett undecontrobu it is t eay srt leating. on t individua otti, is issothg at i fite iortant. isoe backo edating t faly b aso givin em sic protecti, ovs, as.

at the seie nan toiv aalse nsf otti. do nota tmto think th jteus they have gles and a mask tey are ay toe ar our atient weneto be sreduti tas ac prer a they e ry welawef ris enit pteio atsercritical. bunc twrkis very important in a couri. we turn ckrusnt ambulaes we turanhi we n gur ndon intobunces. wereoongat ffen tys thatan tke ptits fr fwayouienour oltreatmtunits. itsetr andcheape tn ttg up in mef tos coti. theris nee to casthat capacity d need torn stforng in mbances. that is a very risky jhen u e i an bunce. it sems tres a venoo acal g aulances in the.

lo of beidonated also weo altnave way anortion. >> i nted toad to theot ou getngo thatnfctn point on the ela cris. i thinth mbinationf geinbo hardwareight and softwa right are hugy imrtt. the cs and gettg man t to couniegein communy re cters to imovaccess. on t other side i at iee haeng on t thnolog frt and vy ickly bothso th warn position t bterjo of testing tracki and trti therus. onhe testingid number of rapiiaosc tesre coming avaab,eg tsted ouonhe grouninhe next couplef months. a t ofo is bng done with s.-bas thnogy cpaes

woinwitheople t grnd evopos to automate ctatracingto in e powerofchnolo into ths, to be abo do a mueer jobof tracking and doing urillance. i ink attoo,is cin i dion to whats happeng erement side. likey collgui v peful t cno b complacent oecre victory. the is still wortoe ne a of thesefronts. >> a iou likeoo thugh a w our qeson beusihithey are al intestg d ow the chaes espeal in rerce to m bradlestestimy. ielievehere was a st of cis cyclgoingn athe rl sag where er w not enouesng so treeot

ou dsnd so ebola paents were bein turdai from the etus both bcause o e ck ofesngand just t sileack of be andheth careworkers. and so tn the ctims are rnwa th go ban tir communy d ey infectthers and they pass aw ath ri teamstha pnt wre ovsttcd. and so that -- bth ofhe issu being adesd, the us having thevaab bsnd enhe bualea beingbl collect theboesreally d a significt imactn lower th rate of anison a then tye continuedo brgdo eumber ofeba viimgoing intoheetus.

at h bn o of theflips that hped scer. bdley testifd ic iwonderl t ar and i wouldi to reitera athile the cmmits ed pteiv uienanddo ne ecaonbout h t hale the sick,h risk o the fae sense of prevention is sothg at we a very cafuabout that jt bause th he ask d gov don' mean tey e leo safely hdle cts. the ureot at awaef tmsofow eyre put toth. eyreer strghorrd puttoth. st areemra stctures d eyrehe fastt ghstig qualy eatmen th you c get. anso yo me wn fr

that y do curoisin rmofheommuni ce centerth heo b lok at rell toaksure tat thquity ofar ivery ryig tmsf the preconth umtied, ithk a l o eprjeio we otng pped, ifedi't do ything. nothat we areoiomething and i thin we areoing alot, ats bringing dwn a l o the ojtis i tnk we ll lo forwardo fure ojtis. onhemban netwrk sothg at we are invve innd rpoin tanot in aotf e oer acvies that w a din suchs contt acing a bunce wo a t mmit engame workn thesohet beusee are latg r tes t countheth tea sowe h a siifant retish wit everyounty

hetheam and wma sre th the bial tesarun t that un hltte. so wnhey sayur ambulance broke wn,can y hp t, we a ae imeaty spond d ry, very qck toake sreth haveanher ambuncorhaitet reir. th's loweds tenge about ten abunc atre begun o o diffent unty health tesstheyave requesd fms. i thinthspt of i to kesu that we e harg dictr t cnt al teams sofhe mote coti, meake twdao ge t oory da d are aletoea fro themmmialynd los respo ryqck. d i tnknthe ohais it is a pttyigfintss ats beinoodty a lot

different ngs. thnre questn ofowyo spd to talihaar infeed, oraniders is gnict. its lstg effe tts gog to he onhivirus >> wiseay chge ist the mist oheth? wenoth w.o.cand some witheringrici imi ocbefr aeport ou h they hisedtndha ineqte stfi. i'm wdengho is ul in chge wh redohepl? wenow cdcis playin aer gnictdvory a adsh re. send, on the issuef trni hltcare rkers,

commithetharrkers, ulyo give snswh thgre e ey oer more expeend? op who he come bacin the syste arth yng peoe o ar stpi u theplte wh ds it lk ke? do t said pove saly suppt? wenoincastph situatnsery of th suidy cabe pvid. i memberei srlanka tethe tsumi issuend w we pang sars to indidus to do or to cleap,otnly wa titing, it opd em om-hey wereacve din the cleap o teirwn homes an cmuti butheas that snificauidto help th g ney inhr poct, to tirusess going loll i' woerg i us ony otr enti i proving sala

suort. >> the ler geren i char a tyhld be in char. at thendf e y 'she countr d areuuts there. wenlwo touhnd with e i dn'th any o os unies wererepared r ch anoutbreakspiay unies lke liberia tha suer from lg civil wa antrng to rov from at. additi t otheysmi su ere. the world al gazaon cd ngor to suppor t bea miry of health an ciwo. eyave byh crda coorditeth elaresponse.

ehg inba to your qution authanes to be done, aotfford to g ba there wer fo t ola outbre. nd to bldheysms beer thanhey were fo becae s they wret that efcte one w doit i supporthgovernmentthe misters of healt buildhe sts,rain theirta, ve emllheuprt that ey ne t mo things foard. d they are in wt eyan gin limed capacit a palities ththha. am i paygor rus lehaa wle ago. theti needsobe aricatioinerms of who responblfo whatndwho i ornangwhat. thatserimportt. ihink asiscusonta aconhegrndha sould

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bett la. no ses of ebola ve bee trsmtetony memr oth neral pbl ithe united at. th new procedureinland wi thexceptionof draig spenceinewyork,o indivialas unknowingly enrehe u. wle affecd wi ela airport sceng anewcdc niri gidelin plend tateandocal bl hlth pames en place. and we have successfuy tead eit ol pies thatave enreu. hpitals. iant to give ced t ese hospals anealthce ofsialth he treat these patients. the prossionalstmo univsity, e nih, t univertyf nbrkaedal center,elvuand txas esterianthr reades s mehu difference. i wnto lcer. gold from the university of nebraska and thank him for sharing his expertise today. unfortunately, the news from west africa is not as good.

while case counts in liberia have slowed, there continue to be increased in the number of ebola cases in sierra lee own and guinea. officials are now concerned about the appearance of ebola in mali. that, mr. chairman, is why we immediate to focus on the u.s. response in west africa. it's a credit to our country that we're leading the effort to end the epidemic in west africa. the early results from liberia indicate that our efforts and the efforts of our partner countries can milwauky s caies . but there's much work to do. i want to acknowledge all of the medical professionals who are doing that work. in particular, say a few words about dr. martin sal ya. we learned yesterday that dr. salia, who had been flown to nebraska for treatment after developing ebola while working in sieree sierra leone died fr disease. we sent condolences and acknowledge his bravery in helping fight this disease.

west africa is balanced on the edge. if our efforts and the efforts of the world health organization are not successful, millions of people in these countries faying a looming humanitarian crisis will continue to suffer. i am grlad that mr. isaacs is here to give the perspective of the international aid community on the west african outbreak. mr. isaacs, your group and other groups like you'res are doing difficult but critical work. you deserve support. we are in a better position to address cases of ebola that appear in the united states than we were a few months ago. i appreciate dr. frieden, dr. lucniac for joining us to share lessons learned and tell us how we can move forward. i'm looking forward to hearing about the supplemental ebola request. it's critical congress support the appropriation request.

it would support domestic preparedness, help treatment centers. it would support treatment and vaccine and it would support us a d and the military in their effort to eliminate ebola in west africa. mr. chairman, i suspect in the year to come we will have our share of discussions about the budget. we support the goals of the president's ebola outbreak plan to combat it. i hope we can move quickly to provide the requested appropriations. thank you. i yield back. >> now recognize the vice-chair, ms. blackman. >> thank you, mr. chairman. i appreciate the hearing. i want to say welcome to all of our witnesses. we appreciate your time. i think we have to realize with the nearly 15,000 cases and over 5,000 deaths that this ebola epidemic is the worst since the discovery of the vice russ in

'76. you need to look at what the precedent is there. 2,400 cases known cases of ebola prior to this outbreak. we know that this is something that is this is something that will be difficult and take time to deal with. we appreciate your efforts. there is good news out of liberia. there is a mixed bag of news that's coming out of the region. it all leads us to look at the magnitude of the situation in front of us and the human to human transmission of the virus which leads us to keep america safe. that's the goal. most believe it ises the job of oh the cdc to keep americans safe from infectious disease. and that all efforts need to be on the table when it comes to

keeping americans safe. don't take anything off the table. the chairman mentioned some of the suggestions made at the last hearing. indeed yesterday i was at fort campbell with troops trying to build hospitals and training medical personnel. they have been opposed to items they think might work. even the institute held a workshop where there were a number of questions about the characteristics of the ebola virus. they concluded, and i'm quoting, many of the current risk, quarantine policies could be better informed and more effective if the means and potential routes for transmission were more thoroughly characterized. until we know more about the nature of the deadly virus it

seems prudent to keep all common sense measures on the table. with that, i yield to dr. burgess. >> i thank the gentle lady for yielding. thank our witnesses for being here. dr. laky, good to see you. >> this will be one of the most serious public health crises of the last hundred years. at our last hearing we had a great deal to discuss. many of the brave pronouncements from september were found to be nonoperational by the middle of october oh. there were failures in dealing with the crisis. certainly communication was lacking. systems and protocols broke down. provisions that we all thought were readily at hand were never in place to begin with. i hope we know better than to let it happen again.

this summer's emergency, to me, emphasized one thing. have a lot of hue mill ti when dealing with the virus. it is difficult to predict. as a physician, one of my big concerns, since july has been the safety and protection of health care workers. i want to thank the cdc for being responsive to my telephone calls and the various conference calls we had over the summer were helpful. i've got to tell you. until you have this thing in your backyard it's hard to estimate how it will affect daily life on so many levels. sure, we had a hospital that was hurt by the crisis. we are probably lucky we didn't have more than one hurt. trash collection, sewer treatment, school districts. every one down the line was affected by having this virus in our area. we do have to take great care.

it is important that it be brought under control. i have to tell you i al grateful for services of the hospitals that handled the known ebola patient. i was much more worried about the unknown patient who could walk through the door at 3:00 tomorrow morning, unknown to anyone, unannounced and provide the same set of circumstances that we have already been through. i'm not sure we have learned entirely the lessons. thank you mr. chairman. i will yield back. >> the gentleman yields back. now mr. waxman is recognized for five minutes. >> thank you. i'm pleased you are holding this hearing. this is an important topic. it's appropriate for congress to learn about it. the american people want to know what's happening and want some answers. i picked up a couple of comments from the other side about having

humility, learning from what's happened. and hope we know better because of what we have learned. when we last had a hearing in october, there was a pronounced disconnect between what the public health experts were telling the committee and the rhetoric of the committee members. some members called for quarantines and travel bans that experts determined would be harmful. some claim the administration's protocols for screening and tracking travellers wouldn't work. some even insinuated immigrants with ebola would soon be crossing the southern border or that ebola had hue tated and become trance misable by air. this is mister call rhetoric. it induces a great deal of fear. mr. chairman, none of these things were true. after two cases were transmitted

in texas the cdc acknowledged the gaps, revised protocols. it learned from its experience. it was 33 days since the last ebola hearing. since then, not one case of ebola has been transmitted this the united states. only one with traveller since then, dr. craig aspencer, has brought ebola into the country. it appears our health care system responded effectively. dr. spencer knew how to immediately report symptoms, was isolated and safely transported to a hospital equipped to treat a patient with ebola and his close contacts were monitored. the health experts told us that our public health measures could protect the public from ebola. it turns out, mr. chairman, they were right.

it's good that we have a chance today to show humility and acknowledge that the fears expressed openly this this hearing at our last meeting were not justified. as i said in that first hearing we should have a sense of urgency about the epidemic in africa. there is a lot of work to be done to stop the ongoing humanitarian crisis there. and we should view the appearance of ebola caseses in the united states as a wake-up call about the need to invest in public health preparedness at the federal, state and local levels. president obama is trying to address these challenges. we should support those efforts. if we don't stop ebola in africa, it could travel to other places. it could spread.

we've got to control the epidemic where it's happening. the president submitted a $6.2 million emergency supplemental funding request to congress to improve domestic and global health cap cities in three critical areas. containment and treatment in west africa, enhanced prevention, detection and response to ebola entering the u.s., and butt residencing the u.s. public healthle system to respond rapidly and flexible many the future. it's critical that congress support the request. in november of 2005 the bush administration requested $7.1 million in emergency supplemental funding to speed up the development of a vaccine and

fund preparedness. a bipartisan congress provided funding. in 2009 congress provided the obama administration to combat h1n1 influenza virus. congress did the right thing by making the investments. they saved lives, enhanced preparedness and congress should do the right thing now. >> we are joined by dr. thomas frieden from the cdc, nicole lurie from preparedness and response at the department of health and human services. rear admiral boris lushniak who oversees operations of the

united states public health commission corps comprised of 600 uniformeded health officers. i will swear in the witnesses. you are aware the committee is holding a hearing and when doing so had the practice of taking testimony under oath. do you have objections to testifying under oath? all the witnesses say they do not. the chair would advise you under the rules of the house and committee you are entitleded to be advised by counsel. do you desire to be advised by counsel today? the panel waives that. would you all please rise and raise you're right hand? i will swear you in. do you swear the testimony you are about to give is the truth, the whole truth, and nothing but the truth? thank you. the panelists have answered in in the affirmative. you are now under oath. you may now each give a five-minute summary. we'll start with with you. >> thank you very much.

we appreciate the opportunity to come before you and discuss what's happened in the month since the last hearing. in the basics of ebola we continue to see the pattern we have seen over the past four decades. in fact, in the more than 400 contacts with we have traced in the u.s. we have not seen spread outside of the one incident in dallas in the health care setting among travellers monitored since arriving from west africa. we have seen a series with fevers but none with ebola. nothing changes the experience we have to date that ebola spreads from someone who is sick and spreads through unsafe care giving in the home or health care facility or in unsafe burial practices. emergency funding is critical to protect americans. it's critical to stop the outbreak at the source in africa and strengthen our protections

here at home. globally, in each of the three epicenter countries we have seen rapid change and flexibility is key to the response. in liberia, we have seen promising developments in recent weeks. we have some decrease in numbers, but still the number of oh new cases each week is in the many hundreds. our ability to stop it is very challenging because it is now present in at least 13 of 15 counties of liberia. our staff are now responding to as many as one new cluster or outbreak per day compared with the past four decades with one cluster or outbreak per every year or two. it's going to require a very intense effort to trace each one of the chains of transmission and stop it so we can end ebola. in sierra leone we are seeing widespread transmission. although some of the areas that implemented strategies we would recommend have seen significant

decreases as well . guinea is in some ways the most interesting or concerning or instructive to look at. it shows what might happen in the future if we have progress in the first two countries. there is a challenge to trace each outbreak, each case, to reach each community and end the transmission. that's why the emergency funding request outlines a comprehensive approach that's simple, straightforward, focused and approaches things by prevention, detection, response. three main categories. in west africa that prevention involves quarantine and screening, infection control in hospitals and burials. it involves detection so we find outbreaks promptly an strengthen surveillance and the ability of health care facilities and public health care workers there to stop transmission and response through core public health functions of contact tracing, training, infection control, public health education, outreach and rapid

response teams. globally, we are seeing new threats with a clus of cases in mali. cdc surged. we have 12 staff on the ground today in mali. we were there before their first case. they are tracing more than 400 contacts. we are helping them do that and test any who may have symptoms that could be ebola. we are also aware with the end of the rainy season, other parts of west africa may experience an increase in travellers from the affect ed countries and may be at increased risk. the metaphor of a forest fire holds here with the center burning strongly with a series of brush fires around the region and with sparks with with the potential of united statesing new challenges in the struggle against ebola. the funding request also addresses the security aspect so we can, with an emergency focus, look at what keeps o