modernization versus refurbishing. i know frank miller has a view on this as well. 2009 witho back to the presidents product speech -- prague speech. one of the lines that people forget about is that president obama made it very clear. he said, as long as nuclear weapons exist, the united states will maintain a safe, secure and effective nuclear deterrent. this is important for a couple of reasons. one, to reassure our allies around the world who don't have nuclear weapons that they don't need nuclear weapons. and secondly to maintain strategic stability with countries like russia and china. following on the president's speech, in 2010 the administration published the nuclear posture review.

it was very clear that we will not develop new nuclear weapons. existingrefurbish 61, but weke the b would not provide than any new military capabilities. that remains this administration's policy. theuld argue if you look at refurbishment program, it is fully consistent with the 2010 nuclear posture review. with regards to the delivery vehicles. this is the new submarine, the new bomber as well as the new ground launch missile. here's the challenge. most of these platforms have been operating well past their service lives. therefore in order to maintain a secure and effective arsenal, we are going to need to modernize

these platforms. we don't have a choice. commander of strategic command mentioned in his speech a couple of weeks ago at the center for strategic and international studies, we have run out of time. and therefore i believe that the modernization of our delivery platforms are fully consistent with the 2010 nuclear posture review as well as the presence 2009 prague speech. >> three points. people conveniently forget that the way the deal to get you start ratified was that the president also endorsed the modernization program. that was critical to getting sufficient votes in the senate. i won't go through the laundry list of systems, but the chinese and russians are putting new systems in the field right now. in the field and the water. won't hits. submarine

the water till 2028. the new bomber, late 20's. the new icbm, late 20's. there's a lot of catching up to do and we are not provoking chinese and russian modernization. third point, from 1985 to 2001 i directed u.s. nuclear planning. ok? i did the war plans. i interact with two presidents and multiple secretaries of defense. fiction that ae senior american official would say, that's a low yield weapon, i'm going to use that. thenotion of crossing nuclear threshold is the most serious decision any president or secretary of defense would recommend. the notion that it's only half a kiloton instead of 10 kilotons does not inter--- enter into that.

the president would use the nuclear weapon in the arsenal that was most suited to the task. it is a calumny to suggest that modernizing the force leads to the increased possibility of usage. it's a calumny against any president, and he secretary of defense, any secretary of state. certainly the use of any weapon would be strategic. in the past these have provided some flexibility -- final question to elizabeth, one of our residential fellows here. thank you. fellow. the wilson center and work on the history of the iaea. thank you for this very interesting panel. i have a question which relates to something that was strikingly absent from the debate. this is the ctbt. that because it is not a

priority at the moment? is it because nobody believes that it will be ratified by the u.s. soon? what's your opinion on that? i think it's a question to the whole panel or to whoever wants to answer. thank you. >> there was a panel a few months ago that secretary kerry engaged in that talked about ratifying the ctbt. the conclusion was that it would take a great deal of ground work in this country to get ctbt ratified and that has not been taken. all, if the u.s. ratification of ctbt would bring the treaty into effect, that would be a strong argument i suppose for pressing ahead. it won't. joinountries that will not the ctbt are india, pakistan, israel, north korea. so it is not going to come into effect. that is a basic fact. hasthird, the united states

had a nuclear testing moratorium since 1998. people ought to focus on the intent of the ctbt and not the ratification process, which will not bring about entry into force. >> i was actually working for frank as his special assistant when ratification debate began. there were fundamentally two questions that opponents of ratification raised. first, that the ctbt was not effectively verifiable. and secondly, that you could not maintain the weapons without testing. i think we have made a lot of progress since then. i think what we have seen on the verification side of the house that through the international system, -- monitoring we have genetically improved our ability to verify nuclear explosions.

dramatically improved our ability to verify nuclear explosions. furthermore, we have been able to maintain our weapons without testing. look at the u.s. senate, i believe 80% of the senators who are now in the senate weren't present during the ratification debate. as frank noted, there has not been a great deal of discussion about the benefits of the ctbt. so instead of pushing for ratification at this time, what the administration is focused on is an education process. discussing the merits of the ctbt with the public, but more importantly, the merits of the ctbt with members of the senate, and of whom are not cited

particularly knowledgeable about the specifics of the treaty. >> bob, we are going to give you the last word. are you optimistic or pessimistic at this point then you were a decade or more ago? >> yes. i am. [laughter] thatank you for appropriate nonanswer. [laughter] all of like to thank those in attendance today. those viewing c-span and other networks. these join me in thanking our panelists for the excellent presentation. [applause]

>> as we leave this event, our live coverage continues as we head over to the discussion on the syrian civil war five years since it started. the hudson institute is hosting this discussion on how that conflict has escalated and what the international community is doing in response. this discussion just getting underway. >> which is something good on

the humanitarian level. what it means in terms of local development in syria -- this is my real fear. this is why i'm bitter five years later. i think what we are heading towards today is exactly a kind of frozen conflict. this is something very familiar to the mind of the russian strategist. they had a frozen conflict in crimea. now they are having one in syria. the frozen conflict has several functions and uses for them. first of all it allows them to wait for the next administration and see what are the bargaining's possible with the new administration. second it will consolidate the frontlines and the divide lines and the demarcations. this is a real potential drama for syria. it means maybe we're not heading towards partition in the de jure sense of the word. we have now i fragmented syria. we have more or less, if assad

survives, which is in question of course. a lot of people are excited about this. kurdistan that has been announced two weeks from now very officially. and of course you have verbal positions from washington and moscow saying this is a breach to the political process but in fact everyone is protecting this could stand. -- kurdistan. and you have is very dangerous unnistan in the middle which will really become the quagmire for radicalization and greater sanctuary of isis and other factions. and whereby you will have isis , circulars,h others etc. in a kind of really

nightmare scenario. i come back to the -- in that respect, we have a very deadly game between moscow and washington. each one waiting for the other to really become exhausted and come back begging for the other for help. battle wee palmyra had two days ago is an exact example of that. as soon as the dust was settled, after in the diplomatic circles, the discussion became, who will take the lead on rakha? for example, i received mail from my former french employers asking, what's the mood in washington, are the americans ready to give it to the russians as a kind of -- subcontracting. which would in fact be catastrophic for the syrians

because it would completely achieve to rehabilitate the assad regime for a while. so this is on the local level. given this very dark and gloomy picture, what couldn't derail this? i think two things. i admit my naive this on that. one is the local reality. as soon as the truth was in effect, very few hours after, syrians went back to the streets. it's as if five years of bloody poetry by assad -- butchery by assad -- the syrian nerve is still alive. people asking for the fall of regime as if it was march 2011 still. and the second friday, clashing physically in several villages. which for me as an observer and is a supporter of the syrian caused, really a motive of

optimism. you will not be able to put a lid on that story. i think this is something people moscow shouldand reflect upon. you will not be able to shut this issue off easily. a motive of optimism. i don't not how it will play out. i think it could derail the kind is theen conflict regional actors. i think paradoxically both iran, saudi arabia, and turkey have an interest of not seeing this situation consolidated. turkey cannot accept a fragmented syria because of kurdistan. acceptdi's will never that damascus is still in the hands of this regime. and iran will not easily accept that the main winner in this relative march -- match is

russia. they have invested a lot in the syrian regime. they would like to find their investment down the road. i don't think they are very happy to see that putin is alone calling the shots on this. what could they do? it's very limited. turkey is really on the verge of completely severing physical contact. will have to find another way to have a link with the syrian revolution. the saudi's a mystery for me. they are entangled in yemen. they are speaking loudly on syria with few very real gestures. they don't want to clash with the russians. this is something they have announced. doing something in that respect is taking a risk of clashing with the russians. so they have a very limited margin of maneuver. will seeith time, they a gradual erosion of this long

truce. -- i sayde i would say it very bitterly had with a lot of sadness. five years later, syria is no more syria. we are talking about something much wider than syria. it's a regional international conflict at one point and in some shape it is a planetary conflict. i think syria will really to find the international order for the decades to come. it's an enormous tragedy. i'm not saying it in multiply. it's a real geopolitical acknowledgment. think it is still open to a lot of surprises and bad surprises. at least as long as the local reality, the regional conundrum the tension between iran, saudi arabia, turkey etc. is not squared off, as long as there is

no real parity between the u.s. and russia on that issue with a stronger leverage the u.s. diplomacy to stand to its own words on the political software of how to solve syria -- as long as the readings -- these three levels don't coincide, syria is unfortunately going to stay an open wound. i'm fearing that in five years from now we will have something of the same talking about syria 10 years later. >> thanks for a very moving and very concise introduction. things i wanted to ask you in particular. , what are theanon kinds of things that we might be paceto look at in terms of and rhythm? we do see the temporary truce

right now. >> will come back to that. ok. >> if you would like to follow up. >> thank you for giving me the opportunity to speak. backted to take a step because my job at the commission focuses really on talking to and understanding the grievances of many of syria's ethnic sectarian communities. the issue of partition is very much a real one. the word federalism has been thrown around. it's really important to understand that a lot of these different communities are asking for. i want to emphasize something you said in the beginning, which is to dispel the notion that assad is a protector of the minorities, that he is a stabilizing force. he is very much quite the opposite. this is based on what minority communities themselves have told me through my work at the commission.

-- ae beginning of 2011 sharp al-assad made a very concrete decision to release many extremists from presence -- prisons. the islamization of the revolution. he wassame time that doing this, he really deliberately used sectarian rhetoric to inform and make sure that the crews and the christians understood that if they do not send their sons to fight for him, a sunni majority would eradicate them from syria. we have seen this emphasize through many different instances. reliedian government has on the forced displacement of sunnis from damascus and removing shia to damascus.

that is really to buttress the stronghold in the capital. recently bashar al-assad gave the sunnis in this area and ultimatum that if they did not leave within 45 days that they would be forcibly removed. voice of america recently said that iran also announced it was encouraging construction companies to come and construct this area. it is no secret that this will be populated with people who are very much pro-assad and would be in good favor with the iranians. the syrian network for human rights has been documenting a lot of the sectarian violence the 56orted that 90% of sectarian massacres that have occurred since the beginning of the conflict were carried out by the syrian government itself.

it prevented many sunnis from returning to their homes in areas where there is regional diversity so as to carve out these areas that could be -- exclude those who are not pro-shia. i really struggle with convincing people that assad is not a friend to the christian groups. i have talked to many christian communities in the north and damascus. assad has targeted 63% of all churches in syria. he has attacked 166 places of sects. from all he has killed around 50 christians and detained over 450 and this is just what we have documented. many others that have not been documented. i want to move over quickly to isil. of the 5800 people that have been killed by isis since 2014,

90% of them were muslim. that's a very significant number to keep in mind. about 100 individuals were of minority dissent. about 50 christians were of that number. this is not to downplay the threat that isis poses to christian communities and others. have beenall churches closed down in isis held territory. christians do not feel comfortable. not wearing the veil in isis controls. it's important to understand that isis is the enemy of all humanity in syria. sunni, shia, christian and others. to the armedy opposition, there have been some instances of the armed opposition carrying out sectarian like crimes. we saw 700 and lloyds caged -- a la whites caged and arrested.

they told us that was the only -- one person died. the government was very cognizant that the national media attention was on this area and therefore did not attack by aerial bombardment and it resumed in the next day after media attention went elsewhere. about the kurdish groups, joe has already mentioned them briefly. there have also been reports of ethnic sectarian violence and ing.ic cleanse includin enough think there is evidence to report conclusively what is happening in the north. there has been some displacement. human rights groups are still collecting that evidence to support or dispute that. ofing on to the issue cessation of hostilities in the

last month. there has been an 85% to 90% decrease in violence. as someone who was working in the humanitarian field, that is a very significant number. talking to people inside syria will to you it's the first time in five years some people have been able to go to sleep. it's very significant that the violence has gone down. of all violations have been carried out by the syrian regime. attacks468 out of 512 that have been missiles carried out by the syrian regime. 32 of those were carried out by the russians. a by the armed opposition and four by the kurds. another issue on the agreement was detainment. the syrian government has also violated this. individuals were arrested this month alone.

stipulation in the cessation of hostilities was .lso the delivery of aid theree heard reports that was a refusal of over 280 deliveries to places that have been deceived. .- besieged my own birth neighborhood has been besieged for over three years and has not been able to receive any medical or food aid even now. 370 people have been killed during this month, which is thertunately or fortunately lowest number we have seen over the last five years. that too is significant. mentioned, the protests. i want to emphasize them also as a syrian american, as a very proud moment, seeing people go into the streets for the first

time in two or three years. we really have not seen protests since 2012. men, women, and children. what is significant from talking to individuals in the syrian nonviolence movement who have been behind the scenes these protests is that these individuals that are out protesting are not necessarily the individuals we saw in 2011. many of those individuals were killed, detained, or fled syria. we are seeing a new wave of people out in the streets still carrying on the message despite having seen their comrades fall or flee the country five years ago. i think wenzhou said really needs to be underlined. movement, this appeared despite the horrific conditions we have seen. they have not given up. face --e stood in the

it was very significant, even when people were arrested from the protest, they were so protesting even today. briefly to the delivery of humanitarian aid, about 30% of people have received some type of humanitarian aid in the besieged areas. that's if we consider the number of the siege to as half a million. -- besieged as half a million. this food may only last for five -- four or five days for an area. it is one way they can hold us accountable based on the security council resolutions that the u.s. and russia have passed and are standing by

according to their own decisions. shame on this issue because we have people that we have seen die when their aid warehouse is less than five miles away. doctors who have told us they are not able to sterilize any of their medical supplies. really causing unnecessary diseases like could be easily prevented. moreover, during these deliveries, these aid convoys 18 shipments that have made it through. you have supplies that are being -- machines that are being delivered, but the assad regime is consciously taking up critical supplies needed in order to operate these machines. it's really hindering this process in a way that is just very -- it's absurd on a very basic human level.

and i think it is something that i hope the united nations continues to put pressure on. heard, the regime is going to start being held accountable for allowing or disallowing aid convoys -- it has to basically give an answer within 10 days as to whether or not these aid convoys can go in. there is really no good reason for in a convoy not to go into a besieged area. people are saying this might be one way to hold assad accountable. by placing this sort of 10 day limit. we have the crisis along the turkish border. we have about one million syrians that have in there since the border closed and on the have aboutorder we 40,000 syrians also stranded in the desert. mention thing i will and i hope this is something joe can expand on, the issue of who

will be able to take part in any next steps in syria? an idea of elections, who is eligible voter. we heard assad say he will have a constitution ready by august. parliamentary elections in april. a lot of people look at this as a very absurd idea. the idea of who will be allowed to have a voice and this is critical and something that needs to be emphasized. attention toaying this because a lot of syrians have expired identification passports. conclusion, i think am i really going back, drawing on the work that i do for the isil's crimes them, to really hold, to

encourage your own government pushing the syrian government to abide by the national security council resolution on a basic humanitarian level. >> thank you very much for your presentation here and for your important work that you are doing and the inferred -- the information you are able to give us. i want to emphasize what you said before by saying that bashar al-assad is not a protector of christians. it is important to emphasize that, not only because it is not , but i'm concerned every time that phrase has resonance in washington or in the united states. >> are in europe.

news up to thes europeans. but here in washington, we are not in the practice of making distinctions between whose lives are more valuable. christian's life is very valuable. no one should be slaughtered in syria. no one should be put through a d' killing machines. i like pushing back on that idea of minorities. minority lives are not more than thevaluable majority. . hope i read mike's piece uniquely identified the different ways the administration has been moving in the region, which are largely

is a iran but also syria major part of this. i think mike is able to put this in a larger regional context. mike: thanks for having me here on this panel. with every word that my colleagues have said. i would like to key off something that joe said in his brilliant analysis. is beingthat would fought over in syria is nothing less than the regional order. i think that is absolutely true. i think it is worth emphasizing. i think we need to think much more about it. i wrote down here what i think thinkx principles that i

president obama has sold us on. there are people who dissent and they don't agree with all of them. it is not just the administration. i shouldn't put it all on president obama very in my own -- obama. in my own party, the republican candidates have pushing the is a pulse think they are all false and i would like to run through them quickly. i would like to run through them in the context of a discussion bout the re--- the first principle that the president has got us to accept the the use of force by united states is always counterproductive or at least, in syria, it cannot lead to anything good. we, thend one is that united states, don't have a vital stake in what is happening in syria area and in the middle east more broadly.

i don't think there is any other way to read that recent jeffrey goldberg article in the atlantic, the obama. and, which i would urge everyone to read. i don't think there is any other way to read it than to say that president has decided that the middle east is just not -- that a stable order in the middle east is not a vital u.s. interests. that the principle is defeat or the weakening of isis is our strategic goal in syria. and that that goal takes precedence over any other goal. the fourth principle is that iran and russia are partners in the fight against isis. are not behaving today is our partners, they will behave as our partners to test tomorrow. -- as our partners tomorrow. you can hear the footsteps of putin.ent clinto

he is going to come in here and help us against bashar al-assad. give up anycan concessions because, any minute now, here comes president putin. president is aware that and he plays to it. i have withdrawn my forces in syria. five, i can't even read it. 5 here and say there are no moderates among the syrian opposition. we don't have anyone we can really work with. been, both by our own policy, the government's policy, and by the rhetoric of people in my party, there has been an

identification with the syrian opposition and islamic extremism, which i think is, a, it is faxing correct, be, it is her industry -- with regards from a humanitarian point of view the way that it tarnishes, it claims -- it blames the victims of this world bowl oppression. and finally, it leads us to that policy because we can't look after our own interest because we are reading what is on the ground and correct way. and then there is the sixth principal. our allies on the problem. the amount of rhetoric that has come out of the white house saudi's, problematic ,he problematic turks and so on at the same time, there is no rhetoric about the problematic iranians. theonly thing we know about

arabians from the white house is that they are these moderates that want to work with us on syria. turnhey, too, are about to the corner and come toward us. in the meantime, we have these allies who are calling -- who are causing us all these problems. the result is we have this event that took place, which is we have this cease-fire, as joe pointed out is an illusion. everyone is ready for the next round, and the next round is .oming, relieve me t assad and his supporters take on my rug. and we get things in the newspaper like yesterday, horse johnson in britain writes that

tamar has been liberated and .hat isis has in defeated in the that really wonderful. thatd to mention the fact assad does use chemical weapons and tortures his own people. i feel a little bit sheepish about saying this, but is in it wonderful. no, it's not wonderful. believe me, i don't should a tear for any isis fighter who is killed. but what are we talking about? who liberated palmyra? and iraqi shiite andtias, trained, equipped controlled by the arabians trained by the rush and power? we have some corrected generations in syria.

which means we are building a new order, not just in syria but in the middle east in which this rissuan-iranian militias -- that is anust acceptable partner for the united states and for the west. we'veo means that completely misread what is happening in europe. the refugee crisis in europe and all the tensions it creates in europe and in nato is a consequence of the ashen -- the actions of this russian-iranian alliance. but we are associating in our minds with isis rather than with the actual perpetrators, this is -iranian-syrian alliance. even the right wing in europe,

the anti-immigrant weighing, is as a partnerssia in solving the refugee problem, which is a completely pathological position. i think that we accept these --ends both at our own perl these principles at our own peril. we have now estimates of nearly half a million people killed, mainly by the assad regime. 10 million people perhaps operated in one form or another. and that is horrendous and i think him as americans, we should be concerned about the fact that we have just turned a blind eye to this. the strategic is

factor. the one is we have degraded our alliances in the region. we have denigrated our traditional allies. our traditional allies do have problems. we have problems. there is no doubt about that. but by emphasizing those publicly and moving away from our traditional allies, the turks, the saudi's, the israelis, we have not the structures in the region that are capable of contending with the challenges of the region with anything other than unilateral military force, which is what we are supposed to be avoiding. if there is another shot that comes, like a destabilization of jordan, the only thing that we have at our disposal is unilateral action, which is problematic. the second thing is we are not building a stable new order. we are sowing the seeds of further conflict.

example, just to give one example, we are now in a with the turkish government about this hundred , theeters of territory syrian-turkish border, that the turks have not closed. we are telling them, if they don't close it, we are going to close it i working together with equivalent or the syrian arm of the pkk. that is a kurdish terrorist organization which the turks regard as a vital enemy. so we are going to work with their kurdish enemy to close this order. they would like to close it, but they want us to work -- they are willing to close it, but they are willing to do it under certain conditions that will protect them from the creation of an autonomous kurdish

authority on the other side of the border that stands for kurdish separatism from turkey. if we continue down this path, we can tell ourselves that, sooner or later, the turks will just except this. but what is most likely to happen is the opposite. at a certain point, the turks will reach a breaking point and they will take a unilateral military action which will work against the peace and stability that we want. , the claim toe goal is that we will defeat isis is just not going to happen. with the absence of sunni partners on the ground in syria and in the region, we cannot retake the territory that isis now holds. we can clear it out militarily, but we can't hold it and create a stable new order there. we might get lucky.

because isis isn't the smartest organization in the world and and maybe isis will collapse, but we will have tremendous bit -- tremendous disorder and a safe haven in the region causing us problems in the region and in europe and elsewhere. a strategicefine goal, not as defeating isis, but is creating a new stable order in the region. and the path to that begins with working with our traditional allies and coming up with an agenda that they can get on board with. thank you. >> that is surfing. i want to come back to something you said. when you said that the administration part [indiscernible]

thanks. were jailed or they were killed. so what you seem to be saying is that, contrary to different messages that we are hearing, it is not too late. think, oh, the whole situation has gone so far to the extreme. there is no one for us to work with. i think it is safe to say that is not going to happen in this administration. but you guys seem to be saying that there are different moderate groupings that it would be possible for the u.s. to work with. first of all, if you could give me kind of a picture of what that opposition looks like on the ground. entirely's not transparent, but just a general picture and then i will ask mike and joe to tell us what that might look like in terms of implementing policy, if there

are actually moderates to work with. quite excited to work with more of the civil society movement. i definitely -- lee: i'm just say -- i definitely agree with the statement you just said head there is a moderate civil society movement in syria and one that the unit since government has been supporting. portion of the funding has been to keep media organizations, local councils alive, etc.. and organizations that have really with stood the pressure. isil asout a year ago, well.

i definitely believe in that movement, not only because we protests, because there is a significant number of syrians who have not taken up arms in the past five years and every my -- and remained in syria and chosen not to leave. they could have left, but i do believe that the people we are seeing in syria are committed to remaining in syria and allah -- not all of them have taken up arms. we need to really show our support for them. and for eckley, i know are allies, like mike has pointed out, is the kurds are now. but they are not going to be able to come to damascus or to homes or two livery these other .reas from isil or assad they are not interested in that kind of a fight right now. you need people from that region to liberate if we only show them

the support. sometimes they are not aware where the national community is on this line. do we support them? do we not support them? i think that would really help. lee: what is your sense, let's say for the next white house? who can be -- you can we work with and i will rescue to follow up on that. >> i will answer your first question differently and take a different angle. since you are reflecting on five years later and what happened, i think it is important to take this moment of self reflection and maybe part of it is self-criticism.

i hope you all remember, in the early moments of the conflict, assad gave interviews. , look, it was only a few peaceful civilian protests. there was no syrian war. he said, look, this thing is going to radicalize and weaponize and regionalized. we looked at that. this could have been analysis from the researcher, but it was the president of the republic saying this is what i'm going to do. that we helped him, we come other world, the west, etc. so these prophecies became self , mistakes,prophecies

inability, everything that might just talked about. i think everything was written on the wall since the start. this is the playbook that assad wanted to put in motion. and by doing nothing or by doing the wrong thing or by having the wrong analysis, willingly or unwillingly, we have this reality taking shape. and then this reality becomes a reality and took it as a pretext not to do anything. if you remember the debate in washington in 2012, if we go there, we will radicalize it. if we go there, we will weaponize it good if we go there, we will enhance the regional conundrum. the buy nothing desperate by not going there, we made this true. now where were the turning points of the missing opportunities? of course, everybody has in mind the chemical episode.

this is probably the historical missed opportunity. missedre were opportunities before that and there were missed opportunities after that aired and there are still missed opportunities today. this type in washington of the kurds. i have respect for the kurdish fighters, but they are only interested in [indiscernible] they will not go and fight in damascus. this is only limited traction. ,ike mentioned allies neglecting our allies is preventing us in building this new opportunity. but not only in terms of military buildup. if you want to rebuild a stable order that will manage a post isis middle east, there will need to be a social contract bp -- contract between pupils and

states. i keeping, turning around the bush on this issue that is really democrats as a show in, ck, change of the social pa russia and the u.s. have written on the geneva platform, it is inc. on the paper of the genome platform, and order to lead to syria into a normal democratic route. we have to look back to the areed opportunities that inherent today. this issue of radicalization and who are the moderates to work with and there are no moderates, it's that are a my bitter feeling five years later, one of the things that i reflect on with self-criticism

is that probably the opposition, revolution, college graduates, this is the reality, the anti-assad forces, they have not built a convincing narrative to their friends, their allies, so the world. i think this is something that is still durable and i think the opposition should work on that. that syria had from the start was that it was a revolution. we are not in a scandinavian part of the world. this is not the way things work in the region. but the construction of a proper narrative that is able to stand in front of the narrative that you are denigrating a few minutes ago, that assad the defender of the minorities and

the christians, let's name , as a as they are, french, partly -- i'm lebanese also -- on easter sunday, to see a delegation of french and solid visions and researchers and journalists going to damascus and sitting with the butcher of damascus, of syria, in the name of this guys defending the christians, for me this is something -- i mean, besides the counter truth of it, but i'm very it or that the syrian opposition and us all have missed of the construction of the proper narrative that is able today to confront this truth that is leading the entire eastern part of europe today to turn to vladimir putin for protection, because they are completely against muslims and getting them in terms of refugees, etc.

onlyis a defining moment -- not only for the middle east, but for the world order your we are constructing the world order that is to come for the next 30 years out of the syrian cauldron. this is partly ethical, partly geopolitical, and partly a strategic issue. you said 30 years? joseph: i'm ready to negotiate on that. lee: mike, what would be the narrative -- why is syria still important right now for the next administration in terms of your strategic interests? of what is the -- in terms strategic interests? and it is such a big issue now. we allowed it to get really big.

what is the way in? and expanding at how? explain why it matters. let me just make some predictions and then i will say what i think should happen aired because i don't think -- should happen. because i don't think what i think should happen is going to happen. when i watch the debate on the republican side, i think there is more of a tendency to agree -- for all that they have claimed to disagree with president obama on these issues, i think there is much more agreement than meets the eye. you can divide the u.s. national security elite into two groups on this. series the way i described it. you can't solve the syria problem -- you can saw the isis problem without thinking about assad and iran. jihadistanory of

from baghdad to aleppo is one problem. we have to have a uniform policy about being -- bringing order to -iranians the assad frontier. seeing it saysf isis is the problem, not iran and russia. in the first category this is is it is not just isis, iran, russia and their proxies. no, isis isde says, the core problem. russia and iran might be automatic in certain respects, but they are not as big a threat to us as isis is. work against to them. we don't have to impose costs on the rations and iranians for what they're doing. , you see some

remarkable things. because on that side, the side that says basically we can work with the iranians and the rations in syria and iraq, you will find that president obama's there. donald trump is there. ted cruz is there. right? they like to blur the lines a admitting to the degree to which they want to work with the rations and the iranians. russians and the iranians. they partly agree that there is nothing that we can do and we do need to step back a little bed and let whatever happens happens. there is nothing this point to come up in domestic politics element the present change his mind about this. so the preconceived notions that they come up with is what is going to determine it. -- she clinton possibly is sending signals that she sees

things a little bit different on this than president obama. but she has the side of her party. it is the bernie sanders wang, the progressive part of her written -- are weighing. bernie sanders does not want to talk about foreign policy. the progressives, the bernie sanders and donald and upon the same position on syria. so it bodes ill. it requires a president to come in with a conception lie joe already has. so i'm not optimistic. -- like joe already has. i'm not optimistic. like is some did come in and say, look, the middle east is still a vitally just to the united states. and what is the proof of that? for seven years, president obama tried to pull back and he can't

do it. he may see the a rapport is over, but we are fighting in iraq. we are fighting in syria. and the trendline is going in the opposite direction. we are committing more resources and engaged in more military activity as time goes on. the idea that we can somehow pull back from the middle east without it following us, that thesis has been completely disproven. i think we need to think of our kind of world we want to live in. right? these kind of refugees flow into europe and the impact that it has had on european politics and american politics, right? we are talking now about much people,control over much greater control over borders, much greater control over our own lives because of this chaos that we have failed

to take care of in the middle east. i think, if a president wanted to explain to the american people why we need to be taking action, greater action in the , playing a more aggressive role in organizing the region and imposing costs on actors like the rations and the arena -- the russians and the iranians, it wouldn't be hard at all. they're still deep trust of the russians and the iranians. the president doesn't talk about it at all. and whatking palmyra does this region look like after those forces are triumphant? it's not good for the united states. lee: i want to open this up for questions and answers in a couple of minutes. you were talking about allies. what does it mean to look at the region still in terms of allies?

we are talking about syria specifically, but also more generally about the american role in the region, the american position in the middle east. i want to finish up on this question. thenon't you start off and joe and jomana. they want our enemy to be the devil and the allies to be on the side of the angels. and they want to feel good that the fight they are fighting is a completely moral fight in every respect, right? what we get in the middle east is something much messier. worse question of bad and and understanding what is bad and what is worse. we don't share the same values with the saudi's. we don't share the same values with present our to one in many respects. but history shows that the turks and the saudi's are willing to

accept a middle east in which the united states is the hegemonic power. that will accept an american-dominated order. history also shows that the iranians in the russians are revisionist powers and that they diminish the united states and its powers. president obama is selling us a bill of goods and telling us that bill -- iran has changed and russia has changed and they don't want to weaken the united states and they understand because we are now reaching out to them, that we'll have the same interests. it's just not true. it may not be their sole goal. up every not wake morning and say how do i undermine the make us trade. but undermining the americans is on their agenda. the group -- the geithner up on the kgb. to don't spend your life try undermine the united states and then, because there are changes in the international order, you forget about how good it feels

to cause americans pain. it feels good to him. when he to understand that. it is as simple as that. joe, if you want to talk about it as a french perspective or regional perspective -- you certainly don't have to talk about it from an american perspective, but with the region looks like and what the american role in the region looks like and then people that we can work with both in europe and in the region. thath: besides the fact mike mentioned the goldberg interview, the atlantic piece [indiscernible] it's true a lot of reaction. mike: people are saying in paris. joseph: they are outraged. one of our french fellow colleagues here in washington

wrote in atlantic a very strong piece in reply to president obama. i would like to say two things. first of all, it is no more only the middle east. i think is what is happening in europe is very grave and very dramatic. when you talk to politicians in france or in england or elsewhere, they tell you they're probably, besides france and great britain today, the entirety of the political spectrum in western europe is shifting towards something between the far right, the far left, both populist and demagoguery. by the way, this is interesting because the center convergence is new in the u.s. but not at all new in europe. thathave been living with in europe in the past 20 to 25 years. and also the kind of putin ophelia by default.

i don't think this is an analysis. it is a fact that putin said this is the worst they of my life and i will take revenge. we are not accusing him of anything. this is what the guy is standing for. so ok, the choice is ours. do we want to build again a europe that is a europe that resembles the europe of the 1930's or of the cold war or do we want to capitalize on the liberal order that was created afterwards? this is a decision that political leaders will have to make an part of this decision is in the mouth of syria and iraq. lee: that makes sense. but if you can explain a little more. joseph: part of the refugee issues that is completely changing the fabric of europe, that is completely changing the perception of political forces,

the perception of the social forces, the way the electorate will behave in the coming years, partly because of what you see it. the defining powers in the middle east, iran, russia, others, etc., if they supersede the west, the u.s. and others, we will also shape the way the world kind -- the world order is structured. they are shaping the way probably the way arab peoples and societies will evolve and ship the vision of the world and of course, you can say the middle east is marginal. we are pivoting to the east -- but even in the east -- and this is news that probably though white house should know -- but even in the east are looking at what is happening in the middle east. when you sit with asian politicians, asian they tell you -- i have these conversations, probably we all

conversations -- the way the u.s. is behaving tells us that, if we are able to account on american protection. as is the new world order. this is not something related to assad and the family and lebanon. this is planetary. we are redefining the equilibrium public world. forget about the saudi's and .hat turks smallt your week i'm a allies. in every speech, the state department says that our aim in the middle east in syria -- and protect, lloyd and strengthen the fragility of strengths like lebanon, jordan, etc. these states living out of the syrian crisis? lebanon is on the verge of collapse. jordan is on the verge of

serious problems. you have more and more sleeping cells. the king of jordan says we cannot breathe anymore. lebanon arers on today really reaching the red line. lebanon has escaped of the searing conundrum so far. at one point, the americans stop. so isis are approaching the border. lebanon is a country of 3 million people where you have 1.5 million syrian refugees. just imagine the entire population of canada pouring into the united states. magnitude. just imagine how long this country can take without the president of the republic, with a militia that is armed to the teeth that is calling the shots and making politics and remaking politics, etc. this is all partly in the discourse of the u.s..

i am not putting in their mouth something they have said. they have set every day for three or four years that our aim in the syrian issue is to spillovers,overs -- to enhance an orderly political transition, and prevent our friends in the region to collapse. everything has happened. all of these things are happening front of their eyes. if you want to talk about allies and etc., forget the grand schemes of alliances. even your small friends in the region are living help us because of your lack of policy. i think this is interesting to reflect. now if you give me one second -- you asked me an interesting question about lebanon and syria. i think we tend to over exaggerate the comparison of the two wars. syrianian war or the crisis is a rebellion of a society against an authoritarian

regime. thenon was the product of lack of any state, the lack of any regime. it was the absence of the state and factions fighting amongst each other on who will define the central power emma whereby in syria you have a fight by a society that is aiming to seize central power. isre the comparison interesting is that lebanon ended up in a way that i think syria should end up if we are able to lead it to the look -- the political process, accepted power-sharing by all the factions. a syrian, not a la lebanese. faction rejecting the power-sharing is the regime. regime also come if you take

its word, is refusing to talk about the central issue, which is isis, saying that the central isis.is the second aspect that is interesting when you think about the way the lebanese crisis was sold and this is why think the comparison stops also at the doors of syria, very ironically, the the one condition for pieces that syria becomes the two toler -- who will become the syria of syria? iraq? of course not. the gulf? of course not. turkey? of course not. this is something to keep in mind when we go very quickly and simply. lee: that's great. jomana: i will ask you to wrap we go toor before

questions and answers. to say it was very moving when you mentioned about your .riend being killed by isis a reviewu can give us of how the syrians are looking at it, the the seized syrian communities are perceived. what it looks like now and what it is likely to look like. jomana: i'm speaking in my own personal capacity of this. from the people that i talked to come i'm sure that you won't be shot that the syrians are he credibly disappointed by the way the things have unfolded. statesaith in the united is an understatement. they felt really not only abandoned but the trade by anyone who has -- in a country or any leader who has attempted or claims to have attempted to

address the situation in. we don't have to go back to the goldberg article, the redline, and how that was the first of many disappointments to come. the security council stoppedons, the syrians getting excited every time they passed one because the implementation was always an issue. i think something -- the goldberg article was translated into arabic very recently and has spread like wildfire throughout the middle east. and the comments that the president made about contrasting asian children who want to build technology and build the world and middle eastern kids who are killing each other -- joseph: waking up wanting to kill americans. jomana: right. those are my cousins. no one has ever expressed the sentiments.

i think it is disturbing to have read it, as an american, but i'm sure even exponentially disturbing in the middle east to hear that that is the way the president of the united states views the region. i think that the syrian people are waiting to see -- there are people who will always have hope, right? syrianto have hope as a american that something will come out of these negotiations, whether or not that is anything tangible, but i guess some are waiting to see may be what the next president can bring to the table. lee: thanks very much. do we have somebody with a microphone here? thank you. >> the question i have goes back to the beginning of the conversation for the desk and

and that presentation of the de facto partition of syria and the attitude of various present parties to it. the question has to do with the relationship between russia and iran. it was suggested that iran was not really like to accept that situation. also what it like to accept the situation where russia's calling the shots. that i completely understand. but i do not understand why they would not be satisfied with a partition so long as their principal goals are achieved. and this is connected with the question of what exactly was the purpose of the campaign of palmyra. i think you suggested whether -- suggested people are asking whether this is the first step raqa.ds rqz

it was the way of protection the partition you are talking about before. lee: how about if we have joe take the second part of the question and, my, if you can talk about raqa and the palmyra campaign. what i just aimed to say is that come after the palmyra operation, if you look at it and details, palmyra was almost handled over by the regime ties is a year ago without one bullet

shot. all of a sudden after they brussels attack etc., taken over by the regime, with also a few battles. ok, it was a battle but it was not so -- so there's something murky here. this aside, the question raised coverte ok, the russian operation by air and the iranians and all the people that mike has enumerated, afghan, has hezbolla on the ground work. u.s. -- or is that a u.s. wanting to take the lead on other battle fronts like raqa in order to establish a balance between washington and moscow?

judging by the diplomatic process and the behavior of the u.s. diplomacy so far, my bed, and i wouldn't say my fear, is that they would also sai subcontract the battle at raqa. the problem is that it would become more problematic. palmyra is a very specific case. it is not really a city. it is an archaeological site. and by the way, it is the siege of perhaps the harshest prison of the assad regime. has retaken its worst dungeon prison, that is not very rejoiceful. sunnien to slaughter the population or to keep it away, someone will have to take order and to put order in that region and to govern it.

and we are talking here about governance and not just military operation. this is what i was implying in my probably very quick remarks. lee: mike, you want to take the first part? and-iranianthe rush -- the russian-iranian condominium? lee: right. mike: i like and then to siamese twins who don't like each other. them to siamese twins who don't like each other. the rations and the iranians both have a strategic interest. it is a strategic interest in maintaining the assad regime in place. they have been entirely consistent about this all along. and that is what allows them to work together.

i'm sure, if i was reading the top-secret intelligence on the relationship, as joe said, the iranians do not want to be supplanted by the russians and they don't want the russians to call the shots. president obama is right about one thing. the russian and iranian position in syria is not that great. if you look at the forces that they used to take palmyra, these are not well trained come efficient forces that are capable of holding out over the long term against an aggressive and determined foe. and there is a reason why iranians are using afghans and iraqis. because they themselves do not want to die. assad andassad himself -- and assad himself cannot organize

his own military. and think the russians iranians are stuck together for a very long time. anyone who says they will fall out anytime soon is selling us a bill of goods. lee: i saw two more hands. i want to get to these because we have to close out in a few seconds. so why don't u.s. the question? -- so why don't you ask the question? we will hold off an answer. thank you. all [indiscernible] joe talked about putin calibrated around president obama leaving office.

here is moscow and you're looking for a deal. the best deal you are going to get is probably on president obama's watch. when you look deeper into it is perhaps that the rationale is that putin cannot deliver in syria because of [indiscernible] thely the differences of russian outlook on syria. we have seen some of that play out in the media. deputy talkedan about a political set up. i was wondering if that was your thinking as to why the man in would rather peacetime rather than passage of?

if you could bring it up here. ask your question. some analysts have said that isis, on the one hand, and assad , on the other hand, need each other and feed each other. on the one hand, assad needs isis that it is us against them. they are the terrorists on the other side and we are the good guys. , is it in thee interest of both of them to continue the war in such a way that isis will remain intact?

but basically to continue announcers liberty to the? lee: let's do this. joe, answer the first question and then the rest of you, f with for the rest -- of you come up with an answer for rafi's question. far, for what is possibly extractable from the american administration, putin extracted it. is thele machinery ultimate thing he could get. this is why both sides have an interest in presenting the [indiscernible] the u.s. administration could say, look, we have achieved something on syria. there is a cessation of hostility and people can live.

and in this local process, believe it or not, we're talking about assad. ise is passing and that leaving in a few months. alsoutin, it is convenient. he got what he wanted. he has become the holder of the keys in syria. but he knows the digestion of the steel, on a syria basis and on the international level, can't be done with an administration that is leaving. it has to be done with a new administration. liverws that he can't syria in the next six months to come. and so he is hanging on to this illusion in the political process. and because he wants to capitalize between this -- capitalize in this new parity between him and the white house,

this is not contradictory to your question. i think what you just stated is absolutely correct. this is something that the syrian people have said over and over again in their protests. as long as assad is here, you are giving putin -- you're recruitsil an excuse to . they are able to arm them, give them food, water, etc., unlike some of the other armed groups that are poorly supplied and poorly funded. i should also mention briefly that we did see some individuals in isil areas during these protests. howe were people in isil

forareas that show we are the removal of assad. joseph: i think there is a lot of evidence -- i think there is a lot of evidence of conniving and isis.etween assad that istually assad buying the oil from isis. the center of gravity for isis is iraq. the senator of gravity for assad is western syria, what they call vital syria, damascus and aleppo. and the geographic continuity between the assad and the

hezbollah realm. so their centers of gravity are different, looking at the iranian structure and isis, there is a same strategic vector for both of them isis isis is a sunni revolutionary organization and the islamic world writ large is focused on revolution and taking over sunni territories. that's where they are focusing. and iran is quite happy to have isis out there fermenting revolution. there's no possibility they are going to become really active in iran, for example. they havepoints where friction between them, iran and assad and isis. but basically the vectors move in the same direction. i want to thank you all for coming in think our c-span audience again. i especially want to thank our panelists. thank you very much. [applause]

[captions copyright national cable satellite corp. 2015] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org]

>> in road to the white house news, florida police have charged donald trump's campaign manager with simple assault in connection with an incident earlier this month involving a

reporter. the ap reporting police in jupiter, florida issued him a issue to appear before judge on may 4 for the mr. turner charge. if you look closely, the surveillance video was released by the police that appears to show him grabbing a reporter from breitbart news as you try to ask mr. trump a question. this happened during the march 8 campaign event. if you watch carefully, you can see the reporter walking with mr. trump, and appeared to beginning grabbed by mr. lewandowski. in a statement, donald trump says mr. lewandowski is absolutely innocent, he also replied in this tweet, really endows you -- corey lee window wasme -- lewandowski aarged with assaulting reporter. look at the tapes, nothing there. donald trump is holding a rally

in wisconsin. you can see that live at 5:00 p.m. eastern. 8:00, twoht at experts on student debt discuss whether there is a crisis in the united states. it was most affected by the problem. the speaker was the first the studentson to loan protection bureau. here's a brief preview. >> we have 7 million people, 8 million people in default, what does that actually mean for individual lives? someone in default has an enormous blot on their credit record. what does that mean? many landlords now do credit checks before someone can rent. they are shut out of parts of the housing market. if they want to buy a car to get to work, because they're living in a neighborhood that's not where the jobs are, they are

shut out of getting a reasonably priced loan for their car, they have to go get an 18%, 20%, 25% interest rate loan, which further presses on their finances. many employers now check credit records. it are going to miss out on job opportunities. psychologicale stress of; your cell phone or your home phone or relatives on a daily basis to harass you about your debt. there's a lot of suffering, and that's bad. i think that is with the crisis is. we have people who went to school to improve their selves and our encouragement, especially during the recession, we provided a lot of subsidies, told people the right thing to do, go improve yourself in school. as result, they are suffering. it's a man-made crisis. that's what i think of as the student debt crisis. you canjust a portion, see all of that discussion on

student debt tonight at 8:00 eastern right here on c-span. >> tonight on c-span, the supreme court cases that shaped our history come to life with the c-span series landmark cases , historic supreme court decisions. series explores real life stories and constitutional dramas behind some of the most significant decisions in american history. >> john marshall in marbury versus madison said this is different. the constitution is a political document, but it is also a law. have the long, we courts to tell what it means. that puts dred scott apart, the fact that is the ultimate anti-presidential case. it's exactly what you don't want to do. >> who should make the decisions about those debates. the supreme court said it should make the decisions about those debates. >> we look at the case the citizenship, and

the consequent is. tonight at 10 a cocky start c-span and c-span.org. >> look now at emerging infectious diseases and what is being done to prevent the next pandemic. posted by the new york academy of medicine, it's about 90 minutes. ms. shah: thank you all for coming. i usually do not like to stand at podiums because i am kind of short but i will get up on my tippy toes for you. when i first started writing this book a few years ago i did not predict we would be living through a pandemic of a new kind of pathogen washing over the americas right when the book came out. yet here we are with the zika virus washing over the americas. that is not my talk, hang on a second.

over the past 50 years, we have had over 300 infectious pathogens either newly emerged or reemerging in places where they have not been seen before. the zika is really just the latest one in a plethora of pathogen's have been doing this. we had ebola in west africa where it had not been seen before. middle east respiratory syndrome , a new virus that came out of the middle east. new kinds of avian pathogens coming out of the middle east and the whole range of mosquito borne pathogens, dengue, chikungunya, and zika of course. so the question i wanted to ask is how do microbes turn into pandemic-causing pathogens. you think of an microbe is a little thing with no locomotion, but it can cause these huge amounts of death and destruction.

the way that i wanted to look at that was a two-pronged approach. first i looked at the history of one of our most successful pandemic-causing pathogens. that is cholera. it has caused seven global pandemics since it first emerged. the latest one is still going on off the coast of florida and haiti. i couple that with reporting from places where new pathogens were coming up. i went to places like new china and -- south china and new delhi to try to see how cholera could shed light on where these new pathogens might be going. what i learned is that cholera emerged in many ways in the same way a lot of the new pathogens are coming out today. it came out of the natural environment.

cholera is a bacteria that normally lives in marine habitats. it lives in conjunction with days will clinton -- with a zooplankton. some places are full of cholera bacteria. it is half fresh, half salty. this is where the major rivers are draining into the bay of bengal. for the longest time, people did not live in areas like this. they are covered in men growth -- mangrove swamps, tidily flooded twice per day, there are cyclones and tigers. people did not really live in cholera-rich environments, which all changed in the 19th century. the british decided to turn these into rice fields.

over the course of 19 centuries, 90% of the of the area is settled. and in our bodies, it does not perform very useful ecological function but it can kill people within a matter of hours. 50% of people infected will die if not treated promptly. it started to move into russia and of into the industrializing cities of europe. this is the same thing that is happening today. 60% of our new pathogens are coming out of the bodies of animals. it happens when humans invade wildlife habitat, forcing wild animals to come in to our territories.

from bats we have ebola, from monkeys, hiv, malaria, and most likely zika as well. from birds, we have the west nile virus, and others. we provide these new pathogens great opportunities to amplify which allows them to better adapt to prying upon human populations. -- preying upon human populations. we first started doing this the 19th century. people were abandoning farms and coming into the new cities for factory jobs. in places like new york and london there was not suburban transit to take people outside of the city to sprawl. in places like manhattan, there were 77,000 people crowded into every square kilometer.

1/12 of the city was covered with cesspools and outhouses. none of this was plumbed, there was no sewage system. people were ingesting but two -- about two teaspoons of fecal matter every day which provided a great opportunity for the cholera bacteria to explode. this process of urban expansion that started in the 19th century is really reaching its peak now. by the year 2030, the majority of the populations will live in cities. they are not going to be cities like stockholm or washington, d.c. they will be cities like monrovia. where there's a lot of ad hoc

development. about 2 billion people are expected to live in slums by 2030. new pathogens have already decided to take advantage of this process of urbanization. consider ebola. we have had ebola outbreak since the 1970's, but it had never affected a place with more than a few hundred thousand inhabitants until 2013. within a few weeks of emerging in guinea, ebola had reached three capital cities with a combined population of nearly 3 million. it's one major reason why the outbreak was such a huge conflagration. you can also argue that that zika is capitalizing on urban expansion. we have had the gun -- zika around since the early 1940's. it only rarely infected people because it was carried by a forest mosquito that mostly bites humans and doesn't bite people very much.

what we see now in the americas is that zika is being carried by a different kind of mosquito. this is a mosquito that has dramatically expanded its range with human, urban expansion. it loves living near people and will breed drop of water. all of our plastic garbage provides perfect breeding sites. unlike forest mosquitoes, egyptai only bites humans. we are not only crowding people together, we are crowding animals together. we have more animals under domestication right now than in the last 10,000 years of domestication until 1960 combined. huge number's of livestock we are keeping right now and many live in these factory farms. they are basically the annual equivalent of urban slums.

this similarly allows pathogens to amplify and change in ways that can make them more virulent. when the virus is dropped into these factory farms where these captive animals are crowded together they start to change. they replicate and mutate. they become more virulent. we have had an increasing problem with these more virulent forms of influenza. we have started carrying pathogens around in a more

efficient way. steam travel. we started skimming across the atlantic and with clipper ships. steaming around the rivers and waterways. we used steam engines to build canals and it connected all of our waterways together. we had this nice international network which is perfect for cholera to take advantage of, which it did, again and again. the erie canal in particular. we do it even better today. with our flight network, we don't have just a couple airports and capital but hundreds of airports with tens of thousands of connections between them. it can very rapidly spread across the rest of the planet. the flight network is so

influential in shaping the epidemic, that you can calculate where and when an epidemic will strike next just by measuring the number of direct flights between infected and uninfected cities. this is a map that plus that same food pandemic i just showed you but this is a map of cities connected by direct flights. you can see that the flu pandemic resolves into these perfect series of waves. these are just some of the ways in which the way that we live allows microbes to turn into pandemic causing pathogens. we don't just take these things lying down. we put up political defenses and medical defenses. it is only when political defenses fail that pandemics occur.

in 1832, doctors in new york state collected this data that we mapped. it shows a pretty clear picture to us today. cholera is coming down the hudson river and heading straight for new york city. the obvious response would have been to consider a quarantine. closed on the traffic on those waterways and protect the city. nobody wanted to do that. quarantine was considered too disruptive to trade. instead, they said, it might look like it's coming down the river, but actually it's being carried by miasmas -- this was based on a 2000-year-old theory that diseases like cholera were spread through these smelly airs that rose up from decomposing things.

some people were violently scapegoated during cholera epidemics. there were countries making money selling cholera contaminated water to 19th century new yorkers. the epicenter of the epidemic of cholera in new york was a slum called five points, pictured here. it is actually the subject of the movie the gangs of new york, if anyone has seen that. that slum was built on what was once a pond. it was filled up with garbage in the slum have been built on top of that. the ground underneath was very low-lying and unstable. the groundwater was easily contaminated by all of the leaky privies and outhouses on top of it. the company that the state of new york chartered to deliver drinking water to the people of new york, instead of tapping

clean them a upstream sources of water, which the new would taste better and be cleaner, they sank their well in the middle of that slum. they delivered that water to one third of the people of new york. the reason that they did that is the same reason that people in flint, michigan decided to change their water intake. they wanted to save money. they wanted to save money because they wanted to build a bank. does anyone know the name of the bank of the manhattan company today? j.p. morgan chase. the biggest bank in the country. eventually, new york did move there well from the slum of five points up to westchester county. cholera ended for good then. what is interesting is why they did it. they did not do it to protect the public health or because they throughout their theory of

the air and decided that cholera was in contaminated water. the did it because the city brewers demanded better tasting water for their beer. the crappy tasting water put them at a disadvantage. i think it's better today, but we can do a lot better. the question is, will we find the political will? that is something i hope we can talk a lot more about. thank you for listening. [applause] we have a great panel of speakers today. our first speaker will be dr. lipkin. he is the director for the center of infection and immunity at columbia university. if anyone has seen the film "contagion," i will add that the scientist in that film is modeled on him. dr. lipkin: i am also the john

snow professor which is particularly apt given that so much of this concerns cholera. i was told about this meeting and i generally accept these invitations. i was told that i could just skim the book and i began with that intent, but i read it cover to cover. i thought it was a beautiful book. for those of you who have not looked at it yet, you saw a bit of an example. you have burr versus hamilton, a whole description of the london underground and slumming. it is an elegant book. what i've decided to do today is something a little different, though i hope during the q&a we can talk about some of the

interesting aspects of the west nile virus, and mers, and sars, and talk about things that may be of interest to you and talk about sonia's next book. that is the future of infectious diseases. the emphasis in this particular book is on the q diseases. the ones are associated with severe illness. pneumonia, hemorrhagic fevers, things that kill us. then we have these other disorders which are typically thought of as noncommunicable. there is a part in the book where you talk a little bit about this. the ways in which microbes have modeled us through evolution. the have contributed to our ability to become mammals by having an impact on whether or not another -- a mother will reject the fetus.

what is a fetus but a tumor growing inside of us? there are retroviral elements that prevent rejection of the fetus. if you look at the genomes, they are riddled with retroviral sequences, and others as well. these have important impacts. in a more basic sense, when you look at microbes and sls, what you are really doing is examining the ability of the body to recognize something as self or not self. we are always dealing with an onslaught of things that may represent nutrients or microbes. the way we grow, and develop this relationship we have had with microbes.

there is a wide variety of these "noncommunicable" diseases which i will show you shortly, have an infectious trigger. they range from coronary disease, stroke, diabetes, psychiatric disorders like autism, autoimmune disorders like rheumatoid arthritis and many forms of cancer. a number of cancers treated to infectious agents may not be fully appreciated by many of you. particularly, when you look at sub-saharan africa and represents one third of these cancers. most people who have cancer are under 50 years of age. hepatitis b and c have human papilloma viruses. here is an example of hepatitis b which causes a carcinoma. an infectious lymphoma also found in africa and human

papilloma virus described as recently as yesterday as being largely eradicated as a result of vaccines. hiv, cap are ceasing, lymphoma -- hiv, as you begin to look at these other infectious causes of cancer, as a "think more broadly, it may be possible -- as we begin to think more broadly, it may be possible to eliminate them. these are vaccine preventable illnesses. we can literally eradicate human papilloma viruses through vaccination programs which means that we can probably eradicate cervical carcinoma, and many other forms of carcinomas as well.

most of the diseases that sonia has alluded to can probably be prevented by using a variety of vaccines. these are diseases which are fairly straightforward to approach. infection is likely to be implemented in a wide range of diseases of the cardiovascular system, including stroke and artery disease. inflammation is the leading attribute. we now know that something as simple as bad periodontal disease can result in an increased risk of stroke. now, today in the science times, some of you may have read this article that appeared.

i tried to sell to donald mcneil several months ago, when we started talking about autism. then we started talking about microcephaly couple weeks ago i said, this is probably just the tip of the iceberg. as we began to discuss, i presented him some of the data that i will show you now. this is a disorder that we tried to model in mice. this was a disorder that has been associated with streptococcus and dramatic heart disease first described by a british internist. what we found is, that there were a group of children who were thought to have schizophrenia, but did not have it. they had an obsessive-compulsive disorder which we associate with the sorts of repetitive behaviors such as you see here. when these children were treated with a plasma to remove antibodies, or an intravenous

treatment, we were unable to remove the disorders. we could not identify the trigger. we replicated it by injecting these mice with streptococci and then went back and found these children were affected. this was worked on by our group in new york, and by paul patterson, who died a couple years ago who was at caltech, to look at historical associations between influenza viruses and other pandemics and stressful environments, and later occurrences of schizophrenia, autism, and other neurodevelopmental disorders. what we found is, if you look at the association of these disorders, it made sense.