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.

that is to say, you would see outbreaks or what looks like outbreaks of schizophrenia following outbreaks of influenza and other viruses. if you look some four to seven years out with autism, you would find examples there, too. we were able to model this with mice. that if you could examine mice that were halfway through gestation, the animals would be withdrawn in the cage, as opposed to the animals that had some sort of a normal -- just two thirds of the way through gestation, these animals become hyperactive, running all over the cage. indicating that, what was important is not so much the infectious agents per se, but the host response to infection.

the other thing that we have begun to learn a great deal more about is the micro biome. there is an excellent exhibit presently literally across the park at the museum of natural history. here, we try to cover through the course of this, to understand something through that micro biome, the implications of disease. we have begun to understand now that the micro biome is important in tuning the immune system, is probably important in thinking about algae. it has a role in colon cancer, obesity, and cardiovascular disease. the flipside of the contagion hypothesis, sonia was talking about, as a reciprocal relationship, we see that as we

know longer have those risks, we see an increased risk of asthma and a wide range of other disorders. it is becoming clear that we cannot only think about pathogens. have to think about balance between microbes and humans. if we look at the micro biome over the course of a lifespan, you can look at individual types of bacteria. the normal progression which we see here has become subverted by this modern life, where we formula feed babies, treat ourselves with antibiotics, we have obesity, and a wide variety of intervention, which has led to all sorts of outcomes which have a tremendous impact right now on the way that we live, and

the types of diseases that we begin to see. if you look at the composition of the gut microbe biome -- microbiome, it is still very different from the fiber-rich diet that you see in africa. there are consequences of this. we have begun to see the appearance of diseases associated with some of these bacteria which are killing people. we have been unable to eradicate these now with modern antibiotics. we are beginning to use fecal microbiota transplants as a way to address these problems.

because there has been so much success of treatment with using these microbiome transplants, people are beginning to use them for a wide variety of other applications as well. i am not advocating this, but simply pointing out that there are theories they can reverse autoimmune disorders, irritable bowel syndrome. their efforts to use it to treat multiple sclerosis, autoimmune diseases, as well as some form of colon cancer. moving forward, sonia, as you begin to think of what your next book. not to say that we have resolved all of these issues with respect to acute infectious diseases, is important to think about ways in which we can bring microbes back into balance, when we can begin

to understand the role of microbes and our responses to them and the genesis of a wide range of disorders ranging from autism to cancer. [applause] ms. shah: thank you for that, dr. lipkin. for my next book, he has already done an outline. my next guest is a doctor who was one of the great sources for my book "pandemic." if you pick it up you will see there are a bunch of pages about him and his fabulous work which he will share with us. thank you. >> what i like about this book that other authors have not touched on is the repeated

cycles throughout history we have gone through with pandemics that we are still in. you made the point today, we are still doing the things that led to cholera around the world. we think about these issues of overcrowded lives, and these bad conditions as being "over there." but we are connected to everywhere on the planet by less than a day's flight away. that is what microbes do. the exploit new niches that we put up, adapt, and infect us. we created this perfect system. i would like to hope we are at the end of it. i would like to propose in a more positive and optimistic way, that in 50-100 years, generations will say, those guys had a lot of problems with infectious diseases.

let's think about the ways we can work together to get rid of the pandemic trap. then we can deal it other issues we are discovering. first of all, i am in an organization, a nonprofit in new york. we work on emerging diseases to try to understand what drives them and what are the underlying causes of pandemics. what is the science behind it? can we prove something is attached to the driver of a pandemic that leads to the spread, and then can we do something about the driver? first of all, we need to know if they really are a big issue. the book lays it out clearly. what is the science, the real evidence that emerging diseases are on the rise? a few years ago, probably about

a decade, a group of us sat around and studied this. i had just finished working at cdc. i was working on wildlife diseases, including a global life -- the emerging disease of frogs that spread globally that wiped out species. even more significant in the 1918 flu. it actually caused extinction of a species. it is something going on on the planet that has a similarity between what is happening in wildlife, with the rise of diseases in those populations, what is happening in domestic animals like livestock, and what is happening in our own communities. we realized these things are connected, of course. we call it eco health. it is the ecology and environment of the ecosystem that drives these problems.

the human micro by them disrupted by modern life, and so are our ecosystems. you don't need to take a trip to the black forest to say, where are the wolves? where the passenger pigeons? completely disrupted ecosystem. what happens when we disrupt ecosystems? we also disrupt the microbiota. we sat around and said, let's take every single example of emerging disease, one that go pandemic, ones that cause a slow cluster of cases. and let's build a database and analyze it. we started this price -- project, and we thought we were very clever.

we got we could do it in a few weeks. it actually took two years. it is not straightforward. the data on where and when a disease first emerges, where the first case of a new disease is, is very hard to get hold of. after a couple of years, we had a database of something like 450 emerging disease events, new pathogens, newsstands that moved into the populations for the first time, or that were already there and began to spread for some reason. we plotted them out. this is a part of that decade by decade, from the 1940's to the 1990's. it is clearly rising, but of course, so is our effort to find them, so we have to correct that. then we have to build a database of every single author of every paper of every infectious disease, to see how that is rising. 14,000 data points later, the gis coordinates of every office, we could correct the rise and

show, yes, there still is a significant increase over time in the number of new diseases emerging in people. this is a problem that is increasing. not only that, the really big ones that go pandemic, as sonia points out, other ones that come from animals, usually. usually they come from wildlife, like ebola from probably bats, or hiv, which emerged from chimpanzees. the ones that go pandemics are almost exclusively from wildlife, some intermingling with domestic animals like avian flu. they are the yellow bars on this graph. they are increasing disproportionately dramatically

compared to the rest. pandemics are on the rise, emerging diseases on the rise. the really big ones, hiv, ebola, 1918 flu, increasing overtime. we can predict how many new emerging diseases we will see next year, which is about five. these are showing to be true. three of those will originate and animals. that is the bad news. what are we going to do about it, is the question. we set about to look at, what are the big questions to deal with this question --problem? first of all, we don't really know how many viruses are on the planet. and to get a handle on dealing with it, we need to work that out. it took us a few years to come up with a strategy. this is what we did. we used well is used in conservation biology. if you are trying to count the tigers in bangladesh, it is really difficult to count every tiger. they don't particularly want to

come out and say hello. so what conservationists do is, you find a tiger, track it, tag it, and release it. then, you try to catch more. eventually, you start recapturing some of those tigers. there is a simple equation too used to work out the size of the whole population, including the unknown sizes, based on the number of recaptures against number of captures. so we did that with viruses. working with the research group at columbia and the global network, we started catching animals that we knew carried new pandemic type viruses. we caught the same species over and over, and tried to discover as many viruses as possible. we could actually be capture the viruses. this is what it looks like. the first graph is one viral

family, looking at the number of samples we collected. this is about 1000 individual fruit bats from bangladesh. these are the giant tropical fruit bats with a wingspan about this big, and the bodies are this big. they are really cute animals. they are like puppies with wings. the problem is, they have big teeth and a bunch of lethal viruses. but they are really cute. they pollinate tropical trees, especially fruits. they are very important pollinators. we had to catch each that individually. -- each bat individually. we have a whole team to do this. and then we but the samples onto liquid nitrogen, which is not easy in bangladesh, and getting all the way back to the lab at columbia university. then, we repeatedly did the very best type of pathogen discovery.

something that the lab is world famous for. what we found was after a well, the samples, we started seeing the same viruses. the discovery curve went up and saturated. we can use the saturation points to predict how many unknown viruses there are. we repeated this for i think about 12 different samples, all of the ones that caused nasty emerging pandemics and people. the predicted number of unknown viruses in this stock was 58. it is simple extrapolation. if you multiply that by 320,000 known -- 6000 known mammal species on the planet, you come up with 320,000 unknown viruses. that sounds like a lot, when we only know of about 4000 so far. there's a lot of work to do.

but, it is not millions, and not tens of millions. if you look at the rates of viral discovery and the increased speed and decreased cost of technology to discover the viruses, we can easily change this. we can discover all the potential pandemics out there. i think this is great. we came up with a figure, because we know how much it costs to do this work. is about $6.8 billion, a lot of money. but you don't need many samples, and you still get 85% for about $1.4 billion. spread that out over a ten-year period, $140 million per year. still a lot. but how much does an outbreak cost? the cost of sars has been calculated. if you look at the drop in gdp of southeast asian countries during the sars outbreak against the market fluctuations, you get a figure of something between $10 billion-$50 billion for one single outbreak.

it is mind blowing. one single market, one person in china, who put an animal in a cage, and that infected other people and led to a global pandemic. the real cost was because it disrupted the trade network we rely on for a globalized pattern of trade. these cost so much if we wait for them to emerge. what i'm calling for now is a global viral grace to the man approach to find as many of these new viruses we can, using the best technology we got, and save ourselves money, as well as thousands of lives. the other big question we had is, where will these viruses originate? where will the next pandemic emerge from? 10 years ago, that was not

known. everybody kind of knew. there were lots of maps where people put pin on, for ebola, hiv, sars. but we did not have science to back it up. we set about trying to do the science. we have a database of every non-emerging disease. we knew where and when the people who -- worked with that word so we can get the reporting biases in the database. we knew there a lot of people working about it. when you look at the raw data, you can see a lot of european outbreaks, north american outbreaks, but we have to correct for that. we did that in our analysis. the other big issue is, when you that the pandemics -- we knew that this pandemic tend to originate in wildlife, but we had no idea whether one species carries the same number of viruses as another.

we made the assumption that overall, most animals will have roughly the same number of viruses as another species. we had incredible data on every single mammal species on the planet. so we knew where every mammal species was. we made the assumption that we don't need to know how many viruses it'd got. we just need to know relatively how many. we got around the problem and were able to show, convincingly, that there is a correlation between two things that tends to be the driver of emerging diseases. first of all, where people are on the planet. not just where the populations are densest, but where we do the most to the environment. land-use change is a correlate of emerging diseases. changes in population density are a cause. disruption to the environment.

the other big issue is where wildlife is. when you look at the hotspots for emerging diseases, which this map shows, where the next pandemic will most likely originate, and includes areas where there is high biodiversity, and growing human populations expanding into the areas, hunting wildlife farming animals, bringing animals into the markets, trading them, and disrupting the ecosystem balance. this is where we work now. we work only in hotspot countries. we focus i'm communities who are at risk on the edge of the forest, people who work with wildlife, in markets, people who work in farms. we interview them about their habits, take samples, and look for the evidence of viruses that we find in wildlife, spilling into people. we also sample wildlife from all these hotspot countries, and work to find where the new viruses are and what the risk of

those becoming pandemic is. recently, we were able to show clearly that in parts of southern china, there are still bats present that still carry viruses almost identical to sars. there are still people who hunt them, live near them, and eat bats, which is how sars originated. we are able to show a clear and present danger, and we work with the populations to try to change behavior and make the things you do a bit lower risk -- they do a bit lower risk. i think all of this is positive, and i think we will correct the problem, but it is not going to be straightforward. as sonia says in the book, we have to deal with underlying issues that are hard to deal with. global equity, poverty, food supplies, clean water, really simple -- well, not simple, but not high tech issues.

at the same time, we and the west tend to look to high-tech solutions. a drone, and new test kit. perhaps what we really need to do is reassess where we are with our own microbiota. we assess our relation with our ecosystem, and try to restore the balance to where it should be. thank you very much. [applause] ms. shah: thank you so much. next, we have carl, coming back from south sudan. he will talk about his work with ebola, and some shots he did -- and also on hiv. >> i spent the last few weeks doing two films.

about the ebola a break in liberia. i was therefore two months. i look at how the community dealt with the outbreak. previously, in the documentary on the origin of hiv. i tried to piece together where the viruses came from, and how the virus actually managed to cause a global pandemic. in that talk, i will talk -- touch on what peter has been saying. about the geographic origins of a virus, the cause of the dynamic, and what conditions there were. it's a bit like looking through a magnifying glass how it feels to be there, and what conditions are there on the ground. hiv, as you know, is one of the worst pandemics we have experienced in recent history. hiv is a virus that comes from chimpanzees. the pandemic form is a virus

that is the similar form in chimpanzees. since the 1980's, we have known it has come from chimpanzees, and tried to figure out where exactly it originated. where did it jump from chimpanzees into humans, and how did it subsequently spread? you have to know little bit about chimpanzees. they live in rain forest areas in western and central africa. the good thing about chimpanzees is they don't move a lot. they don't like water, they don't cross rivers. for many generations, they stay in the same place. what scientists did is, they looked for chimpanzee populations. they collected fecal samples, they looked at whether they were infected in the chimpanzee version of hiv, and compared it to the human version that caused the global pandemic. by measuring the genetic

distance, they could figure out where the virus must have originated. that brought them to central africa, to cameroon, which is here. more specifically, to an area in southeastern cameroon, bordering three countries. the central african republic, republic of the congo to the south, and cameroon. this is a very, very remote area, and we went there for our film to document the work of the scientists there. there's a lot of science going on, looking at what peter has been talking about, looking at the emergence of new viruses, because a lot of the factors and drivers that drive viruses into human populations are at work there. it takes about four days by car to get there. it is a long journey . you end up at this place. is the river network that flows out to the condo, and the congo

flows out to the big capital of the congo. this area has been an area that has always been remote, but since the colonial opening up in the 1850's, there was a lot of input of people and a lot of economic activity. we know from genetic dating estimates, that hiv originated in the area around 100 years ago, between 1880's and 1920's. if you look at the history of the place and the geography, you think, why they are and why then? but that's only looking at the historical developments. then, everything starts to make sense. all the major colonial powers were operating in the area. they went in there mainly for rubber, but also for timber.

there was a huge disruption going on off of the original lifestyle, a huge movement of people, because they had an enormous demand for workers, and over the decades, there were networks being built, river networks, and railway networks, and growing cities. you had all the drivers in place that hiv, once it managed to jump from chimpanzees to humans, could expand and gather the momentum to finally make the leap out of africa and into the rest of the world. we also know by now that by the 1960's in that city, there was already an epidemic of hiv-aids. there were hundreds of thousands of people infected. but of course, because of the postcolonial chaos that was there in the 1960's and 70's, the house infrastructure

collapsed, there was a civil war, nobody noticed. it wasn't until the 1980's that we took notice of hiv here, in new york and on the west coast. cameroon was the place where hiv 1m originated. we went there because we wanted to understand whether they have the potential to basically breed another virus or facilitate another emergence of a virus. another emergence of a virus. these are scientists collecting fecal matters from chimpanzees, where we can analyze them in the u.s. also in the area, there he remote area, it takes about four days to get there, it is a rain forest area. there are huge logging operations going on.

it is not going on at the edges of the forest, but it is going on in the middle of the forest. the cameroonian government is auctioning off to international companies, certain areas in the rain forest where they log. this is an italian company, logging for timber there. so you have networks, where they have to bring out these timber to the next part. the next part is miles away to the west. you have roads where there is a confluence of trucks bringing hard work and timber to the coast. so, you have networks again. secondly, you have a lot of people coming into that area to work for the logging companies, first of all, and also to provide services for all these truckers. there are no supermarkets or anything there. it is just bush tracks, and little settlements like these. the people that -- live exclusively off of bushmeat. these are pygmy hunters. these are women slaughtering an

animal. we were there for almost there for three weeks and we could not get any protein except from bushmeat. we were eating monkeys, snakes, parking fines. all of these people were eating them there, and all the people were coming in close contact with wildlife, either through slaughtering it -- here is the preparation of a monkey over a fire. here you have constant exposure to wildlife, and constant opportunity for viruses and pathogens infecting wildlife to jump over into humans. there are doctors -- we went there with a cameroonian army medic, working with a team of scientists in southern france, but also here in philadelphia. they are actually monitoring these populations.

first of all, what you see is very high hiv rates. the truckers, hiv spreads along the trucking routes. the truckers have lots of relationships with the population there, so that is one way of hiv to spread. it is almost 25%. almost every fourth person has hiv there. they are analyzing blood samples. they have evidence of transfer of pathogens that normally only impact monkeys and apes. i live in hiv, they have indirect evidence that these populations have these viruses through antibodies, and some of the people actually are infected with the pathogens. they don't make them sick, but we don't know whether that happens, if that happens, but the first steps are already taken. in a nutshell, this is one of

the areas which peter pointed out in central africa, where you have all the drivers their. you have mobility of population, a population growth through an input of population working there, you have a very slow and intimate contact with wildlife, and also, you have networks that can bring pathogens to the big cities in west and central africa. i am a biologist, and what i realized there with chimpanzees, is, if you look at evolution and the fact that you look at the selective factors going on, it was like hiv found itself in a chimpanzee population that was dwindling. any virus at the moment in chimpanzees has a population of maybe 250,000 chimpanzees left.

for any virus that makes the jump into humans, it has another expanding population of 7 billion people, so the selective pressures are therefore viruses to adapt and go into a human host and survive in a human host. listening to peter, i find it very interesting. some of the efforts are going on to understand which viruses are circulating, which viruses can make the jump into humans, and of course, if we can prepare ourselves, if we had genomic sequences, it would have a huge advances -- advantages. these areas, remote as they may be, have to be on the map so that we can react early enough, or actually asked preventively before it is too late. finally, i just want to say with ebola, it was basically the same thing. ebola, the outbreak in west

africa, originated in guinea, and they call it the forest region of guinea. this is not a forest region anymore. it is a deforested region. there has been a lot of deforestation going on. from an evolutionary perspective, if there is a virus there, and the habitat of the bats is destroyed, then the population dies out, or it manages to live next to humans. bats are mammals and are very adaptive in that sense. that is probably what happened with ebola. you have the bats living in very close proximity to humans, and that made it very easy for the ebola virus to jump from bats into humans. of course, it was in an area where the next capital city was

not far. with ebola, everything was in place, as with hiv. we know the factors, and it is probably a matter of looking closely and thinking very hard about how we are in touch with nature, and thinking how we can use knowledge to prevent this in the future. thank you. [applause] ms. shah: thank you, carl. next, we will share some recording from amy on ebola. she is a scientist who has been supported by the pulitzer center.

>> hi. i am a science journalist. i'm going to talk -- my talk is a little bit different. it will be a lot less sciencey, actually. i will talk about the u.s. response to epidemics in the developing world, and also what we respond to and don't respond to. i had gone to sierra leone to cover the ebola outbreak, and i was just going to cover science, because that is what i do. i have a background in science and i wanted to cover treatment. what i was really stunned by was the largest -- large distance between the response versus what you see on the ground. i was very intrigued by that. that is what i really spent a couple of months reporting on. so, this is what we maybe think about. white tents, biohazard suits. where i spent a lot of time was the hospitals, which is where people go when they are sick, and they go seek medical care. that is before international

response shows up. this is a photo of exhausted nurses. if you go to hospitals, you find underpaid and overworked staff. often, there is no electricity or running water. specifically, i spent a lot of time in the west of sierra leone. there is a large district on the border of guinea. in april 2014, that is when doctors without borders was chatting about the terrible ebola -- shouting about the ebola epidemic. at that time, they were worried, saying we have never seen this before. at that time, dr. khan, a leading biologist in west africa, he was at a big effort -- hospital in western sierra leone. he was at this hospital in sierra leone.

he's worried, because they are on the border with guinea. he called all the young doctors he has trained to come there. he convinced a lot of nurses to come for training on what should they do should ebola show up in sierra leone. within a few weeks, there was a pregnant woman who came to the hospital. she miscarried, and she could not stop bleeding. she kept bleeding and they moved her to the surgical ward. she had a hemorrhagic fever, >> she knew enough to tester for a hemorrhagic fever that is a pandemic in the area, and also for ebola. she died, and then tested ebola positive. at this point, it blows up in the region. ebola spread rapidly, and it is tough to care for it. they do not have gloves or protective gear. commercials stopped flying, so it is hard to get there. they just have tarts on the

walls. this is one of the walls, plastered with flyers for memorial services for nurses and ambulance drivers and lab technicians who died, because they don't have protective gear, and they are working very hard to do what they can. maybe, june, july, it is escalating. -- may, june, july, it is escalating. this is one of the morticians from the hospital. he convinced me to come into the morgue. ebola was not so strong in the area at the time. but at the peak of the outbreak, there were more than 3000 ebola tests done at the hospital, and he just slept. he showed me where he slept on the other side. he slept on the ground, because around the clock, he needed to prepare bodies, and there were piles of corpses. by the time i got there, around august, in august in the west they are dealing with expanding.

there are a thousand people who have died by august 2014. that is when the world forth organization decided there was an international health crisis. that is one fundraising begins, and countries start donating money. but that even starts -- takes a lot of time, because they had to decide how they can implement it, are they getting the army? it all takes time. the whole time, the virus is multiplying and spreading, and it hits the capitals. by october, there are 3000 people dead, and still, not a lot of international aid. all of the white tents and biohazard suits, they are starting to show up. late november and early december, that is one finally, mid-december, they decide there are enough ambulances, and the white tents and treatment centers. when i come, the plane is full of aid workers.

at that point, when you go to a public hospital, you will see strikes across the country. in sierra leone, liberia, and guinea. part of the problem was when the staff was working, they were told they are going to be paid $50-$90 per week for risking their lives. some people were paid, but a lot of people were not paid, or they were paid half, or extremely late. there were protests. somebody had dumped three corpses on the ground in protest. part of the anger was also, headlines were reading, obama donates $100 million. there were huge donations, and it is clear people are donating, why aren't they getting it? you can see there is money. there is united nations helicopters flying back in forth -- back and forth, and the capitals are full of new cars donated, they have plastic wrap still on them. there are ebola treatment centers being put up. there are lots of donations.

it is clear, some of those things are going to good purposes, other things are little questionable. but what people keep asking me as i visit there is absolute oath -- hospitals, is who is getting the money, because we are still not being paid. this is a chart from may 2015. these are actual donations made to west africa. the u.s. was the biggest honor with $1.5 million. the u.k. had $30 million. -- the u.s. was the biggest donor with 1.5 billion dollars. the u.k. had $30 million. when governments make donations, they make donations and the money goes to either the united nations agency, to their own nation's agencies like the cdc,

or big ngos like red cross or save the children. there, they might hire contractors, who hire the next level of people, and maybe they hire other ngos. there is a whole hierarchy. where it does not go is to the public hospitals, or to the nurses who are within the system. it doesn't go to the government of the country. it goes outside of the system. however, the government of sierra leone, one of the poorest countries, they asked for money to help them cover hazard pay for health workers in the system, and they did donate money towards it.

in an investigation i did, less than two points -- 2% of the $3 billion was earmarked for the staff in the international health system. so, very relatively small amount. of the 2%, why are still -- people still not being paid? one of the u.n. agencies, the development program, was asked to implement this kind of awesome way of paying people through mobile phones, because very few people have bank accounts. you get text message that says you have $90, and then you go to a vendor and pick up the cash. a supersmart idea, but it is not simple because you still need a system. you need administrators and the human resources department to keep track of who works where, and when, things like that. i went about trying to make, at least in this one hospital in the west. in the end, the sad conclusion is, i don't think anyone really cared if the system worked or

not. i don't know if there is a lot of -- if the system doesn't work, i don't know if it ever comes back to the people who are supposed to implement the system. that is the end of that. i think the reason why it bothers me now, is because it is a question put out there. there will definitely be other epidemics. what would have happened had in april, when dr. khan knew that ebola would cross over the border, what if there was a hot with running water -- hospital with running water and electricity, and gloves, and protective gear, and nurses who were supported and paid, what would have happened if they were prepared to take care of the outbreak themselves?

i think the cdc might have dropped the ball for a minute, but nonetheless, there was not a spread of ebola in the u.s. the women in the hair cap, she was the head of ebola treatment in the hospital. they built a new nurses quarter, and i visited her in july. this is the nurses corridor for the isolated -- isolation unit. it is the rainy season. there is a soggy mattress in the corner where the nurses can share. all 15 of them have to huddle in there when it rains. the files are completely covered in water. that is the state of the public health system there. it may be a challenge and a question for before and after the crises, is, is there a way to support the system inside these places as opposed to

outside? i have an e-book that tells more of the story, that you can download, or there is a shorter version of my book on the website -- on my website. thank you so much. [applause] >> thank you to all our speakers. we have a little bit of time for discussion. if sony has questions for the panel, she gets to start. if you are interested in asking a question, because we have limited time, if you can make your actions as brief as possible and indicate when the pedal they are indicated to, -- indicate who on the panel they are indicated to, if that is

appropriate. thank you. >> is it working? ok. concerning trying to identify the 300 million mammalian viruses, as we know, there are many viruses that are nonpathogenic. is there a way to parse that down to make it more economically productive? also, we know there are non-mammalian viruses that can cause disease. are we limited ourselves? also, concerning water in manhattan in the 19th century, that was started -- they were interested in developing a bank. they applied to the state to get a charter, but the deal was, and

ehrenberg was one of the people involved, -- aaron burr was one of the people involved. the deal was, in order to get a charter, they had to develop a water system. they were not really interested in water at all. my point is, i think it is the profit motive and greed that drives a lot of people here. i don't see a solution to that, unless we change our whole society. i think we are so driven by the profit motive. winston churchill said that americans try everything first, and eventually they will do the right thing. i think that applies to human beings and gentle -- in general. i don't know how long it will take rest together, but i'm cynical. >> thank you for the comment.

>> you go first, it is your book. [laughter] ms. shah: i think it is a huge political challenge. i go into some detail about that in the book, if anyone's interested. it's a great story. certainly, the political challenges are huge. we talked a lot in the panel about pathogens that are coming out of distant parts of the world, but it's another point to keep in mind is that it is happening here, too. a great example of a political challenge and pathogens, coming out of our inability, is antibiotic resistant bacteria. we have known since 1940 that if we use antibiotics in ways that are not medically necessary, we will get super resistant bugs. and yet, decades later, for decades we have been using the majority of antibiotics used in this country, 80%, used for

commercial purposes. they are not for medical uses at all. this is obviously can trading to the increasing problem with antibiotic resistant bacteria. we have only taken baby steps to address that. the political challenge on our size is the rise of private interest. the political challenge is building these systems in places that were some of the pathogens are most likely to come up. i think it is going to vary place to place, but the political challenges, to me, is one of the top ones. >> great question. i will continue in reverse order with your questions. why mammals? if we do the math on the previous emerging disease events, the mass majority of the viruses that come from animals, they tend to come from animals. mammals cover the vast majority.

you should probably include birds, because of avian flu being such a threat. but that does not increase the cost to much. the first question is more difficult. you are right, it is a stamp collecting exercise. some of those stamps are penny blanks, and you have to throw them out. some of the viruses will be killers, and some of them won't. how do we work that out from a viral sequence? it is not straightforward. first of all, we are only looking at viral families that include those that have gotten to people from animals. we have narrowed it down from there. then, when you get a sequence, and it looks like a relative to the known nasty pathogen, just like we did with sars -- we

found viruses in bats. some of them looked very similar to sars. we sequenced the spine protein, the protein that attaches to cells, and then you create pseudo-particles, insert proteins from the viruses that combined to human cells. each step of this, you move closer and closer to could the virus become pathogenic in people? you narrow down the field. you reduce the cost, and end up with a small number of viruses that really do look like killers. and you look at the people, and the people in the region that live where the animal lives, do we see antibodies to that virus? just as the group is -- in cameroon a new virus coming into people. what is the activity, and can we find the alternative? it's not straightforward, but there are ways to hone it down. we had just got to do it. it makes sense economically, and for humanity's sake. >> i have one comment on the

absurdity of things. i asked the company of the people who do the logging in cameroon, what the timber is used for. it is used for matches and toilet paper. >> we are not going to have a lot of time to go into this, but if you would like the details on precisely how we do this in a laboratory, i will be happy to talk with you about it afterward. >> thank you very much for talking about the most likely origins of the next pandemic. perhaps the highest risk, any comment on bio hacking or intentional man-made pandemic's? >> this came up after 9/11, when we had the anthrax attacks, with

a big emphasis on developing a program here, focused on bio defense. it was subsequently spend it to include emerging infections, because it became clear that the majority of emerging infections were not designed, but in fact, came from nature. there has been a shift back now again toward consideration of deliberate biological weapon hearing -- weapons. i still don't feel that this is a huge risk, because it is easier to find these things in nature. but it is something we are all concerned about. which actually then leads me back to addressing yr question, anyway. one of the things, what we tried to do, is try to find out

whether or not a virus can bind to a self. viruses -- bind to a cell. viruses can only grow inside of a cell. the next thing the virus has to do when it enters the cell, is to find some way to evade what is known as the innate immune system, which are molecules inside itself that decimate viruses so that they can't otherwise grow. we look for these evasion molecules, and the innovation systems these viruses have. if you have a virus that has the ability to get into a cell and evade the invasion immune system, then you know it is a serious candidate for causing human disease. typically, the closer host organism for that virus to a human, the more likely it will be to be able to infect human and cause disease, which is why we focus so much on apes, and lesser extent, other nonhuman primates.

that is not necessarily the only indication of disease. for example, with west nile virus, its ability to replicate inside of native species here in north america allowed it to exclusively grow and become the source of the virus in mosquitoes, and gave rise to the epidemic. the last speaker was talking about the ebola outbreak, and how -- the lessons learned in terms of rapid response, and so forth. in 2004 and 2005, peter and i had an award together from google.org that was designed to address proactively some of these things.

we actually set up outposts for this sort of disease monitoring. one was in bangladesh. that system has become quite robust. the other one was in sierra leone, at the general hospital. how ironic is that? we actually placed into a hospital there, equipment that was monitoring, set to go. the first thing we ran into, was we were trying to bring in the machinery. when we hit freetown, people sabotage the equipment, because we didn't have bribes. the u.s. government allowed us to allocate money for brides. we had to bring in the missing parts in personal luggage thereafter. after three or four years, google decided they no longer wanted to support this particular organization. as a result, the whole thing collapsed.

now, we had -- a resource request from the obama administration to congress for $1.8 billion to address the zika virus. the information that came down yesterday, or maybe today, we are not going to give you any money, spend the money from ebola. the major problem that i see in much of the world is poverty, and a lack of infrastructure. until you can address property and -- poverty and lack of infrastructure, even though we had great materials and technology, it is very difficult to deploy. you've seen more of it than i have. as you said earlier, lack of clean water. pove therty isig enemy, i think. >> i just had a quick question about prioritizing.

we look at something like zika virus, which is at the bottom of the pile of things we are worried about, and then suddenly it was up to the top. as we are discovering new viruses, how are we going to prioritize which was to be concerned about, and which ones to address first? obviously, there are limited resources and we can't take care of everything, unfortunately at the same time. >> if you look at the hotspot map we produced in 19 -- 2008, prior to west african ebola, although west africa is a hotspot, prior to the so-called swine flu, mexico with a hotspot. it is clear from looking at it logically, you can't prioritize where to work. it is what you do about it. responses are after-the-fact. it is not good public health. smoking, diabetes, we had lousy

public health on that pandemic. we had the worst ebola outbreak. $5.1 billion was used not to fund the operations. where is the money to move forward? we need the funds to be allocated to the places that would be the next outbreak, not the one that was the last outbreak. we know where they are, we know how many they are, and we know how to go about identifying them. i think it is good commonsense public health to get out there and do this proactively. prioritization, you go back to which wildlife species are the viruses found in, are they in areas where there are already on -- ongoing outbreaks, other people hunting the animals and exposed.

there is a whole series of things you can look at to prioritize, which is fairly logical. it's not rocket science. it is straightforward. we just don't yet have the global will to do it. >> thank you. >> i'm curious, if we do manage to find these viruses and find places where they are jumping over to the human population and we know that, how do we contain that. knowing is nice, but doing something about it is nicer. >> let me give you an example. a great example, going back to the work we have done in bangladesh, with the old cholera hospital. we know there is a virus out there that is really lethal. the average mortality rate is around 70%. there are no vaccines, no drugs. it is a nasty virus. it is bat born.

people in bangladesh drink sap that they scrape out of a palm every evening. they go up in the morning, bring it down, selling fresh. you can't leave it, because if it cements, you can't eat it. it has to be fresh. unfortunately, the open wounds on the trees, we know that they secrete viruses into the trees by urinating, defecating, and spitting into them. there is a simple solution. the simple solution that i see is really cheap to make bamboo skirts, very low cost, put them around the place where you tap the tree to prevent bats from getting in there. it is about reducing contact and still allowing people to do the things they have done for thousands of years, and make money, and finding a solution that keeps the concept between wildlife and people.

every virus has a different solution, but we need to be creative and find alternatives. ultimately, we need alternatives to logging tropical forests in these emerging hotspots. selling matchsticks, not a good thing to be doing now. >> and what ian said as well, poverty. i witnessed that during the ebola outbreak in cameroon. sometimes it's a totally different logic at work. the beginning is the demand created through companies saying, we want to do logging there. next to poverty, corruption is the next thing.

the cameroonian government says, ok, it we designate the area, you cannot go. the whole thing starts, because the people do not understand causes and consequences. they look for work and opportunity. you have all these people moving, nobody controls them. the pictures you saw during the blood testing, the blood is only tested for hiv. i saw several people who tested positive. the people there died of hiv. they do not get medication. there is a corrupt network that holds back medication, and that is in cameroon. it is a set of obstacles from the ground, which you need to understand the logic, in order to implement programs that can stop and reverse these things. it is very difficult. >> hi.

i am a neurologist. i came in late. do you describe, with the zika virus, the cases where it was isolated in microsoft we was in a single or double digits, compared to the 4000 plus that were identified in brazil? i know that maybe 1500, that they identified for every let's say, one that they had identified, that is truly microcephaletic. there are two they have thrown out. but the numbers were the actually isolated the zika virus is very low.

>> the question is, what is the mechanism by which it might cause microcephaly? other way in which people try to identify a virus as being present in the simple is material,ing genetic proteins. there has not been a lot of analysis about microcephalic brains, because most of these children are still alive. it may well be that if these children were to die, you would find fossil fragments, genetic elements possible -- present within the brains.

what people are trying to do is demonstrate different methods -- methods where you look for antibodies, but they are not as specific as we would like them to be, so you have crosser activity between that and dinky dengue virus. the question i want to get back which ofe identify these viruses peter and i described it should be prioritized in terms of importance? todo a lot of work characterize unknown viruses present in the blood supply. up with very rapid and less expensive ways to do this. we have not found thousands of new viruses that

need to be characterized. if there were to be blood from areas like cameroon, where we do not currently have access, and if anyone would like to provide us with access, i promise we will let you know how many viruses are lurking there. the number of viruses, i think, would number in the hundreds. that is a fairly simple experiment to do. we can charactize them in culture. we can look at their ability to we canide human cells, look at their ability to immunes innate responses, we can adapt them to .rgan cultures ultimately we can move them into animal model experiments. if we take it through that whole throughf entry points this rational fashion, i predict

we can identify those viruses andh pose the greatest risk we can give you a top 10 list of what we would be concerned about in the americas, in asia, in africa, and so on. staggeringlybe a expensive process to pursue, but someone has to pay for it. there is no way to do the work otherwise. >> ok, on that note. thank you all so much for coming. [applause] on sale in the back. we are also having a reception. please do stick around and have more conversation. thank you. >> thank you for joining us. pick up the book on your way out the back. thank you. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org]

[captions copyright national cable satellite corp. 2016] [indistinct conversations] >> we will have more road to the white house coverage this afternoon. donald trump is in wisconsin, house speaker paul ryan's home state. he will be in janesville. we will have live coverage starting at 5 p.m. eastern this afternoon. coming up, two experts on

student debt discuss whether there is a crisis in the united states and who is most affected by the problem. include -- a new york times columnist. here is a preview. >> what does that actually mean for individual lives? someone in default has an enormous lot on their credit record. what does that mean? many landlords do credit checks before someone can rent. they are shut out of the housing market. if they want to buy a car to get to work because they live in a neighborhood where the jobs aren't, they are shut out of getting reasonably priced loans and they have to get an 18%, 20%, 25% interest rate loan, which further presses on their finances many employers now

check credit records. so, they are going to miss out on job opportunities. and add to that the psychological stress of someone calling your cell phone, your home phone, your relatives on a aboutracist to harass you your debt. there's a lot of suffering, and daily basis to harass you but your debt. there's a lot of suffering. we told people the right thing to do -- the job market is weak, go in your self school. as a result, they are suffering. think up as the student debt crisis. >> just a preview of what you will see tonight, the discussion on student debt that gets underway at 8:00 eastern 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

series." real life stories and constitutional dramas behind the most significant decisions in u.s. history. constitution is a political document. it sets up the political structures. but it is also a law. if it is a law, we have the courts to tell us what it means. >> it is the ultimate anti-precedent case, exactly what you do not want to do. >> the should make the decisions about those cases? the supreme court said it should make the decisions. >> tonight we look at the decision that invalidated the missouri compromise -- scott versus sanford. at 10 p.m.ght eastern on c-span and c-span.org. and media teaches us

democrats and republicans are supposed to be at odds with each other, and i think people need to recognize that -- we need to be respectful toward each other and we need to understand that senators are respectful toward each other and that will be more policyve to getting more done instead of acrimony and vitriol. >> the truth is, the people that we see on television, on c-span are real people. when we saw president obama, the thing that stood out most to me is he had bags under his eyes. he is a real person. sunday night, high school students attending the 54th u.s. senate youth program talk about their experiences, plus their plans for the future. the students met with members of government, plus military and media representatives. >> "washington post" journalist

jonathan case art talk to us, and i really love to be in sight theave us about being inside source, reporting back to us and the electorate about what is going on in our government. has been one of my idols for a long time. i either want to be in the legal profession or possibly a senator. >> i understand the need for bipartisanship at times, but i think it is important that politicians go to washington or their state capitals with their eyes on a goal and determined to meet that goal instead of sacrificing it in the light of bipartisanship or whatever it is. >> we have to get back to respecting all americans, no matter what their backgrounds, and making this country a more respectful place. >> sunday night on c-span's "q &a."

court delivered 4 decision -- split 4- on friedrichs versus california. it is a case considered one of the most important for unions in years, a clear sign of how justice antonin scalia of's death is impacting the court. currently 23 states and the district of columbia allow public employee unions to collect fees from nonunion embers to cover the cost of workplace negotiations. here is a look at the oral argument from the case. chief justice roberts: we'll hear argument this morning in case 14915, friedrichs v. the california teachers association, et al. mr. carvin. mr. carvin: mr. chief justice, and may it please the court, every year, petitioners are required to provide significant support to a group that

advocates an ideological viewpoint which they oppose and do not wish to subsidize. abood's authorization of this clear first amendment violation should be overturned, both to end this ongoing deprivation of basic speech and association rights, and to restore consistency and predictability to the court's first amendment jurisprudence. justice ginsburg: mr. carvin, is it permissible, in your view, to allow the union to be the exclusive representative so that nobody else is at the bargaining table? mr. carvin: yes, that's fine with us. our objection, of course, is being forced to subsidize that exclusive representative. the fact that they are exclusive representative impinges on my clients because it disables them from individually negotiating with the school board, but that is justified by the need for an exclusive representative. and that is why, indeed, requiring agency fees in the collective bargaining context is less justified than, for example, requiring agency fees to support union lobby.

in the in collective bargaining context, we are required to free ride on the union because they are the exclusive representative and we don't have our own vehicle. so the free-rider justification is far weaker in the collective bargaining context than it is in the union lobbying context. justice scalia: mr. carvin, is is it ok to force somebody to contribute to a cause that he does believe in? mr. carvin: i wouldn't think, your honor, that you could force republicans to give contributions. justice scalia: yes. that's that's what i'm thinking. could you enact a law? let's say the national political parties are in trouble so they enact a law that says all all members of the republican party, if you want to be a member you have to contribute so much money. is that ok? mr. carvin: no. justice scalia: is that ok? mr. carvin: no, it's not, and that's because the bedrock principle, as harris made clear, is not whether or not you vividly oppose what they're saying -- justice scalia: right. mr. carvin: it's because you don't wish to subsidize it. justice scalia: exactly.

so i don't know why you're putting so much emphasis on the fact that your clients oppose. it really wouldn't matter, would it? mr. carvin: no. and i don't i did want to point out that that's the reason that they've brought this lawsuit. but but no, you're a thousand percent right, your honor. you don't -- justice kennedy: if if you were to prevail, what would happen with private employers in a state which said that there should be a union shop? mr. carvin: nothing, your honor. justice kennedy: what 25 -- justice kennedy: and and because? mr. carvin: because the first amendment doesn't apply to private employers, and because in beck the court established the rules for agency shops based on the statute without any first amendment -- justice kennedy: i think that's correct as a basic distinction. it is true, though, assuming that you have a state statute which allows an agency shop or a a closed shop, that that is state participation in the very kind of coerced membership and coerced speech that you're objecting to.

mr. carvin: well, i don't, in candor, think that that would create state action under the court's modern jurisprudence, such as moose lodge, where it turns on who is making the decision that is being objected to. in your hypothetical, it would be the private employer. but that aside, as the court made clear in harris, even if it did reach first amendment, there's a there's a serious difference between a grudging authorization or the government permitting private employers to engage in agency shops and the government itself affirmatively imposing them on its own public employees. justice ginsburg: what about the railway labor -- justice kagan: what is the -- justice ginsburg: what about the railway labor act? mr. carvin: i apologize. justice ginsburg: the railway labor act. mr. carvin: yes. justice ginsburg: you answered justice kennedy that, in the private sector, this is all right, you can have an agency shop. how about under the railway labor act? mr. carvin: well, as you know from street, you can have agency shops but the agency fees can only go to things that are germane to collective

bargaining. in other words, they impose the abood rule in the private sector as a matter of statutory interpretation, and nothing the court says about -- justice ginsburg: but you don't have any first amendment argument about that, about the either the private sector or railroads. mr. carvin: not at all, your honor. we are strictly limiting ourselves to public employees because public employers obviously are subject to far greater constraints under the first amendment that the justice kagan: well, one of the points of your public employee cases generally, mr. carvin, is essentially to ensure that when the government acts as an employer, that the government be put in the same position as a private employer; in other words, that the various constraints that would constrain the government when it's acting as sovereign fall away and a different and lesser set of constraints apply that are meant essentially to ensure that the government doesn't use its position as leverage over things it oughtn't to be able to control, but that the government

can do the same things that a private employer can. and so why doesn't this fall within that category of things? in other words, you've just said private employer can decide to do this. that's not a constitutional problem. so too with the government employer. mr. carvin: for two reasons, justice kagan. first, i must respectfully disagree none of the court's -- i must respectfully disagree with the premise. none of the court's first amendment says public employers have the same rights as private employers. the constitution can discriminate on the basis of political affiliation. they can even discriminate on the basis of sexual orientation. but nobody thinks that public employers can do that. plus which, even under pickering, for example, the deferential review you're referring to imposes greater constraints on public employers than private employers. bargaining -- justice kagan: as i said, mr. carvin -- mr. carvin: sorry. justice kagan: but there's a lesser set of constraints. and and the lesser set is basically to draw a line and to

ensure that the government doesn't use its position as employer to do things it oughtn't properly to do. but the government, when it's acting as an employer with respect to its employee workforce, really ought to be able to do the same things that a private employer can. mr. carvin: the court's government as employer speech and first amendment draw a clear distinction between restricting employee speech, like under the pickering line of cases where there is deferential review, and circumstances such as this where they do leverage the employment relationship to coerce the employee to subsidize or associate with an outside group. that's obviously -- justice sotomayor: how is that different -- mr. carvin: for example, rutan is subject to strict scrutiny because they are leveraging the employment relationship to force you to associate with a political party. justice kagan: well, that sounds -- mr. carvin: similarly -- justice kagan: like you're drawing a distinction between restricting speech and subsidizing speech. and i had always thought that these were two sides of the same coin, that compelled speech is is no less and no greater an

offense than compelled silence. mr. carvin: yes. certainly in terms of petitioners' rights. but your honor, the scrutiny given to the speech being subsided doesn't dictate the level of speech scrutiny given to the compulsion speech. for example, the you can stop unions from making political contributions under the case law, but that hardly suggests you can compel a nonmember to subsidize the union's contributions. you can stop public employees under the hatch act from engaging in basic political participation, but that hardly suggests that you could require a nonmember to subsidize political activity. so there's always been a clear distinction in the case law between those two things precisely because subsidization is an entirely different infringement than restricting employee speech. restricting employee speech is an inherent part of the employment relationship. the employer has to be able to

restrict the employees' speech, as this court has frequently noted, or you couldn't have a workplace. plus which we give deferential review because we don't want the federal judiciary micromanaging the literally hundreds of thousands of personnel decisions that public employers make every day. neither of those concerns is present when you have a categorical rule that requires one set of employees to subsidize an outside advocacy group like a political party or like a union, and that's because you're not involving the federal judiciary in personnel decisions. and it's certainly not an inherent part of the employment relationship. it is, to use your phrase, leveraging the employment relationship to require something that the state couldn't require directly. justice sotomayor: well, why are we treating the government differently than a private employer? you just earlier said, and i think our cases are replete with the point that as employer, the government can already restrict

speech which is, i think, a higher problem than subsidization. we've already permitted subsidization of bar associations, of government programs. we've permitted assessments on a lot of different levels, so why can't the government, as employer, create a state entity? because this union under california law is a state entity. mr. carvin: no. justice sotomayor: oh -- mr. carvin: i'm sorry. justice sotomayor: i beg to differ. hold on, mr. carvin. i'll get you the section. mr. carvin: sure. justice sotomayor: it says, "when recognized as the exclusive bargaining representative, a union assumes an official position in the operational structure of a school." so it seems to me that and california tells the union what topics it can negotiate on, it

requires them to do training, and in the end it accepts their recommendations with respect to the issues of employment at its own will, meaning the state is creating the union as part of the employment training and other responsibilities. mr. carvin: justice sotomayor, i think it's important to draw a distinction between having an official position -- they certainly do. they are the exclusive representative of the employees and suggesting that they are somehow state actors. if they were state actors, the state legislature could tell the unions not to advocate pay raises. it could tell them not to -- justice sotomayor: oh, in fact, it might be able to do that. mr. carvin: i don't -- justice sotomayor: if it it tells them what they can they give the state legislature has given them the right to do that. mr. carvin: right. justice sotomayor: but what would take away from their right to say, no, you can't bargain on these particular topics? mr. carvin: the first amendment. in other words, the scope of collective bargaining is obviously something the state can dictate. it could never dictate the union's position collective

-- position on collective bargaining. justice sotomayor: absolutely. mr. carvin: well, then, that's my point. but of course, if the if they were state officials subordinate to the state legislature, the state legislature could tell them, don't advocate pay raises, don't advocate this for health and benefit. justice sotomayor: well, they wouldn't say, don't advocate this with respect to the state legislature, but they could say that's not going to be the subject of discussion at the bargaining table. those are two different things altogether. mr. carvin: well, again, we need to distinguish between collective bargaining and lobbying. justice sotomayor: exactly. mr. carvin: exactly. and here's the point: they couldn't collective bargaining is unique, because it requires public officials to meet and negotiate in good faith and mediate any impasses with unions. none of that exists in lobbying, for example. state legislators could close their door whenever they want. justice kennedy: well, even with -- mr. carvin: what -- justice kennedy: even aren't charges suppose the union has an article or a public relations campaign to protest merit pay. i take it that's a chargeable

expense. mr. carvin: yes, under lehnert. and on my -- justice kennedy: so collective bargaining in this instance subsumes -- includes this wide-ranging effort on the part of the union to have a public relations campaign in favor of principles that some of its members that some teachers strongly object to. mr. carvin: exactly, your honor. and my point in response to justice sotomayor would be if they were really state officials subject to subordination by the state legislature, the state legislature could say, just like they could say to their own employees, don't run public relations campaigns adverse to the government. and the key point is, i think they say you can abandon you can ban collective bargaining, but you can't ban lobbying. but it's important to focus on why that is so. the reason that is so is because we are imposing an obligation on public officials in collective bargaining, that exists nowhere else, to negotiate in good faith with the union.

but they couldn't tell the union don't advocate to the school board, pay raises, and things like that. they can simply revoke collective bargaining by saying, just like the state legislature, the school board doesn't have to listen. justice sotomayor: if we -- mr. carvin: so the distinction is between what public officials have to meet and negotiate on, but that doesn't translate into any ability to tell the union what to say or do. and i'm assuming -- justice sotomayor: in terms of -- mr. carvin: the respondents will agreed with that. justice sotomayor: but the teachers can lobby. there's nothing wrong with the teachers speaking. mr. carvin: and that's the whole point. the teachers can lobby. they can go to the state legislature. justice sotomayor: mm-hmm. just like the union can. mr. carvin: just like the union can. and yet, they can't be forced to subsidize the union's lobbying -- justice sotomayor: but what does your lobbying do -- mr. carvin: however so with respect to collective bargaining, they can't negotiate. so the free-rider rationale is much weaker in the collective bargaining context, because the teachers' right to negotiate with the public officials that the union is talking to is extinguished in those

circumstances, even though in lobbying, they can engage in their own lobbying, but we don't allow agency fees for lobbying. justice kagan: mr. carvin, you come here, of course, with a heavy burden. that's always true in cases where somebody asks us to overrule a decision. it seems to be particularly true here. this a case in which there are tens of thousands of contracts with these provisions. those contracts affect millions of employees, maybe as high as 10 million employees. so what special justification are you offering here? mr. carvin: there are two special justifications, justice kagan. the first one is that this abood erroneously denies a fundamental right. it doesn't expand a fundamental right. and as the court made clear in gant, the right of the citizen not to be subject to unconstitutional treatment outweighs any reliance or predictability interests of stare decisis. justice kagan: you say this a lot in your -- mr. carvin: the second -- justice kagan: excuse me. mr. carvin: sure. justice kagan: you say this a lot in your briefs. but i guess i found it hard to understand that the idea that every time we deny a claim of

right, whether it's the first amendment or the fourth amendment or the fourteenth amendment, that denial of the claim would not have any stare decisis effect. i mean, we do that constantly. we do that tens of times every year. mr. carvin: but you are asking what if the court concludes that abood was erroneous, what special justification is there? justice kagan: yes. and your answer is essentially you don't need a special justification if the initial decision improperly denied a claim of right. mr. carvin: right. justice kagan: i guess i'm saying that i find that an extremely difficult concept to understand. it would take away stare decisis effect from numerous -- i mean, just hundreds, thousands of our decisions. mr. carvin: but justice kagan, with respect, i think the proof is in the pudding. the court has never upheld an erroneous denial of a right on stare decisis. justice breyer: and you think all the fourth amendment cases, in your opinion, are correct. i mean, you know, the police can go search a car, the good faith rule in respect to admission of

evidence that was seized unlawfully under the fourth amendment. i read a lot of criticism of those things in the paper. and it seems to me you could get people who are judges, who are up here, who thought that the fourth amendment should be really extended and, in fact, there should be no rule that gives police any special authority to search a car. mr. carvin: that -- justice breyer: there should be no rule that stops any incidents from coming in. i mean, there are dozens of cases where this court has denied individual rights. and you're saying all those cases are now free of any stare decisis inhibition. is that the point, or is it just labor unions? mr. carvin: no, no. your honor, in fact, the fourth amendment is not a hypothetical. that was what gant involved. and gant is the one that i was quoting when it says the right to constitutional treatment outweighs the reliance interests of stare decisis. but if i could move to my second --

justice breyer: well, wait. well, what about the eighth amendment? that's a good one. there's an individual right, some think, perhaps, against capital punishment. the court has consistently ruled against it. so i guess if that's ever considered again, under your view, the court would give no weight to stare decisis. mr. carvin: if the court was convinced that capital punishment was clearly outlawed by the constitution, i think it would be very strange to tell people who were being executed in the future that even though this an unconstitutional execution, we are bound by our erroneous prior decisions. justice kennedy: well, mr. carvin, let's assume that stare decisis an important consideration for the court. let's assume that. mr. carvin: sure. justice kennedy: what about the answer to justice kagan's questions about the many contracts, perhaps thousands of contracts? would they suddenly be endangered? would they all be void? could you address that? mr. carvin: there is no reliance interest. these contracts will operate precisely the same, the day after abood is overruled, as they would before. justice ginsburg: but what would

happen then? mr. carvin: sorry. justice ginsburg: what would happen to the employee who said now abood is off the books? mr. carvin: right. justice ginsburg: i want back the agency fee that i was compelled to pay. that was an unconstitutional exaction. so all of the people who paid these fees against their will -- mr. carvin: when you -- justice ginsburg: have a right to get it back? mr. carvin: no. no more than anybody had the right to get recompensed under citizens united or the commercial speech cases, once you relied those first amendment speeches doctrine there. as i understand it, the court's analysis prescribes prospectively. that's all we're asking is for is prospective relief. it doesn't apply retroactively. and to get to the point, all of the benefits remain precisely the same. they simply -- the union's future bargaining efforts would no longer be subject to

unwilling agency fee. justice kagan: well, mr. carvin -- mr. carvin: do you -- justice kagan: remember, one, you're assuming that these provisions are completely severable, which i imagine depends on the contract. but number two, even suppose that they are severable, these provisions are bargained for benefits. the contracts would read differently. the unions would have gotten different things if that provision had not been there. so you're essentially saying that the exact same contract should go forward, notwithstanding that the union has given up things, or has not gotten things, because the agency fee provision is in the contract. mr. carvin: no. again, i must respectfully disagree with the factual matter. the union did not go in and say we would have asked for a 10% increase, but now we're going to sell out our members' rights to a 9% increase so we can line our own pockets with agency fees -- justice kagan: the unions have -- mr. carvin: but they're not sorry. justice kagan: for many ways of dealing with their need for adequate funding in order to perform their collective responsibilities

collective bargaining responsibilities. they asked for this way and not for other possible ways of achieving adequate funding. and you would be essentially stripping them of this way, and not giving them anything to replace that with. mr. carvin: well, again, they didn't negotiate with the employer for funding because they don't get any funding from the employer, they get it from their members. so no position they took in collective bargaining is at all affected by the completely separate issue of how they -- justice sotomayor: ah, but that's the question, isn't it? would it be illegal for the government, as employer or government, to fund the union? mr. carvin: that's -- i thought about that, justice sotomayor. it's a very tricky question. under johanns, for example, the government can engage in a lot of speech that it can't compel citizens to engage in. the government, for example, can subsidize planned parenthood, but it couldn't require citizens to subsidize planned parenthood. so in that sense, yes, the government would have far greater leeway. that said -- justice sotomayor: so if the union had a way, or something to negotiate, which was right now,

the union participates in the grievance procedure and it pays certain expenses for that, it could have said to the employer, we're no longer getting enough money to be the exclusive representative of every employee -- mr. carvin: right. justice sotomayor: so now we want you to fund certain things. mr. carvin: well -- justice sotomayor: that could very well have been part of the negotiation. mr. carvin: not in california, for two reasons. one is the state statute requires agency fees. the employer couldn't have done anything with respect to agency fees. that's all decided by statute. justice sotomayor: no. you're assuming -- mr. carvin: prior -- justice sotomayor: i'm not assuming the state of the law as it exists now. i'm assuming that we were to undo and say they can't charge an agency fee. mr. carvin: right. justice sotomayor: all right? california's going to have to respond somehow. it's now breaching the agreement it had with the union. mr. carvin: it's -- justice sotomayor: they're going to have to come to some sort of accommodation. mr. carvin: right. and they would excise the agency fees part of the contract. justice sotomayor: even if they did, could they then decide to

fund the union? mr. carvin: oh. but that's a separate question. justice sotomayor: well -- mr. carvin: if they wanted to go ahead and fund the union, as i said, they've got some discretion to do it. i think the one area the government doesn't have the power to subsidize speech is when it's engaged subsidizing political speech in a viewpoint discriminatory way. justice sotomayor: let's take that aside. i'm talking about the collective bargaining part of the union. mr. carvin: oh, ok. then i'm maybe not understanding it. if the union is -- could they subsidize the union's collective bargaining efforts? justice sotomayor: mm-hmm. mr. carvin: i think they might be able to, but of course no state -- justice sotomayor: all right. so why can't they assess why can't they assess all of their employees a tax for that contribution? mr. carvin: right. and that was the point i was trying to get to, which is agency fees don't go just to collective bargaining. as we know, they also go to political activity. and i don't think the government could fund political activity in a viewpoint-discriminatory way. justice sotomayor: i'm a little --

justice alito: is there any history in american labor management relations, at least going back, i don't know what, 75, 80 years of employers paying for unions? i thought the union movement was against this long ago. mr. carvin: your recollection of history is correct. and of course, currently no government ever funds unions. indeed, under the nlra, it's -- justice breyer: there were company unions, but regardless -- mr. carvin: but -- justice breyer: i'd like two minutes to -- mr. carvin: but if i -- justice breyer: sir, go ahead. finish. finish, finish. mr. carvin: before you -- justice breyer: finish. finish, please. mr. carvin: just one more sentence. under the nlra, it's a felony for the employer to give the unions money because it would influence the unions, and contrary to the entire structure of collective bargaining. justice scalia: is it a bargainable subject? mr. carvin: excuse me -- justice scalia: is it a bargainable subject? i mean, it's a political subject. i suppose you can enact a statute that says the government will fund you, but is it bargainable? is it one of those items that the union can bargain for? mr. carvin: it doesn't exist, it's never existed in american society, and there's no way the public employer, particularly

because agency fees as a matter of statute, could all of a sudden say, sure, we're going to take our taxpayer dollars and start giving money to unions, because they've always been funded through voluntary contributions. if they did become recipients of federal or state funds, that would impose all kinds of restrictions on their speech and other activities that the unions presumably would never have asked for wholly apart from any funding shortfall. justice breyer: i have a different -- somewhat different subject, but it and i don't know how to get you to focus on this exactly. because i think there are good arguments on your side, and there are good arguments on the other side. when you go into this, it was, in my view, a kind of compromise 40 years ago. but it was 40 years ago. it was 40 years ago. i mean, maybe marbury v. madison was wrong. there are people who argue certain aspects were. and the concerns i have in terms of workability are not so much the details.

i guess something would work out in the labor area. it would certainly affect the bar. it would certainly affect the integrated bar. it would certainly affect at least student fees at universities. it would require overruling a host of other cases, i think, at least two or three that i can find, and that's quite a big deal. mr. carvin: it certainly is. justice breyer: and so what is it, in your mind, that you can say from the point of view of this court's role in this society in that if, of course, we can overrule a compromise that was worked out over 40 years and has lasted reasonably well, not perfectly, i guess people could overrule our decisions just as easily. i've had a few dissents. in those dissents i think i'm right and the others are wrong, and then think i'm wrong and they're right. all right? there are a lot of people who think that. you see where i'm going? i'd like you to talk for a minute, because it is a matter

of considerable concern to me, even when i'm on the other side of something. mr. carvin: justice breyer -- justice breyer: and you start overruling things, what happens to the country thinking of us as a kind of stability in a world that is tough because it changes a lot. mr. carvin: and i think you put your finger on precisely the same question. i think the principal reason to overrule abood is that all of the rationales offered in support of abood's result directly conflict with other precedent of this court. so by overruling abood, you don't do what you're saying, you do just the opposite. if i could walk through the list for you -- the standard of review, the new rationale for abood is it's subject to deferential government as employer review. it's contrary to harris, it's contrary to knox, it's contrary to abood itself, which is huge pickering analysis. the notion that the union's duty somehow justifies agency fees because they've got a duty to represent nonmembers, which we've chatted about, that comes

from the dissenting opinion in lehnert. so you'd have to overturn lehnert, which characterizes this argument as turning the court's principles on its head and is wholly unworkable in the name of preserving another precedent. the notion that collective bargaining doesn't involve matters of public concern, which has been offered up, that's contrary to harris, abood itself, which said it was, pickering, which involved basic issues of school finances, so you would have to strike all of those down. respondents' radical arguments that it's not entitled to any first amendment protection under the employee speech doctrine and under the glickman commercial speech doctrine is contrary, not only to abood, every abood case, and the harris dissenting opinion because -- justice kagan: mr. carvin -- mr. carvin: because everyone recognizes there's some first amendment protection. justice kagan: i mean, it seems to me -- i guess we have one disagreement, which is how well abood fits with all of our other employee speech cases, because i

think abood fits pretty well. it didn't cite pickering, but it essentially had the exact same concerns as pickering, which was the employer's interest, the government's interest as an employer, and how that related to an employee's speech right and basically arguing for a balancing test. so really what your argument comes down to is two very recent cases, which is harris and knox. and there you might say that harris and knox gave indications that the court was not friendly to abood. but those were two extremely recent cases, and they were both cases that actually were decided within the abood framework. in the harris case, the parties came here and explicitly asked us to overrule that case. almost all the briefing was about overruling that case, and the court decided not to overrule that case and instead

to say that the employees there were simply not public employees at all. so taking two extremely recent cases, which admittedly expressed some frustration with abood, but also specifically decided not to overrule abood, i mean, just seems like it's nothing of the kind that we usually say when we usually say that a precedent has to be overturned because it's come into conflict with an entire body of case law. mr. carvin: again, i must respectfully disagree. i think the classic justification for stare decisis overturning the case is that subsequent cases have undermined the reasoning and principles there. i think we can certainly agree that harris and knox certainly undermined the doctrinal underpinnings of abood. the fact that they're really recent as opposed to not so recent doesn't change the fact that abood has been overwritten. citizens united pointed to two differing lines of cases in the first amendment area as its

principal rationale for overturning austin. the hudgens v. nlrb case. in logan valley, it upheld something. in lloyd corporation, it distinguished it, but not overruled it. hudgens -- justice breyer: well, i -- mr. carvin: this doesn't this -- justice breyer: i'll accept that. let me accept that what you can do is you can go through and you're good at it, and so is the other side. you know, you go through the cases and you draw the line here, there, and the other place. and i'm trying to abstract from that in a very basic way for this reason. i think plessy v. ferguson was a case that certainly should have been overruled. it certainly should have been overruled because it was basic, because it was a right to treat people equally, and there were millions of people who were not. now, you see the level of abstraction i'm working at? now, if i put that same level of abstraction here, i see the following -- you will go out this door, and you will buy hundreds of things, if not thousands, where money will go

from your pocket into the hands of people, including many government people, who will spend it on things you disagree with. i don't see anything too basic in the lines you're drawing there. the second thing is, what you said was -- and it's true --employees can say what they want. we're talking about six people in a room bargaining about wages, hours, and working conditions. that's pretty far removed from the heart of the first amendment, and pretty close to ordinary physical activity carried on through words. regulation, if you like. so i can't find a basic principle that's there that's erroneous as in these major cases that we have overruled. and if you have a response to that, i'd like to hear it. mr. carvin: sure. as to requiring people to give money to which they don't wish to give, thomas jefferson said that was sinful and tyrannical. james madison famously said,

requiring three pence is the thing. so it's not at all something that we've invented. for example, you couldn't require, as rutan makes crystal clear, people to give money to a political organization. because money is not money when it's supporting speech, it is it is association with an advocacy organization. and the compelled association is something that this court has consistently condemned as basic to the abood itself said it's contrary to the most basic principles of the founding, which is to force people to -- justice ginsburg: mr. carvin, do i take it was something that justice breyer said. you didn't respond directly to it. he said if abood falls, then so do our decisions in keller on mandatory bar association, on student activities fee. do you agree that would be a consequence of your theory? mr. carvin: well, no. in fact, that hypothetical was completely eliminated by harris, which made it quite clear that neither keller nor southworth

was in any jeopardy, because the rationale of those cases was significantly different than the rationale of abood. justice kagan: those cases -- mr. carvin: keller -- justice kagan: start with abood, mr. carvin. those cases say abood is the framework, and those cases decide the questions that they decided specifically within that framework. mr. carvin: a lot of cases cite cases, but the question is -- justice kagan: it's not a cite. it's a -- this the way we look at mandatory fee cases. mr. carvin: again, i must respectfully disagree. they do have that in common at that level of generality, but there's a key distinction, as harris, itself, pointed out, between giving money to a bar association, and giving money to a union. the key thing is that the bar association is a nonspeech restriction. it's like what the court said in the glickman commercial speech context. the initial association has nothing to do with speech. there, it was regulating lawyers, not advocating on behalf of lawyers. and if those -- justice kagan: bar associations do things all the time that lawyers disagree with. they engage in certain kinds of litigation and not other kinds of litigation. they take public policy

positions on certain issues and not other issues. i mean, i think it would be impossible to make a distinction along that score. mr. carvin: keller struck down those kinds of activities by bar associations, taking positions on federal jurisdiction, taking position gun control. it said they could only spend money -- justice kagan: do you think bar associations do, now, nothing that members of the bar could disagree with and find hostile to their own views? mr. carvin: if they do it, and if it's not germane to lawyer ethics or service, then, by definition, it's a violation of keller. so i sure hope the bars are not violating the clear pronouncements of this court. the keller only upheld expenditures that are a necessary incident to their principle role of regulating lawyer ethics and legal behavior. all of the other things that were law related were struck down in keller. so that is not -- justice kennedy: any jeopardy, if not -- justice scalia: i think that we're talking about two kinds of bar associations. i mean, voluntary bar -- mr. carvin: oh --

justice scalia: associations get into a lot of those other things. you're just saying that those bar associations that you're compelled to join as a condition of your practice do not get into those things. mr. carvin: oh, absolutely. if they required me to join the aba, i would have an absolute first amendment right not to do that, because virtually every word out of their mouth i disagree with. justice kennedy: mr. carvin -- mr. carvin, i see i see your -- i see your time is running. could you address briefly the opt-in opt-out requirement, an issue which, i take it, is in the case, regardless of the way we rule on the issue we've been discussing? mr. carvin: it certainly is, your honor. and that's because the only it will only affect the amount that you need to opt in or opt out on. and my short answer and i am running out of time is, if this regime is upheld, that means tomorrow the state of california could say every public employee contributes 1% to the governor's reelection campaign unless they affirmatively opt out of doing so. no one thinks, realistically, that's a voluntary decision to

give money. there's only one purpose behind that kind of requirement, which is to inflate the governor's political war chest, just like the only purpose behind this is to, through inadvertence and neglect, inflate the union's war chest by people who really have not made a voluntary decision to do so. unless there are further questions, i'd like to reserve the remainder of my time. justice roberts: thank you, mr. carvin. general dumont. mr. dumont: mr. chief justice, and may it please the court, california understands the first amendment interests that are involved in this case. but the state also has critical interests in being free to manage the public workplace, much like a private employer, unless we are improperly leveraging the employment role to coerce or suppress citizens'

speech. so let me try to briefly address why i think, if we are going to have collective bargaining in the public sector, mandatory agency fees can serve important state interests without unduly burdening citizens' speech. justice alito: before you get -- mr. dumont: if -- justice alito: before you get into that, could i just ask you a preliminary question that came up earlier in the argument? do you think that the california teachers association is an agency of the state of california? mr. dumont: no. i think a union that becomes an exclusive representative, under the perry case, has an official place in the functioning of the school district. but it is not it does not become an organ of the state. and that's actually a very important point. precisely because of the company union concern, what's delicate about this, from the state's point of view, is that we want if we're going to have collective bargaining, we need to have a system where there's one representative that we can deal with, and that representative has to be both a

good partner for us, from our point of view, but also perceived by the employees as representing their interests, which is why -- justice roberts: but it's not -- mr. dumont: we can't take it over. excuse me. justice roberts: no. go ahead. finish. mr. dumont: well, which is why it's very important that we not fund it directly, and that we not be perceived as controlling the speech of that representative. justice roberts: it's hard to visualize this in a pure employer-employee relationship, when the collective bargaining agreement, itself, has to be submitted for public review and public comment. that suggests that you're doing more than simply regulating the employment relationship. mr. dumont: well, the public employment context is certainly different from the private context, and that's one of the important ways. we don't contest that. but i think the question is, before you get to the final legislative approval or board approval stage, what kind of system can we have, legitimately, that will be a workable system, both for our employees who overwhelmingly have shown they want collective

bargaining, and for the local managers, the actual managers of local governments, of school districts, or of state agencies who need to have the practical problem of reaching an agreement that will govern -- justice roberts: if your -- mr. dumont: their workplace for a period of time. justice roberts: if your employees have shown overwhelmingly that they want collective bargaining, then it seems to me the free-rider concern that's been raised is really insignificant. mr. dumont: with respect, i disagree with that. because many people can want something in the sense they view it as very advantageous to themselves, but if they are given a choice, they would prefer to have it for free, rather than to pay for it. this a classic collective action problem. so when we -- so from the employer's point of view, when we're going to have collective bargaining, we want one union to deal with. we want that union to deal with all employees. and so we require it to represent all employees fairly, whether they supported the union or not. they might have supported the rival unions. they might be in favor of unionism, but they supported a

different one. but once the majority has said this our representative, then that is going to represent all employees. and it's important then, from the employer's point of view, that that representative be adequately funded and stably funded, so that they can work with us or work with the employer to reach actual progress. justice kennedy: but it's almost axiomatic. when you are dealing with a governmental agency, many critical points are matters of public concern. and is it not true that many teachers are strongly, strongly disagree with the union position teacher tenure, on merit pay, on merit promotion, on classroom size? and you -- the term is free rider. the union basically is making these teachers compelled riders for issues on which they strongly disagree.

many teachers think that they are devoted to the future of america, to the future of our young people, and that the union is equally devoted to that, but that the union is absolutely wrong in some of its positions. and agency fees require, as i understand it -- correct me if i'm wrong -- agency fees require that employees and teachers who disagree with those positions must nevertheless subsidize the union on those very points. mr. dumont: and let me what i'd like to do is to separate out the important public policy issues, which we do not deny crosscut between the public's fear and the realm of citizens' speech and the isolated collective bargaining realm. they do crosscut, but that does not mean that the two spheres are the same. so in the collective bargaining context, what the employer needs