territory in the 1960's, 1970's, 1980's, when some republicans did not want to be identified leader andparty lik many democrats did not want to be identified with their party leader. when richard nixon was reelected in 1972, he carried, i think, 389 congressional districts against george mcgovern. half of them voted for democratic congressman. so, the americans are capable of splitting tickets if they want to. in this context, i think turnout is going to be important. we had a surge-increasing surge of turnout during the george w. bush presidency, including the 2006 and 2008, a repudiation of the bush presidency. we have had declining turnout during the obama presidency, particularly of democrats, but not any surge of republican turnout. i have been of the view that the fact of republican turnout was a lot bigger in the primaries this

year and caucuses that -- than democratic turnout has, perhaps, some significance for the general election. and others in the 538.com website, for example, have pooh-poohed that and said in 1976 it didn't. i don't think that's relevant. i think, i think it may still have something, but i don't feel i have any confidence how it is going to work out there. in my initial presentation, i mentioned the rules for both parties. if you look at if the democrats had rules like the republicans, which include winner take all primaries, hillary clinton would be ahead in delegates 2-1. the bernie sanders campaign would have disappeared almost as much as the john kasich campaign disappeared sometime ago. ms. bowman: henry, a quick comment, and then a question. mr. olsen: with respect to turnout, i have been looking at

purple state turnout, and with the exception of ohio, and also with the exception of pennsylvania, republican turnout has vastly exceeded democratic turnout. we have two competitive races, and if everyone who cast the republican ballot in the primary cast a republican ballot in the fall, the democrats would need to win between 53-60% of t carry -- 53% and 60% of the remaining voters in order to carry each of those states by one vote. i think that's the promise and the pitfall of the republican party is that, of course to put that coalition together means to put those three factions together in a coherent way, and the reason why trump may not win is precisely his inability to do that. i do think it indicates where a unified republican party could go, which is it would be actually hard for a democratic party to respond when you have 50% of the general election voters in the state to are

actively considering themselves republicans. we have never dealt with that in our lifetime. ms. bowman: all right. now we are going to turn to your questions. i should tell you that cnn has come out with its first matchup. it is 54%, clinton, 41% trump. 13 points. double-digit lead. i should point out that that handout will be available to anyone outside, and we can e-mail it to anyone. we'll be updating it throughout the summer. joshua myers: could this be the year the libertarian party breaks 5%, and could that have any long-term consequences? >> my initial answer is no, and why would libertarians want government money? [laughter] ms. bowman: right here.

larry: thank you, very much. we're talking about the soul of the republican party here, and it is my opinion, and i may speak for some around the table here, the real issue is out is the party going to coalesce around this person, or are we going to coalesce around america? i think this is not a condition where we should be -- the party is second to the country and i think most of us agree to that. i would just like to know, most of you said there was going to be some coalescing around this man, even though they said some very negative things about him in the past. what can we see for the party if that becomes the norm? ms. bowman: another question is what should the never trump movement be doing now?

mr. barone: your point of view is clear -- clear from the question. they shouldn't coalesce around trump. i think he will get less coalescing than other republican candidates have gotten, but i think he will get more than the tenor of your question suggests. we have people like bill kristol, the editor of the "weekly standard," talking about a third party as a kind of bases for republicans to vote for and to come out and vote for so they will come out and vote for republican candidates, in the senate and the house, and so forth. i think that -- i suspect not a whole lot is going to come out of that, and so forth. it is obviously a different situation from which we face where both parties have nominated candidates in recent cycles who have been widely acceptable to the party's

constituency, and the question is how much of the party's constituency considers trump not acceptable, and does trump add some people in the contest to compensate for that? my view is he is probably unacceptable to fewer than the tenor of your question suggests, and the number of new people he brings in his fewer than the anti-trump people would suggest. mr. fortier: i think there will be a fair amount of coalescing. the anti-trump forces don't have a lot of places to go. i think there are several dangers. if after the convention there is some coalescing, and i do not put much stake in the matchup

polls at this point, but if the matchup points show trump by a lot, the lack of and is you is or might be very strong. i do think there is a natural place to go, and the natural tendency is to come together, but if it is not enough, that will show in late-summer, early-fall. mr. olsen: i think you will see a lot of pivoting. newt gingrich, who has set a lot of nice things about donald trump, has won -- one part of the mantra -- we cannot allow heather clinton to transform the supreme court into a liberal court that will change the -- hillary clinton to transform the supreme court and change america for decades and others will be using the mantra anything will be better than hillary clinton. my guess is some people will coalesce around them. there is some that won't. that is true of people outside of the political arena, but i would bet the best -- vast majority will fall in line, and

they have to live with the consequences. one part of this is when they do the second autopsy, and this time it will be a real dead body, most likely, it will be back to the same set of issues. how do we expanded base the aunt angry, white, working-class voters? and if you have an immigration position that has taken you so far away from that, and a rhetoric that is going to so alienate the growing forces in the electorate, you are in trouble, and that is going to be a battle that will follow, but those who fall in line are going to make it much harder to have that battle won by those that think you need to broaden your base. ms. bowman: we have a question in the back, then mike gonzalez in the front. >> thank you, gentlemen. i was wondering if we could move to discussion about split-ticket

voters. there was a poll that 50% of clinton voters in ohio are still going to vote for portman. i was one if you could speak to how the gop could target these split-ticket voters, and what the strategy should be involved to motivate them to vote for gop senators. ms. bowman: split ticket. mr. barone: if you're running rob portman's campaign you talk about his campaign, his legiation against opioid abuse, which is a real problem in parts of ohio. you do what others have done for 40 years when they sense the party is not strong or might be unpopular with significant parts of their electorate. emphasize the specifics of those issues, the character of the candidate, and things of that nature. voters are capable of splitting tickets, they just haven't felt the need to do so lately.

you know, given the choices before us, they may -- you know, it is quite possible they will need more, and i do not think they really need a mechanism of a third party, which is not going to be competitive anyway, to bring out voters for down-ballot people. mr. ornstein: one of the challenges for mitch mcconnell, the expectation was they would have a robust record to run on, and they could say keep us in power. look how we are le to act legislatively. this is a congress that left without dealing with the zika virus, which is becoming a hugely -- a huge epidemic in the country, without dealing with puerto rico, which has gone past the deadline for a budget, is

not going to do a budget, which appears to have difficulty doing an appropriations bill, and is not acted as a congress on the opioid legislation. if they cannot get much done, that is a slender reed for people to run on. mr. olsen: this is a party that remains mired in the past and a repeat of the 1992 campaign where it appears that dole is going to lose. don't give him a blank check. that would be a way to take care -- put her innton the white house, but don't get her a blank check, vote republican down ballot. ms. bowman: go first to you, then mike gonzalez. >> my question is to henry. how likely do you think is the possibility of unifying these different factions of the party, and you mentioned immigration and nationalism, but there is one strong message of trump,

which is the anti-trade and anti-globalization message. how do you put it together with the business conservative coalition? thank you. ms. bowman: mike gonzalez has a question, and then in the front. mr. gonzales: very similar to the question you just asked. i'm mike gonzalez from the heritage organization. henry, i would agree, that a yearning for national identity, not nationalism, is the important thing right now. it could be the theme around the different factions build, but how does that take place? how does the reckoning happen? if trump wins, obvious, the populist will be ascendant, and everyone will have to glob onto them, but let's say trump loses. there has been so much self-incrimination, how does the ship up look?

ms. freeman: do you think the republicans might consider -- reconsider their opposition to the barack obama nomination to the supreme court? now that the alternative is a nominee hillary clinton or donald trump, and the possibility of a democratic senate doing the confirmation? mr. olsen: the possibility of unifying the gop -- that is a matter of choice. if people want to find peace and hang together, they will find a way to do so. if they think that it is better to try and continue the warfare to try to engage and have your faction be dominant under the

misguided belief that somehow you can put together a national majority by having only two prongs of the stool rather than three, then we won't unify the gop, but it is a matter of choice from other different factions, and i can't say what the probability is of that, but as far as the possibility i think you have to have a unifying message that forces around national identity, but not week national identity. one that embraces a limited, but active role for government to care about people like me. that's essentially what the plea of the trump voter is, that you have not cared about a person like me for decades. and that's always been the weakness of the republican party. republicans do well at saying we care about people, but have a really hard time saying people like me. with respect to how do you do this, i think what you need to do is you need to do an immigration policy that's more like australia and canada that says we need immigrants but we are going to decide who they are

and bring them in. canada has a larger share of foreign-born population than we do, but they do it by choice. australia's conservatives dealt with immigration by saying if you are a refugee come in here by boat to try to land on our territories, you're not going to be admitted to australia. they, too, have a large immigrant population, but it is not one that places the foreigner ahead of the citizen. with respect to trade, what you need to do is stop treating people who are indirectly harmed by trade as collateral damage in the willy-nilly pursuit of globalization, and what that means is a tony blair-esque view. that means a more robust system and an attempt to bring people to work.

i think we need to rethink our social safety net, that, on the margin, says that if you are of low skill, you will get a handout. we will do nothing to help you get really back on your feet again and support you and help recover some of the income you have lost because of the jobs that we have encouraged south koreans or burmese to have. a republican party that is portrayed, but for a serious way of accommodating the people that are dislocated by trade, letting in the immigrants that we need but only the immigrants that we need, i think that could unite this wing. it requires choice and compromise. that may be something that certain elements of your republican party are unwilling to do. after the debacle of 1964, it was not just party leaders like nixon who said we had to

accommodate the goldwaterites, it was the goldwaterites who said they had to stop trying to overturn the establishment. that is when new strains of conservatism came in and buckley moved to the most electable conservative model. >> i was going to say, on immigration, it would be interesting if the scenario that norm talked about came to pass, the democrats had majorities in each house of congress and the presidency, whether they would bring forward immigration

legislation, which they did not do when they had votes to pass the so-called comprehensive bill in 2009 and 2010. from a democratic point of view, you would have the potential to legalize 3 million or 4 million net democratic votes. they may be fearful of blowback. i fear they would not do what i think the country should do, which is have a system emphasizing high skill immigration like australia and canada. the democratic party, on the supreme court, is obviously totally hypocritical. the idea that a democratic congress in the eighth year of a republican president would confirm a republican appointee to a democratic appointed supreme court justice is absurd. they would not do that in a million years.

the republicans aren't going to do it. if hillary clinton is elected, and particularly, if democrats get a majority in the senate, i would expect judge garland to be confirmed in december. they would have to eat words to do that. judge garland is a decent sort of judge. he is unlikely to roll the way republicans would like on a lot of issues. >> they are in a box right now. if you noticed jerry moran, a very conservative senator from kansas who is up for reelection, he said, we ought to hold a hearing. the club for growth and others came down hard on him and said maybe it was time for a primary challenge. the next day, jerry moran was saying, not only should we not hold a hearing, but this guy is a dangerous leftist. that is the problem that mitch mcconnell has. if we get to october and the cnn results are still what we have, it is going to be a debacle. republicans are looking out there and believing that very possibly the day after the election, president obama said

the voters should choose, so i am withdrawing this nomination, and i will let the next president, hillary clinton, pick a nominee. they may well come in october, and especially if chuck grassley is underwater in iowa, go ahead and confirm. if he kept t nomination, i think it may happen in a lame-duck. what i think is happening now is republicans in the senate having said, we should let that go. that wouldn't filibuster for an extended period of time, any nominee from hillary clinton. we could end up with a 4-4 supreme court for a significant time. but we could have, and i could see this playing out through much of 2017, is yet another change in the filibuster rules. i don't thing that would happen until we get eight or 10 months

of a filibuster. that would be unfortunate. >> i do want to disagree on the merrick garland issue. i think it is very unlikely that republicans will go back on this, no matter how badly they are doing, and confirming somebody in a lame-duck or early on during the election. there will be opposition to a new nominee by hillary clinton or perhaps more than one nominee. you have the potential for other nominations either from resignations, especially on the democratic side. there will be intense pressure to fight back. i think the filibuster is always under stress there. there is some pressure to get rid of the filibuster as they have for lower court justices. ms. bowman: we have time for one more lucky questioner.

in the meantime, political corner is going to be having some special events this summer. in september, this team will be back, and in october, and on the thursday after the november election. >> can you please explain why the system allows different levels of social classes to vote. you have a class system -- why would every level of criminal activity be allowed to vote? >> i'm not aware we let every level of criminal activity vote. we just saw and executive action in virginia, which is perhaps of dubious legality, to have convicted felons who have served their sentences to vote. i think arguments could be for and against that as a public policy.

we have sort of gone from manhood suffrage, which meant white men basically, as far back as the 1810's, we moved in that direction. i think that, despite some lament over results in recent years, and each of us perhaps as our different lists of lamentable results, we are not going to go back on that. mr. ornstein: i have long been a supporter of something that will not happen in this country, which is the australian system of mandatory attendance at the polls. in australia, you don't have to vote but you have to show up, and that makes you subject to a small fine if you don't. this gives them 90% or more turnout. belgium has this as well. it does not create disaster. there are always questions of

whether the least informed are out there voting. the fact is, most people who vote are very little informed. it begs the question of what do you believe by a republican form of democracy? i believe in enhancing the electorate. we had a literacy test at one point, and then not sure i want to turn that into an iq test. frankly, there are a lot of people we know with very high iqs that i would just as soon not vote. >> brazil, which is now in the process of impeaching its president is on the list of mandatory voting countries. of course, we have impeached president's in this country as well. ms. bowman: we're out of time. join me in thanking the panelists. [applause] the handout is at the reception desk and we will be here for a few more minutes to answer any additional questions you have. [captions copyright national cable satellite corp. 2016] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy.

visit ncicap.org]

>> road to the white house coverage continues today with donald trump. he is in west virginia, where there will be a rally in

charleston, the state capital. there are 34 delegates at stake. like coverage begins at 7:00 p.m. eastern with donald trump here on -- live coverage begins at 7:00 p.m. eastern with donald trump here on c-span. secretary, we probably give 72 of our delegate votes to the next president of the united states. ♪ [applause] >> coming up next, a discussion on the future of children, and how climate change impacts kids

professor talks about the rising temperature, and a link between climate change and the zika virus. mr. haskins: welcome to brookings. i am the codirector of the center on children and family. we study kids, obviously, and where incident poverty issues and issues of economic mobility.

i am also an editor of "the future children" which we published twice a year with colleagues from princeton. sarah is the editor in chief, and the managing editor jonathan wallace is here in the audience today. jonathan thank you for coming. , you're primarily keeping an eye on us, i think. whenever we release a item, which we do twice a year, we write 3,000 word policy brief about some issue that's covered in the volume and we try to pick , an issue that's related to public policy. then, we have a public event thatnnounced the release and announce the -- public event and announce the release of the volume, and give an overview of the volume. that's our purpose here today, thank you all very much for coming. here is the program we are going to follow for the event today. first, after i get through janet

currie, who is one of the senior and theof this volume, professor of economics and public affairs, at princeton -- i am not sure how she sleeps. she does all of that stuff. i am going to give a brief description of the policy brief and tell you what the argument of the policy brief is. our event is organized around the policy brief rather than the entire journal. human time will talk about the journal is -- the only time we will talk about the entire journal is in the beginning. then we are very fortunate to here, to talkubar about administration's proposal on the zika virus. joined on a be panel. a panel of four people will discuss several issues that have come up, and we will give each of you a chance to ask questions of the panel. barreca will participate.

that is the plan. genet. -- janet. ms. currie: thank you very much, ron. this starting point is the idea that climate change is centered around the effect on our children, but we are not specific about what those effects might be, so the volume is to get more effective -- specific on what the effects of climate change might be on children. there are four broad themes. this isrtant theme is no longer something which we are speculating about. this is something that is already happening and will continue to happen, and it is

going to, and is already, affecting children's health and well-being. children are likely, for various reasons, to bear a disproportionate share of the brunt of climate change. children, children in developing countries, and especially children in countries that do not have very strong institutions are particularly at risk. although we know this is already happening and wil continue to happen, we still have a lot of uncertainty about exactly how bad it is going to be. that depends, in part, on what we do. the fact that there is this uncertainty, and also that the costs and the benefits are in the future, and also that they are going to be very unevenly distributed, i think makes the politics surrounding climate change particularly difficult.

off justgoing to start with this article, which many of you may have seen. it appeared in "the new york times" yesterday, and i thought it was perfect for this presentation because it hits all the themes i have talked about. climate change is already happening. as you can see here in the united states, we have our first climate refugees, who have been moved off the island that has lost 90% of its landmass and most of its trees because of salt coming up through the water table. so, 48 million has been million has $48 been allocated to move people off of the island to different locations. you can see literally the poster child of the article is a 3 --year-old girl whose family is

going to have -- three-year-old girl whose family is going to have to move. this is a poor community. this is a native american community, illustrating again that it is a poor that are most likely to suffer. then, on the political front, even this relatively small and well-defined thing -- let's take these people on a sinking island and move them somewhere else, is still, kind of, a heavy lift, and fraught with various difficulties that are discussed further in the newspaper article. so, in terms of what this volume covers, we start by talking about the science of climate change -- what is known, what is not known. having set the stage, with an focus on temperature extremes, which are one of the most obvious implications of climate change. children are particularly vulnerable to health effects of

high temperature, which is one of the many ways in which climate change affects children. we talk about climate change and conflict. there is a growing body of evidence that high temperatures are related to conflict, in part because they can have severe economic effect. so, in parts of the world that are prone to conflict anyway, if you do things that threaten farmer's likelihoods, that makes it more likely there will be an armed conflict. we discussed natural disasters and effects on children. again, that is one of the things that is expected to become more common due to climate change. we talk about pollution and climate change, which i will go into a little bit more detail about in a minute. climate change in developing countries, which is a particular problem. and then we talk -- it is a little more technical, not just

a little about how we measure the costs and benefits of climate change. a lot of the standard ways economists think about things are quite difficult to apply when you have something that is going to have -- take place a long time in the future, and also where there is substantial uncertainty, and that, i think, be doubles efforts to talk about this in a really rational way. then, finally, we come back to the political problem that it is so difficult to mobilize effort to combat climate change. ok, so, looking at temperature, this figure, which is from the chapter on temperature, shows the number of days over 90 degrees that are expected in four u.s. cities. 2001, 2010.r is for that has already happened.

the next graybar is 2046-2055. the black bar is the end of the 98-2099.20 what you are going to see is it is going to get even hotter in houston, although it is pretty hot in houston already in the summer. maybe, arguably, people in houston are used to dealing with that. if you look at kansas city and new york, the two middle sets of bars, you have a really big .ncrease in expected hot days so, in new york, it goes from 10 days in the summer to 70 days in the summer by the end of the century, so that is a big change. then seattle comes off relatively easily with an increase to only 20 days of really hot weather. so, this is just illustrating how the cost of climate change, even within the u.s., will be unequally distributed across regions.

that wee of the things could do about climate change in the short term, which will also have some benefits in the short by, are reducing pollution for example, switching more to renewables from fossil fuels. so, this table here, which is based on the projection made by the intergovernmental panel on climate change -- the production -- projection a1b, for those of you that follow these things -- is based on the idea that we use more renewables. and if you just look at the far right column of the table, there is an estimate of how much the switch to renewables would reduce infant mortality by reducing particulate matter. so, this would be a benefit of something that would affect climate change in the longer

run, but would have a short-term benefit on the ocean. you can see these benefits are also unevenly distributed. so, -- pollution. you can see these benefits are also unevenly distributed. and the south east you would have a decrease in infant mortality. in the northeast, you have a fairly large decrease. in the west, not so much. this figure is just summarizing what is in that column, showing the decreases in infant mortality that are projected by to doingmpared nothing, which is the light gray bars. similarly, infant mortality is obviously very important, but one reason why it is important is it is a more general marker for child health. the same things that reduce infant mortality are the same things that will increase people's health in the long term, and help your people will have higher earnings, so this

projection is projecting that earnings would also increase in the same places that had the biggest decreases in infant mortality. now, moving a little bit from the u.s. to the rest of the world, this figure is just showing particulates for one u.s. city, pittsburgh, where we have data over a long period of time, and we all know the air to be really bad in pittsburgh, but it has really improved over time, and showing by way of comparison, numbers for the same particulate matter of pollution for mexico and for china. and see things have also been actually,in china, but they started at a much higher level, so people were being exposed to really bad air. so, again, anything that affects pollution and also affect climate change would be a win -win in that it would have both

short and long-term affect on people's health. staying with the developing countries area, i mentioned a little bit about the research on conflict. this map is showing the horn of africa, which is a place that has a lot of conflict. is ae left, what you see map showing how much change in temperature that has been sent 2009.-- since 1991 to you can see even within that relatively small area, there are some places having even more temperature change than other places, and then using that kind of variation, the authors of this study, which is summarized in the chapter on conflict shows that you would expect to have both a short-run and a longer-term increase in conflict as a result of the temperature change.

so, turning again -- this is a, kind of, rapid walk through the volume, but turning to the chapter on cost and benefits, this table illustrates one of the problems. so, what it is actually showing is the solid line being a projection of economic growth -- not paying any attention to climate change. so, standard economic models that forecast economic growth don't usually take climate change into effect. so, we think that growth continues, and in the future we should all be richer. line is showing what happens if you have catastrophic climate change, and the interesting thing is that nothing happens immediately. it is happening at the end of the century, and then you have a

decline in real consumption compared to business as usual. ok, so this is one of the things that makes climate change a heavy lift in the sense that if we do nothing today, nothing will happen tomorrow. it will happen in the future. then, another issue with respect to thinking about costs and benefits is the issue of what discount rate we should use in the future -- that is how much should we value things that will happen in the future relative to today? onyou look at the numbers the far right, it is showing a 5% discount rate, which is really standard, and what that says is we do not value at all 2200, because that is too far in the future to care about. in order to have a discussion about climate change, we also have to change the way we talk

about future costs versus benefits to take into account the needs of future generations. ok, so i just wanted to make one comment about the heavy lift. to talk about one particular example, the waxman-markey bill of 2009, which was not passed -- so, 2009, only seven years ago, already seems like a long time ago -- if it had been passed it would have reduced carbon emissions by 83% by 2050, so that would have made a really significant impact on what is going to happen in the future. now, of course, it wasn't passed. after going through the house, it didn't make it through the senate. and -- so, this is just one illustration of a history of

failure to address the issue. so, that is all i have time for. you would like to take a look at the issue, i think you can get copies at the back, or it is all online at this website. [applause] mr. haskins: thank you, janet. i appreciate it. as i said before, whenever we published a volume twice a year, we write a 3000-word policy brief trying to seize upon some issue that is implied in the volume, but to play it out a little bit, especially in a policy sense, and we try to pick things that are actively under consideration in washington, and we were quite forward -- fortunate this time that zika appeared. it is unfortunate for people's health -- we do not know the extent yet, but it certainly

does lend gravity to this event and this issue, and it makes our point, which is there are a lot of implications here for public policy, especially for children's health. so, we will learn a lot more about zika in a few moments. so, here is the logic of the brief. temperatures are rising. janet already covered things. i am going to mention a few other things i think are interesting. rising temperatures have impacts on children's health. there is a whole chapter that goes into that in some detail, and one of the indirect effects -- paths is through infectious illness, which a lot of people might not think of as being related to environment, but i will show you how that is the case. zika is a great example of that, and i will talk about why. in doing so, we will focus a lot of attention on the 1980's egypt time mosquito, which is a

strange creature that has all sorts of habits that make it unlike other mosquitoes, and some of it there on its vector, the means of transition. we are fortunate to have debra here to talk about the administration's proposal, and as is good in washington, we will have an argument about the proposal. i want to talk about temperatures. this is from the national oceanic and atmospheric association. if you look at it, the trendline begins in 1950, but it looks like it is starting to pick up around 1980, which is consistent with other evidence, and it has gone way out. years have been huge temperatures. i think 2015 was the hottest year we ever had, and we are on course in 2016 to repeat that. so, temperatures are going up, and especially -- this is an important point.

this is a difficult draft. greatoubtedly have experts that understand this stuff, but for a normal person, what has happened is the red is temperatures, and the white is normal distribution. and what is happening is that the temperatures are shifting up . the entire distribution of temperatures have shifted up. and an especially important feature of that is the details of the distribution, is increasing even more. so, we are getting even more increases in extremely hot days, usually defined as 90 degrees, or more often defined as 90 degrees or more. those are the one suggested pointed out can have a big impact on health, especially on infants. deaths show that infant rises at temperatures above 90 degrees. so, if projections are correct, these are really important considerations.

so, temperatures going up. it has an egg on children. it has direct impact -- it has an attack on children. it has a direct impact on infant effects,d indirect especially on vector-borne diseases. i want to focus on vectorborne decisions, and the vector here is 80's egypt i. it was said of this little mosquito, he loves us. it loves our cities. he loves our blood. it is a colorful statement of what this little guy is like. this guy is especially thirsty. mosquito carries a lot of infectious diseases, including yellow fever, dengue fever, and i have read several arguments about how you pronounce this word, but i'm going to say it with an

english-american way of saying it, chikungunya. there is a more fancy way to say it, but i could not master it. it carries all of those, in addition to the zika. is a very important means of transmission of disease two children. why is that the case, and why andwe concerned about zika the role of aegypti? there is some evidence that has the widest range now that it has ever had. places that have increasing temperatures -- many mosquitoes are more likely. it is easier for them to breathe, they multiply faster, and productions -- i think these are mentioned in the journal, but our journal is more focused on climate and children -- that say even in the united states we are going to start getting zika. quite a bit of expansion of territory is present in the southeast, but it will expand.

it breathes in and around standing water, which is extremely important. especially when it is hot, people like to have more water, and especially more traditional societies, they keep it in buckets and pals, and all sorts of things all around, and if that can be breeding grounds for mosquitoes and all sorts of other things. so, that is an important idea on what might have an impact, and has in the past, on trying to control insects, and especially zika, that you need to do something about standing water. also, a rising temperature allows the zika virus to , and therere quickly is a particular feature of this mosquito that i found fascinating. i did not know anything about this until i started reading into this. most mosquitoes bite you and talk up your blood, and they go away, and they do not bite another person. they are satisfied for a while.

this mosquito only takes a little bit of blood, goes to the next victim, takes another little bit of blood. they can infect several people if they happen to be carrying whatever they happen to be carrying, so this aedes aegypti is really a formidable weapon in nature's attempt to get us. it is after our blood, and it has the capacity to affect many people at one time. chan, they margaret head of the world health organization, in discussing the zika virus, she said it is the main cause of what she called explosive spread in the americas. i am sure she was referring primarily to south america. this, of course, raises the question now what? what are we going to do? it is not an emergency at this moment in the united states, but it is potentially a very serious problem. so, should we do something? and here to answer that question bar from the centers

of disease control and prevention. thank you so much for coming. you, ron. thank i am glad to be here, and i'm glad you set of our nemesis so well in the fight by describing the aedes aegypti in some detail. i am going to tell you a little bit about cdc, what we are doing, and what we need to do, and give a little bit of background about the zika outbreak. just a little bit about this great agency that i represent -- cdc was founded in 1946, and we were founded to deal with malaria, so mosquitoes are part of our origin story and continue to be part of the work that we do. we are in atlanta. we are the only, i think, federal agency headquartered outside of washington, which gives us a different perspective on life than many of you probably have.

so, our mission is to save lives and protect americans from health, safety, and security threats. and one of the interesting things about this outbreak has been seeing all of the expertise at cdc that we are able to draw on. a lot of times, when we are responding to emergencies, it is infectious disease outbreak and infectious disease doctors and experts leading the outbreak. in this case, we have really seen, across the agency, drawing on expertise and vectorborne disease, environmental health, birth defects, reproductive health -- i think we are a very usual -- unusual collection of people that are able to bring all that together to support this response. so, we base our actions in science, but we are very much a practical agency who is out in the field, and you will hear more about that. we work in partnership with state and local public health agencies. so, there is the public health

system in this country, and cdc is not in charge of it. that is an interesting thing about our work. a lot of the authorities for public health interventions are local and state-controlled, so i'm going to talk a little bit budget, because a lot of ovi do is fund and support the public health system in this country and around the world. we are all over the united states, even though we are headquartered in atlanta. this gives you a little bit of a sense of where we are. we have some very specialized labs around the country, and one of them that you will hear a lot san juan,y is in puerto rico, where we do our work on dengue and increasingly, zika. this will give you -- i'm just going to go through this very quickly. we are working on disease detection in general, polio eradication and measles immunizations, flu, still

working on malaria all of these years later. hiv and aids is a huge part of our footprint. we are training in partnership with other nations, and we are working across governmental initiative that i will mention a little bit later. budget is really complicated, and my job, which i should have mentioned, is running the office of appropriations. so, i work with congress and the white house on cdc's budget, which is why i'm here today to talk about the zika request. cdc is funded from a number of different sources, and this gives you a pretty big picture of what our money does and where it comes from, and i can answer questions about that if people want to dive in deeper. our core budget is about $7 billion that congress decides on each year. this is a budget history of your budget, and you can see 2013 was

low. you guys remember 2013 in d.c.. we had some sequestration, and things like that, but it has been relatively steady the rest of years. we are funded in these broad categories you see on the screen. something people do not really know or understand about cdc's budget is how detailed this is -- this is one page out of a five-page table where 160-ish budget-line items are presented as congress directs us to spend it. we are bound by that. ,t is one of the reasons that when we have emergencies and a need to surge, it can be challenging for the agency financially, and we are not always able to be as nimble as we would like. that is as one example relevant here, this is a budget history on vectorborne diseases.

line item for that. the name has changed a little bit over the years. you can see there was some growth there. you remember the west nile ,utbreaks of the early 2000's and there was some attention to vectorborne diseases in the united states. it has been, kind of, relatively steady since then, since the drop in 2007. that is the place where congress has this is how much money, you will spend this much, and only this much, on vectorborne diseases. we get that direction every year. so, zika comes along, and this is an overview of the transmission patterns. until the last few months we actually did not know about two of these transmission patterns, or transmission pathways. so, this is really a space where we are learning more every day, and we are more and more alarmed by some of what we are learning. we expect to continue to find

new -- hopefully new solutions, and also new challenges with this virus. the sexual transmission pathways and the pathway to the fetus are the new findings. -- which are related to other viruses, west nile. a is spread to the bite of --. this virus is not new, it was discovered in 1947. for 57 years, there were 13 cases reported. very surprising, there was an outbreak in 2007. year wend of last started to see huge spike in cases in brazil. authorities in brazil suspected

there were nearly one million cases. that is tremendous growth, and not what we expected. the other thing that we did not riskt was the significant to pregnant women. the efforts that you will hear is not a serious disease for most people. most people don't know they had it. and it might look like any other viral infection that we might get over. the tragic outcome has come for pregnant women. time in moreirst than 50 years that we have discovered an infectious disease cause of birth defects. it is really the first time the enemies get a bite could cause these lifetime consequences for families. it is also an association with guillain-barre. is section during

pregnancy. we have now determined it is a cause of microcephaly and other brain defects. fullwe don't know is the range of health problems that might result from this infection to the fetus. that is something we really do need to study. it will take time to see how children who may have been exposed develop. that is part of the work we are starting now and that we hope to continue with, some emergency funding. this is what we have been doing, what we have been able to do to date good we have determined the length of the microcephaly and guillain-barre. looking at other pregnancy outcomes, we have seen miscarriages and other things. we learn that sexual transmission is more common than

tension. it seems to be happening more than we would have predicted. there a lot more to be learned. here are some of the things we're doing. i hope you have all heard about our travel guidance, or particularly for pregnant women. we are working with clinicians so they know what to do was somebody in the united states who may have traveled. this is not an emergency yet in the u.s. lot of our early response has been to support those areas. i'll talk more on that. we have been doing a lot in the lab ignore -- laboratory diagnostic area. we have several different tests that we have been getting out to the public health labs around the country, that system where

it is not all cdc during the testing. we do a t of validation. we have been without -- developing new diagnostics that are easier to use and better at detecting. this is a picture that you have described well. i want to talk a little bit about the factors that contribute to spread. we have heard a lot about climate change. certainly vector-borne disease and being able to track where the vectors are happening are part of understanding changes in the climate. is it is not easy to determine what role climate might be playing. there are a number of other factors that are affecting the spread of the disease, including global travel and movement of infected humans and we have over

400 secret inspections in the continental u.s. -- 400 zika inspections in the continental united states. living conditions, i'll talk a little bit more about our very big factor. in terms ofibed standing water and urbanization. the disease reaching populations who have not been exposed before cause large outbreaks as well. there may be changes in the virus. our public health intervention, if we can get the anduitoes to just avoid us go to happy are, that would be a most excellent outcome. but that is not available. we are looking at one of these other factors. this is a really interesting case. this is spread of the same mosquitoes spread at the u.s.

and mexico border. is obviously these places do not have difference in climate and vegetation, but they are very much in the same place. but the living conditions are dramatically different. in see 4% infection rate brownsville, texas and 32% infection rate across the border in mexico. here are the factors are 85% of the homes in brownsville are air-conditioned and only 29% across the border. texas, you arein not crowded together. that is part of what we are seeing an puerto rico, infection rates that are close to what you would expect in that kind of an environment. travel.the map of air

this is right come back to the global health security agenda. the cdc is a part of governmentwide effort to include -- improve health around the world because of the connection that we have with the rest of the world, that we are all connected by the air we breathe, the environment that we live in and by the human connections andugh all of the travel trade that goes on across the world. underlies thet outbreaks that we see is to capacityer countries to respond and prevent diseases .round the world to strengthen that globally. that will help us -- ebola was a stunning example of how an outbreak in one part of the world can affect the global health and economy. effort, been a major

and is part of the ongoing public health capacity building that we are doing following the ebola outbreak. , thiso show you some maps is the spread. from 1950 to 2013 this is spread ofchikungunya. moving is part of this trend. you can see that these are fairly regular patterns. i want to talk about puerto rico quickly. where we have seen these outbreaks as the bellwether for the u.s.. chikungunya in 2013.

this is what we are seeing now in puerto rico, the top line is seek a --zika. you can see the dramatic increase in the third or fourth week of the year. this is what puerto rico looks like today. 600 locally acquired infections. their labs have done over 6000 tests. the have 6500 pregnant women with zika. lab needed a lot of support. rico, we lab in puerto have been and will to partner with them effectively. we are also helping with pregnant women and newborns to understand what the risks are longer-term.

here is the map. we have some concern about transmission. what i want to say about this map is this is the best data that we have. a lot of it is based on models and other things. we don't have really strong vect or surveillance. go out and confiscate a spirit we are hoping that one of the things we can do through this response is really improve tor surveillance and's country. mosquito.challenging that is why people call it the cockroach of mosquito. we have to do many things to try to control it. or is not one specific intervention that doesn't job.

rico, those efforts are focused on the homes of pregnant women. very targeted. it is not something that is affected -- effective if you try to do a communitywide. -relatedover 400 travel and sexually transmitted cases in the continental u.s. right now. we are working with state health those,ents to monitor and to provide clinical guidance particularly for pregnant women. i will get to the spending request. the administration has as congress for $1.9 billion in emergency funding. 1.5 of that is for the department of health and human services. talk aboutard me some of the work we're doing.

we really need to dramatically expand, and we need to do it before mosquitoes even hit the counter no united states. with someeady working toding that we repurposed work with all of the states, particularly those that appear on the maps. we know that we have seen limited outbreaks in the united states. we don't think we will have explosive outbreaks. vigilant about that. we need to continue to support puerto rico. we also really need to learn more. some of the things that we would like to get started on as soon as possible are some of those longer-term studies, to see if we follow babies born to women who are exposed to zika. what are some of the factors or risky for those women?

what are some innovative message -- methods and what are some better diagnose -- diagnostics. that's an overview. thank you. [applause] to hear fromike alan brekke from tulane. >> hello. thinking about ways for us to mitigate the health cost of climate change. today i was sure some lessons from my research on malaria, it is also transmitted by malaria.

we can see -- we will see how we can apply those lessons to zika today. i want to start in a nonfictional setting. in 10,000have a one .hance from dying from malaria you also have a one in 50 chance of contracting this malaria, it brings unserious fevers and for youvery challenging to go to work or school. if you happen to be a child who is born in a particularly bad epidemic year, where there are may haveria rates, you development delays in childhood, 10% less likely chance of finishing high school, 10% up inchance of ending

poverty. this is not the case in the u.s. today. there are the world, some 200 million cases of malaria every year. 500,000 deaths. it is virtually no chance of contracting malaria in the u.s. what can we learn from our experience with malaria? i should say that this fictional setting and taking to -- taking you too, is we will look at malaria in the united states. the u.s. in the 1920's and 1930's, malaria was a serious problem. what can we learn from our experience? you of malariar cases. they were very hard to record in the early 20th century this map shows places like louisiana, panhandle, mississippi delta, was the area where this was most

prevalent. 10 times higher than say in virginia. the south, malaria was a southern problem. , the south is also poor. zika.s also regarding it is another important lesson for our talk today, given our focus on climate change. shocking is revelation, warmer than the rest of the u.s.. i am from new orleans, and i can preach to that. experiment says malaria. sites, the mosquito populations rise when the temperatures are in the 70's and 80's. it has to be nice and warm. these are from lab experiments. what does this mean for us in the future?

noted, we will see the distributional shift in temperatures in the u.s.. we will even end up with more .emperatures in the extreme to put this into a nice and simple specific, climate change model predicts something like 60 -- 80ays of add agrees degree fahrenheit prayer the study that i have seen on the 1980's, they suggest though temperatures are ideal. that is suggesting that we will see increased risk of mosquito borne illnesses in the u.s.. ,ore risk in the south throughout larger parts of the year. also the risk of moving north. what can be done. a little bit of hope. malaria is not a problem anymore for the united states. what happened over time?

in the 1930's, malaria death rate was 10 per 100,000 per that's about the same level we debts through motor vehicle accidents. that's relatively high. that's a real number. they think the infection rate was 200 times higher than that. in the 1930's, malaria transitioned in the u.s. was relatively stable. and a big drop between 1935 1940. there are few things. being the new deal allocated a considerable amount of money to drain ponds, constructing better drains. something like tens of thousands of ponds were drained, and thousands of miles of ditches

were also better drained. this is the first thing that we think led to this drastic decline between 1935 and 1940. the second thing we think is that populations were moving out overall areas in the united states, where the context trained humans and mosquito was relatively frequent. and you take people mosquitoes and you separate them, you break the cycle of the disease. as part of the new deal, they paid farmers to follow their land, this led from a church is transitional way of sharecropping, where we had large numbers of farmers with small plots of land who ended up having to leave because there was no need for their labor. they moved to urban places or and it up moving north. that helped to break some of the cycle. i want to mention is where we don't have as much as evidence

for is that education was increasing over this time. start't account for the decline between 1935 in 1940. it wasn't until 1900 where people knew who malaria. site was caused by the mosquito. they used to think it was caused by bad air. earliest 20th century people did not quite have the grasp of where this was coming from. there might be some lesson here about how we can use education sicaduce the prevalence of zik -- the cdca came into being around. 1946. we began spraying for mosquitoes around that time after world war ii, because we knew to conceive this paris. ddt chemicals, very powerful

chemical. it wasn't the sprang back caused this massive decline. old-school technologies ended up having a sizable affect on the mosquito borne disease in the u.s. , one southernngs states are more risk, i would expect children to be more volatile -- but normal. climate change will increase these risks. 60 additional days in really hot temperatures, and some -- i don't want to say that these are the magic zikat to solve the problem. to think about spring the powerful insecticides, if there were some s effective tools we can draw on from the past, we

could think about another drainage, economic development possibly drawing people in from subsistence farming and to an urban environment. we could also think about teaching and educating people about the ultimate cause of zika . the final thing i want to leave you with is a quote by the dalai you think you are too small make a difference, try sleeping with the mosquito".

>> thank you for the most great presentations. i really enjoy them. first, i'm going to ask a few questions here it i want to talk about timing. ofthe journal, a lot articles about what we can really expect for nations to change carbon emissions. that, which is no

means certain, how long would it take before you begin seeing impacts. the mosquito, the spread of illness, all the various effects that are shown to have an impact . how long will it take? >> i can talk about that. when of the problems with talking about climate change is that there's so many timescales to be aware of. scientists say now that even if we cut carbon emissions to zero tomorrow, temperatures wilson keep rising for a while. we are already on that half, and we will haveth and to start dealing with it. we probably won't see a but weon in temperature, want to see a but it doesn't

keep increasing anymore will take a while. there are some things like reducing pollution, which will have an affect on climate change, but we could say a -- seem more immediate benefit. it also has a more local benefit, if you are a diverse particulate matter in washington dc, people there will benefit say in the next decade. then the timescale we are talking about for the zika virus, that is where we need to respond right now. we wish we had responded yesterday. that just makes it difficult, because you have to juggle all these timescales. >> here's another time-related question. i am fairly new to this question

questions are coming up a mile a minute. one thing about this area that is interesting and public open general, is that a lot of things haven't happened yet that you're worried about. those are hard to convince people that they ought to watch out because this could happen. it is also difficult to convince congress that we are to spend money on things that didn't happen yet. this is a problem with this whole area of trying to get people compared for what could happen for one or five or 10 years from now, with pregnant women, that's a great example. we don't really have great information from brazil yet. how do you deal with that? what are the conclusions we should draw from this?

convince policymakers that this is a big threat, and you better take care now or you'll be sorry later. that how we market climate change, we always talk about it in terms of these one and two degrees celsius december, if it is it's hard to feel that is a bad thing. that's whatto do -- i think is important to emphasize, coming up with these metrics that are really easy to feel. a lot of hot days we will experience. days are we going to

experience that are above 80 or 90 degrees fahrenheit. feel whatcember, i that's like. a huge challenge for public health in general, and not because we have to get people to pay attention to things that haven't happened yet. when we are successful, things don't happen. it is hard to point to the successes as well. health, theypublic feel like it is invisible because the only time people has been i think zika an interesting example because it has been creeping our way. where theremething is huge person to person ebola, wherelike people wear afraid that if we had even one case in the u.s. that we would see something very germanic happen. that they are recognizing the seriousness of

this issue, and seeing what is happening in puerto rico has moved people. beenhopeful that we have effective in communicating what the risk is. up the same time, the risk to the continental united states we think is fairly limited in terms of person to person, it mosquito transmission on the continent. ,e don't want to alarm people and bedo want to have able to target interventions and prevent as many cases of pregnant women as possible. >> one of the things i think we have to discuss briefly, this seems different from other mosquitoes.

one of them seems to be that it is hard to kill. a lot of things we have done in the past, especially spray them and spray in areas like we was right in a forest when i have an impact. sprays,annot use doesn't that limit our -- they will be less effective -- the most effective is going to people's houses and spray their house, which a lot of people will resist. that is not often table, but not going to be a major method of control. what are we going to do and control the spread and kill the mosquito in areas where worried about? drainage, attacking them at the source. cannot breathei in small pools of water, this is an informational campaigns to just be mindful around your house. if we can stop that part. this probably suggest going into

developing countries where there is this problem. that's where the returns will be, not necessarily in the south of the united states. the returns will be higher there with educational campaigns. the u.s. had yellow fever up till 1905, and it was a problem in new orleans. despite --red it with educational campaigns. it was an important trade town. they thinkespond if it is their health or the health of their children, that's a motivator. >> what is happening in puerto the behavior change and wearing on clothing and staying , are focused literally on the pregnant women. we have been working with puerto too department of health

identify women who are at risk and working with the health department to bring the spring to their homes, screening the windows, provide individualized p --acks onpacts things they can use in their home. it is very targeted. spring, by itself is not going to solve the problem. >> i want to talk about the and policy.on, this is an interesting case. i had the opportunity of talked to several people in congress, wrist -- republicans. here is what i think the situation is. i have not heard republicans oppose the administration, not saying we don't need this proposal, not saying this is not

a big problem. they are claiming it is not an emergency, and that the administration should not pay for his proposal, the administration should increase or cut another benefit. then they suggested using my from the ebola fund. how do you respond to that? it is the case were republicans not opposed to the policy, they are opposed to the financing. how do you think administration can respond to that? >> the administration requested it designated as emergency spending. our position is that it meets the requirements. it is necessary to protect the health of the u.s. and others around the world. this was sudden. we were not expecting the spread

of this disease and your brazil another did countries. it is urgent that we act. this is a temporary surge that we need. there are some longer-term , but inhat we need general it is a temporary surge. for us it meets the criteria. my daughter was doing her homework and she said i have all these questions -- i said i have all these questions from congress and brown -- about zika . she said of course you need money for zika. but she said why don't you just use your ebola money? she going to grow up to be a republican. there, we cannot

stop working on ebola. we have had recurrences and flareups that have created the .eed the reason we are finding this is because of our continuing work. the way our budget is structured, we are asking to something.s we had to repurpose funding temporarily, and we are hoping we can replenish that. that is part of the proposal. think that public health spending is underfunded. the responses saying, we have so let's take money

away from something else. it awayuld you take from? should you take away from other maternal and child health programs, other infectious disease programs? cdc thrives on state and local agencies, and those are underfunded. i live in new jersey and work with the new jersey department of public health. stock seen the number of cut by half over the 15 years i have been working with them. if the government does not want to pay people what they are worth, he can get a lot more somewhere else. personally, i think it is robageous to say that we peter to pay paul, as the saying goes. to get aher thing is

from the chinese and the saudis, which is a normal course of actions. if you decide you're not going to increase taxes at -- taxes, and only increase of the con ami goes bad. then you are really limited at what you can do. that's the situation we are in. we have a situation not in public health funding, but all kinds of agencies and issues. stay tuned. this will continue. this will happen over and over again. vest, itoked in the seems on its face to meet the congressional definition. is standing so far firm to we will see what happens. questions from the audience. i will recognize you and stand up and introduce yourself.

question, try to make a question and not a comment. comment, this reflects my age. i have friends who looked at the chart of lead in children's blood before and after we band let a ghastly come after the first summer of the band i remember he said he wished he had that for his dissertation statistic. i have a question about a risk issue, the focus is on pregnant women and the military has offered to pull pregnant soldiers out. what about childbearing age of your not pregnant. it is also a risk to your childbearing age and might become pregnant, and how do we know about the male soldiers?

>> in terms of women of childbearing age, that is part of the communication strategy, is for women who could become pregnant to know the risks to manage their travel decisions and and and former way. that there are many unintended pregnancies as well. so encouraging people to avoid exposure to zika if they become pregnant is part of the intervention. >> we do a lot of work on prevention and unplanned pregnancy, form couples of -- for couples of any age. it is very difficult to affect fictional -- people's sexual behavior. teen pregnancies declined every -- since 1991.

it is still difficult, especially for people in their 20's. the they are beginning to come download bit -- down a little bit. women who are had in their 20's and expects sunday to become mothers, should they stay away from brazil and puerto rico forever? till their past menopause question mark --? there is not evidence that an infection prior to pregnancy has any ill effects on future pregnancies. > ? singapore. see the seas working with clinicians. have you -- what do the

clinicians tell the women you are traveling or have traveled and in terms of people looking for fertility treatments, is there a message to tell them to put that off for certain time until further notice? and on educational outreach. what are you doing in terms of educational outreach? >> in terms of clinical advice in the u.s., the travel advisories are out there and tonicians, we work with them make a more. for pregnant women who may have for beingthe advice tested. they -- this is asymptomatic. we don't know if it has the same effect on a pregnancy. we don't have as many -- four clinicians.

that's one of the reasons we think having testing available across the country is important. we want them to be able to get testing. the tests are not perfect. there is advice about monitoring a pregnancy that is likely to have been zika expose. we are working with doctors on the kind of monitoring. forave many channels communicating to clinicians, and you can get messages and materials on our website. that is also true on more general educational outreach. there is a lot of outreach going on in puerto rico right now. all of the things she would imagine for an imaginal -- educational campaign. that in the less of u.s. right now.

i think you will see that increasing. peer --plemental fund a funding. >> thank you. i'm wondering what the environmental factors were -- or moreare making zika prominent in puerto rico. you mentioned air-conditioning. >> we had an article, just last on academic analogy in puerto rico. epidemiology. standing areas like water. when you think about standing water it is not just about buckets. it's little microenvironments.

a lack of window screens and junkyards andng, homes that have a lot of standing water. it's a close proximity in which people are living. think some of that is regarding poverty. >> heat and humidity are obviously important. is less clear what the relationship is between poverty and mosquito borne diseases, because historically we have had a lot of people living in hot and humid places. you can't say if his is just a history of party or correlated.

i would think it is more he feared -- heat. we have limited outbreaks in texas and florida, in that the living conditions, if the heat and humidity is there but we don't get that kind of spread that you see in puerto rico or the virgin islands. , and outs a checklist -- and all of the things have to be checked off. poor living conditions, all those things have to be met. when you start to break any of those links, in the south of the u.s., when people moved away from these places where the mosquitoes were, the transmission goes to zero.

have a question for you, dr. curry. you just briefly touched upon in failure to pass that and terms of temperatures and other things. as we are looking to rally more public support and engagement around climate change solutions, the health frame, the importance to our own personal health and children, the most cherished population. what opportunity do you see to highlight this new threat, and at the same time not overstate the connection to climate change. it seems like a really important opportunity to get the public more engaged about how this is personally affecting us, especially during a presidential election cycle this summer. i and curious about any of your responses to that >>. >>you just gave a great summary

of the spread of zika and climate change. recent is i am trained as an economist. i would say every economist thinks that cap and trade is the most rational way to try to approach greenhouse gas emission. here at the bill which will do cap and trade, it didn't get any traction. i think that's a lesson in what alan's talk about earlier, that you have to present things in a way that what is appealing to understand why this is a good way to do things. so cap and trade people -- .eople just like the control

if i am an environmentalist, i just want to tell people not to pollute. that is not practical in many cases. so trying to do the work to explain to people why this is a reasonable way to proceed is important. peoplethreat from zika, have been saying a number of not going tos the be an explosive threat in the u.s. i think it will be more like west nile, where we saw itething, it was introduced, follows very much the geography of places where there are lots of mosquitoes. are not huge numbers of cases of west nile, but there are cases every year. takes hold, we saw the map

of where the mosquitoes are, there probably are going to be cases every year. there are probably going to be kids born with these herbal birth defects. it is important for people to know that so that it doesn't get established and we don't end up upsetting the equilibrium. init's another opportunity response to your question, you can make the argument, and you did, just one of the problems with making the public health argument is if we are successful , people say see we spent all that money. ,ou can turn it around and say it have to be on the offensive to do this, is to say the reason this didn't get out of control is because we took the questions and answers, you could make, a with stuntedes

brains it will have to have -- and spend dollars on something like that. one of the things that we do is educate parents between the link between climate change and health. i have a question about the zika epidemic. i was just wondering if you think we have any evidence that this epidemic is fueled by climate change, or rather do you see this as an example of how climate change may threaten us in the future? this is important in terms of how we frame our education to our members. able toe not really determine the role that climate has played in the celebrate. like climatepen -- change does it we cannot this entanglement from other factors

like global travel, living gettingns, the virus out of hand in a population. there is not a way for us to know that. understand some of the changes that could be happening if we did have better surveillance data on mosquitoes and the disease. that is one of the things we would like to do. what some ofanding the longer-term effects might be for babies is part of what we need to understand. to inform some of the arguments you're suggesting, what can we avoid by having an effect requires knowing what the full range is. >> if you want to at some states for the control group, give me a call and i can tell you stay so we can put in the control group. responses debra's

appropriately cautious, but it a also clear that because tropical disease, the u.s. is becoming more tropical because of climate change. there is a larger area that is affected. we know that these kinds of vectors are spreading north. cannot make a solid line connecting all of the dots, but i think it is pretty clear that the dots are connected. definity -- say definitively that climate change caused the outbreak, that it will make it worse in the future because mosquitoes like hot weather. the more costly this will be to contain. to make another point which is standby, there will be more like those, and impacts like this on the vector

and therefore on the disease. read on the aisle. i and here for interest, but i have to questions. the first is that hawaii has had a big outbreak of -- fever. you haven't talked about zika being a problem in hawaii. if hurricane , with newppens again orleans having standing water everywhere. how does fema work that into their plans? >> we have been engaged with ,awaii in the dinghy outbreak one of the places where we have concern about local transmission with zika. you are right about that. one of the things that the cdc's role is really to have to help health departments prepare for

if it is likely to occur. we work with all of the heard areas, hurricane prone and certainly one of the areas they need to prepared for his vector control. other questions question or when more. we will make this the last question. >> good morning. i was wondering if you could talk about any emerging technologies that may be helpful in combat -- in combating the spread of zika. at some of thert emerging technologies, but i do know that we are very interesting in interest -- innovative vector control. it is challenging to control all of the and methods that do combine to be

able to reduce the risk. reportse lots of media and there is lots of interest in new technologies. we have to use what we know works. we do work with some of our partners on developing new and innovative ways. we are doing that a lot in the diagnostics area, there is a big effort on vaccine development and vector control is another area where it makes a difference. a comment,o add everybody likes to think about new technologies, this is making sure that you don't have little bits of standing water on your property, that's an old technology. think there is a lot of room thathat sake of things --

type of thing. i know it is possible to reduce the number of mosquitoes on your , and things like that. if people did that on a larger scale we would probably have an impact. >> i want to thank you for coming. you have been a very attentive audience and have asked great questions. please join me in thanking the panel. [applause]

>> after the primary in indiana

this week where donald trump and bernie sanders one or parties races, c-span's coverage of 2016 continues saturday with the democratic caucuses in guam, followed tuesday by note raskin holding -- nebraska holding is primary. old parties go to the polls in west virginia, where donald trump will be speaking tonight in charleston. you can watch it right here on c-span, coverage scheduled to begin at 7:00 eastern time. later go boarding that is senator kerry read -- henry reed , already focusing on what he calls an anti-woman, donald trump nomination. here is some of what he said during a conference call with reporters today. >> a couple times every day sent yesterday, so today for sure. i have to remind myself that donald trump is the republican nominee. it hasn't sunk in yet with me, but that israeli.

want -- him, obviously. he rigs the system by scanning everyday americans. he is the embodiment of everything americans hate about a system that is rigged for the 1%. he is the definition of a man born on third and thinks he hit a triple. nowips people off, and spewing hatred and division everyplace he steps. by nominating donald trump, i guess it is a natural evolution for a party that spent years defining itself entirely on what anti-woman,t, anti-obama, anti-working people.

i have seen it close for seven and a half years. we don't do anything to help low-wage people with the minimum wage. we bury people in debt when they are trying to get an education. we have totally ignored climate change, as we see miami beach getting swallowed up with water. it wasn't long ago, and i was there, when republicans used to engage in thoughtful policy. mcconnell ordered republicans from promoting any policy supported by obama or democrats. following mcconnell's