Transcripts For CSPAN3 Politics And Public Policy Today 20240622

The scope of safeguards and there could be some extensions of authority that are appropriate as part of this agreement. The iaea will require continued Financial Support. The process for Financing Agency activities is to get approval i should wind back again. The iaea is a member of the United Nations family of organizations. As such, it has its own membership and has its own budget and a formula for assessing members in accordance with approved budget to carry out programs. To change that requires today the approval of the 35 governors which is very difficult under any circumstance so whether all 35 would be enough or whether it forcing it to a vote is unusually not the way that the agency would operate. So i would hope that part of the American Perspective on how it can make this effort succeed is to consider a contingency grant to the agency of something on the order of 50 million which sounds like a nice round number but it is much smaller than the i have to say, i dont know exactly. So in relation to the police force for washington, d. C. I think it is very modest, okay. In addition, Technology Support must be continued. There are today Member States volunteer support programs that do research and development for the iaea. Those exist in 20 countries and in the European Atomic Energy uroatom organization. The American Organization is the largest current funding above 15 million or so and without that there is no hope you can solve any continuing problems. There are a number of new ideas scientists and engineers are smart guys and they come up with a lot of ideas and some percentage of them actually pan out. A lot of them are whacky and go nowhere. But in any case the questions of finding a facility in a place twice the size of texas will require every bit of attention we can get. So that Financial Support the Political Support that is that is so amazing to me. The most amazing thing about this agreement to me so far is that the coalition of the p5 held together with germany throughout these several years of negotiation and i can only hope that will continue to be the case. So with that, i will stop my prepared remarks and respond to any questions and in the course of the discussion. Thank you. [ applause ] thank you very much. Im going to introduce our other speakers now. We are very lucky that we have a representative of the administration who has just joined us. John wolfsthal is the senior director of arms control at the National Security council and served previously as Senior Adviser to Vice President joe biden for security and worked at the Monterey Institute and carnegie and the Strategic International studies and the coauthor of deadly arsenals tracking weapons of mass destruction. And the other two members of the panel who will come up after john speaks. Jim walsh is an expert in interNational Security and a Research Associate at m. I. T. In the securities study program. His research and writings focus on interNational Security and topics involving Nuclear Weapons and the middle east. Hes testified before the senate on Nuclear Terrorism and on Irans Nuclear program and hes one of a handful of attorneymericans, and im one of them too, who have traveled to iran and north korea. We like the rogues what can i tell you for talks to officials about Nuclear Issues and served as director of atom project at john f. Kennedy school of judgment and the scholar at Lawrence Livermore National Laboratory and hes taught at harvard and m. I. T. And he received his ph. D from m. I. T. And last but not least john limbert is the class of 1955 professor of middle Eastern Studies at the u. S. Naval academy. Hes had a 34year career in the u. S. Foreign service. Mostly in the middle east and islamic africa. He was bast to mauratania. In 20092010 he came out of retirement to serve as Deputy Assistant secretary of affairs focused on iran and helped craft some of the language that the president has used in his messages, has taught the u. S. Government how to speak to iran. And he should know. He served in iran before the revolution. He was a guest of the ayatollah for 444 days. He holds a hpd from harvard in middle Eastern Studies. He has also authored many books on iran including sheraz in the age of halfas and negotiating with iran. And so john ill ask you to come up and talk about negotiation and is this as foolproof as we can make it and any comments reached about this agreement yesterday and then well have a Panel Discussion and take your questions. Good morning. Thank you, barbara. On the one hand i want to con gat late barbara so farsighted that she scheduled this event on this day or she has a good source inside of the u. S. Government or both. She was obviously she didnt need higher brain function to assemble the panel today and im honored to be grouped with tom and jim and the ambassador. What ill do for a few minutes is talk about the deal that we have negotiated and why we believe it is very much a good deal and in our security interest and then im sure well have a chance to talk about the support for the iaea and the role that plays because we recognize this is a critical component. This deal works if the inspections and verifications work. We have high confidence that the verification deal with work was ber committed to them and because of the agencys capabilities that are proven, demonstrated and the agency is the only organization on the planet today that has the track record and the capability to be able to do this job and were very thankful they are there and one of the reason we support them so consistently. So very basically and briefly, this is a good deal. This is a very good deal. If you had told us coming out of loousan that we would meet the benchmarks we would have been skeptical but we have been able to achieve that. It is built on verification over the interim period but over the longterm. Irans responsibility to abide by the protocol is in perpetuity. It is not sunset or limited. They are to abide by the nonproliferation treaty and not develop Nuclear Weapons is permanent and we have the ability to verify that under this agreement. Sanctions relief which a lot of criticism has been focused on does not take place until iran comes back into full compliance. There is no signing bonus. There is no big pot of money that iran gets the day they all get home and open up their suitcases and we all do our laundry. Iran has to do a lot of very difficult things they have been unwilling to do for many decades to get sanctions relief. And once that is achieved we have a period of time that sanctions can snapback into place on our authority. If you read through the documents, the United States the president can rescind his waiver of sanctions with a stroke of a pen. We have the authority under this agreement as does any member of the u. N. Security Council Permanent body, the veto wielding members of the p5 can call for a resolution and through the exercise of the veto can snap the u. S. Sanctions back into place. We dont need russia or china and they cannot block the reimposition of sanctions over this period. There are a lot of people who say iran is getting rewards, they are getting let off the hook. I havent been to iran since 2006. So over the last ten years iran has paid a significant penalty billions and billions and billions of dollars of scrutiny and tension and conflict in the region. This is a price that iran has had to pay because they violated their legal commitments. This agreement gives them a pathway to come back into compliance and therefore once they come back into compliance can do what other states in compliance with their nonproliferation treaty obligations can do. But in the case of iran it will be limited for a significant period of time, in some cases ten years, in other cases 15, 20 or 25 years in ways that other nonproliferation treaty members are not limited. So they are paying a price for they are behavior and one i think is very significant. And we talked about the four potential pathways iran has to a Nuclear Weapon. All four pathways are cut off under this agreement. The uranium enrichment will be limited and under 24 7, 365 monitoring in human presence or in Remote Access monitoring live camera feeds, radio identification tamper seals. Well know everything that goes on in that facility. If a rat takes up residence well be there and know about it. Forwardo will not be enrichment. They can do isotope enrichment. Into Nuclear Material is permitted in fordow for a significant period of time and even once that long period of time takes place the iaea will have permanent access to that facility. The plutonium reactor at iraq that can produce weapons grade plutonium, the heart will be ripped out and treated so it can never again be reused and redesigned so it cannot be used for weapons use plutonium. How do we know that . Because we get to help design the fuel and manage the reactor and inspect it 24 7. So again the declared facilities facilities, if iran tries to use those, well know within days and more likely within hours and theyll still be a ways away from building a system. What is very important, because the break out scenario is more likely it is the sneakout scenario. We believe given the inspection and the knowledge this agreement will give us into Irans Nuclear activities that our ability to detect an undeclared Nuclear Facility or Nuclear Activity is greatly increased as a result. Given the iaeas ability and rights under the Additional Protocol and the modern technology and equipment under the Additional Protocol and under the jcpoa it is unlike they could build anything of significance and operate it without being detected. Were being asked already could they have a small facility where some grie is drying pictures of a Nuclear Weapon . We do not suggest that this verification plan will prevent any and all minor activity that could be related to a possible nuclear interest. What we can say is nothing that iran could achieve under the verification provision gets them any closer to building a nuclear bomb. And that anything of significance, trying to rebuild a reprocessing facility which they are not allowed to have for 15 years and no access to uranium and not allowed to have foourjs at centrifuges at any other facility and we can detect that through satellite radar or any other means and if iran refused access this would be in violation of the joint comprehensive plan of action and the United States could reimpose Security Council and domestic sanctions. So we dont claim that as barbara said, is this verification plan foolproof . Iran cant get any closer to a Nuclear Weapon under the plan without us knowing about it. And that is the standard we are trying to achieve and one quite frankly while we are pushing the iaea and giving them additional capabilities is well within their ability to implement. This was the organization that got it right in iraq. Iraq had no ongoing Nuclear Weapons. The iaea said so. They were right. Not only that, the iaea when it was alleged that iraq was seeking sources of uranium in africa, within 36 hours the iaea now that document was a forgery. This is the organization that we know can do the job but to ensure that they will be able to do this job effectively and efficiently, the United States and the p5 partners are working with other Member States to make sure they have the technology and the resources and as tom said the people needed to do the job without draining resources from other important responsibilities. That will take money but quite frankly it is a bargain, as the iaea has always been. It is a bargain compared to what it takes to try and surveil Irans Nuclear program on our own and a bargain compared to the military preparations to head off a Nuclear Weapon program in iran and a bargain in terms of the what the iaea does for peace and secure and so well ensure and the iaea will carry out the work it needs to complete the job and people like tom and the inspectors who spend weeks and months away from their homes on location doing this job in the most professional manner possible that well be able to have an agreement like this that we believe will stand the test of time. With that, im hanny toppy to turn things over. [ applause ] gentlemen thank you so much. Very, very useful remarks. Im actually going to start with a question to john limbert who has to leave us early and then well get back into the technical discussion. So john, i wanted to ask for your reflections on this agreement as somebody who has a unique experience in iran shall we say. Youve written an excellent piece for the cairo review that i read recently about the ghosts of history. To what except are we excising these ghosts and knowing iran as you do and having suffered the worst of iran, do you think they will implement this deal faithfully and does it represent a turning point for the regime . Good. Well thank you, barbara. And let me also thank ambassador miller who really undertook a humanitarian and Political Mission back in 1979. And what were seeing now is essentially president carters letter getting a response after 36 years. And were also seeing of course president obamas outreach efforts, which he began, in fact as senator obama back in 2007, with the opposition i should say, ironically, of then senator hillary clinton, those efforts also bearing fruit. But really it comes down it comes down to the word that you hear so much is trust and mistrust. And what you hear from the opponents in both capitols is very similar. You hear we cannot trust them. And you can interchange the we and the them according to where where you are. And this is a real issue. Just give you one quick example of this. A few years ago, the iranians announced they were ready to switch on their Nuclear Power station at bouchere an old project going back to the 70s, which at the time they bought it was obsolete german equipment to build this in the mid70s. Well in 2010, 2011 they were ready to switch it on. And someone asked then secretary of state clinton what do you think about this . And she said oh were not worried about it. We know what it is, we know the technology and we know the safe guards. We are well aware it is not something were concerned about. And then the reporters went back and asked an iranian official, i dont remember what he was and they asked what do you think about this about the secretarys statement. And the answer was, well i dont know what it is but i know there is a trick somewhere. You know the americans just dont say that. And what weve seen the phenomenon weve seen variations of the phenomenon in both places. In the u. S. Weve seen what i call the rise of the geneticists. Weve heard things like from a senior official, things like deception is iranian dna. Well geneticists talk about dna. And weve heard something similar from a very zinged retired military officer who is now the president of a one of the great universities in this country who talked about imperialism, persian imperialism is in iranian dna. Why does this stuff come from. Where do people start being geneticists . Im about they are about as equally qualified if i were talking about Nuclear Physics than to talk about genetics. Well, to quote Lyndon Johnson, or to paraphrase Lyndon Johnson because i wont quote him in this grated presentation he once said i dont know much, but i know the difference between chicken soup and chicken salad. Now he didnt he used an earthier expression. But when i hear people pretending to be geneticists, you know that. But the issue does come down to trust. And we again, you hear it again. We cant trust them. And if you go to iran events in this town, particularly to iran events in this town, and these are some of the outstanding ones, but youll hear things like well we know the iranians are working for a nuclear bomb. And the question is well how do you know . And the answer is because they are bad people. Variations of that. But i and i would answer your question at the end, to sort of long answer and get back to the answer this way this issue of trust, people say ask me, do you trust the iranians, do you trust the iranians and what i say is no. Because to quote the president , the president said you dont make agreements like this with your friends. You dont spend two years and 100 and some pages with a country that you have immediate trust with. But as someone who practiced diplomacy for 30some years, not always very successfully, but when i hear these comments here is where i come out. I say diplomacy, what is it . Basically it is making imperfect agreements with people you neither like nor trust. Imperfect agreements with dubious, perhaps with dubious people. And if you think about the history of the cold that essentially is what kept us safe in the cold war for 40 or 50 years. And that is what this agreement is about. It is not about it is not about trust. It is about, as we are saying here verification. Okay thanks, john. Im going to ask all three of the other speakers to look specifically at the verification issue in the program. As the ambassador pointed tut in began in 1959 and the United States is responsible and we gave iran the technology at the beginning and supported the idea of 22 civilian pour reactors for iran. There has been a certain momentum to the program with fits and starts. The ayatollah homeainy stopped and started it again and are you confident with the level it has reached and that it is satisfied with the agreement and will carry it out faithfully for the next ten years and that its object isnt really a weapon, that it is satisfied at being this you call it a threshold state, however you want to describe it and ill start with you, john. Well, i want to be very clear that we believe that iran having signed the agreement has the authority and have determined that this agreement is in their interest as have we and other members of the p5 1. Our expectation is that iran is going to faithfully implement this agreement but we are not leaving that to trust. The verification provisions will give us ready ability to determine whether or not iran is going to comply with that agreement and that is true in day 20 as it is in day 2020. In terms of irans satisfaction, i cant tell satisfaction is an emotion. What iran is required to do is lay out a Detailed Research and Development Plan and declare to the iaea what its prospective plans are and the plans have to be consistent with the spirit and the letter of the joint comprehensive plan and action and it is then for the United States and other members of the p5 1 to determine whether the proposed plan is consistent. Because of the details of the plan, both that we have and provided to the iaea we have very high confidence that the predictability and the transparency of the plan well out into the future, past year ten, where some of the restrictions expire but many remain in place, particularly a cap on enrichment level of 3. 67 and strictly defined progression in terms of the Centrifuge Research and development that they are satisfied. Where they will go in the future in terms of Nuclear Power Plant Development which is their right as a nonnuclear member of the npt is for them to decide as long as it is in conformity with the obligations. And obviously all of this is very complicated but it comes to a basic principal which is under the treaty they are obligated not to seek or pursue in any way Nuclear Weapons. If we believe either through intelligence information or through the conduct of the Nuclear Affairs they are out of compliance with that we can find ourselves right back in the situation that we inherited when we took office in 2009 and that led to this negotiation that culminated in this agreement. But in terms of how they feel internally about it, that is for them to choose. And let me ask you about the pmd question, the possible military dimensions. Tlef to satisfy the iaea by december 15th. They have to satisfy the iaea by october and the iaea must provide a report to the board of governors in december. And there is no sanctions relief without that . None. Is there a date in october . It may be the 15th. I have to look. But this situation lingering for well for many years, since prior to 2003, has been lingering because the iranians felt they would admit or have to give access that the iaea would write a report and we would use that to impose further sanctions on them. We found a formula that said if you apply by the principals of access, the iaea is satisfied it gets the People Places and things it needs to do the work to complete the investigation and so that five years from now iran cant say well you didnt need to go into the facility back then and why do you need to go in now and then we are prepared to move forward. But without that commitment and follow through to access, there will be no sanctions relief and we wont have a deal. Wow jim, your thoughts on the Iranian Program and whether they will implement it. Well lets i think it is important to step back and put this in context when we think about verification. This is not our first rodeo. This is not the first time weve wrestled with the problems of verification and cheating. Weve done this for decades. Weve had agreements with bad actors. Be it the soviet union or ghadafi. And now were in a situation like with every arms control and every nonproliferation agreement, you are trying to sort of identify how risky this is and what is our level of confidence. It seems to me that the first place to start is where the director of National Intelligence, the top intel official begins and he said iran had a Nuclear Weapons program which it ended in 2003 it has a basic Nuclear Capability you cant bomb the knowledge of how to build a centrifuge out of their heads but they have not made a decision to pursue Nuclear Weapons. So every time you hear in the media that said iran is racing to the bomb that is in violation of what the u. S. Intelligence came to conclusion at high confidence. So they are at a fork in the road. And this is a chance to lock them into the nuclear future. So i think it is when you compare the other verification challenges with which you have had success this is a good situation to deal with. It is the most watched country in the world. I assure you that israel and saudi arabia and opposition groups in iran will look for the slightest hint of noncompliance. And unless there was an agreement in which there was nor intrusive inspection and more inspection on the ground with greater mandate and then cheat. This would be a dumb thing to do, right. If you would cheat, you wouldnt open it up and then cheat. Now, they made change. The regime made change. At some point in the future some things may be different and they try to reverse that. But we lock them into a situation before they make a decision to pursue the Nuclear Weapon. So that is a favorable verification environment. I dont want to go on for too long unless my remarks were right. But part of what we need to understand is the American Public and members of congress have an idea about verification frozen in their minds that goes to the early 1990s. To iraq and north korea. Anywhere any time. And obviously the iraq situation is different. That was imposing against their will the verification regime and that is setting that aside. But as you suggested this is not your fathers iaea any more, right. Weve entered the digital age. I remember what my first computer was like in the 1990s and it was putting disks in and out and things like that. We have tools, science and Technology Available to us that the agency could not have imagined then, including open source digital and the rest of it and a strengthened mandate. There have been crisis and then the International Community responded to the crisis by writing new rules that are stronger. And where did this come from . Directly from the problems from iraq. So crisis, iteration, improvement that is the story of iaea. And i will say theyll continue to be helped, i think onsite inspection is critical but they will be supplemented by National Intel meetings. And one of the things that the Edward Snowden revels will reveal is the u. S. Has robust communication technology. And there are a lot of ways to do verification. You might have heard the story of the over anxious lawyer of defending a client of biting off the finger of a man in a bar fight. And the witness for the prosecution is on the stand and the defense lawyer gets up defending this guy and he says, well, were you in the room when this happens . Yes, i was. And did you see my client bite the finger off of mr. Jones . No, i didnt. No you didnt and yet you are up here. Why are you so confident that he did that . And the person replies, well i saw him spit it out. And that is another way of illustrating there are a lot of ways to find things out. The most powerful of which will be the iaea. But it is not the only by far. That is wonderful. Dr. Shea, i would like to talk about how verification measures improved. I remember when there were physical seals on the facilities in north korea. They physically broke the seals with a hammer and that is how you knew they were going to cheat. What are the methods now used like compared to that. Ill address that but i want to come back to the pmds for a moment. Sure. So in 2011 one of the papers sent to the board of governors contained an an ex with a list of ten or 11 or 12, i dont remember right now areas which iran had allegedly investigated aspects of developing Nuclear Weapons. They included weapon design work, high explosion for triggering, fusion and firing systems and now the director general has traveled to tehran a week ago and has come back with an agreement as that will allow the iaea to enter into this activity and reach a conclusion i think it is 90 days after the implementation of the Security Council resolution. So that date is still sliding somewhat. But it is not a long time. And none of us knows what is in this agreement. And to my mind, the question of if you are given an explanation this was a peaceful activity and even if it is plausible it doesnt mean the activity was carried out for other purposes an the only thing you are told about is the one dimension. So how the director general will formulate his report will be a question of artistry and diplomacy, as far as im concerned. And also the question so what about these activities. And in the one sense if you assume the activities were carried out and successful it means iran has more knowledge than anybody would like it to have about the nuts and bolts of putting weapons together. And if it does have this, it would mean that the time between, if there were to be a breakout, which i find very unrealistic, that the time to actually build the first one would be shorter than it would otherwise be. That is an important consideration but it is already factors into the fact that the agency is doing inspections and gathering information on critical things on a daily basis. Essentially in realtime. So it doesnt effect what it could do other than that that is one aspect which im okay with. The other aspect is supporting it finds something downstream now that is going on and how can it determine that this was something new versus something which predated the report that will be coming in december. And that will be a thorny issue along the way. So no as far as the technology it all depends on what kind of facility you are looking at what the materials are and so on. And the iaea today has over 100 different verification systems that it maintains and procures et cetera and that are approved for use in the field. And to get there, it is now a much more demanding process, sort of like mill speck. You go through a specification and prototypes and until you ultimately get to equipment that can be relied upon. And the reliability and the efficacy and you talked about your grandfathers iaea, there are still some old seals in place because they used 10,000 of them a year so they are cheap, et cetera compared to digital. Compared to exactly digital, with fiberoptic connectors that can be reviewed automatically. The surveillance cameras of old were the movie cameras used then that were engineered so they would start and then stop and then stretch this out so you could get a period of surveillance of maybe three months so that inspectors could come back at a reasonable time. Take the shelf. And now you have large scale digital storage all state of the art and the equipment is nothing like it was and the reliability is phenomenal and the performance and the information given and the fact it incorporated protective features so you cant diddle with it and expect you can defeat this equipment so that it will give you false results. You can kill it, you can heat it up and put the wrong voltage into it, et cetera, but that would be a separate matter and how it would the agency would resolve itself would depend. But it very much depends on an enrichment plant and equipment that is appropriate in an isotope production reactor it is very different, et cetera and so it is all designed according to those. Looking in the field, obviously, youre more concerned with eyeballs. There is nothing like the expression boots on the ground. An intelligence inspector trying to know what to look for is worth any number of items of equipment. Okay. Were going to open up to your questions now. Please wait for the microphone. Say your name, ask a question and say whether it is directed to one or the other of the panelists. So ill start with greg tealman back there. Wait for the mic. Greg tealman. Arms control association. This is a question i guess for tom. The iranians in the past have demonstrated great sensitivity to the nationality of the inspectors and i wondered if you could tell us how much of a concern that is for the future both in maintaining the integrity of the inspections of iran but also the precedent set for other countries around the world, vetoing inspectors. May i . Yeah. So there are today 176 Member States of the iaea which means inspectors can come from any one of the countries. Any country under the nonproliferation treaty safeguards arrangement can say yes or no to any individual inspector that is proposed and any other reason that it doesnt really have to cite why. Iran does not accept american inspectors today. And whether it will in the future, im as hopeful as bill miller that at some point this will produce a circumstance in which iran may change its attitude in that regard and that would be a helpful thing. I do think there is a need for more americans on the staff. At present time, the iaea budget, one quarter is paid by the United States. That is the u. N. Formula. And almost every other agency of the u. N. The budgetary contribution was reduced to 22 . But in the iaea, it has kept with the full support of the u. S. Government at 25 . Not only that, the u. S. Government donates about 50 million a year in extra budgetary volunteer contributions that allow the agency to do things it couldnt otherwise do. But with this quarter, in effect, it entitles the United States one out of every four staff being an american. Some years back the u. S. Gave up 5 for developing countries because otherwise they would be dramatically underrepresented so that means 20 . And the last time i checked and it may not be the most current data, the numbers were running about 12 were americans. So part of the problem that we face is we dont send enough people, good people over there. And this is in part due to the fact that the experts would come from national laboratories, from federal government there are some wonderfully qualified people there from academia and from the industry. And we dont have a mechanism which makes it in the u. S. Interest for people to go and im hopeful part of the legislative review will address the questions of what things can be done to assist in this regard. Can i ask a follow up. Are there any other nationalities that are barred. I would assume israelis. If you would have asked i wouldnt have remembered the israelis. Because i dont know the answer to that. I dont know if anybody else know. A lot of them have been from scandinavian india china. China. Yes. Over here. And wait for the mic. Jim cunningham im a senior fellow here and counselor and former ambassador to the u. N. So i had some painful experience in dealing with iraq. The criticism has already been made that the verification regime takes too long and has too many problems with dispute resolution dealt into it and weve seen with iraq how easy it is to play cat and mouse with the inspectors and i found your presentation by all of you very reassuring in that regard but how would you answer the question that there is so much time lag built into this giving iran numerous opportunities to obfuscate that the purpose of the inspection could be diluted or mitigated by that . You are right this is a criticism levied. I think that is one of the reasons we talk consistently about read the agreement and then lets talk about it. Im sure youve read it. But under the Additional Protocol, the iaea can request access to a site and at under normal circumstances, a military site, a sensitive site, shish kabob site, they can get an inspector within two hours. They are equipped, they have their visa and they are able to go in a short period of time. But in the state in case iran said you are looking for the blueprints, let me give them to you or what you are looking for are the alarm system codes or the electricity site, they have the opportunity as does any state to say would you will this satisfy your response. If the agency says no, sorry. And if the agency says no and the state said you cant get in, well immediately the red flag goes up. There is no cat and mouse right. Everybody, cnn, fox, us dia, the russians and the chinese are watching this one piece of desert all right. In the agreement, there is a timebound process that no more than 24 days can pass. That means within less than four weeks the iaea gets in or they are in violation of the agreement. And in that time period if we see anything going out the back door, iran is in violation of the agreement because they are not complying with the Additional Protocol which is to facilitate access. Now that is the broad scope. Lets talk specifics. What are we worried about . Are we worried iran will be an underground enrichment facility . If they are, you cant get rid of it in 24 days. They are still worried about parchin. It is a pesky element, it doesnt go away easily and we still have facilities in kansas you cant go in the building. Radiation and Nuclear Materials last a long time. But if you cant go in you cant say it is a baby milk factory, we know what it is. And it is for us to decide are they in compliance or not and because we can snap back sanctions there is no scenario that i can envision where iran will take the chance it is okay. It is a small reprocessing facility and we wont play that game. So i dont want to be reassuring because when i talk to a Nuclear Engineer and they tell me that Nuclear Plant is perfectly safe i get nervous. There are things that can go wrong. There are things that iran could try. But we have spent years to negotiate this agreement to make sure if they try we will catch them. And the chairman and people know this very well, the framework for north korea was four pages long. The agreement that george w. Bush and Donald Rumsfeld and john bolton negotiated with the North Koreans in 2005 for denuclearization with no provisions at all was five pages long. The treaty of mosque ow between bush and putin was three pages long. Had no verification provisions and got 71 votes in the senate, all right. This is over 100 pages long. It is like no other nonproliferation agreement ever negotiated and signed. It pails only in compare an to the most detailed arms agreements with the soviet union and russia. And jim said weve done our homework. If we have done something doesnt quite capture it we are open to understanding what that is and the constructive criticism but i think were going to be giving a fullthroated defense of what we believe is a very effective verification provision which makes sure not that iran wont try to cheat and we are not assuming they are going to comply, we are assuming they will try to cheat and we will catch them and that is what will keep them from trying to cheat. And Richard Savoy there in the middle. Richard sofoy with the National Trade council and a member of the barber iran here at the council. While were on the subject of criticism of the deal i think that everything that has been said in terms of the strength of the agreement in the Nuclear Space is accurate is a good deal, is a winwin in terms of diplomacy as john limbert has defined diplomacy. The criticism that i worry about over the next 60 days in the body politic is you are giving iran over time over time all of this money with which to conduct the activities in the region that we put them on the state sponsor of terrorism list year after year after year. So i would be appreciative of your comment about that space. Imsure you want to respond. I would like to talk about that for a second. Good. So im confused by this argument. Im deeply confused. For a couple of reasons. So it seems to me if you dont like iran their terrorists then you dont want them to have a Nuclear Weapon. So what is worse than iran involved in terrorism. Iran involved in terrorism with a Nuclear Weapon. Im not getting this. The other thing that doesnt work for me is so the argument goes we cant give them any of their own money back we cant have any sanctions relief because theyll take a dollar and spend it on terrorism. What does that mean then . That means that the people are saying we cant have any Nuclear Agreement. Because they are imagining there will be a Nuclear Agreement where iran does everything we want them to do on the nuclear and they get zero in return. They dont get any relief. Im not aware of any agreement in the history of human kind that would work like that. So if you are saying we cant give any sanctions relieve because theyll use it for terrorism, you are essentially saying, no Nuclear Agreement leave iran unconstrained, pursue a Nuclear Agreement. That is my opinion. You may have a different view. Far be it from me to put word in jims mouth. I think people are right to be concerned about irans behavior because iran is not a state that does things that we like. Iran threatens our neighbors, they threaten americans. They are Holding American citizens. They are engaged in activities in countries that lead to real regional instability. We are not blind to that. Barbara started with is this sort of turning a page. We are not assuming that iran changes its stripes. We are assuming they wont. We dont want them to have access to a Nuclear Weapon or the ability to get there quickly and we intend to increase our capability to challenge iran throughout the region because we do expect some of the money may enhance their activities. But the point i would make please go ahead. Thanks, john. And i would point out that iran is under the most crippling sanctions ever imposed on them. They are still conducting the activities. It is not a shortage of money preventing them from terrorism or setting sending arms to the houthi, they are doing that any way. So is there an in kremental risk, yes, there is a risk. And are we taking steps with allies to do that . Yes. And were going to do that when they are not hiding behind a nuclear shield. And there are stats coming coming out. If you look at a recent article talking about defense spending in the region. By how much does saudi arabia outspend iran . Three times. Uae is 50 higher than Iran Military spending. This is not just purely a money scheme, right . Its a capability scheme. Its an investment scheme. Its a sharing scheme. Thats why secretary carter is going to the region. Its why we had the gulf leaders here for the camp david summit. It wasnt to say hey weve got this great deal. Youre going love it. Its how are we going to Work Together on missile defense. How are we going to Work Together on Maritime Interdiction . How are we going to Work Together on Counterterrorism Operations because were expecting the neighborhood is going to be bad. Because the neighborhood is bad. But it gets worse if they have got a nuclear program. Wait for the microphone. Thank you very much for the great discussion. This is from west asia council. I have a question for the panels. Of all the joys and jubilations that were getting clips of it from the streets of tehran and its all young people out there impatiently waiting for the sanctions to be lifted. And with all these strong measures that have been put into this agreement to stop iran from making a nuclear bomb it seems to me that this regime will be on a Suicide Mission if they do not comply with this agreement. They have a lot of answering to do to their own domestic population and also to the world. So i need your input on this. Thank you. Yeah i might grab that one if i may as somebody who has been to iran a number of times. People say oh, its the regime and the regime makes all the decisions. Its Ayatollah Khamenei. Its the Supreme Leader, that Public Opinion has nothing to do with it. This is not north korea. Public opinion does have something to do with the policies undertaken by the government. Yeah, they do a lot of things in the region that frankly most iranians dont support. They dont like to see their money going to syria and to lebanon and to iraq. They would like it spent at home. But in 2009, there was an earthquake in iran called the green revolution. The government stole an election to reelect ahmadinejad and millions of people came out on the street to say where is my vote . Even though the regime crushed the protest, it shook them to the core. So they made sure in 2013 when there was another president ial election, there was actually a reasonable choice of candidates, and in fact the most pragmatic individual Hassan Rouhani won. And its Hassan Rouhani and his team that have been able to negotiate this Nuclear Agreement. This is their second bite at the apple. They tried before and failed largely because of the lack of the foresight of the Bush Administration i would argue back when iran had no centrifuges spinning. This is their second time around, and they have succeeded. And they are well aware of popular sentiment. They know what sanctions have done. Youth unemployment is extremely high. Brain drain is extremely high. And Hassan Rouhani talks about giving hope to the youth. He talks about economic development. So while some of the billions of dollars that iran will receive from this deal wind up in the pocket of hezbollah or the Popular Mobilization units in iraq or Bashar Al Assad . Yes, of course it will. But i would argue that if this government wants to retain legitimacy, and remember what the Supreme Leader here is doing. He is making a pact with the great satan with the font of global arrogance. And everyone knows this. If this system wants to continue beyond Ayatollah Khamenei it will have to meet some of the aspirations of its people, i would argue. Yes, maam . Wait for the microphone, please and identify yourself. Hello. Thank you for a fascinating panel, and so timely. Im barbara rome, Israel Bureau chief for defense news. A few questions. First of all, in parallel to the inspection regime that will be led by the iaea, is there any provision unilaterally for the administration to collect the best minds . I know you mentioned the labs and all that for the iaea, but in parallel to have experts seconded from the Pentagon State Department and the arms a control community to alleviate a lot of this inherent suspicion. And on another issue the president gave an interview about a month ago to israels channel 2 tv where he essentially conceded that year 13 or 14 of such a deal that the breakout time could be reduced to nearly zero. I know there is an explanation, but id love to hear from your experts and from the nse official. How can that be ameliorated and reinforced so at year 13 or 14. Yeah, well start with jon and then well move down. I think if i understand your first question, its how are we going to make sure that the best people are working on this problem, and that the iaea and the government have what they need. Thats why were here. Thats how we got to this stage. The iaea receives a tremendous amount of support from the United States, including through people like tom shea and other experts that are provided. They get great doo hickeys from the National Laboratory which he we helped develop. We helped train their people. We send young people to intern and become staff members. So in terms of the technical capabilities and the leadership the iaea already has that and we are working closely with them to understand what more they would like, what more they will need. A great example is the new types of cameras or the online enrichment flow monitors that will be installed in each cascade that will instantaneously be checking the enrichment level sort of like a thermostat. You can it is when it hits 3. 67 youre good. When it hits 3. 68, an alarm goes out. I think that part well continue to work through and we expect there will be more resources. In terms of the u. S. Government were also looking at our own organization. We believe right now that our military and our intelligence capabilities are properly resourced. That may change over time. Were constantly evaluating those things. We are looking at how we will organize ourselves for the implementation of the jcpoa. There is still some decisions that have to be made. But were also just as we learned lessons from trying to implement iraq and north korean agreements, were learning what well need to do to organize ourselves effectively and who will staff the joint commission and so forth. In terms of the breakout time lines, what we have been able to achieve in luzon and in the jcpoa is a predictability to irans enrichment capacity. And that extends through the research and Development Plan that the iaea will receive from iran. Some of those documents are laid out very clearly in the jcpoa. Theyre ten years of restrictions on the number of centrifuges. There are very strict limits on the types of r d that can be done there is a strict cap on enrichment level and more importantly the amount of enrichment material iran may have. They cant go over 300 kilograms of u2345. There is a plan iran must provide to the agency that provides predictability and is consistent with their energy needs and with their development. So in year 14, or let me rephrase this. Right now we have a plan through year 13. They will have to continually update that based on their development. So lets say in year 10 they update their 15year plan and it says okay, were going to have 5,000, 5,000 9 million swu. That appears inconsistent with their obligations under the j krah poa. We will still have the right to say that appears inconsistent with us. We can work to impose sanction. We can work to get our allies equally concerned as they have been at 19,000 installed centrifuges. So the predictability is what weve been able to achieve. And the iaea will get access to that in the plan. So iran has an incentive to have what we have described as sort of a soft r d landing. Thats really part of what dr. Moniz, who has now been knighted by the portuguese and im sure will be getting other accolades once he gets back and has working out there. Are some provisions that will be coming out that we expect will be investigated during the review period. But we dont the agreement does not provide for this exponential increase in enrichment capacity or a dropoff in terms of the breakout timeline. Okay. Let me can i follow up on that for a second. Because i testified before the Senate Foreign Relations Committee last month. And they asked what are the criteria we should use for evaluating the new agreement. I offered several. One of them is assessment is not about imagining all the bad things that could go wrong and listing them. Thats not assessment. Assessment is you try to put parameters, measure the risks involved and weigh these risks and calculate tradeoffs. So how do you do that . Well, you compare one thing to another. And weve talked about this being exceedingly strong agreement compared to arguably the most robust negotiated nonproliferation agreement in history. So if it looks good compared to the others, that should give you some confidence going forward. A second and separate, it seems to me evaluation criterion is how does it compare to the alternatives . So i hear a lot of folks saying well, 15 years isnt long enough. Part of me really has to fight hard and resist going down the road of ive heard this song before. Its called moving the goalposts. I remember on breakout time Prime Minister netanyahu in that famous speech before the u. N. , i think it was 2012 said we need at least a few weeks or months notice before iran does something. A few weeks or months. And then john kerry comes and testifies before the Senate Foreign relations. He says were going have six months of breakout time which is more than a few weeks or months. Then he was told six months isnt enough. Then they come back with an agreement that says a year. Doubling that. And then suddenly we hear well actually we need two years. I dont know if there is any number that we can could choose for breakout time that would satisfy people. And it seems to me that 15 years is a really, really long time in nuclear years, years for a nuclear program. But thats my judgment. Lets compare wit the alternatives. Lets say we use military force to decimate that program. I was part of a study that looked at the costs and benefits of military action against irans program and was the estimate of 40 retired military and defense officials including former National Security advisers that after doing that iran would be able to reconstitute its program in roughly four years, right . We wipe it out. They rebuild it in four years. What do we do . We wipe it out again i guess . I dont know. But thats were talking about an agreement that is going to go for 15 years. Compared to the four years that they would take to reconstitute it if we used military force as an option. So, again, all these debates about the details are important, but how do you judge things . You compare them to other things. You compare them to other agreements. You compare them to your alternatives. And that gives you a greater sense of the sorts of risks youre taking. So we have the iaea being involved, which is an International Organization which grew out of president eisenhowers proposal at the end of 1953. And it is as an International Organization responsible to its Member States of which there are 176. And one of its obligations is to respect the sovereignty of each of these states. So it cannot act in an impromptu or whiplash effect. It has to proceed with due caution so as to avoid false allegations on the one hand while being mindful that if there is something going on that it must act in sufficient time to allow an adequate response. And that will be i think a problem if depending upon what goes forward. So these questions of the 24 day, et cetera thats a sort of period during which the degree of certainty would continue to build up, maybe its denied or not yet permitted to go to a particular location. But there are a lot of other things that be going on in a circumstance like that. So my own perception may be clouded by the fact that im an optimist and i want this to succeed. But i think this is a new era and that im hopeful that iran will seize upon this as a chance to demonstrate its commitment to the obligations that it is entering into. If it doesnt, were going to know about it. And things that interference with activities or just the color of how much cooperation is there is it something which is demonstrated on a daily basis by providing assistance that the inspectors can actually do their work, or are there things that get in the way. So that will be known soon. And i think we know that the iranians have abided by the interim agreement that was reached back in 2013 quite faithfully for the last couple of years. And thats a good precedent. Okay. Gentleman right there, wait for the microphone. My name is mike sponder. Everybody here agrees that the agreement is a good agreement. My curiosity is since there is no longer any state secrets, when you use the word tough negotiations, what didnt they agree to . Because at this particular point, only what they didnt want to do is relevant. What did the United States want that iran did not want . There should be no secrets on this. I was once the director of innovations at the office of naval research. We knew what was going on. If somebody asked us a question, we either said i dont want to tell you or im going to tell. Tell us what they didnt agree to. No. Im not going to tell you. I mean we will have lots of discussions over the next several months about, well, you know, iranians won or they got all these things they wanted. That wasnt my question. I understand. My question is what did you want that they did not agree to . Its simple. You can say i dont want to tell you. If you cant tell me, well find out. Im not sure i understand the second part of the question. But im happy to talk about the verification. Why we think the deal is a good one. That wasnt my question. And its prerogative not to answer. What they did not agree to. Im sorry. I cant provide you with an answer to that question. Im afraid we have run out of time. Those of you who have more questions, please, if our folks here have time they will be happy to answer them. And check out the report of tom shea. It should be available on our website and on the search for Common Ground website in a couple of days. Thank you so much for coming. Coming up tonight at 8 00 eastern on cspan, president ial candidates hillary clinton, ben Carson Martin omalley, jeb bush and senator Bernie Sanders speak to the annual meeting of the National Urban league. The group is holding its meeting in ft. Lauderdale, florida. Thats tonight at 8 00 eastern on cspan. This weekend on the cspan networks, politics, books, and american history. Saturday night at 8 00 eastern on cspan, Netroots Nation hosts a discussion on Illegal Immigrants and the enforcement of arizonas immigration laws. And sunday evening at 6 30, new jersey governor and republican president ial candidate Chris Christie on National Security. He speaks at the university of New Hampshire at manchester. On cspan2, saturday night at 10 00 eastern, on book tvs after a words Michael Tanner talks about the growing National Debt and looks at restructuring entitlement pramts as a solution. And sunday afternoon at throw 00 glenn beck presents his solutions on growing american extremism. Sunday morning at 10 00 eastern we commemorate the 50th anniversary of president linden johnsons signing of the 1965 Voting Rights act. Our coverage includes white house phone conversations between johnson and his aids, civil rights leader dr. Martin luther king jr. And congressional members about strategy on how to enact and enforce the law. And lbjs 1965 speech at the u. S. Capital and the signing of the bill. Also this weekend, saturday night at 7 10, university of californiaed a berkeley history professor brian delay looks at the history of gun production in europe and how arms trading contributed to an american victory during the american revolution. Get our complete schedule at cspan. Org. The republican president ial candidates are in manchester New Hampshire for the voters first president ial forum on monday at 7 00 p. M. Eastern. And cspans road to the white house is providing live coverage of the twohour forum on cspan cspan radio, and cspan. Org. The New Hampshire union leader along with media organizations from the caucus and primary states are sponsoring this forum. And following the live forum, you can provide your input by joining our callin program or adding your comments on facebook and twitter. Road to the white house 2016 on cspan cspan radio and cspan. Org. Coming up next, the role of religion in health care. Panelists discuss the importance of faith based organizations in delivering care in countries with Health Challenges such as aids and hiv. The usaid center for faith based and Community Initiatives director talked about the Important Role these organizations play in responding to pandemics such as the recent ebola crisis in west africa. The center for strategic and International Studies is the host of this event. All right. Good morning. Sorry for the few minutes delay in getting started. My name is talia dobovi. Im the Deputy Director of the Global Health policy center here at csis. It is my pleasure to welcome you this morning to what promises to be an edge gauging publication of a new series on Faith Based Health care. Before we get started i want to thank shepherd and anita smith for their work on this event. I want to say thank you to katie peck and julian lock on my team who are instrumental in pulling everything together this morning. Faith is a powerful force in the lives of individuals and communities throughout the world. Faithbased organizations are an important provider of health care globally and theyre a resource for support particularly at the Community Level and for hard to reach populations in some of the poorest places in the world. As rick warren of Saddleback Church has noted, there may not be a Health Facility in every town, village and hamlet but there usually is a church or a mosque or another place of worship. Engaging and leveraging the reach of faith leaders can be critical to meeting Global Health and development goals. The nexus between faith and health and the potential for better cooperation and new partnerships is an important topic for us here at csis. Weve explored the issues through a variety of lenses including active collaboration with the Faith Community around the aids 2012 conference here in d. C. , as well as through janet fleischmans work looking at opportunities for faith leaders to play a role in promoting knowledge of and access to Family Planning and Reproductive Health services. These issues will continue to be a focus of our work. As we celebrate the role faithbased health care can play in the Global Health arena we must also acknowledge the challenges and disagreements that are sometimes associated with the communitys role notably in encourage organize discouraging the use of Services Including Family Planning and immunization as well as controversies in places like uganda, where discrimination against the lgbt population and endangered people with hiv. Moving forwarde inginge inging forward, of faith based providers and to improve coordinations between the faith and health communities. We will hear more about all of these important topics from our panelists today. I will now turn the microphone over to bill summerskill who will introduce our first panel. Thank you and good morning. On behalf of the authors im delighted to introduce this session about the lancet and faithbased health care. This is made possible by sponsorship from capital for good. In addition to the booklets that you have received, additional material is Available Online for free and the full contents will be published in the weekly addition of the lancet next month. Faithbased organizations deliver a substantial amount of health care around the world. How much and what benefit has not been well documented. In preparation for the Sustainable Development goals in which collaboration between different sectors will be crucial, this series sets out to estimate the contribution of faithbased organizations to health care. The particular strengths and weaknesses of faithbased actors, and how their expertise might be best recruited in the future. By doing so the authors have initiated a respectful sciencebased dialogue about faithinspired edd behaviors. The three panelists here were each lead authors on one of the three review papers in the series. Going from your left to right, jill olivier has worked with the world bank and is now senior lecturer and Research Coordinator at the university of cape town. She is also director of the International Religious Health Assets program. Jill combines these skills as the lead author of paper 1, understanding roles of faithbased Health Care Providers in africa. Andrew tompkins is emeritus professor of International Child health at University College london. He combines a distinguished academic career with extensive experience in the field to present a sensitive review about the influence of religious beliefs on behavior in the second paper, controversies in faith and health. The final review towards stronger partnerships between Public Sector and faith groups for improved health was not intended as such, but rather planned as a brief viewpoint. However, peer reviewers were so enthusiastic that the authors were asked to expand the manuscript into a fulllength review. Leading that effort was jean duff head of the partnership for faith and development and coordinator of the joint learning initiative on faith and local communities. And at your far right anita smith will moderate todays session. She is president of the childrens aids fund and a past cochair of the president S Advisory Council on hiv aids. Ladies and gentlemen, the panel. Thank you. Thank you so much to csis for hosting this important event, and to bill for the introduction. I did want to ask bill one question, if i could before we start with the panelists. I dont you probably would need to get back to the microphone. But this entire series would not be possible without all of your support. And i just wanted to hear from you as we start this discussion what your goals are in terms of how you want to see the material thats being published used. And what you would like to see outcomes based on how your supporting through this effort. Thank you, anita. The found over the lancet in 1823 set out with two purposes, to inform and to reform. So the name lancet means both a surgical instrument and a narrow window. He said he wanted to use it for beth of these purposes, to cut out bad practice and to shine light on good practice. And i think that still directs the way we approach topics. And health is such a vast part of our lives with so many different interfaces that this is a really large area of health, which has received disproportionate attention over the years. Its a very sensitive area. And i think that may have may have made it difficult for groups to explore it in the past. And i think its also a very vast area with a heterogeneous Evidence Base. So its difficult to make firm conclusions in the way one might do for other aspects of health care. So with this issue, what we want to do, however imperfect, is to set down a marker. And say this is an important topic. Its actually going to be more important in the future. And if we are to achieve the Sustainable Development goals we need the help of all potential actors. What im hoping is that this initiates a dialogue which is then taken up by other science, sociology Health Journals that we move the influence of faithbased provision of health care from the margins of the debate and make it mainstream. So my metric of success would be for people to write in three, four, five years time this was great, but its so terribly out of date this issue. I would like to see things move on. And as they do move on, i hope the lancet can be part of that. Thank you so much for that perspective, which gives us a Perfect Foundation for the presenters this morning. Jill . Thank you. Good morning, everybody. Im going to cran my neck a little bit because i do have a few slides. This paper that im presenting on behalf of my coauthors, for those of you that are not familiar with the area at the intersection between religion and Public Health and development, its a very diverse area with major evidence holes. I dont even say gaps. They are big black holes where we simply do not know things like how many faithbased Providers Services there are, what is the influences of health on individual health behaviors. So what this paper sought to do is provide a synthesis based on a series of systematic reviews on which the authors were a part. A synthesis of primary research in which there was some substantial evidence that could actually be committed to. So what the focus ended up being on was on african faithbased Health Service providers. We were presenting this at the bank, and i put this quote up there. There has been a lot of these kinds of quotes that have been floating around for the last 20 years, this idea that there is a substantial Provision Health Service Provision in africa by these health faithbased providers, but we dont really know the numbers. We dont really know what is going on. These kinds of quotes have been around for a long time. But i think i would argue that we do know a little bit more now in the recent time. So what this paper is focusing on is specifically on that cluster of countries in africa where there is a particular presence of faithbased biomedical Health Service providers. So were not looking at traditional healing practices here. Were not looking at faith healing. Were not looking at a variety of other important issues. This is really looking at the hospitals, the Family Health care centers in those regions. The Evidence Base is biased towards africa towards christianity, and towards english literature. Im saying that now. We did not know enough about the islamic facilities and other facilities. We did not know about the Northern Africa sahara regions. But there is some evidence in relation to those countries. This is a very common slide. The first column provides the national faithbased health net works selfdeclare on their percentage of Health Service providers against the Public Service provider. So for example they are normally counted number of hospital beds or number of facilities and they would compare the faithbased normally the christian based services against the government facilities. And i must point out these figures are highly contentious. I wouldnt like to get a quotation in the new york whatever or Washington News saying ive quoted these. What the paper tries to impact is the fact that these figures are very contentious, and what we actually argue is that there is a need to move away this focus on percentages of market share. The argument is really is that basing your entire engagement in the faith sector on the idea of whether or not they provide 20 or 25 or 30 of the Health Services is actually less important than the issues such as do they provide Quality Health care to the rural poor . Do they emphasis universal Health Care Coverage to people that otherwise dont get access. Do they provide a different kind of care that supports the system and makes the general and National Health system more resilient. So really, the argument is to say moving away from those kinds of figures, and trying to look at things such as utilization, cost satisfaction. So putting data in this paper we were trying to pull on what data there is on these other aspects which we consider to be more important. Ill just touch on a couple of issues. We presented some Household Survey data, which was looking at utilization, which did show some slightly lower market share than we had originally assumed. However, its a different its comparing apples and oranges to the faithbase kind of comparisons. Dont worry than too much. But we did find quite a lot of evidence to the fact that a lot of in those countries, a lot of patients were reporting on higher satisfaction levels. And the higher satisfaction levels were normally based on the idea that they were getting a Higher Quality of service in the faithbased business versus the public facilities. There was also some evidence to show that faithbased Service Provision is particularly important in weak Health Systems, and thats not just in africa, but thats internationally. And weak Health Systems is not just normally weak, but in times of humanitarian crisis in emergency response, that is when faithbased Health Services jump in. Im not going to go through this whole slide, but just to say that there is as i mentioned earlier, there is a push towards away from broad generalizations about faithbased Health Service providers. I would encourage you very strongly not to use the word fbo just generically. There are all kinds of fbos and fb things. Being specific in the evidence, being specific in the engagement, and being specific in the implementation strategies is really important. And im going to stop there. Thank you very much, jill. So we will go ahead and have all the presentations. And then open for questions. So amber . Andrew . We had a very interesting and challenging task of looking at the controversies. And as you would imagine from the title we had a rich diversity of people to inquiry and include. And i think the key thing we wanted to emphasize in the paper was that there are many, many people who report faith in the world. In fact, the pugh forum says in their surveys more than 84 of the World Population report having a faith. This slide just shows some of the major faiths and methodology involved looking at differences between faiths and sometimes differences within faiths. And that is a very important thing to do. The second slide i think just shows the importance of not being too simplistic in attributing anything to faith belief alone. This slide just emphasizes what in the center were talking about things like attitudes and beliefs and prestigiouses and behavior and choice of technologies. All the things that we think of every day. But it isnt just faith that actually influences. Sometimes its actually centuries and thousands of years of culture. Sometimes its social and economic aspects. Sometimes its issues in relation to the laws in the country, which may actually conflict with faith. And obviously, there are very important political dimensions. And unfortunately, sometimes beliefs and behaviors are affected by extremist ideological positions. When we looked at various components, we looked as you will see in the paper at a series of health damaging behaviors, which included childhood marriage opposition to immunization violence against women and female genital mutilation. We looked at the way faiths actually had a viewpoint on this. And then we looked at how notwithstanding the considerable varieties, there was often a commonality. And we gave a lot of examples in the paper of ways in which groups sometimes with different faith backgrounds have come to Work Together for the reduction of child marriage, for the increase in uptake of immunization, for the improvement of care for women. For the reduction of stigma and improvement in the provision and care in hiv aids. So these are some of the things that we looked at. And this slide just shows a bit of a problem. What we found was that within the faith Leadership Group there was often a limited awareness of what was going on in the world. And we actually found that there was a considerable problem in faith leaders remaining within their intellectual and theological faith faculties. At the same time, we found that those working in some Development Agencies and some working some Development Agencies were actually extremely unaware of what faith actually meant. And therefore there was a tendency particularly for those affected by intense secular agendas to stay within their secular silos. So we had faith faculties and secular silence. And this may be a bit of a parody, and i dont i do apologize to those of you who object to this. But we actually specifically raise it because we saw at the bottom some remarkable opportunities of faith groups, probably using the word but actually ive just been told not to use. But faith groups working intensively with governments and local communities. And we provide within the paper some great examples of that. What are our recommendations . Well, we would like to see that the Health Care Leaders become more faith active and the faith leaders become more health active. Im not suggesting that all faith leaders join gyms or Health Leaders go to the mosque. But its obviously important that literacy and understanding are improved. Notwithstanding these issues, we do provide some evidence, and there is quite a lot of Peer Reviewed evidence showing that there is remarkable opportunity for faith to be integrated within programs. And we can actually see that already there are opportunities for programs. So what do we seek to achieve from this paper . We would hope discussion possibly disagreement, but we see actually quite likely to be an opportunity for groups to Work Together for the improvement of care. And what our real goal is to move from controversies into compassionate, professional patientsensitive, faithsensitive care especially for the hard to reach. And we do not believe that the goals of Sustainable Development will be achieved unless some of the issues that we raise in our paper are taken into action. Thank you. Thank you, andrew. Jean . There we go. Thank you so much. Good morning, everyone. Thanks to csis and to shepherd and anita for helping to organize this session. Thank you, bill and the lancet. Thank you my fellow authors in the working group of amazing people who collaborated over a sustained period of time to bring this unprecedented series on faithbased health care to launch at conference on religion and Sustainable Development which was held over the last several days at the world bank. Kay warren was a key inspiration to this series, informed by her deep lived out experience personal experience of how religious and faithbased organizations transform stigma and save lives of People Living with hiv aids. Our paper focus picks up really where andrew just left off. It focuses on the question of partnership between Public Sector organizations, between governments and donors and faith groups in general. And the question of what exists by way of partnership and what might scale up and strengthen partnerships. The paper lays out a case that the time is now right in the context of Development Trends and opportunities to very substantially increase engagement with faithbased organizations. It basically pause sits the notion that seems to be moving beyond the question now of weather to engage, but how to collaborate. The paper offers a couple of signs including the recent meeting between president kim at the world bank and the holy father where they discussed their mutual approach to implementing a preferential option for the poor. At our conference over the last couple days a notion that was tagged in the paper of Public Sector organizations themselves becoming more activist around these issues was underscored by the very activists participation of the German Government who w. H. O. Have newly constituted a focus in their agency on this work. On the faith side groups next slide, please. Sorry, anita. Great. Thank you. And now the next slide. On the faith side, the paper reviews how existing partnerships and mechanisms are expanding collaboration. And we look at those in three groups. We look at large scale interventions, suches as the australian governments extraordinary tenyear investment in papua, new guinea where they work through the congregational networks of seven denominations to provide services to the very poor there. We look at public cofunding for faithbased hospital and primary care through National Networks such as the churches Health Associations throughout africa. And thirdly we look at Global Health campaigns where faith groups are involved such as the United Methodists imagine no malaria campaign, which to date has raised over 66 million and is a significant donor to the global fund for aids, tb and malaria. A very Interesting Partnership there between a faith body and a multilateral donor organization. The paper also references the longstanding ongoing efforts at key u. N. Agencies to facilitate partnerships. I would like to just note in terms of the cofunding the important leveraging of substantial private assets that the Faith Community brings to the work of development. And to tag for your further reading a study of the revenues of u. S. Faithbased ngos, which in 2013 amounted to over 6 billion of which public funding represented only a small proportion. I think it was 77 777 million. So a small share. Next slide please. The paper reviews the paper drills down on this on the case for partnership by looking more specifically at contributions to the prevention of maternal and child deaths. And impacts every woman every child framing by unicef that looks at the accelerator behaviors that are key to determining Health Outcomes for women and children, and makes the point in a systematic way that faith communities are very wellpositioned to influence those key healthrelated attitudes and behaviors such as breastfeeding immunization access to care that make a difference to those Health Outcomes. We offer a variety of interesting case studies and examples from nigeria from mozambique, from sierra leone, drc and elsewhere. And i commend them to your more detailed attention. Finally, the paper drills down on a series of recommendations for strengthening partnerships and those recommendations are clustered in five areas. And again, time doesnt permit us to go into them. But we offer them for your further consideration. They include a suggestion of new Business Models in a sense ways in which both the Development Communities and the faith groups can reorganize themselves and strengthen themselves to be more effective in partnership mechanisms. It was interesting that when this paper was conceived almost 18 months ago, the conference that took place over the last couple of days was not even intended. But it was absolutely fascinating i think for all of us to see how the work embodied in the lancet paper was very much a grounding for the conference over the last couple of days. And these recommendations that you see here were elaborated very extensively in the work of the conference which looked at ways to strengthen partnerships between Public Sector and faithbased organizations. Thank you so much. Thank you, jean. Well, based on these presentations, this is just a taste of what is in the document that you have that you will definitely want to read. If you arent already into it. Thank you all for your excellent presentations. I just wanted to while youre preparing your questions in the audience, let me just ask each of you a question. Jill i wanted to clarify that the faith hospitals that you were looking at were you looking at clinics or just hospitals . How extensive was the data . The data i was looking at all of Health Facilities down to primary care level. But again, there are data holes all over the place. But most of the ones shown there are christian Health Associations. And they normally map the whole number of facilities down to primary care level. There obviously is a lot of work to still be done to get beyond just the christian facilities. Is there work under way that youre aware of . There is work under way, but it is also, i just want to stress there is a lot of complexity as well. A lot of, for example Health Facilities faithbased facilities that are owned by the church but operate as a public district hospital, for example. So its not quite as black and white and clearcut. But yes, there is work under way in a number of countries worldwide. How many of those facilities would be kind of a partnership between government and faith . It differs per country. They call them district designated hospitals there is probably 20 or so big hospitals. Theyre normally in areas where there is not a substantial presence of the public system yet. Okay. Great. Thank you. Andrew, interesting paper and look at the controversies. How did you and your team go about deciding what you were going to look at and how did the team Work Together to come up with the outcomes in the paper . With fear, trepidation, Energy Enthusiasm and an objectivity. Im just giving off the top of my head. Basically, as scientists, we are basically looking at what is the evidence. And we didnt have any particular ax to grind. As the readers of the paper will see, there were representatives looking at all the major faiths in the issues. We came particularly from the perspective of what are the particular needs for hard to reach populations of particularly women and children in poor communities unreached communities in poor countries. And that was really why we looked at some of the key risk factors for poor mortality rates, for poor nutrition rates, and Poor Development of children and adults. How we did it, we basically looked at the problems and we analyzed them using traditional texts and we also looked at the ways those texts have been interpreted in different ways. And then we moved on to see how the texts have actually inspired and driven Health Workers to provide services in very difficult situations. Very interesting. Thank you. Jean, congratulations on already putting some legs to this effort through the conference. I know it was a very successful event. I think one of the questions that people have is why hasnt why have these partnerships been so difficult to bring about and why has it taken this long to come to this place . Thanks, anita. The event that anita is referring to is this conference on religion and Sustainable Development. Effective partnerships to end extreme poverty which was held over the last couple of days at the world bank and cohosted by the u. S. Government. Im looking at Mark Brinkmoeller in the front row, the British Government world vision, and other leading faithbased organizations. And in itself i think it represents part of the answer to the question. An extraordinary collaboration among governments, faithbased organizations, and the academic Community Around these issues. Anita, i think that part of what we struggle with is a cultural divide. We have different methods and different approaches. We definitely have a Common Ground, and certainly as framed now by the coming Sustainable Development goals and this commitment to end extreme poverty, we have very clearly Common Grounds. But we have different approaches. And i think what is so heartening about the discussions over the last couple of days was the spirit of collaboration and the reciprocal frame. Yes, a call for on the part of the Public Sector organizations for a very strong evidence grounding, and really a challenge to the Faith Community to step up just the kinds of evidence that jill and her team, for example have, been presenting. As a basis for discussion. But i think that our work, the work ahead continues to be the building of trust, the building of understanding, the building of what we call faith literacy and development literacy across the two communities. And i would like to just point out that the materials, all the materials for the conference are available on the website of the joint learning initiative at www. Jliflc. Com. And i commend those two. Great. Thank you. Well, now well open the floor to questions. There will be people coming by with microphones. And so please wait to get the microphone before you ask your question. Id like you to identify yourself and your organization before you ask a question. Well take three at a time, and then well pose them to the panel. Okay. Weve got several hands up here. Good morning, ladies and gentlemen. Thank you so much for your presentation. My name is rosemary segero. My Organization Called hope for tomorrow. A u. S. Based organization, though we are also based in kenya. Thank you so much for your presentation. I just wanted to mention about what you said there has not been partnership, collaboration, outreach and awareness through partnership with Civil Society, government and other people. So how do we make this happen . Hiv because of lack of cooperation, lack what are we talking i dont know what we are talking about. So this message is very, very important to faithbased all over the world. Because without this message reaching them they cant so how do we work with you guys . We just came up with applications of common indication where people are in africa can hear what we are talking now. Using health care, education and everything. So how do we collaborate instead of just hearing of the report instead of actual implementation what you are talk. Thank you. Okay. Thank you. Hi, my name is katie lutens and im the Health Program coordinator at the council on africa which is an association of businesses interested in africa. This question is mostly i think for andrew. Did you find big differences between religions, particularly religions that do not have sacred texts or that are not dont have one overarching philosophy for the entire religion, like folk, folkbased villages . Thank you. My name is michael and am world bank staff. I have worked in many countries in subsaharan africa, and for more than 35 years. And a lot of what is discussed here is timid in the sense that i expected your team to look at the relationship between faithbased Health Services and government policy development. The relationship between funding agencies and faithbased institutions in countries. Ill give you examples to give a little clarity to my question. When i work for the world bank and went on missions to countries, my colleagues were very reluctant for us to spend time discussing either the baptists or the catholics or the presbyterian institutions. They were very unprepared to integrate statistical data from these facilities. I remember the case of where one time the catholic children were doing a lot more than the government were doing. But this was never really integrated in their policy reforms or for Program Development or for program evaluation. When i myself worked for the cameroon government before i joined the world bank, i helped and developed a relationship between the missionaries and the government especially in the area of medical statistics. And the most complete statistics we were collecting were from the reverend sisters, the nuns, and so on and so forth, not from the government. I worked on other countries where when you visit a Health Center in an urban environment that is missionary run or faithbased run attendance is probably four times the size of a more equipped more staffed Public Health institution in the same town. There are several african countries where the hospital in the country is not in the capital city. It is in some remote little town. Monies either by the catholics or by the baptists. And so there has been a conflicted relationship. I hate to see us move ahead as if things have been very sweet and nice between government policymakers and the religious institutions because that has not been the case. In fact, in some countries, the missionaries that are trading, but the governments got discouraged from supporting the programs because of World Bank Institutions discouraging the use of public funds in what was classified as private enterprises. Thank you. And that has cost us a lot. Okay. Thank you for your observation. Lets take one more question, and then well go to the panel. Yes . Good morning. My name is john blevins. Im director of the interfaith program. My question is mainly to dr. Tompkins, but i wonder if others have thoughts on it as well. In regard to reaching hard to reach and vulnerable populations, particularly in activities and programs that might be of a contentious nature in cultural context, actors from Civil Society or the multilateral or bilateral donors are made aware of the programs, how does it change the impact and the effect of the programs in ways that may be negative . That it makes them and the staff in those organizations more suspect ander or maybe puts services in danger. I wonder if you saw any evidence of that, and if you have any thoughts about ways that civil. Thank you. Andrew, do you want to good ahead and respond . Yeah, those are some great questions. Thank you so much. If i could start with the call which is coming out of all the questions about collaboration if we look at the political framework in which my comments are based it is that Sustainable Development goals are going to talk about universal health are to reduce poverty. The bank has changed its mind. It used to say you can become healthy once you become rich. Now youre saying i know this is true. The bank is saying you have to be healthy to increase your standard of living. Several things part of them are comments that have come out about review in the paper. My authorship team. Partly some comments because ive lived in africa for many years. And have been privileged to do so. The first thing is, that when the faith groups are involved in Healthcare Delivery, it seems to me often there is a tokenism. One of the challenges seems to be coming out of this that the governments and the agencies actually need to lose the nervousness that you sir described. The anxiety and just get real and say if we want to achieve health coverage, then we have to look at ways of working together with partners who are working there. That means that literacy as jean was saying needs to be developed. And there are some good examples in the paper of ways in which faith leaders have actually been the leadership of the programs. Particularly in some of the health damaging practices. More recently our experience in northeastern nigeria is faith leaders are absolutely vital in assisting the increase in development of immunization services, which are tragedily declined over the last few years. You mentioned about kenya and youve given a good example of countries where there are great opportunities for people in government and the donors and the people who work at delivering healthcare to actually understand each others language. And i think there needs to be a greater appreciation, a knowledge, and respect at the moment i have found that quite lacking in international Development Agencies. They do not want to accept that there are people who they disagree with in their own personal lives. I think the challenge is how do we get people to move out of their personal prejudices and work into global care. Which is what were talking about. Just a sort of a short synopsis. Would you like to comment . Sir, i didnt catch on the thank you. And i think theres been a bit of a change since the era that youre talking about. Ive been involved in this work for a long time. I have a number of friends and colleagues have as well. In the beginning, even 15 20 years ago. Every time we started a meeting we have to the first sentence would have to make an argument for the relevance of looking at them and thinking about the collaboration between the Faith Community. That was our one piece of evidence that people were using for that statement. Things have changehead quite a bit. There is published work on statistics on contracting. The w. H. O. Has sponsored work on the contracting relationship and the official relationship in three african countries. Universal healthcare coverage studies. Im not saying relationships are not fraud. Its an ongoing all partnerships have done them. I dont think its quite the same as this kind of no, were not going to think about it. I think theres been a change. There are lingering biases. Which many of you in d. C. Will be very familiar with. And is also very, very familiar with. I think that was part of the about saying how this is an unusual area of engagement because of those biases. I think theres an International Effort i think theres a slight more openness to thinking about this and engaging this and considering those issues. I think the engagement, i think underlying your question is why have the meeting in d. C. And talk about these things here rather than in the countries. Im not sure if that was the underlying all i can say these collaboration and partnerships are happening on the ground. Several partners here i know theyre doing lots of work on collaboration in kenya with local partners. I think its not just here in d. C. These conversations are happening. If that was the subtext to your comment. Just to support what my fellow authors are saying here in going to our sister from kenyas question around the challenges of partnership. What im so excited about is there seems to be a Real Movement both sides to look at Evidence Based developments and new approaches. To forging those partnerships. I see deb derrick in the audience there from friends of the global site. Organizations like the global fund frampor example are working very intentionally on the challenge on how to engage more effectually and more inclusively local faith communities and faithbased partners in country. I was so heartened during our conference to hear christopher bend from the global fund saying that during the ebola situation in west africa that they directed their ground teams to basically repurpose funds that had been assigned for hiv or tb to ebola. I thought that was a wonderful example of sort of the institutional flexibility, obviously in the crisis. A really good example of that. Going to jills point in terms of contracting and new innovative financing mechanisms in contracting, camroguo from your country kenya spoke to us at the conference yesterday and actually challenged faithbased Healthcare Delivery systems to formalize and to strengthen their contracting mechanisms. In fact, he kind of challenged them to say that those mous that you have are not worth the paper theyre written on. They were pushing people towards more formal contracting. On the faith side i think its up to us to step up to offer a more robust collective organizations that bring us together in larger scale so that we can deal as collective bodies, not necessarily just small institutions with governments so that they can achieve their scalable objectives in terms of development. Thank you. There was one more question for you on the differences between religions that youve seen. Yeah, that was an interesting question. You asked about were there any differences between those who had a written theology as opposed today a more verbal. The main faith that we looked at, obviously did have a written. What we didnt look at was weve actually referred to this in the paper. Was the enormous richness of traditional faith. Certainly, i can speak mainly in africa. But i mean, im sure its true in asia. Where these faiths have been there for years. And are sometimes in a sinkionistic way combined with more modern faiths such as christianity and islam. We didnt look at those because the diversity of those would have needed a lot more work. What we could all we could see was a very interesting thing. Is that there was a considerable enthusiasm among all the faith leaders for seeing how they could be more involved. And actually there was great opportunity expressed in the work that we did for making faith leaders more aware so that their sacred teachings their preachings about traditional values could have a clear help content and they could be part of the action rather than just leaving everything to the health professionals. Were closing in on the end of the hour. Maybe we have time for two more questions and short answers from the panel