Transcripts For CSPAN Key Capitol Hill Hearings 20141216

We are also very concerned about the longterm issues of the registration of these products, in terms of the affordability of these products. This is especially important because this is unfortunately something that is going to keep coming back. We are not sure our organization in the future will be able to respond. Need access to these products in the future. We need to take steps now to ensure that we can safeguard the longterm access. In terms of the vaccines, we very much worth thinking about t and the important of importance of vaccination protection. The stops pull a all in terms of really accelerating the trials and in terms of accelerating the production and recognizing that both for the companies and the donors and that this would entail certain risks in the short term and the medium term. We certainly take a very pragmatic approach to that. Approach of the structure that has been put forth. One is certainly around the price of the vaccines, which has not been specified actually in the strategy that has been put forth. It has been very vague. We think these vaccines should be available close to a marginal cost. Related to that, we would like to avoid overpayments for these vaccines. There are a lot of contributions that these companies are making, and there are contributions that governments are making to help pay for these vaccines, and we certainly support direct compensations that these companies are making. Order to make sure that these vaccines are available at a marginal costs. Cost. And we want to make sure that it is a small amount of money, and congress has just amended legislation in regards to ebola, so we need to make sure how this funding is well coordinated, as we have been discussing. We areainly see that moving towards an industrial scale production, but in the short and immediate term, there will be some problems as far as providing adequate soprano adequate supplies. We want to make sure that they are prioritized for the affected communities, and we want to make sure that there is enough supplies for all companies whotries, and we hope the is able to take a central role. At our organization, we are hoping to develop a clinical we hope we can get off the ground by next march. Moving out to issues around secondgeneration products which we think are very important, including vaccines, we would like to see a future vaccine be more stable. Sf, ins a challenge for m that we are not able to deliver them in very remote settings. We cannot move them out of a controlled temperature chain. We hope that we will be able to overcome these issues. We think that these vaccines show a lot of promise, and we are concerned over the potential biological samples in a population, and in order to beelop these products would a concern, so we sibley want to in sure that materials are being used from affected countries are being managed. Ensurese, we want to that these products are available again in sufficient untries. In these com remarks, weon some also heard there was the expansion of the orphan tax drug credit. It pays for 50 of the trial cost, but it does not safeguard any of the issues of that were concerned upon, so demanding that there would be affordable drugs, they should be available in sufficient supply, these are also concerns that we have and with all of the funding that has been happening, and it seems that it is not being tied into this global access. We are going to be responsible for acquiring these products and using them in the field for our patients. Just to end in terms of some additional thoughts. Certainly in responding to this outbreak in terms of drugs and vaccines. One is certainly about the challenges that we continue to the an really relying on importance of access. Whether it is in the short term or the mediumterm, we need to have access, and we have access issues. To think the course about these drugs in Clinical Trials, but this is front and center for us. We are trying to deliver treatment for the longterm, so there are certainly a lot of challenges there to normalize these more in Clinical Trials and in the future. Another concern is around transparency and money pain for resources. We think that we need to understand better how this funding is being used and how it all works together. Certainly important for the u. S. Government, which is offering money from all isferent sources, and there not a lot of clarity for us as an organization. Lastly, there is the issue of failure in research and development. Wasrk for an entity that launched in 1999 because we were concerned about research and development does not ensure that the development of drugs and vaccines are affordable. Is what this outbreak represents to us. We are faced with the same situation that we had 15 years ago. That systemic failure is something that we are all responsible for in a global community. It is something that we have not responded to. When you look at how the vaccine has been a licensed by the canadian government many years ago, it was license to a Small Manufacturer to which nothing was done for a long. Of time until this current outbreak. That is a failure. Unfortunately, this is an informsity cost, that can our concern. They should not be seen as opportunity cost. They should be seen is front and center to read that is really what is required to have the heanges in te. This is an emergency, but so are other things. So is basic antibiotic resistance. So is the range of 17 other neglected diseases. They all demand our attention. But they require new ways of thinking and new ways of research and development. And it is only if we are able to develop new kinds of drugs and vaccines that we will be able to be on these panels in the future , because we will be facing these challenges in the future. Thank you very much. [applause] it is really striking how much soulsearching and introspection this crisis has stirred and how much effort and innovation and changing business operationand most of how all of you have stretched in this. To do think there outside the normal pattern. There are three issues that i would like to quickly touch on and then open to the audience. One is the question of how these trials can be best carried forward. There is a debate going on now. There would be, in an ideal situation, and obvious preference for the classic randomized trial approach, doubleblind trial, and that will be attempted in many settings as we go forward. There is uncertainty, though, we know the risk environment is complicated. We know the operational environment is complicated. We know the acceptance by the communities is very difficult in being able to move forward with trials. So it seems to me as we are entering 2015 with expanded multiple trials, that this unresolved debate around how you operate with greatest adherence to the principles of safety and efficacy while being pragmatic and adaptive to a highly challenging and highly virgin environment, how is that likely to play through . Ofis an honest and open set challenges with that i do not know if there is any immediate answer. It is very clear from all of you how you anticipate navigating the environment and moving forward. Tony, do you want to say a few words . So, first of all, when youre dealing with trials, there is a balance of trying to get a product that potentially is going to be beneficial to the people as quickly as you can will making sure that it is beneficial and not harmful. That is really the fundamental rationale for the placebo doubleblind trials. I think that it can only be done inh complete by in buyy by the people involved, which is why we are in our fourth visit to liberia with the meetings regarding whether decisions in the medical community should be made, and to do randomized control trials, fully being aware that the advantage of doing a placebocontrolled trial where not every Single Person gets the product is that from the standpoint of proving efficacy or not, it is really of doingrefire way that. You can have other trials. You can have cluster randomization. Those are actually ok. H lessey are muc stringent than a doubleblind amount of data. The benefit of these kinds of trials is that everyone can eventually get the vaccine, so if that works, that is good. But with a randomized trial, you can probably get the answer about efficacy more quickly. When she get the efficacy, you are going to distribute that vaccine that everybody and anybody who might benefit from it. So there is a balance about ultimately if it works, everyone is going to get it. That is the framework. Then we look at the advantages and be disadvantages. If foreign fact you are distributing the vaccine before you know it works, the advantages are if it works, you get it to people quickly. The disadvantages is are the if it proves that it does not work, we are going to be sitting on the panel with the inevitable next outbreak and will not know if we have a vaccine that works. That is the problem. Randomizedith the controlled placebo trial is that some people are not getting it right away. There is this absolute understandable desire that if going to be beneficial, and going to get it that quickly as possible, is important. I will just finished with this. I have just been to another seminar that we had here about the issue of the difference that you canpy make readily available, for which i was the champion of during the hivaids. , first as a vaccine that you dont know works. Hivaidess period, verus and vaccines that you dont know works. They have heard of this, we had that lookedr hiv really good in an animal model, and hast taste for one, it lookedphase one, it safe, it even passed phase twoa. The last four days 16,000 people have died from aids. Argument for you have that data in each of the trial, give it to everybody who needs it because it is a terrible and catastrophic pandemic. The only trouble is within the randomized control, the doubleblind trial, we found there was a 41 increase of risk of getting hiv infected if you were vaccinated with the vaccine. It had nothing to do with behavioral changes. It had to do with the vaccine. So that is one of the reasons that if you are given something giving something to someone who is an otherwise normal person, there is a great risk that you must seriously balance. I dont know what the right answer is. Able to consider the pros and the cons, and that consideration has to be with the people and the country were going to be involved with the vaccine. And if they dont want to, they should not get it. They should get whatever trial they feel is appropriate for them. We are balancing out the andncy and the leadership that is all to be determined. A mix of tools and approaches. I am very supportive of you, and i would like to add two dimensions to it. Between 12000 and 18,000 children every hour. We need to be very cognizant of the proportionality. The very important point regarding a bull is regarding , we dont have a vaccine to m as everybody. Izeunites immunzi everybody. This is not a situation where we save peopleially who participate in the trial, and i think the ethical question is keeping people away from the that could be expanded to the overall population. For me, it is one of the reasons there is nothing else that we can do in providing these vaccines to a smaller proportion of the population. Having an agreement is absolutely paramount. It is the reason why we are not favoring anyone and people are working to two put one forward. I do have a concern when we look at library a, will we see the next was introduced a month ago, and we have seen events now, therefore, we would not know that we may be wrong. We should have a very balanced, very open, but also scientifically sound discussion regarding this. This hits really hard, and i just wanted to jump in here for a second because i completely agree with tony. Par the separate ticipatory is very important. We need to have a conversation with all of the people involved, and have a cultural context on the situation. The only thing that worries me is that even if we knew the vaccine works, will people take it . See is a problem that we with vaccines that have been around for as long as they have been. The polio vaccine has been around, and when a disease is as frightening as ebola, it is going to be very difficult to help a population have trust and confidence in a product. Thehe more participatory processes, it can be helpful to actually be at the front line were people need it. I fully concur. By the be as excepted entire population, not only by the medical communities, but by the entire population . Be occasions anyway the social start thinking around how to involve a certain population and to work importantues is very to make these trials successful. One thing that i would like to go to that is on how we later on demonstrating for later vaccines whether we can go to when theses again, vaccines become even more controversy or. Should we start looking into these discussions that we sunni to have . Msf, out of all the organizations here, is the one that is deepest on the ground and has the most extended contacts and knowledge to read you are being pulled in divergent directions in terms of these issues of ethics and trials and community relationships. How do you see this . It is what the others are say, it is about Committee Case and and the acceptance. We are built on that basis. That is just part of the dna of the organization. We have not finished the trial design for the vaccine. We decided not to do randomized trials. We made that very early on in the decisionmaking process. We looked at the historic trends in some of these communities, in terms of what is the outcome of mortality rates, and there is an understanding of the shortcomings, but also as a medical provider, there is a need for us to be engaged. We felt that we sibley could not simplyged that we could not be engaged. Steve, again, the point that you made is an excellent point. I think the people need to when someonetween is sick versus a vaccine, there tono kind of trial you need do what is acceptable and what you feel is the best, so there isbetween us on that. That has the issues surfaced in this. Is coordination. How to make sense, how to travel , how to make efforts, getting i would likeine, more toosh a little bit just say a few words. There is a microphone right here. How does this help put in place mechanisms that build confidence around the coordinated efforts looking forward . Are you excited about that . Thank you, steve, and the you are a terrific group of people who are really in the middle of all of this right now. It is great to be here. Ofgive everyone a little bit background, in september, our executive committee and our board asked the secretary to basically look at ways to have a role in the Ebola Outbreak and the crisis. Essentially, over the last two months, there has been a tremendous amount of work that has been done over this. All of the people on the panel and pretty much every stakeholder that is involved in came to a point at the board last thursday when the board discussed the idea what the role would be. The decision was a couple of things. The first was that everybody that was related would have a funding envelope to up to 300,000 to a vaccine that was be deemed safe and effective by the who. There is also a 90 million envelope for two purposes. One is for the rollout of the vaccine once it becomes available, and the other piece is around the recovery of the m ationzation immuniz systems. Especially these countries, there has been a huge reduction of immunization. A lot of these countries are going to have to rebuild, and we are going to be part of that solution for them. I think it is very important for people to understand, i think some people here know that we are just weeks away from our second replenishment. The number we are looking for is seven and a half billion dollars, so the numbers we are talking about ebola are in addition to what we are looking for as far as replenishment. I think it is important to know that that funding is active and not part of the regular critical immune eyes asian immunizatio n work. The work is already started to really get ourselves in place. To be ready when a vaccine comes about. Four work streams have been created. They will roll out for potential outbreaks and recovery of the system. We are really working to ensure that these pieces are all set. When a vaccine becomes available, we are prepared to roll it out. Piece goes,recovery as i said, i think countries are still in the process of figuring out what they need to do, and we are putting ourselves together, so when countries are ready to start rebuilding, we will really be there to support it. Far as we are, we have seen in the last two months that it shows the Important Role that we have around m as asian immunization. Does going back to what everybody said, this is all about partnership. People play a certain role in the vaccine process, but in order to ensure that it is really getting in control and to the people that need it we rely on our partners on the ground, along with all the other people. Thank you very much. There seems to be a pretty strong consensus among the speakers that future Business Needs to be done on a different basis and that part of this introspection process is looking ahead with that in mind. Could we get a little more particular, a little more concrete as to what would you see as essential changes in practices and inquired coordinating mechanisms and in planning and creating incentives. Julie . One thing i would think we would all agree on is that companies crave predictability. So we like to have the confidence that if we start something, we can move it to completion. We like to have the confidence, for example, we have a government partnership, and that the partnership is good for the duration of what ever it is we are trying to do. Whether it is the next sequestration or the next challenging circumstance within anybodys government. That is kind of the concept, if we are going to make an investment in our partnership, that the partnership can hold. I think we have really good examples were that happens. Have been able to come through on commitments, and i am not a resizing not criticizing anyone in any way. I think we would all benefit from a public that is more informed and more reliably informed about why these kinds of investments are important. About a pledging conference were people need to tomit and governments need commit, and donors need to commit, and in order for that to happen, the public really have to understand and understand why it is important to vaccinate. What is the benefit that not only the children or the adolescents are benefiting from immunization, but what is the benefit to the people who dont have Affordable Access . What is the advantage to the rest of us . I think it is important that we not be shy from the fact that vaccines and vaccination is a Public Health good. And the problem with sharing a good has become very global. Awaye only one traveler from a threat in our own neighborhood if we dont do a good job asserting Affordable Access to all of these communities. I think in terms of how we vaccines, iline think one of the areas for opportunities that we are othersng, but for many it is hard to find treatments , increasinglyor for there are interesting places where companies can come together and work on projects and bring different ideas together long before there is a product for a candidate target so that we can kind of share in our own intellectual capabilities but also partner with the people in academia and others, other nonprofit organizations to bring the best ideas forward long before we are targeting a product. That is probably the only way to harvest that intellectual competency and expedite its useful fruition. Hear from the other two industry representatives here. Our company is extremely committed with some very specific ideas around what should be done Going Forward. There are the vaccines that exist, and those that dont. I think allxist, the companies have a process to is ae that there fundamental provision of this , making itity available for access and use. I think that the challenge, actually, is how to incentivize integration in these very high risk investments. Diseases. Areas of the key elements as they leave through, and every time there was an out rake, we did, speech. And volume. Outbreaksnd all the and scares in which this occurred, we have been very fortunate that none of them actually turned out to be one. We actually dont know if we are prepared are not. ,e very careful, as a society to be much more fairly, frankly. In way that we look at this terms of the vaccine being the concern is that vaccines work through what we would call blackhole technology. You have seen the chimpanzee or , and there is a Great Technology that can be used to make many different vaccines. And in fact, we can predict, with reasonable accuracy, but not total accuracy, which vector, which technology, which platform might be best suited. Our recommendation is actually to create an organization. Exactly how we can organize it, i dont know, and we should fund it to specifically include an open debate for an organization that is going to identify all five or six such and prepare them for scalability. To gain that type of reaction. Use vaccinesem to for all possible outbreaks. Have that vaccine available. But also, when we have not predicted the pathogen that this scale is built into the platform , it can go very fast. These collaborations would be new, grand collaborations of a kind that you are talking about in which different industrial interests would be sharing in this. Can also beit competitive or pretty competitive. Models are possible. There are very significant synergies between the way that you design a vaccine for ebola and the way that you design and deliver vaccines for another disease, that are more commercially relevant. A sustained business of risk innovation like the vaccine itustry, the knowledge that generates from one cant the other and vice versa. I think that there is a need for and aned efforts organization that is dedicated to this. The other point is the following. I would like to say the following, if i may. In thishe points particular situation is that if a company did not care about ebola, no one would talk about it. There are Vaccine Companies not doing anything for ebola vaccine. Thosed to be careful that who have actually made a commitment outside any form of financial or any otherwise contribution from anybody, to commit their resources to make the vaccine, to make them available, that they are not those that are posted. I think that is the first difficult thing that we need not forget. What is very important is that this type of commitment to Global Health has to be sustained in the world that we live in. In this world enormous andstments are made in r d in some cases they succeed in we need to be able to sustain that innovation. So, i think that we need to have , i would say, the courage, but at the same time be a Sustainable Business will commit outside of any condition what the public needs. That is what our company is doing every time and what we are proposing is to do it on a grand scale for many, many more pathogens. I think it is an excellent idea, but once you go into detail we will need some more discussion. I think that both companies are quite similar in terms of the possibilities of thinking. We do have a dedicated public that does r d only on those types of projects. But otherwise you would just come forward with too many of them. Certainly, when you were working together with a network of partners, being companies or being institutes in this area, i do think that part of the future is there. Part of the future, i think, the reference was made to the problems with antibiotics and multiple systems, Society Needs to stop thinking about how drugs specific antibiotics are being with a normal high setting that does not work. Wayseed to look into other , nothing too expensive, but you as the experts in some way are taken into account so that progress can be made in the field. Im going to turn to tony and then we will open for crest for questions and comments. On this question of what needs to change, tony . A few parts. We recognize the efforts being made by companies right now and we certainly appreciate that, but if you take the example of the ts k vaccine that was only acquired because you purchased the company for another vaccine and unfortunately unfortunately this was just sort of included in the package. Of course, a lot of the other vaccines were actually developed by the government through public funding and had shown activity through the efforts. There was simply nothing to be done. To take a step back, the big picture about this is we only have one system of innovation today. That is something that all of these companies have rushed aggressively for over the decades, globalizing in the 1990s. In a sense, you own the system of innovation. And is what you asked for this is what you have today. This is what we have to deal with in the field and that is one of the results that we see of the Ebola Outbreak today. People can dispute that, but again, your companies today are still pushing for higher levels of Property Protection that we are we think are only deepening the problems rather than solving them. Terms of the suggestions of the things Like Development partnership landforms, this was something that had been introduced 15 years ago. Our organization launched one of the First Product Development partnerships. 25 ofl pay for about the operating costs. While we do not necessarily disagree with looking for solutions, for us it is really more of the same, there are Product Development partnerships out there and we are just adding more and more to paper over the tracks. Doing over theen last decade is working at the World Health Organization and elsewhere to document the systemic failures we see in development and the World Health Organization has come up with two comprehensive reports showing the extent to which the patent system is not developing what is needed in developing countries, they have developed a range of recommendations to try to break this impasse between innovation and access to make sure that we have what we need in order to respond to emergencies like this. Ofre are a range recommendations that talk about thatodels of innovation sink seek to review the cost and so that we can develop for publicth goods health needs. That is essentially what we are doing today through substantial investment and procurement. We are essentially developing these vaccines through new models of research and development, really just through a random process. Unfortunately many in the industry have been fighting against these models because they challenge our existing system of r d and we have continued to advocate for this because we are concerned about the longterm impact. We have seen success in the vaccine space, like with meningitis, which developed financing from various partners developing a secondgeneration vaccine at . 50 per dose. So, this can be done and we think it can be done in other areas. Our concern is that the Solutions Coming out are just more of the same. The United States is completing negotiations of the Transpacific Partnership agreement at this time, seeking to introduce high levels of Property Protection and none of that will deal with these problems. We will simply have more of the same problems. Again, we think that these new models are not just for ebola or neglected diseases. They could be for basic things, like antibiotics. Basically United States is saying that we cannot rely on the current models of innovation wethe hospitals today and will need new models with substantially new forms of funding and we think that this can be applied on a much broader scale and it is necessary not only for those in the United States but also around the world otherwise we will just continue to face these problems. But it will not be the solutions from the last decade, they are not getting the job done. Thank you. What needs to change . First of all, the colleagues of my comments on the panel are right on and i agree completely with what people have said. Maybe just make a few brief comments, in a different area, fully knowing i think what they said is probably the most important thing, two things, they have to do with something we have been dealing with for some time, the issue of changing, in a sense, of making sure that we Pay Attention to something that has been started some time ago that has recently crystallized into what has been called the Global Health security agenda. In other words, to try to develop some sort of infrastructure in the developing when you go into a country for one reason or other sustainableme infrastructure. So that the countries involved if we had had some sort of an infrastructure available in guinea, liberia, sierra leone when the first cases came out to be able to do the kind of identification and isolation, we may not have had an outbreak as explosive as it was. It is interesting, we have had this since 2003 and has not only had an impact on hr d, but it is also left in countries and extraordinary infrastructure of people committed to the health of that nation who have now transcended hiv in a way that involves a variety of other diseases. Maternal health, child health, vaccinations, measles programs, etc. We really need to Pay Attention to that. I have extraordinary admiration and respect for the courageous they do,ng things that but the cavalry cannot come in every single time, they only have a limited amount of resources to do that. We need to start developing some ingrown groups that can do that. The other thing, i could not help but think, as you were talking about we all said it, but i know that julie said it right off, these are surprises that are not surprises. If you want change, we need the mindset to realize that outbreaks actually occur and when youre dealing with infectious diseases, you should be asked that she should be expecting them. Some of you may have seen years ago the hbo series, a band of brothers here a1 hundred first airborne was going in and the army was retreating, the guys in the army were saying why are you going in there . You will get surrounded. He look of the major and said we are paratroopers, we are supposed to be surrounded. [laughter] it is the same thing with infectious diseases. You should expect that there will be outbreaks and they should not surprises. A very good image. Ands open for some comments questions. We will take three or four at a time. Sir, down in the front . Please identify yourself and please be brief. Thank you. Owner of the Medical Center inlay goes, like your nigeria. We were the ones who jumped on the first and last ebola grenade. [laughter] thank you. [laughter] to bring the issue that i think is very important Going Forward here. It is the issue of stigma. Now, i have come here because of what lies ahead. In a country of 160 million people, 18 people were infected. 12 were from my hospital. Now, eight have survived. Thathave been declared thee see room has antibodies, but they are still suffering from stigma. Now, in the country and the continent, a zone where 70 to 90 of the people get their health care from the private people, how are we going to be able to introduce this . Is tonow the practice stop the fever. If you have a fever at the gate, you dont come into the hospital. So, how are we going to be able to convince them . The comment about participating. It means that you have to really, really go in there and talk to the people and get to fearsow to overcome their , which we now know as the stigma. Thank you. Thank you. Lets take a few additional comments and questions. Right here . Sir . Name is wayne. I tip my hat to you all, you have done a marvelous job from the beginnings of this outbreak to testing vaccines and drugs. Starting next month is really quite miraculous. One observation that strikes me, given the number of patients and i understood some of the earlier slides, only two drugs are being tested. It seems to me that in this country alone there must be many candidate drugs and i wonder how that narrowed. Thank you, there is a gentleman right behind you there. Yes, ken meinberg. The red cross worried about the development of biological people byrgeting genotype. For instance, race. Of the white or yellow people who have contracted ebola, all have survived. All the people who have died of ebola are black. Does that distinction, in addition to the officer at number of deaths that have occurred, suggest that the west africa ebola variant may be a weaponize version of the virus . Lets take one other. Are there any others . Right here, sir. We will come to you in the second round. Yes . I again commend the effort here. I am the head of r d here, we are a Vaccine Company and i the effort is commendable and i dont want to put any potholes in the way. I think that the companies have mobilized tremendously, cooperatively. I would point out that these are vectors and we are very focused on just vector technology. We know their limitations. They have not worked on their settings. They have preexisting immunity to the target antigen. So, we have nonhuman primate data. I think that the best bit and be at the should forefront for a second kind of vaccine. Wen we come to phase two will look at this and say i dont know if that is something we would want to is for. I appreciate comments on the longterm plan that sounds like it is being discussed. Is there a shortterm, backup lan . Thank you. So, we have a question around overcoming fears and stigma, a question around is it only two drugs in development, a question around differentiation between black, white, african populations is this weaponize of all . And then the appeal around plan b, should there be a formal plan be put forward right now . We would like to jump in and pick off whatever piece of those you care to. With regard to overcoming stigma, i dont have a punishment or resolution to that, but the point is made earlier that people organizing such a study really need to have a lot of attention paid to this pacific aspect. We did the trials in senegal in the 1990s and we studied nurses who went into the compounds and actually really took their time to tell the people about the vaccine. It was certainly not the objective to have the vaccine that day. It really takes a lot of fire and a lot of explaining and discussing, such that you really get the trust of the people and get them involved. I do think that socializing through the vaccine is an for the teamsct in place that they will need to take into account. Should engage, but we should never underestimate how much of a challenge this will be. Left there is a there is the stigma of the , for instance if any one of the vaccines and how the community reacted to that is something that the Community Really Needs to go out and through the local help of the community and the investigators. There is notthat actually an unpredictable reaction that could be extremely detrimental to the introduction of the vaccine or the conduct in Clinical Trials. That the larger the population that we immunize, the more concerned there will be that there will be with Time Associated between the events in the vaccine and the immunization. Very, very important issue. If you study the history of infectious diseases, smallpox, it is apandemic, flew, history of stigma. An inevitable complication of the fear that the outbreaks engage in. We would be naive to think that this is not going to be a major challenge in the situation we are facing here. Maybe no worse than it is anywhere else. I remember people meeting in chinese restaurants. Even the highly educated are vulnerable to that kind of irrational response. And we dont have an easy solution, but one really important aspect of it, at least in my experience, has been finding the local people who are trusted and help them to understand the whole situation so that they can speak on behalf. F their own communities did you get to complete your thought . The stigma is seen in the United States i dont know if some of you saw the Television Show that they had, of all of the old all of the ebola survivors. They asked if they were being embraced or if there was a stigma. They said it was maybe 60 40. 60 embrace them, 40 said stay away. One of the ebola survivors made the point that it was very easy for him to get a table in a restaurant now. [laughter] we will see. It is not just in nigeria. Maybe a couple of points. It was a big concert that concern and we need to make the sacrifices. It is also important to note that much of the stock we have going in which we normally do advocacy in a local communities through these affected countries , we are really working on effective underground communications. With people on the front line communicate, and that that is where you can get the involvement of the local communities. Also simply that this is not going to be, as an organization, where we do a lot around trials. We have not stopped the call for more urgent teams to go to the field. Obviously government funding in response to the outbreak, we have been glad to see a separate discussion along diagnostic lines. We think that that will be critical in turning around the future response. Nothing specific. On the question around the pipeline of drug. On to ate only testing. He outset and were worried consideration also repurpose and drugs to the extent that there is a supply with safety data. Arelieve that other trials using other drugs. From this question around survivability . There are too many confounding factors. If you look at the white people that were infected, a substantial proportion were even act to the United States, when i got intensive care. That does not mean that the physicians in west africa are not as good as the physicians and at one time, so . I think that the survival of people in intensive care, monitoring electrolyte with central lines, it makes a big difference. I think that happens to be the distribution of things. And it is a point that i was making last week, it is to organize day care programs. Anyont know if they have more vaccine. So, we need to pursue all of this. Thank you. That is a very, very nice way to draw things to a close here. We are at the end of our time. This has been an exceptionally rich and informed discussion. For weighing in on behalf of gabby, natasha. , thank you, johannes so much. [applause] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] [captions Copyright National cable satellite corp. 2014] works if you you missed any of this discussion, you can see the Video Library at cspan. Org. At 8show it at epm p. M. Eastern on cspan 2. David cameron answers questions about the uks Climate Change priorities. He also talked about what his country is doing to fight isis. He testified before a Parliamentary Committee today. Here is more now. Start, after the wants of yesterday, i just to say i think it is right to pay to beat for those that were murdered in australia and in pakistan. Im sure the prayers for everyone here will be with the family of the loved ones who perished. I am now being told about what happened in that cafe in australia. That is what we expect from people of that remarkable country. What has happened in pakistan simply defies belief. Humanityark day for when something on this scale happens with no justification. No belief system in the world can justify this sort of appalling act. I think what this shows is a worldwide threat that is posed by this poisonous ideology of extremist islamist terrorism. It has nothing to do with one of the worlds great religions islam. This is a perversion. We have to understand the scale of what we face. We see this in the country and around the rope. We must use everything we have in our power to defeat this. Combating terrorism. The values of freedom we hold 2 tolerance and democracy. This is the struggle of our generation and around the world. We have to show the resilience we have shown racing similar problems and challenges we are faced in the past. Prime minister David Cameron earlier today before the British Liaison Committee which is made up of the house of Commons Committee chairs. You can see all of that hearing tonight at 8 p. M. Eastern here on cspan. Tomorrow, randy white garden of the American Federation of teachers discusses the white houses push for education. Shs Political Announcement today and his interest for running for the presidency and what he needs to do to get to a republican primary. After that, the National Brain Tumor Society looks at the prevalence of brain tumors and brain cancer in the u. S. Plus, your phone calls, Facebook Comments and tweets. It is live every day at 7 a. M. Eastern on cspan. This week, author and townhall. Com editor katie pa vlish on what she perceives as the war on women. Tedhat is your problem of kennedy . Said, where the idea of this booking from was the convention when they were showing distribute video this tribute video. They betrayed him as a womens rights champion when he left a young woman to drown in his car and did not go back for nine hours and tried to save his own behind, she probably wouldve survived. You cannot do an entire video at a convention claiming to be preaching and fighting about the war on women and glorify somebody like that one not including that part of his life in the video about his womens rights record. Sunday night at eight eastern. We are airing one program from each year starting december 22 at 7 p. M. Eastern on cspan. Earlier today on washington journal, political operative and brothers from opposite sides of the political spectrum discuss their new documentary what house divided woodhouse divided. This is 50 minutes. A moment, we will introduce you to brad and dallas woodhouse. Their new film, woodhouse divided. [applause] i always hope we are divided about it. I dont hope we ever agree on that. Hope we are divided about it. I dont hope we ever agree on that. We will send him a message today. Hands off my health care. Hands off my health care. Thank you. These lies, were going to pass it. If the american will do not like it the momentum has moved toward the president in the past week. There and iss out going to lose. Money offe a lot of of their misguided ideology. That is it, youre just making stuff up. Lisa and i are having our own event because of obamasailing agenda. Obamas failing agenda o bamas failing agenda. Host woodhousedivided. Com is the website. Who introduced you to Brad Woodhouse and dallas woodhouse. What was this film all about . Guest it is interesting. When it started out, i did not know it would be a known. It was supposed to be a short, for youtube. Then brian miller, who directed and shot the film and produced and edited the film, saw a story there about, you know, our political divisions in america. And he did it really based around the healthcare law and the fighting past the Affordable Care act, which my side one. But dallas was fighting in North Carolina, so it had a political element to it, but also an element of, these are the types of divisions that you see in families. Divisions in your state and counties in america. It was kind of a microcosm of the political battles he had seen in washington and around the country. Host what is carolina rising . Guest a nonprofit Political Group i started to sort of help the conservatives and republicans in North Carolina who may come into power and sort of tell their story in North Carolina. The film goes through a lot of the time that iran the north hairline a chapter of americans for prosperity. , it goes through a lot of the time when i did that. I spent the early part of my career as a television reporter. In North Carolina. Moviemaker, brian milker ,yan miller brian miller when i went into the Television News business, we became very good friends. We have children the same age. With him on some projects when i was at americans for prosperity and he came up with this idea. At first, he did not know what he was going to do with it. He ended up following me around the north airline it in washington and over the course of three years, as we fought the healthcare issue, and what is interesting about the movie, it is about an hour and 10 minutes long, it is not really a story of just grabbed and dallas veryouse, who have different clinical ideas. I make my living in North Carolina fighting on the right side of the aisle. Her brother makes his living in washington trying to destroy the country for the left side of the aisle. [laughter] so we are little different. But it is not really the story of our family. I would make the contention that it is the story of our family and the conversations they have around the thanksgiving tables, and the conversations they will have with their extended families and christmas and hanukkah coming up in the next couple of weeks. Talking about the very real discussions family have about dividing politics in our nation. Host we have a clip of what it is like at thanksgiving in your house, but what was it like rowing up . Growing up, we did not take political sides growing up. Our parents guest he was significantly older than me. Were our parents interested in following the news and politics, but they do not force us what to believe. I was older than dallas and went to college, and we were not all that close when we were children. We actually got a lot closer when we got older and he moved in with me. He paid rent for a few years, and that is when we got closer. He left the News Business and went into politics, my mouth hit the floor because i just had no idea that he was going to be a right wing republican wingnut. Guest i do not know about that. I am a product of the reagan resolution revolution. Washington,e up to your brain gets poisoned, as we see constantly by people who, peer. Guest present company excepted, right . Woodhouse, dallas woodhouse. They are brothers. Woodhouse divided. Lets see what your thanksgiving was like a few years ago. Dallas, i see a lot of good pictures of you from your bus tour earlier this year. What smart asked comment are you going to make now . Ass comment are you going to make now . After you lose, we win and we pass it and it gets in law, will you keep your job . Shut up. 85, democrats. 85 against it. You cannot even keep your own stay together. 85. The woodhouse man yell at each other. Men yell at each other. Guest it is funny, you see that clip, and brad was right that they were able to shove the healthcare bill down the throats of the unwilling American People. How has that worked out for you . It has not worked very good for the country. I dont think so. We had the votes in congress, and we passed and the republicans run the senate now, run the house, and that is what our democratic process is. A bitgree with you quite on the success of the healthcare law. On thiser people coming show and predicting that the healthcare law would crash the economy. Eu in the video said that the people would love it. Has that worked out . You believe the American People love it. Guest i believe the people who have gotten it guest [inaudible] there are polls that show people have gotten it, people have signed up and they are receiving health care through the exchanges, they do love it and i will show you these polls. Think of this there is a lightning on the building. Someone is going to get struck. Young ande pretty they have not been bitten by the bug. Important thing to know is we do set the stuff aside. Brad will be in raleigh in a few days for christmas. Intol welcome his children my home and whether he comes or not is an open question. And you come in near family members say, oh god, they are here and add it again . Guest we have a very boisterous family. Whether it is about politics or about some discussion of athletics or sports, we are going to have a boisterous conversation. Fan ofis not a big having arguments about politics. It is not just us. My wife is the chief of staff to a republican member of congress. I they gang up on me when they have the opportunity. Guest at least i do not have to sleep with her. That is a good thing. But no, i think, what i hope people get out of the movie, and it is free, you can watch it , is that, look, i believe in political division. I think it is good. We have had an election here recently. Brad did not talk to me after that. It did not go his way. We smacked him around in North Carolina. Eat his candidate. Beat is a good thing his candidate. Which is a good thing. We fund the government, getting something done in this lame duck session i expect needs to get done. Other things, we disagree on. We need we need political division. That is ok. You are right. You did not agree with the president. We can disagree without being disagreeable. Having the economy humming, how i having unemployment below host how did that work out . Host i am also concerned guest i am also concerned the country out of recession, got a below 6 which your party left out of control, is below 3 of gdp, 11 when bush was in office, look. We can argue about why the midterms turned out the way they did. The republicans ran on nothing. Guest what did democrats run on . What did your candidates run on . What did your candidates run on, brad . Ran on hatred of the president. You saw this. A press conference in kentucky. Youre the majority, what are you going to do . We are going to restore regular order. That was his agenda. Not say anything about jobs or health care, fixing it, doing something different. He said were going to restore regular order. You are in not say anything abot jobs or health care, fixing chal hill and your party will have to have an agenda. Host Brad Woodhouse and dallas woodhouse. Yes, they are brothers, and they are polar opposites. We will get to your calls. Joining us from new jersey, good morning. Caller good morning. Gentlemen, you need to stop what dallas,oing and you, you represent a part of the republicanhost party, a frencht is so loud mouth, that what you people who make sense. Right now, what you have to do to get to the people, they start they have awakened the ed host do you want to respond . Guest look, i was on the forefront of the tea party movement. The modernday Republican Party, i think it is a movement out of love, love for country. It really started overspending and health care. We have fought about since the beginning of our republic. Much. Isis something our it something we will fight over, so long after brad and i are ashes to ashes, dust to dust. Guest is something we will fight over, tt protesting when president bush was expanding medicare. Guest a lot of people process and over that. Guest when he spent trillions of dollars on a war in iraq he started under false the tenses look. Guest [indiscernible] the tea party was a creation of the insurance company, [indiscernible] guest timeout. Timeout. Guest that is crazy. Why do you insult guest i am not insulting him. Is, theirsaying history is not spontaneous. Spontaneously, when people start casey showed up in raleigh, to get on bus and go to washington dc. He set up invitations and paid people. Ll types of people i am not saying they did not believe what they are protesting, but suggested some Popular Uprising that had nothing to do with what the it depends on the question. U. S. To go to sign up and they overwhelmingly supported it. Were just going to get people to sign up and be more more popular. That is the attitude of the Obama Administration and democrats and we have seen how that works output it. Host lets go to joy in North Carolina. You are right, i am from down south, and im your mother. I disagree that all families are like ours. I dont know many families that are fighting at thanksgiving. Glad that this thanksgiving was the year you two were supposed to go to your inlaws, and i am hoping you will have some of this out of your system when you come here for christmas. I would really like a peaceful christmas. I love you both. This was not planned. She called in on a normal line. But did but since you did call him, what was it like to raise the two voice . Boys . easy. it has not been and i love politics. Their dad and i both love politics and we follow the entire country. I know that we have to take responsibility for them. Theyre both very passionate about what they believe in, and i love that about them. But i hope they get this out of this is in today on the program. Host are you a democrat or republican . I am a registered democrat, many years ago. But i have at times but my ticket. I am concerned for the party that will expand medicaid. I have an autistic grandson who sol expand health care, those are, i guess i am more of a one issue person right now my life. I have such concern for my autistic grandson. Host we are glad to hear from you. James from fort worth, texas. Democrats line. Caller good morning, gentlemen. Good morning, cspan. Dallas, hope you let me speak without rudely interrupting like you do with your brother. The Republican Party spent the last 40 years converting the american middleclass income into executive compensation and investor payouts. Currently exists with two factions. In stateather was politics for a long time and i grew up and attended the 1951 Republican National convention. I Pay Attention to it. , theere is the thing Republican Party currently is composed of wall street sorry, butand i am the tea party is a reaction to white backlash reaction to the election of our first black resident. It started with him with signs with bones in his nose. Guest i think those comments are undignified and what i will the biggest negative gottion the president has is on the healthcare law and so has the president. Host the house divided on the Affordable Care act . Dallas, i see a lot of good pictures of you from your bus tour earlier this year. Comment aret ass you going to make now . All, after you lose, we win and we pass it and it gets signed into law, do you get to keep your job . We should point out that was the same clip we just pointed out moments ago. Lets go to greensburg, North Carolina. Good morning. Caller good morning. Thank you for the opportunity. I do not know any republicans so this will give me a good opportunity. I have always wanted to ask, what is it in a prisons mind or in their heart that makes them begrudge another human being having access to health care . Dont think anybody begrudge is somebody having access to health care. What i will say is there are medicaidhat people on do not ask necessarily Access Health care. In some cases, they access are and what i would say, we have taken a situation here with the healthcare law and in a lot of cases, the vast majority of people were happy with what they had and we made their situation worse. I got a get in here. All questions to from callers have been to you. That is factually not true. Absolutely, were getting the savings. Medicare inflation has gone down. The premiums for most americans have gone down. Seniors have access guest keep their plans . Guest yes. Guest oh come on. Guest one of the biggest lies was always cancellations, some people lost people loss plans, but they got better plan. Host let me jump in. Well come back to this. Heres more from the film. [video clip] we are here to represent you represent yourself every member of the United States of the senate this bill we want killed. When i stand up in front of a big crowd, it is exciting. You have a lot of people to you you can star for a rock minute. Thank you for coming today. Were going to send a message today hands off my health care. Hes a rabblerouser. He inflames peoples passions. Hes just on the wrong side of the issue. Those tea partiers really got all those people they talking about . That is harry reid right . Woodhouse the film divided. Guest what you thought was pure unadulterated politics. The republican governor of massachusetts passed a healthcare law almost identical to what the president passed. There were republicans in the that and the senate other healthcare laws, then, a democrat got elected and proposed Health Care Law. He said lets take the health exists ce system as it in the build on it, expanded, but keep it in the private market. And republicans they can lead a democratic president went on an issue. Guest i will stand with my brother buddy, a senator who says that the democrats made a big mistake. To another go carolina. Om north caller lets talk about carolina rising. They did away with the earned income tax credit. The only people in North Carolina rising are the wealthy. Guest thank you to the caller . Caller on correct the a couple of facts. Over the past couple of years, number of tax a reform. To pay everyones taxes them. We started four years ago when tax for anybody who goes and buys anything, we the sales tax. We cut the iincome tax for everybody. The reality is, you cannot cut taxes for people who do not pay them. Nature of then, we did a major tax reform. People for years have talked tax reform it was hilarious to me in the last election that we had were kay to talk d the nerve reform, her opponent had passed one of the tax or form. E of a lower the tax rate for everybody. Guest he did. He provided a huge tax windfall to the wealthiest in North Carolina. Went after medicaid very similar to what republicans guest thats a lie. Guest let me say this bunch of issues in an election in North Carolina for be the laws that wont same when governor mccoury is up. The governor is one of the least popular governors. Guest he is in fine shape. Truth of this one second is so ax reform the rate , you lower North Carolina republicans, did it ng the governor anyway. It was a tough road, and it will be rewarded for. Host will you ever run for Political Office . Guest i dont believe so. If you does, i will run his campaign. Chance. Not a host republican line. Are you with us . On to vermont. On ler i want to comment dallass attitude, it seems typical of republicans. Brad was saying, tthat the republicans will not vote for their own ideas because they do not want democrats taking credit for it. Guest brad has appointed some of the Health Care Law had looked at the individual mandate. You think the entire Republican Party has to accept it . I dont think so. You made him the nominee passed the nt, he bill. Guest yyou have to remember the president did not even run on his own bill. Guest when you get to washington, you have been congress to deal with. Guest are you saying the president is only for an individual mandate . Guest im not saying you are only against the Health Care Bill because the democrats propose that. That bill, at the time, you were against it because the democrats propose that. That bill couldve been introduced by republicans. The truth is, republicans do not want to reform healthcare, they want to take it back to where it was when Insurance Companies called all the shots. Not against the Health Care Bill, im free market. Im not a republican, maybe i am e voted republican, but i free market. Film is called woodhouse divided. Good morning. Guest good morning. Qualify my e to i have n, i am a vegan, veterans benefits. You come from, and the southern states, lead the all the negatives in healthcare, finance, and others. Is very easy, it appeals to a majority white crowd which is going extinct. Guest i am certainly not antigovernment. Thank you for your service. We commend, especially this holiday season, all the members of the military who have given so much for us. It is a shame that the present United States has not stood up law and order. Guest that is one of the most irresponsible comments ive ever make to say this president has not stood up for Law Enforcement or for troops. Guest i said guest what youre saying is completely undignified. Guest has he stood up and said that people should be responsible . Bbut anyways, the caller guest you want to talk about party protests gunshots get me dont even started. Guest i just want to say, the am not to the caller i antigovernment. A strong have military. Making people pay for people to show up at the emergency room is also not the way to do it, dallas. Your putting the gun to taxpayers had either way. Is so is the free market good then how come the Healthcare Industry is going to make people . Guest we did not have a free market system. You were not able to buy healthcare across state lines. We were not able to have True Health Care savings accounts. We could have had a more free market system, and i continue to support that. Host lets go to the next caller from georgia. In northern ive georgia, 6 miles from from north 12 miles carolina. To my three children were born in North Carolina. Guest youre in gods country out there . Caller yes. Ive lived in North Carolina. What i wanted to say, the in son republicans whine this area is because of fox news. No one has said that. News has evidently use subliminal advertising. So ave friends that are brainwashed, tthey used to be intelligent people. But, the reason people vote fox blican is because of foxnews says that the democrats will take away their guns. People in this area want to go out and hunt. In st in our senate race North Carolina and i think states bates in other were undignified but, in a rth carolina, we had substantive debate on education funding, other issues. A serious debate. Good for state. Host this tweet, poor brad, he to t really love his brother keep from reaching across the table and slapping him. Guest i would not do that. Do love dallas dearly. Host but this is how you interact when you talk politics . Guest yes. Host lets go back to the film. Available online at woodhousedivided. Com. [video clip] has ou know the momentum moved forward in the past week. People see this leadership on display. Ive always tried to take an interest in his personal career. Somebody out there will do what he does, so he might as well do it and make a lot of money off of it. Is, the democrats have been very good to him. Host from the film, we will go to dallas woodhouse. Of my brother. Oud the easter o to bunny role at the white house. He gets to have cocktails with joe biden. Hes been on air force one. I am proud of him. I disagree with his ideology, but hes done it great deal. Theres a picture of him with president obama and my mothers house. Was in one person obama raleigh, president obama commented on how good my brother was in the dnc. Whatever your ideology, that means a lot to your family. And you know, i disagree with president s politics i think hes a good man, but i disagree with his politics. Of the hope you get out can disagree you vehemently, and we do, but then we get together and go out and play football with the kids. We have a lot of conversations on one phone, we hang up another, but that we pick it up and call again. About these to talk things. That is up one thing about is we had extended family that say do not talk about this, do not about that but why . Guest i do not know what we would talk about if we didnt talk about and look, the whole family to some extent or the ked in politics government. Our parents started out in in the tic politics back late 1950s. Had their wedding reception in the Governors Mansion in North Carolina. Its to say, it is in our blood. Think it reflects what some other families go through, but it is an extreme case. Melissa from o to raleigh, North Carolina. Caller maybe i should confess that i worked in the same retired as fore i dallas. Guest melissa, how are you . Caller i watched when she did. Hes getting a bad rap here. He never paid anyone to go to washington. I was one of those people that read that Health Care Bill, and was s really sad about what in it. I said at the time to dallas, nobody who voted for that would understand it. That e do not understand it is in the first 30 pages it says that according to this blog, and this regulation there is not one democrat who voted for it that understood what they were reading. Guest i do not believe that is true. I think that principles of healthcare reform are fairly simple. We went to get rid of discrimination on preexisting conditions. We expanded the ability for people to get Health Insurance by eliminating gender discrimination. I do not think it is a complicated. No matter what politics are a divided country if anything the president does gets above 50 , i would be surprised. The Health Care Law is working. There is not any dispute, it is down cost we had 10 million more people to have Health Insurance now. What do you want . Dallas is right about one a radical a radical conservative, radical republican. The traditional republican view so be it. You can live on the street. Guest i have never said that. Guest every insurance policy in the world, in this country, is regulated. They regulate auto insurance. Should be regulated in a way that lowers cost . My god, what a horrible thing. Host at what point do the work of brian miller become a film . Guest im not sure. They may have decided from the a little , i was blindsided. People were attending strategy meetings, and making web videos. Dallas was leaving these boisterous rallies on capitol hill . Just kept coming. I thought, my god, again . Then finally i realized, this is not going to be a 10 minute for you to, it will be a documentary. I want to say about brian, he he t the entire thing, edited it, he asked the questions. I think there are very few things of this quality that have been done by one person. None of it eally to its important understand, we never set out to make a movie. This is what we did. Me, raising my kids. Meaning, having to deal with brother at thanksgiving. And the camera picked it up. Host i would ask you to reverse roles and be very serious. What advice would you give the democrats moving ahead in the next congress . Guest obviously i would change some phases. It is hard for me to believe keep some faces like harry reid, nancy pelosi the same. Way to ed to find a present some credible ideas on work conomy that they can with the republicans on. Have to the republicans show, and present some things that they can send to the president. My side is very as large of anything comprehensive immigration, reform, nsive tax anything comprehensive. It depends on several things to happen, and we do not believe that the government can do big things. You have to send one bill at a time, one part at a time. Thats what the republicans do, and the democrats should join them. Host lets go to our last call. Caller good morning. I just have a couple comments. Brad has been tight mahogany obama care is, and how is working so well. Why has so great, obama delayed the mandate for the last couple of years . Just do it. You my second comment is, remember Nancy Pelosis comment, we have in order to bill know what is in the bill. Say this the present and hhs has the authority to implement the law. Look, you saw last year, there was some real problems with the website. They fixed those. This is what dallas would tell you, it is a big law. The implementation has been good, the mandate will come in. I think the law will continue to strengthen. You can look, people are burning up the phone lines to enroll. I would give ice to republicans is satisfied their hatred for the president. They get 70 of the vote, they are drawn to the very extremely , conservative this hatred for the present is what the leaders and of having to deal with. This with u will see mcconnell, finding some accommodation where they can with the president , then they get pulled back by the caucus. Grow a pair, and of being pulled by your caucus by these elements that are completely to your president. The president has repeatedly was trying to make a big dealing with debt, walked away from because there were so many people in the caucus that have sheer hatred for the present. They say, you cannot compromise with the president. You cannot govern that way. Host final question for you, of your did you get out system . Guest you can never get this of your system. I hope people watch the film. Its a great film to watch in the holiday season. Guest we will have these discussions around the dinner table. Guest we will have these questions in the rest home while we are looking for tea, nurse, help me. Then matthew us talks about a runsh possibly exploit for the presidency. After that, a look at the prevalence of brain tumors and brain cancer. Calls, andhone tweets. That he is the first major republican to formally move towards a possible candidacy. He said that he will establish a Political Action committee in january, a step that an aide said will allow him to engage politically with supporters and potential donors to determine whether sufficient support exists for a run, the former florida government audience that the wall street ceo council is thinking he about running for president , so heres where he was two weeks ago. Is kind of like any other year. Im thinking about running for president and i will make up my mind in short order, not that far out into the future, i dont know the exact timeline, its the same decisionmaking process that ive always had, do i have the skills to do it anyway then tries to lift peoples spirits and not get sucked into the for tax and that sounds easy to say, it is harder to do. Though i have those skills, i have to really do a lot of really makeng to that determination. And perhaps more importantly, can i do it with a sacrifice for my family is tolerable. Every person that runs for office at any level, it is a big sacrifice because it is a pretty ugly business right now, some not saying, oh woe is me, there is an level under which i would never subjugate my family because that is my organizing principle, that is my life. I think people kind of appreciate that. I dont know if i would be a good candidate or bad one, i win,how republican can whether it is me or somebody else, and it has to be much more uplifting, much more positive, much more willing to be practical now and lose the primary. Without violating your principles. It is british politics tonight on cspan as the british Prime Minister answers questions on the u. K. Climate change priorities. He also talks about what his country is doing to combat isis and religious extremism. You can see his comments before the Parliamentary Committee. This month is the 10th anniversary of our sunday Primetime Program and we are featuring an on Court Presentation of one from each year highlighting authors, historians, journalists, filmmakers and leading Public Policy makers. The interview on the september 2006,pensation fund, from lonnie bunch on the importance of the African American experience to u. S. History. Robert novak on his fifth years of reporting in washington. The value of Higher Education america, from 2009, a conservative commentator. Executive compelling conversations, december 22 two the 26th at 7 p. M. Eastern on cspan. Earlier today, josh earnest talk about the west johnson the economy as well as pending executive nominations being considered in the senate. This portion is about 15 minutes. Report earlylatest this morning, the white house has not yet received the enrolled version of the bill. That was the president , was the white house has received that version, the president will sign it. Is my understanding that in order to prevent a government shutdown, it have to be before the end of the day tomorrow and i would anticipate that we would be able to meet that deadline. We will get it done. To the russian can you say ife, what is going on in russia among with that make the president more or less likely to sign the bill . As you know, United States and Obama Administration have been working closely with our allies to implement a sanctions regime against russia. It has had a devastating impact on their economy. It has also isolated them from the local community on a variety of fronts, including in the area of the economy. The success we have had in implementing the sanctions strategy as depended on a lot of flexibility. The reason for that is we have, as jason mentioned, or is not significant u. S. Exposure to the russian economy, that they only consist of 1 10 of 1 of our gdp in terms of u. S. Exports to russia. Some of our partners in europe have bigger impacts. By working close concert with those european allies, we have been able to maximize the impact of our sanctions strategy against russia. Tried to do is optimize the impact on russias theomy while mitigating impact of sanction regimes on american impacts. We do not want american businesses to be held at a