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conclusions on issues such as that evidence of their final report? .. facts out there and of course that is what the inquiry will do. >> i very much welcome the announcement of an inquiry today, but can i ask my friend to revisit in some respect of the advice he has been given by the cabinet secretary. i understand why the advice was given in two respects -- one because the objective is surely >> it surely is to establish the truth of what happened. that must be the purpose of the inquiry. msa secondly the committee that i chair has been taking an interest in the form of any inquiry of iraq should take the we held a private inquiry last week and we were about to issue a report. i have to say what those people thought was frankly an inquiry was appropriate 25 years ago. but a private inquiry would not be thought appropriate now. and the worst thing of all, the worst thing of all surely would be to replicate all the arguments we've had about iraq. with similar arguments about the form the inquiry should make. so i just have to ask you, as i say, i welcome his statement. but he could he just regarded as a short process so he can carry the whole house with them. spirit i read the letter that he has written to me, and i appreciate what he has said about the views of him and other people on this. but his point is answered by the fact that the range of this inquiry goes through eight years. it goes from 2001 to 2009. what he wanted to be sure of is that all the issues relating to iraq would be discussed. we could have had an inquiry like frank's only to the run up of the war. we could've had an inquiry about the conflict itself that we could've had an inquiry of reconstruction. we have an inquiry that covers all these issues, the range of the inquiry is as big as it could be as a result of the decision that we may. some of the point that this committee or he wanted to make them he was to be sure that the range of the inquiry was sufficiently wide so that all these issues could be dealt with, and that is the case. >> thank you, mr. speaker. in the answer the prime minister gave to my friend suggested that having this inquiry and secret would mean that he, we, would get the answers that we were requiring. doesn't he understand that the british people require these answers and what they are inquiry is the truth of what led up to this war, and tell us that he will make sure that any of the taped conversation between the then ride minister tony blair and the president of the united states, if they are available, are made to this inquiry. woody also make sure that all of the recorded telephone calls between the prime minister and president bush, which i understand are recorded, are made available over that period of time? and can i ask them again, don't think about what he wants to hear from inquiry. can he consider what the british people want to hear? and what they don't want to hear is this inquiry is being held in secret. everyone can accept that part of the inquiry for security reasons was necessary have to cover that fact, but most of it. >> mr. speaker, he asked that the inquiry deal with issues surrounding the run up to the conflict. that is exactly what the inquiry is going to do. it's going to start in 2001. he wants to be sure that it will look at the issues surrounding the decision that was made to go into conflict. that is what the inquiry will do. it will look at all these issues. the disagreement between him and us is about whether we have a frank style inquiry which both the main parties ask for or whether you have a fully public inquiry. i given him the reasons why the public inquiry can he does not seem to be appropriate that we are dealing with issues of national security and giving with issues dealing with the military. >> thank you, mr. speaker. the. >> i have felt ever since i came here, number one asked the question and other government, during that period because i have always thought on the knowledge and therefore extremely disappointed they were talking about an inquiry which is going to be limited because at the end of the day i have always said to my constituents that we will look at the inquiry for two reasons. we must learn the lessons of our mistakes that were made. two is the truth must come out and indeed the public need to know drifter gets far more important for people to understand that when that is given no ba day day of reckoning. >> mr. speaker, i'm going to document or he has always stood by the armed forces of his country when we have been in conflict and i appreciate he holds strong views about the issue. i just have to say to him that while the inquiry is done public, in private the report will be fully published that we will be able to debate in the south. people will be able to see for themselves what conclusions are drawn by this inquiry. at the same time, as i said to this house earlier, i would ask the inquiry that the published information other than all information other than the most sensitive of the military and security information. this house will have a chance to debate a fully comprehensive report that covers eight years and covers all issues for the run up in the aftermath of this conflict. in tonight on the communicators a discussion on how digital media copyright policy and google are affecting the publishing industry. our guest is richard sarnoff of the media company. that's tonight at 8 p.m. eastern here on c-span2. tomorrow we will have coverage of the senate commerce committee on two nominations to the federal communications commission. that's tomorrow at 2:30 eastern on c-span three. >> starting tomorrow look for our newly redesigned book tv website you're now every weekend stream of tv programming right to your computer. it's also easier to search for and watch videos with the redesigned search function and video player. and you can share the videos you are watching with everyone you know. the redesigned booktv.org or look for it starting tomorrow. >> hallie c-span funded? >> i have no clue in maybe some government grants. >> i would say donations and advertising for products. >> public money on short. >> by taxes? >> how is c-span funded? 30 years ago americas cable companies created c-span as a public service. a private business initiative. no government mandate. no government money. >> now a discussion of world health organization's efforts to eliminate polio around the world and the lessons that can be applied toward developing other vaccines. you will hear from the physicians leading the group effort, the global health cancer posted this 40 minute event. >> especially grateful that you didn't ask me to talk about polio eradication and how we were going to get it finished which is what most people ask me. you've asked me to look backwards and talk about the lessons that we've learned. i first want to table are not going to talk about, ladies and showman, over the next few minutes. i'm not going to talk about the horizontal, vertical debate about polio eradication, eradication and vertical programs in general and i'm not going to talk about whether they are good or bad. of course you talk about the politics of polio but i'm not going to talk about that bit where in washington. i think you get enough of that. what i'm going to focus on really isn't going to look back over the last 15 years as suggested by the time i was given by the global health council to look at what have we learned from this global effort to eradicate polio that might be somewhat applicable to what we are trying to do, all of us, and improving global health in general. and improving in particular the uptake of other vaccines. now, before getting to the lesson, i want to make sure we are all on same page. i want to talk about it about why we are trying to eradicate polio and did what we are doing to put that in context. there are really three reasons for doing this. this picture for me always captures the key one, and that's because this is an absolutely devastating disease that affects the most marginalized communities in the world. over 350,000 children were being paralyzed by this disease every single day. i'm sorry everything that year when the initiative was launched just 20 years ago. and it's a disease widespread not only in asia when we started the eradication initiative, but also in africa, of course. by the time we got started, thanks to the work of the real hero of polio, the disease had largely been eradicated from the americas. so a devastating disease, but also one which in contrast to hiv, malaria and other diseases we actually have the tools to eliminate forever. the other key reason for the second reason that eradication is i believe so important is i think that's put in the work here of doctor bill of the cdc is that eradication attack in equities and provides the ultimate in social justice. i think this is something we'll come back to again and again as we talk about some of the lessons from this program. but what i think is most important about eradication, interesting wishes so much of the other things we do in international health is that it requires getting to the populations that everyone else misses, where the road stop for every initiative you have to keep going if you are to eradicate a disease. it's the ultimate indicator that you are actually reaching children and achieving the goals that we set out to. most things, as you know, in the pursuit of the millennium development goals must of what we have done so far is been given more thing to the 70, 80% of children. what this talk is mainly going to be about is what have we learned about trying to reach the other 20, 30% of children. and not only been bringing me to the third reason about eradicating polio. the third reason is not just to get there to eradicate polio to put the skids on a map, but also to establish the structures, the infrastructure, the processes and the support for going to scale in the areas where we need to get other interventions if we are to achieve the mdg's. these are just a few examples of what we have been doing while we have been eradicating below, whether it's delivering bed nets, helping with the effort to eliminate measles or fighting flu. a few words on what the initiative is. first is a partnership first and foremost on the right hand side you have some of the private sector partners who are part i'm sorry you're left. at the eradication initiative. on the right hand side some of the political bodies, ngos and others who played a critical role in the program of course, at the center you have partners in ministry of health that have over the last 20 years been responsible for coordinating the implementation of the eradication strategies. the strategies are fourfold, which you see here. consist of a base of routine immunization on which you conduct national immunization days and eventually mop up activities to interrupt the remaining chains of polio transmission. to give you a sense of the scale of the program that we are talking about from which i am going to take some of the lessons, this program has been running for nearly 20 years now. 20 and a half years actually. and it's operated in over 200 countries, over 20 million people have been involved in the eradication initiative in either distributing the vaccine, immunizing children or supporting it in other ways. and over 2 billion children have been immunized probably with close to 20 billion doses of vaccine. it's a partnership that continues to grow, to change, to adapt to the nature of the disease, the epidemiology and the challenges we face. as you see from the statement by the present last week in cairo. now if we look at what's been achieved just before we go onto some of the lessons, this is what the world looked like in 1988 when the global initiative to eradicate polio was launched. and the commitment was made to get beyond the 80% that had been achieved and immunization globally or thought to have been achieved at the time and to reach that final 20% of children. this is where we were. nearly four years, 30 years after the vaccine, polio vaccine had been developed and was widely available in the industrialized world, you can see that children were still being paralyzed in vast majority of the country's. nearly half a million children per year. as a result of the application of the eradication strategies, the disease was eliminated from all but four countries in the world by 2004. and at that point, the world got stuck with the four-part, four of these countries, northern nigeria, northern india and parts of pakistan and afghanistan. and in the situation got further complicated when the virus began to spread out of those countries and back into countries that had been polio free. so at this point in the program, we faced really four major challenges. in afghanistan and corners of pakistan, as you know, active conflict as well, a challenge of insufficient political in some corners of pakistan in particular. and in india, a very different problem with insufficient vaccine effectiveness which i will come back to as we go through the presentation. and then in northern nigeria a combination problem related to both iran and both political leadership at different points in the program. and the societies in which the program was operating. whole thing than complicated, as i mentioned, by recurrent into areas that had been polio free. in addition to the four countries that you see here in red, another 15 countries just this year alone were reinfected by spread from these two countries. so this is where we are. that's what the eradication program is. what i'd like to do now is to look at the lessons that we have learned before returning to what we are going to do to try to get the job of eradication finished. now, as i was putting the talk together, i shared it with a few friends there and they said you need to talk about partnerships and the power of partnerships. i said no, actually i'm going to presume partnerships basically as a become what we are trying to do because i think whether it's the partnerships that we have with groups like the global health council or whether with sanofi and with others, that is the way that we will be working in the future as we weather in the un or outside seek to improve the health of the population. so i'm presuming that we will be working in partnership. the other thing i'm presuming as well is that whenever we are pursuing will provide opportunities for strengthening health systems. i'm not going to talk about that aspect of the program either. but focus on eight lessons that i've taken away from the 15 years in the eradication program as to what we have learned about getting beyond the 60, 70% of children we usually reach and what it takes to get to the end of the road, so to speak, and reach the children because of differences of culture, of religion, security, geography, or whatever, are not being reached with the most basic of health services. the first lesson i think overwriting one is to bring in professional management. i'm a doctor. i was trying to take blood pressure. i was trade to look at sore backs and things like that. i was not trained in my professional training to run international health programs, and the first thing i did in coming to the program in who was to hire people who did know how to do this thing. the first person was an nba, the second person was an mba, the third person was a communications officer. the fourth person was a lawyer. the first person we got rid of was also the lawyer. [laughter] >> but what we learned very early on was that in managing a program like this, you have got to rely on people with management expertise. when we talk about, these are just a couple of shots to keep you interested in the presentation. but as we talk about management, we need to go beyond simply hiring the people, but also putting in place the management processes that are used to run a company, to run in order to enter and other organizations. you need to bring that to public health as well. and what we find so often of course is people bring in management people but they're not the processes, and it's sort of like saying i have a democracy because i have elections, but i don't have the checks and balances. you have to have the whole shebang. the polio program is just one example. we measure anything. again, this is the legacy of people who would be forced into global program especially here in the americas, and we began a process really that today measuring absolutely everything to maximize efficiencies, but also to maximize accountabilities your there is a terrifying timidity and international public health, to hold people accountable and this is something that we have got to get over as well. i probably should have put in as a specific lesson, but if we were to accept the kind of shoddy sometimes accountability in public health in the area of mechanics, most of our cars wouldn't start in the morning. we need to hold people accountable to the process indicators, to the goals that we put in place. this is an example from pakistan of a year ago, or two years ago, we went to the leadership, to the prime minister of pakistan and said we need your help to hold people accountable in the eradication program and get the job finished. and he asked for a map showing where the problem was. someone handed him a map. it was like this, a district map, but it was all green. what it showed, it was over 95% of children were getting vaccinated in every district of pakistan and he said i don't understand what is a problem, what am i supposed to do with this? so we obviously were not properly managing the program. we went back and we said it doesn't count if you say you are vaccinated. you have to have a mark, a purple mark on your finger, every single campaign we marked the fingers of the children and then we look at that to see whether or not they are truly being vaccinated. and a very different picture, as you can see here. were brought in and put in place to objective measures as to whether or not children were being vaccinated. by february of this year, the prime minister had announced his action plan to hold the leadership of each district accountable to reaching their children with the most basic of health services. and then he put in place down here on the bottom, you can see a polio control room. they ran the ticker across the bottom of a showing that this district leader has failed to vaccinated as children, and people would go in and take my district leader isn't either. and very, very quickly thing started to change. but again, basic management processes have to be in place, and you've got to close the loop and hold people accountable. and we don't do that enough in public health. the second thing that i tried to pull out some of the things that are maybe a little bit, if not controversial, not being practiced. the second thing you need to do i believe at this point with the extremes we have is do have to invest heavily in on the ground technical assistance. we all want to biped metzger could all want to buy vaccines. all want to contribute that way, but in many of the places where we got to operate where those children are being missed is because the basic capacities are not there to be able to manage the resources that you are putting at their disposal necessarily, if you need to invest in building that capacity. polio eradication is the easiest task you are going to have. dewdrops in every single child that even i have done it successfully. and we still need to put a lot of people on the ground. here's what we did in the polio eradication program. guess what year i was hired? but when i arrived in geneva, and i looked at what we were trying to achieve globally it was quite clear that we simply did not have the personnel, the expertise on the ground to be able to put in place the basic management processes. now, this is something i discussed with malaria people, i discussed with other people, i discussed with everyone who else who uses of these 3000 people that we have now put on the ground because what seems to be a terrible distaste for it but quite frankly without people on the ground to manage the resources, to build the capacity, you're going to learn by trial and error very, very slowly with a lot more air than trial. this is the current distributional. do not point me to put people on the ground, and again this is a big challenge to un agencies. you have to have the right distribution mix. obviously he need to be able to move people. those are things we are very good at. as you can see here at least now the distribution of people reflects the epidemiology and the risk of the program dish to the program. the other thing you need to do to be able to be flexible and able to respond to and your resources where problems are. this is the last reservoir we are of type one polio in india. what you see here is a cozy river coming down from the north part of the country. along the bottom you see the ganges river running and this is where the two meet. this area around the river, is a massive floodplain basically. every time you see india flooding and you see people standing on the roads. you are looking at this part of india on tv. and is also as you can see is where polio viruses are right along this area when you map a fairly. when you look at what was in place there to serve these people to manage the program, there was one primary health care center within the flood zone area, if i were never correctly, an area of about a hundred kilometers long, 20 miles, kilometers wide. and i think a million people during the flooding period. so you need to be able to put in place, if you want to deliver, to reach these children, you have to help put in place the infrastructure to do it. this is what our team in india did. they were right on top of that, those viruses. they lay down very, very quickly a whole infrastructure to deliver, not just a polio vaccine, routine vaccinations, other basic interventions. did you have to put that infrastructure in place. the third thing and i was so glad that actually you were speaking to the memory of beth waters and her work is you have got to establish a robust capacity for all aspects of communications. this has become one of the biggest, most diverse parts of our program which i'm not going to go through in detail. but just you an example of a couple of points. i spoke to one of our team in india who sent me this. i asked for some of his reflections on the role of communications of polio. and you can see what he has said here, is that it required us to think differently about the communities, and especially in this case the muslim community where the disease is predominated to understand the structures, the networks, etc., and then to be able to then penetrate that and engage with that community, develop the trust and the perseverance needed to be able to make the change. and we learned a lot of other lessons as you can see here. you see toward the bottom something that we had not been very good at all. although a lot of the above we could have read from a textbook, i think one of the things we learned from the polio program really the second to the bottom was the importance of scale when it comes to the communication side of what we are doing. we scale up our technical assistance. we scale up our refrigerators. we scale up our vehicles, everything else, and then we try and run the committee patient on a pittance usually an often as an afterthought in what has become very, very clear is that certainly to finish eradication, to reach these populations, we had to invest very, very heavily and we had to make sure it was a data-driven. everywhere we built our communications capacity, it had to be in response to who we had to reach and what we were seeking to achieve there. this is a map to show you of the scale of what we had to put in place in northern india to work with the muslim community to engage in any underserved communities in seeking not just the polio vaccine, that any vaccine. olio, they were best vaccinated against polio, in fact. as you can see here we put nearly 5000 part-time people on the ground. these were people from within the communities. we trained them on social mobilization, interpersonal communications, etc., to begin the process of building the community engagement needed to be able to eradicate polio, to get the population in unity up to the levels that would stop transmission. as we worked with the underserved communities to engage them as well, this required use of another tool we weren't used to certainly an immunization or at least any areas i have been working in. that was the widespread use of social mapping to figure out how do we reach these populations. for those of you who know communications is probably second nature. for those of us who are doctors and used to approaching medical problems another way, a lot of this is to a certain degree new. but this is an example you see here from the tribal areas of pakistan bordering right on pakistan. as you can see they mapped out here along the different parts of this tribal agency. this is where fm radio reaches, where they had these taliban meetings, announcements, etc. to be able to mobilize and engage the community. so increasing at an increasingly more and more social mapping to figure out where the people are and what they will respond to. the other thing is bringing again professional management, accountability, also to what we are doing an area of communications. this is just an example of using indicators to monitor what's happening in terms of our social mobilization and back. in august, july actually we began investing heavily in terms of community immobilizes in this area of karachi. and you can see how we track over time what happens in terms of refusals. and then finally we need to develop against special strategies for very specific issues. as you can see here, not everyone thought polio eradication was an absolutely wonderful idea and they have to adapt our strategies as we would look forward to deal with these issues and to ensure that the communities were fully engaged. again, using locally appropriate mechanism where the community dialogues, leaders in northern india to achieve that. this brings me to one of the fourth biggest lessons that we learned, and this is the lesson in terms of advocacy. i think we're getting extremely good in the world of international health at national advocacy, at international advocacy, the advocacy of rock stars and heads of state. but the reality is that will raise awareness about what we are trying to do if they raise resources for what we are trying to do, but it will not necessarily get the children vaccinated. in the big federal republics where we are working now, federated republics, we need to be operating at the subnational level. this is an area where we are not very good at, but when you look at where polio exists in india, for example, it's up to northern state. there are two chief ministers who between them had what would be, if i

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