president's jobs plan. a lot of good ideas in there. they will give us 1.5 to two million jobs according to the economic analysis but if he returned to -- start having 204,000 jobs a month i think we average 207,000 a month for eight years. if you want that you have to flush this debt to get going again. soaker kenneth wrotedoff at harvard recommend some people -- if we lower the mortgage rates, if we bring the mortgage down to the value of the house, then the people who hold the mortgages will lose money. who is going to compensate them? what is it going to be? he suggested the banks of the people who ultimately hold the mortgage. instead of writing down, just cut them in half by taking an ownership position in the house so that when the house is ultimately sold, the people who issue the mortgage will share in a profit and you get the same practical results. you no longer have a bad debt on the books and the homeowner has a mortgage that he or she can pay. and i said in the book i know this will work because when i was governor in the late 70s and early 80s our farmers got in trouble. we had hundreds of small state-chartered banks who did not want to foreclose on the farmers. they knew they were having a couple bad years and they couldn't pay their farm loans off and they didn't want to take possession of these farmers. we allowed the banks -- changed the law. take an ownership position in the farm and give the farmer a buyback price to take his farm back and the full title once they could pay off the farm. >> you can watch this and other programs online at booktv.org. up next, alex perry recounts the life of ray chambers to eradicate malaria from the planet. the disease affects half a million people year and killed a million. this event is about an hour and 15 minutes. >> i am warren hoge, ip i's senior adviser for external relations. i am happy to welcome you to this event featuring alex perry, author of "lifeblood" how to change the world one did mosquito at a time and ray chambers, a central figure in the book. malaria is the world's most contagious disease. it in fact two fifty million people year and kills 800,000 of them. besides the human toll the cost to africa alone is estimated to be more than $12 billion a year. ray chambers is a wall street pioneer and philanthropist who turned his business and marketing skills to goal of drastically reducing children's deaths caused by malaria. february of 2008 he became secretary general bond he moon's special envoy to mobilize global support for action against malaria. one uniting political and business leadership and the power of publicity, he built one of the largest aid campaigns the world has ever seen. a campaign that drew in presidents, celebrities, scientists and attracted billions of dollars. brought a businesslike provided a positive response to the complaints developing world leaders that aid from abroad was often not distributed a way that addressed the problems they identified at home. alex perry is time magazine's africa bureau chief. a britain i was about to say in july learned that he is a britain born in philadelphia. he was based in cape town and covers 48 countries in sub-saharan africa. in the book he follows ray chambers through two years of the campaign 2009-2010. having spent three is in the far east, alex wright that he often pondered the question does external aid really work. in 2009 he heard about a charity called malaria no more u.k. and got in touch with ray chambers, the co-founder. in the book he gives an arresting account of his first conversation with ray and his decision to take up the story but i'm going to leave that with alex himself to tell you about when i turn the floor over to him in a moment. ray chambers said the ambitious goal of getting insecticide to everyone who needed one by the end of 2010. though he missed that target he managed to distribute three hundred million nets, the remote and inaccessible parts of the african continent. as a direct consequence hundreds of thousands of children's lives were saved. some have focused on the missed target but alex argues the focus should instead have been on more importance statistics. the number of children lives slave to. ray chambers is clearly not the type to be imported by a temporary setback so i am eager to find out tonight how the campaign is doing even though it is nine months after his end of 2010 deadline. the new york times, a paper that some of you will know i like to site as often as i can shows as the reviewer of alex's book brian borough, vanity fair financial journalist who has gained fame over the years by chronicling wall street miscreants and misdeeds in books like barbarians at the gate and the movies like wall street:money never sleeps. here is what this frisky critic of wall street had to say in the new york times sunday book review on august 11th about the ray chambers campaign and the account of it written by alex perry, quote, corporate chieftains tend to have an overarching faith in the curative powers of modern management. incentivizing, metrics, accountability. the whole shebang. people like ross perot and mitt romney have sought to introduce this thinking in government circles with mixed results but it is in the realm of charity and especially international aid where these methods are really succeeding beyond the confines of the corporation as alex perry, chief correspondent of time magazine generate convincingly in lifeblood of the digital how to change the world one did mosquito at a time. is widely praised book is for sale at the door and alex will be right here when we finish to sign copies. i am glad this evening to add alex perry to the list of distinguished authors who have spoken at i t i and it is a real added bonus for us having the protagonist of the book, ray chambers, onstage also. welcome to i p r i and the floor is yours. [applause] >> good evening, everyone. and extract practical about the morphemes in the book, and we are going to talk and then you guys are going to talk like a contagious disease of conversation. let me start off with a few facts about malaria. malaria covers half the world, potentially three billion people contract it in any one year between 250 and five hundred million do. at the start of the campaign that the book concerns a million people dying from it. it is a disease that primarily kills children. you build a certain immunity to it. but you don't do that as a baby and basically children under 5 are the most vulnerable. they are the overwhelming victims of the disease. and aid would seem to be an obvious way to attack this disease. there's a pretty good record against disease. near eradication of polio and smallpox, jimmy carter's efforts to eradicate -- good intervention of tetanus, syphilis, the list is long and honorable but there is a gathering skepticism towards aids for two reasons. one is whether despite these achievements, whether it is delivering money or might be saving more lives per bug. new york's william easterly who is that noted a skeptic and observer on the subject. however, using the world bank statistics of a program, nigeria came up with a particularly egregious assessment of the value of money that aid delivered. it had taken $3,521 to raise one person's income for one year by $3.65. it is that kind of -- increasingly hounding. i kind of -- a related concern is how aid increasingly resembles a big business. global aid is worth $260 billion a year. it functions very much like this and contracts are awarded by competitive tender, ngos structured very much like countries as a ceo overseeing managers in charge of departments and human-resources. a workers follow a very similar kind of career structure. they start off in other regions. in this case an african village or capital and work their way through to corporate hq. in this case it will be you an agency in geneva or new york. for very generously compensated if you take a senior manager at at you and agency who is responsible for feeding the refugees in eastern condo his salary will be to a -- between 204 dow thousand dollars a year. add to that $7,000 car, $7,000 a month -- kids education, flights home and to aid conferences around the world and fight to geneva and new york. coming in at half a million dollars a year. for those in the aid world who say we need to recruit the best, u.s. president those $500,000 a year. we have to face facts. so that is the context in which i came to malaria. let me share this. i am not anti aid. i am pro results. malaria offers the aid world reinvention, salvation even. not by shying away from the similarities between business and aid but embracing the idea that aid wasn't as much about health and charity. sorry. it has its intellectual foundation in the 90s and the world bank and jeff sacks. thapwe-- o ñperu.t research that malaria would save if malaria keeps africa poor and aged dependent, fixing it should be the way to move africa off of aid and on a path toward prosperity. seeing malaria as an economic problem massively broadens its appeal. you can now approach the african government instead of saying it will be very nice if you take care of your people and they will show you the health benefits. if you say i have an idea to increase your gdp growth by 2% or 3% you see the prime minister or the president. everybody is interested in that. you can also approach a multinational company like exxon mobile and instead of saying it would be very irresponsible of you to protect your workers, if you say if you protect your workers against malaria they will be 30% more productive and you don't have people off sick, your workers wouldn't die and profits would increase. what company wouldn't go for that? the result of one of the key things is a massive involvement of business because the aid program is run -- if businesses were getting involved, individual business will too. we are familiar with -- at the turn of the millennium there were philanthropists like bill gates and warren buffett involved in aid very quickly some of the biggest noise but for me, ray is a former -- a man who pioneered leveraged-buyouts. almost the ultimate tool of the 1980s. he had the weather awkward discovery to make it happen. almost instinctively giving away money -- folk philanthropy built, until 25 years later he brought outside europe to the deal in the states and looking at global challenges. when ray made that's which he didn't leave behind. he took those methods with ham. nonprofit commodity trading to raise. looking at investors for commercial products. he took. return on capital ability. treasure is made product. he took that to the aid world triangulating political leadership, business and media and repeated skill, management to create something much bigger than the sum of the parts and in the two years i followed him across africa, health ministry and villages and so on, put together the white house, biggest businesses in the world and the biggest tv show in the world, american idol and creative $3 billion year campaign. ten years before i am right in saying $17 million a year on malaria. the preview is in the putting. the first part of the campaign was to get an advisory out there. that right now, the last of those are going out and we are talking about three hundred sixty-five million men. we're talking 300,000 or so in that. they for the last three years. if the level of coverage is overseen, merely maintained until 2015 it will save 2.5 million lives. no aid program has come close to that. no aid program has imagine that would be possible in that short amount of time. the revolution here, the results speak of the revolution but the revolution is in the intellectual foundation of this. it isn't about -- this is about inequality -- poverty hurts all over. of prosperous healthy africa, more as a trading partner, less as an aid recipients. when i saw -- basically i was writing a magazine story about a blood borne disease in africa but by then i had a book about africa and africa's life blood. so that is the book. why don't you update as as to where we are now? the book answers sort of april/may. explained why we are particularly critical time. >> had we known you were going to write a book we would have let you come with us. the sort of a magazine article. >> alex did an extraordinary job of going into many different countries and going into a villages and health clinics. he lived in the most malaria and stricken places and stayed several nights in northern uganda. the book is really touching. when alex speaks of his first visit and when he came back later after he had the bad men distributed, what a pronounced difference there was. it wasn't a riding of the book from afar. he was really up close and in the middle of it all. this is a critical time. we didn't hit the target of covering all seven hundred million people with three hundred fifty million medved by december of 2010 but we did achieve that in august of 2011. the most telling part of this to me has -- as alex said, malaria has killed over a million children a year mostly under the age of 5. ninety-five% of whom in sub-saharan africa in 43 endemic countries and this total over a million deaths a year has gone on for decades. we estimate more than fifty million children have died from malaria and it goes back millennia. as a result -- really not my campaign. for current -- this has been a wonderful partnership with so many organizations like mad as for life and nothing but medved leaders will be w h o, unicef, dan gaetz foundation and world bank. as a result of this partnership coming together and focusing on the fact that these children did not have to die and we have gone to a number of think tank meetings where the scientists said we have the tools and the technology to end malaria and we kept asking ourselves why don't you? we really put the challenge out there and bill and melinda gates in october of 2007 said we can't eliminate malaria. as a result of many of these business ideas built on top of traditional aid and partnership over $5 billion in the last five years. we covered seven hundred million people with three hundred fifty million bed that is. and the partnership is predicting a zero death from malaria by 2015. that really is the story. we are now working at the un with the millennium development goals seeing if we can extrapolate that strategy and learn from malaria to the prevention of transmission of hiv, readers in -- reducing mortality by two quarters by 2015 and reducing child mortality by two thirds by 2015 and creating cost cutting strategic objective of 1 million community health workers in africa by 2015. my wonderful partners and staff that work with me on malaria are working on a much broader goal encompassing all of these. >> can i ask you a question. when you talk about zero death. edison point there are a references in the book to the theoretical effect that you could actually eradicate malaria but every reference always says that presumes the creation of a vaccine. when you made that prediction were u.s. to me that a vaccine would be created? is a vaccine close to being created? >> good question. it did not assume a vaccine because the most effective vaccine development from glaxosmithkline will be available in 2015 after our cutoff date and it is expected to be 50% efficacious which is going to help us greatly but we don't think we can eradicate malaria without a vaccine. we can eliminate death or bring death down close to zero. that is the most powerful, most deserving objective if we can eliminate or come close to eliminating death and we're doing not just -- this collective including the president and the health ministers, the endemic countries, leaders of the villages all working together. that is really effective. for individual spring helps a lot. than -- this type of mosquito generally doesn't bite until after 10:00 at night and is most voracious at 3:30 in the morning. you can get three children under one of these $10 mosquito nets. it has a twofold purpose. it protect the child or children from getting bitten and when the mosquito lands -- buys from the insecticide. it is the female gender of the mosquito that causes the problems. >> you have to replace those nets as i understand it. this is part of the challenge, extraordinary number. three hundred million nets to the most remote places in the world. theoretical you have to keep going back to this places for placement. that is part of it. >> it really is and that is a good point. the insecticide on the nets last three to five years. as recently as ten years ago people had to go back and dip their nets every six months to get a fresh insecticide on them. so technology has helped greatly. so the nets last an average of three years and even when the insecticide lasts longer children get colds. that is the challenge to get everybody far as to sleep under a net. our best guest is 80% of the people who have nets are sleeping under a the nets and that is just because of malaria. we met with women in a village in nigeria who told us they were sleeping under the nets because it gave them the first good night's sleep they ever had without bugs bothering them. we have to keep raising money to a placement of next. nuts are coming down in price and a cooperative reform so instead of having each country negotiate to get the funding and to buy the nets we have disparity in the price of the nets from $5 to $8. cooperative with 40 african presidents endeavour leaders and now we have a 1-stop shop where they share best practices and we have a real political club in these 40 presidents as we negotiate with the world bank and the global fund. with the price of nets coming down and people recognizeing how they protect against malaria the average african woman has a fertility rate of 7. three four of her children will live to adulthood. we are expecting that success in fighting malaria will reduce the fertility rates but in addition to protecting their children and getting a good night's sleep if the price can come down to $3.50 a net. we expect a few people buying them without subsidies from donor governments and we are presenting that possibility to the donor governments saying that this is a temple or larry attempt until the market becomes self-sufficient. >> you mentioned something i want to ask alex about. this is the journalist in me asking the journalists in alex to tell us a story. the book begins and ends in a little village in northern new gone the -- >> no. you got the. >>,patch. part of the power of this book is alex is a very good writer and writes with his eyes. he sees extraordinary things. could you recreate for this audience what you saw when you first drove into apackage and what you saw when you went back a couple years later? .. the is mumbling. he does not seem said it see me. i see another guide exactly the same, same name. another naked man. he is growing as a passive. i drive around for about five minutes. the sign said district health office. but there is no answer. walk down the corridor and the final itself and adore this a district officer and a voice as lead enter and their under to screens and the fan is a district health officer. until a new a.m. and one and during. he shows me some stats. the popular oscillograph million . the year before that the figure was even higher. that was seven out of every ten children. i went to the loss will and it was overflowing. they have and that's on the beds . the did not have malaria when you came in, you were sure a sell going to get it. they had acquired nine, essentially sugar, and headache pills to treat malaria. it was, the burden of the disease and this town was so evidence that is shipped all life. the only businesses were pharmacies and churches. that was it. everything else was shuddered and boarded up. it was -- it was -- it was remarkable, very disturbing, but remarkable and scary, actually. in the end of tournai of days there and went into the hospital . there was the stuff. there was nothing there. everyone was looking to me for help. a joke as fast as i could. i came back 18 months later. i felt as though i needed to, having seen the work across africa and all of the campaigners, needed to come back to this town to see whether it had benefited in any way. uganda was a particularly tough place to campaign. driving out there, 9:00 in the evening. we pass this time the little shack. there are 50 people outside standing run the fire. i go, that is really weird. prime mesquita time. this one has will murder people outside. we get to town, and it is to:00 in the evening and everyone is out in this tree is truly a round other children, businesses are open to mullets are on. i go to the hotel. it is bold. another place is full. i get up in the morning. we are in a traffic jam. all of the businesses are open. places have expanded. d'agata to the hospital. the children'sward is virtually empty. maybe eight beds. it -- the transformation was just monumental. unrecognizable, and eventually i found lion way back to the same menu showed me the steps. the most amazing thing about the trends permission was that if the village taken a few weeks. basically the malaria campaign one, up until that point there were treating three and 5,000 people a week. the nets arrive. what then about two weeks. the rate of malaria plummeted. fifteen to 12. i mean, it is the third of what it was in about six weeks. and then it rises a little. essentially they cut it by more and half in a matter of weeks. i went to the hospital. who you're treating. i was there in december 2010, last month they had available, in october in the most malaria top honors, and a disease that kills children, no child dies from malaria. it was a major story. >> we are across the street from the un. the api calls itself the un good friend and most destructive critic. most people in the audience of some association. let me read you a paragraph which will make any of us with the association to the un cringe . alex writes that when he was in tanzanian and he had attended a you in meeting afterwards he looked to his notes and found what he called a meaningless sequence of pages speak. public-private partnerships from abridging the gaps, all protocol. those were the notes from the meeting he attended. a little bit later in the book you run into the fact, and actually, the author is in the audience right now. when he saw the terms of reference furs to bring you in job and his associate sphere will basically rejected those terms. what was wrong? if. >> i don't know that there was a wrong with them, warren ice, or that the aid organizations were not doing all the good work that they could possibly do, but it involves a schedule of having to go make speeches in africa so many times per year. when margaret jan suggested that be this special online for malaria there was no precedent tests, i said i would do it, and that would be focusing on fixing children's lives. then negotiated with the powers that be. efforts -- after several months might try to grab my terms of reference to use charge assyria's many lives as of this possible. drexel today. >> the dollar. >> still a dollar a year man. this president is a dollar a year man. >> at one point alex rights that it is almost the first time in each year. thefts -- he does not drop names, but in the course of a conversation he manages to get mentioned a range of people. i believe alex when he said that raid did this in an unpretentious manner, but it leads me to ask your question. brings up another point in the book we talk about celebrities getting in the way of aid. can you discuss the power of celebrities? we see a number of them in the human community. i have my own feelings of which ones are effective. it talk to me a little bit. >> i think they can provide powerful leverage. when ashton kutcher was in the race to be the first person on target to have $1 million he pledged that if he won, if he beat cnn breaking news, he would donate $100,000 to malaria network to buy it bed nets. c-span2 and did that and was on the oprah show the next date. she charged to a dozen dollars that day to buy bad debts. that night the sun of pd went on to larry king live story and kept telling the story. they kept calling me at home. first they went on. they made malaria the number one cause on twitter and facebook. they set up these social media on voice. there were 50 of them. every time they treat a messes it reaches 200 million people. as a result of that that resulted in us getting an extra $200 million to buy pet deaths. so i see the power of celebrity be able to do what we could not have done without their involvement. >> i'll go further. i do not particularly enjoy a being asked to interview a celebrity about a developing world problem. all give you an example. kind of the justin bieber of the day. the malaria organization, he steps of the plane and gives a press conference. and i did not take part because i could not get past that bizarre juxtaposition. i am sure she is a very nice person. i have since come round to the area that celebrities, and several i think, it's -- the bigger point is that is an indictment of us. refine developing world poverty and malaria pouring. >> general public. to be honest, i write those stories. but the delicate red. if i get a cover and times the circulation drops. this is the reality. we need celebrities to embrace malaria or hiv or world poverty because then people will tune then. until that point it is just be telling the story, and apparently that is not work. >> when i was covering the u.n. as the new york times correspondent we saw lots of celebrities come through, and one who came through was george clooney. i like him for a lot of reasons. he brought his father, a journalist, great cincinnati journalist. but clearly had just been darfur where i am sure you know he is pretty frequently. he had spoken in a meeting about a pretty intelligent manner. he had done his homework. he got to the microphones in front of the security council. all of the u.n. press corps was gathered. somebody tell instead by saying, what is this, you are a hollywood movie star. what do you know about this? what could is that point to do. he looked up and said -- he was surrounded by may be 150 journalists. he looked up and said it very modestly, i get the cameras, don't type. and that was a modest way of saying. acting as you call that leveraging, or somebody tells somebody else to tell somebody else. >> show was not going to tell alex, but our most recent celebrity is somebody by the name of $0.50. >> it is -- >> i want to ask you about a contentious side of this whole thing, the a debate. this has to do was to people, a former world bank official who love of a snow called william easterly who has written two books basically arguing that aid is ineffective and even damaging . and a zambian and a former goldman sacks banker. i am sure you have a response to those two arguments. >> they differ. it was ending curley will be a subject. i have written things that i know his editor with. i think there are a bit hysterical. with dry all aid would be an absolute disaster. as i said, i see day to day travelling across africa ineffective, wasteful aid. i have a particular hatred for the toyota land cruiser. by a new car in every country that i go to. i don't see why they can't take a cab. that is me, and that is what i see. there is some of that in the book, but i think what i am interested in and, again for the campaign interests me is because this is effective. it is the innovation that it is worrying and the lives that is saving, the spectacular results of is getting. that is the reinvention. refreshened and restored. >> do you find now that you are a dollar a year u.n. official, do you meet resistance? to you find them accepting your ideas of how they got to be disbursed? i mean, your business principles , have the b-s yet been able to advance? >> absolutely. he is the one who had the courage no nearer zero death. but on -- the u.s. and plays a several. we have gone directly with the it u.s. government from a u.k. government, world bank. i've got support. these have to play an advocacy role to get the type of funding. we're going to continue over the next four and a half years. i think this properly allocated has really made a world of difference. the thing that changes africa now where investment is pouring into african countries, economic growth as a percentage is greater than anywhere in the world. we're seeing leaders take the position that we don't want more aid or subsidy. we want investment rita think we will see a transition from subsidy to investment that i don't think the african country could have gotten without aid. >> i want to test you if you would tell the story of susan phillips exxon mobile and how he persuaded business but it was his business is interest to get involved? >> he has played a very quiet on sun and the head of infectious diseases at exxon mobile who have given hundreds of millions of dollars to support malaria permitted or refineries and platforms throughout many parts of africa. they're losing productivity because of malaria and also not been well supported by the people and local villages. once it became known that exxon mole was making grants to buy bayonets, to do residual, but the world, making them more welcome in the kennedys, and making it more projected far exceeded what they actually spend. steven phillips convinced several succeeding that the west, perhaps, one of their most prolific and significant investments. >> good for the bottom line. >> good for the bottom line. >> they took alter capitalism and dovetail did with aids and world disease. that is extraordinary. >> a question for you, and excuse me if this sounds personal. alex mentions that of one. ninety-nine to e-mail "wall street journal" reporter to five months of community service in exchange for an interview, and then you agreed to communicate with them by facts. is that true? >> partly true. this is the man that i met at forbes. i wound up on the ford 100 list indebted know what to be there. he did not check my financial balance sheet. he said, you sound like you don't want to be on list. i said, i don't. and he said, why don't people -- why don't -- what people make money of the dollar to show it off. a ticket to a programmer we had 1,000 year a master's degree of promised scholarships to college if they stayed on the right track. he had right into the middle of that experience. and from that day on every saturday for three years it took the train and volunteered in the program. he wrote the story. >> a couple of less questions. eradication, is is still a goal? >> we are on the path toward eradication. we of for the stories that rely drop wiped out malaria. the same thing happened in zanzibar. we now have zero. so vigilant over the next 15 to 20 years until a vaccine is developed. we have lots of breakups. and we had to replace the next. this parasite, the medicine that worked 15 years ago has no affect today. so we have been working with the chinese and seeing resistance in cambodia and thailand. so we are ever watchful where we have another reticent in the queue. we have watched ms. skeeters develop resistance to the insecticide. that is another issue. freetown's it towards a percent mortality . turn to something more significant at that point in time. until we have the vaccine, and hopefully we will have it, we're going to have to be careful, vigilance, and every time there is a breakout, we have to jump on top of it. we cannot let the interest waned because of the success. this is still a major mountain ahead of us to climb. >> i want to ask you one last thing before we go for questions and comments. that is, you tend today your involvement in all of this with an encounter with jeffrey sacks. i've referred to him and the indication. can you tell us what happened that day? >> well, we had founded a foundation called the alliance to try and bring organizations together with a cohesive business plan. achieve the millennium development goals. they had the idea of creating villages. they weren't used. they had these incredible returns. four times what it was. hiv, victims being treated. we went to see one of the villages, and he went to allow when i went with my family. he brought back these videos. angelic-looking children sleeping. the commerce. presumably they did recover from it. being that vulnerable. a lot of that was just because of the place they were committed after worry about malaria. did not have to worry about malaria, and here, a million children per year were dying. that was a seminal experience for me. i have never get in the image of that struggle of of my mind's eye. >> i would love to get, the questions from the floor. raise your hand and wait for the microphone. will you please introduce yourself? >> hello. thank you. women's college university. maybe it is two of them. is there an echo? >> stand-up, if you will. >> thank you. is there a side effect for children or adults sleeping under these chemically treated nets? secondly, is their are weighted geographically go to the area and destroy the mosquito? fifteen years ago we had something called west nile virus. the former administration. much wiped it out with spraying, out there was a side effect. it was pretty successful. those are two things i would like to address. thank you. >> the insecticide found itself in the net through an extrusion process, so there is nothing that can drip down our otherwise affect the children. one of my advisers, the negative side effect. we did use it widespread here in the united states in the early part of the 20th-century to get rid of malaria. we had military and to the 50's and some of the southern states. they had to screening closures. they held eradicate malaria here and in europe. a number of the african leaders would like to see us use ddt widespread in africa. the who. they under use it for legal spraying, and it dies when it meets the insecticide. finding the site of malaria mosquitoes spawning and developing, certain stagnant ponds of water. we learned that mosquitos can breed. the accumulated in a horse's hoof prints, and we get it to every one of those places where stag new order would reside. sanitation and the elimination of state and water would help the process. >> the front row. >> first of all, thank you very much. allegis is having about tuberculosis and hiv aids. those are massive killers. you only very briefly referred to hiv aids. my second question is about the challenge of having african health workers continued to work in all of these communities because without that it is that hard to see a sustainable health system. there has been a chronic problem of motivating and incentivizing human women to work on a sustained basis. >> how will try to give you a quick response. significant issues that we are confronting. if you have malaria you're more susceptible to hiv and conversely if you have hiv you're more susceptible to malaria. the 40 million are so hiv-positive people in the world, and 46 million are in africa. of that, a 26 million, 14 to 15 million could use the benefits of anti-viral treatment. we went from 230,000 people in africa to over 5 million today, which is a credit to president bush, whenever we think of his policy. it tb is so significant, roughly one half million people plus die every year. "recorder of the people die from tb. most people don't know that, so he has taken it on as part of the goals, a campaign that was stopped tb for sure. 1 million lives of victims that otherwise would have died by 2015 by testing and intervention one of the most frustrating things, they don't have enough money anywhere in the world to give treatment for those victims . and somehow we have to drag the prices down and spread the treatment for all those who needed. it is a bit of a cup of to eliminate the transmission of hiv because we are not addressing that part of it. 20 percent gifts where there are all forms of medication. iran needs so much more knowledge to go into research that we cannot treat with any of this with the efficiency. >> did not forgive. >> you said something. we had a vertical disease intervention. strengthening local delivery. and in many places, hire consultants, a little bit of a report of the delivery system. the best tangible evidence of strengthening health of the local community health workers. the more we can train than the more we can support them. i think it is ten times as effective as consultants doing analysis. people want to be a community health worker. it is a source of pride. over the last three years they experienced workers. the results of each of those barred trenton. >> a couple of questions. there one, two, three. one, two, three, four. making rather concise, answering all four at one command and we will be done. >> i am struck by the success using relatively low-tech technologies. i would imagine that part of the resistance to using your almost cure would be first in pharma because of the pad and space and economic advantage, but i would imagine biomedical scientists prefer the kind of more high-tech molecular wizardry handle factor receptor blockers and vaccinations. and remember when they gave foundation competition was announced. all these molecular cowboys. i was wondering if my field reflected a barrier to the low-tech approach? >> hold that thought. a woman in the second row. >> good evening. i am an artist can do will ambassador. i often go to the fields and worked extensively with malaria. them very happy to hear all the good news you're giving tonight. one of my concerns growing up in africa is the stagnant water. can we get -- can you help us get the government's of each country were you're working to really focus on the sewage? because stagnant water psst, the sewage is filled with air bridge. the water ends up being stained. it is the duty of the government of every country to make sure the sewers are doing what they're supposed to do. the water to live it does not stagnate then we really can eradicate malaria. until we do that i fear we will have a lot of work on our hands because the water, as you say, mosquitos cambrian it, and it is important to do that. >> the lawn behind you. that will be it. >> thank you. i am from uganda. eric talked-about issues like malaria. i am embarrassed my colleague from africa are not here. as the diplomatic corps this should be here. as i said, i grew up in uganda. i finished the university, and to my siblings died of malaria. thank you for the good work you're doing. my question will really be on africa. as you know, with the political cooperation from government some of this good work will let go anywhere. have -- we tend to emphasize good government. the relationship between the so-called democratic government and public health. what kind of leaders are responsive. >> of the woman behind you. right behind you. thank you. >> i am from the gambia. i have started for a very long time. totally of touch so far as the subject is concerned. i worked in the evaluation office. very touched by your presentation. what you are presenting, but very significant. you talked about the subject itself. about the result. you know, i am actually wondering, a development language, what are the key elements that actually go along with it? there are a number of factors that have created the systems, was sort of paradigm to be able for us to understand better, you know, how will not only reduces but eradicates. there is the point made above the key issues. i think an idea of how much attention is being paid to those areas that would enhance success. very quickly, second question has to do with the aid package and evaluating. it is really going forward. the resources are there. a question that i have, what would make that sustainable? you know, what elements make it critical so that this new emerging architecture, the new business model, you know, perhaps elements within africa. i am glad to hear you make reference. you know, perhaps you can tell us what some of the engines are that would make the process sustainable. >> thank you very much. >> by the way, do you want to answer those questions? take those and answer them and then we will wrap it up. my gosh. >> of biotech. , and not an expert on any of this. i am a businessman, philanthropist who is really china to help this -- to these disadvantaged children the most rewarding for the five years. i have learned this knowledge along the way. on the biotechnology side last year they gates foundation asked if i would chair the research for malaria medication. medicines are based in geneva. so learned quite a bit about what format is willing to do, and i have seen him do nothing but cooperative. in fact, leading an effort now to take 25 percent of all of the profits in the developing world and put it to help workers. great cooperation from parma. recently merck committed $100 million to help the campaign. the star wars technology. the week after next. the gates malaria film. funded a man by the name of nathan mere gold. used to be the technology officer at microsoft. a renaissance man who is an inventor. focusing on malaria. is going to show me next monday, she says diaz. and looking forward. did you want to add anything? >> you're right. i think that actually is weighted so suited to business. this is a logistics problem. who you want to do that? is -- this is a business problem . the logistics'. it is more practical. >> on the question about sewage and getting government to pay attention to that, the whole in d.c. area, the principal and just. he cannot understand why we cannot get african leaders to focus on sanitation. he believes the lack of sanitation and the lack of focus on sewage causes malaria. we need to keep thinking that is