Jimmy had the responsibility of looking at the response. Was it responsible for a large response portion of the financing and also the support and how we say and perhaps some of the coronation they commit that with a lot of experience with trying to really deal with how to get that humanitarian support out there. I think you probably artie saw the research at the same time that the Communitarian Services were supported. And whether this report if it had been available back in 2013 but it helped. I ran the office during that break. We are tasked with managing the Emergency Response to the outbreak and very close partnership. I come at this from the operational side. Im not a dr. Or scientist. But i have a long career. I also now serve on the Oversight Panel that they established after the outbreak to supervise the implementation of their reforms. This is an extremely important issues because we were very fortunate that we have that tools at the outset of the off outbreak. It was a very close call. We came very close to having that become completely outofcontrol to a point that its hard to imagine how it could ever been contained without doing more damage that was. We didnt in the end meet some of these research products. In order to contain the outbreak. We could have. Have it been worse. And its very easy to imagine and i think we have to expect that sometime in the next 50 years we will see an outbreak in the world may be much sooner than that where the tools available to us will not be enough to contain it. Well had to have realtime information. This is a very important issue. The report is interesting to see some other convergence around what this report identifies as success factors. And what we were seeing for the overall response at large and thats where bandwidth becomes very important. Everyone, the researchers they are all jacking in the same as space. And everyone has finite bandwidth. Talk about the legal and ethical parameters with the host government. And the host authorities. Those are also charged with a million other things. So getting this on to their radar screen is can have to jackie for space. In the case of west africa this is a real issue because nih wanted to send it Research Teams just one very basic example the embassy has to manage all of these different visitors but it could be difficult for the ambassador and would sometimes be skeptical of why we need yet another Government Agency showing up to do something that they are gonna do medical research from. These are some of the realities that this kind of report is important in highlighting to in vassar. This is why this is really important. So they can come in and do the research. One problem we have at the outset of the outbreak was a Public Health specialist in human tearing the specials specialist really didnt have much of a common language and the head that because its inherent to the nature of the organization. The u. S. Government did not had that. I think that is one of the important aspects of what they are proposing here with this they begin to establish the tonnage touch point when its go time there relationships that need to be in place are in place. And there is much more of that ability. With that context in mind a few things i would highlight that the report talked about and one thing i didnt see a lot of in the report. The First Community engagement. And who important important issue for that. There will be challenges doing specific Community Engagement on research amidst much larger Community Engagement push. They will need to be mapped very closely together. There were problems in the early days with just massive confusion about what the disease was. Getting a very clear and consistent message. There was interesting differences across three countries the types of Community Behavior that you saw. We saw interestingly enough so much more better uptake of some of the key messages then we saw in other places. And that had to do in part with the populations trust of the government. Dropping another element into that can disrupt some of this balance. And it can affect the credibility. So that needs to be very carefully handled. You want to really handle this. On the court messages of how you protect yourself and part of the core messaging is the only way to protect yourself in your community and the best way is that you have to get people there. Talking about what the treatment entails it is inherently an unknown and that. We are gonna treat somebody with this. How do you explain that and have how you map the explanation process into that Court Community mobilization messaging. And its pretty delicate. And it needs to be very carefully handled. Its very delicate and very difficult. If its done over this created confusion. With the highlight on the patient data and it was a huge problem for us. The data was terrible. At the outset. People could be counted for them to be the second time at the case. Or a third time if they passed away and were buried. See could have one case and initially it was impossible to track people consistently across Different Centers and avenues. That in turn made the response very difficult. You need to have good realtime information and understanding we did not had that in the offset. Your project not what this disease might do if you dont have a good picture of that so a huge issue for the operational response. And so interesting to see the challenge as how do you get good Data Management argument for very difficult operating environment. There is some fastening work that has been done with biometrics and other humanitarian context it can be done in a very selfcontained way in a very hostile environment that may have some applicability here. In any case this is an area where we need a lot of product innovation. It wasnt until they went out and took a few and if you u. S. Personality. Thats and we started to get a much more accurate picture of what this looks like. Lets move now to that general a discussion. I want to give a chance for them to say one or two sentences only please in response to these types of common mints. As i said the basic principles. Did you highlight the importance of what is the research and not just production. When youre being really kept behind. In the long experience of that. It is the idea of patient identifiers. One of the biggest challengers its on a much different time frame for years or decades. One of the biggest problems as is that the patient counted multiple times. We dont actually had as much information as we would like. The issue of the patient identifier strikes me as a common theme. With this. Im wondering if carrie and jerry and david would agree as part of the technical fix that strengthening patient identifier systems is a necessary foundational step in order to prepare for the next outbreak. Thats basic Public Health and health system. How do you feel about it. I think the answer is yes except i think the biometric identification we can of step away from that a little bit. You are worried about some of the implications. If they could be effectively address youd feel more comfortable. Thats what you need why you need the engagement of the community and to me to the leaders. Lets start to take some questions from the audience. I am converted to the Public Health practitioner. In the days before and under what the social awareness revolution and became the Bloomberg School im very happy to hear so much discussion about that. The goal of the intra apologists. That would be a key role in the prevention. A key role in the area of mediation between the different actors. And also between the researchers in the community. I would hope to see at some point that it becomes a key player in this process. Can we get two more questions and very curious myself. My question is about the government funding for such which seems to be on the decline was some of the Department Fix on that. Do you think there will be an appetite for this kind of work that youre proposing. It seemed interested in the field. Could you maybe comment on some of the lessons learned. If you can hear and the tone of my voice. The funding Going Forward the very ambitious plans. During the outbreak the platform proved itself to be very useful. Having that platform its all part of it. I would say thats one of the questions in terms of the Broader Research agenda. There is huge questions on the applied research as well as the actual programming. It is an important part of the Community Engagement. With the assessment and engagement. Thats what they did early on. There are some groups working on the anthropology. I think some of the same methods and tools would be useful both at the global level from the global mechanism as well as the practice and research response. I wanted to try and as well. These kind of clinical trials. It was interesting at the beginning they really had it hard about social mobilization. And why even evenly need to make those connections. And once it started to happen things began to move and in fact but only when the community was engaged and understood what the rationale was. A key requirement is a community understands the depth of the ignorance about what really works. Theres a lot of therapeutic misinformation. Im not saying that the community itself has missed communications. I would think for the community to endorse that. They would have to be convinced that there is no cure. The best people in the world dont know how to fix this. It would be difficult to assume that. Some of the constraints of that. One of the senior clerks in liberia who got engaged in this the Community Engagement. In addressing his congregation and talking about safe burial hands on. All of the things that exposed people when they talked about the laying on of hands he demeaned skin to skin. Its those kinds of insights and messages that need to be there from the very beginning. Its a time to get that conversation going. Some of the lead researchers in this field said we never heard about that. And social mobilization. Now is a time to make that connection. Ive never heard that pronounced like that. Before today. A lot of operation implied research. When we heard the deafening silence of the about the field. Including most certainly was anthropologist. They enabled us to get patients treatments. The role and importance of anthropology is really route recognized commit on this. Anytime you hear social mobilization youre talking about a roll in the reinforcement and importance. Among the reforms. Theres also building more of that capability into the Emergency Response. Just quickly on the funding it remains to be seen yet what well actually happen. They are but cuts that have been proposed by the white house that are incredibly irresponsible im not a u. S. Government employee anymore so i can say that. What is encouraging is those cuts have not gotten a lot of traction in congress. I think there is some reasonable hope to hold out that some of the more damaging things that have been proposed well not make it through the appropriations budget. Its hard to have that level of confidence based on past performance. I think there had been some strong signals in fact when they proposed reducing that to this fiscal year. My billion dollars. The increase it by 2 million. And that as the point. If its a continuing resolution for next year is not 2 billion more than it was a little while ago. One of the things that we are trying to do we are not getting into politics but raising issues in the public to respond to and challenge the u. S. Government policies that are being proposed and sometimes implemented we need to raise the alarm and get the Larger Community in agreement that our health is tied to the people elsewhere. Its part of overture to do. In disseminating the issues around this report. In activities that they can do. It has some substance and trying to get that out there in this part of the agenda. Its what were trying to do. The cost benefit on that spending is so incredibly compelling. But having a slow response that did not had much in the way of therapeutic tools ready the u. S. Government had to spend 5 million to prepare on the home front end respond in west africa to this crisis. Is a lot of money. Its a small amount of money compared to what the nation would have to spend in the case of a true and deadly pandemic. This sort of Research Spending pales in comparison to what would have to spend in a crisis scenario in and helps to convert those. The pay a lot more later is not just the treasure and the money. They have huge implications. About the research contortion. Its something thats different. Its about an integration of response and research and as a different set of players. We havent done that before. Not the global level. What makes it work is the same kind of principles around how do you add value. In the kinds of things we talked about in terms of recognizing different interests in matching accountability. You lose the ability to add dollars. We try to be more explicit about what are the things you really had to take care of and understand and go in with your eyes open rather than to same that we will take care of ourselves. You let industry do something and we will combat it on the other side with government. It really needs a new type of approach. Let me just on this last point with the who mimetic system with a Single Institution responsible for the entire chain. We at least know who screwed up. What worries me with this with respect to the proposal is that your accountability echo system may not allow us to even know that. Im wondering and i guess it would allow us to know that if the accountability part really works. It looks like is what theyre proposing is the more inclusive system one which involves multiple entities in a more peertopeer Network Arrangement there are accountability systems that hold each of them accountable. How would you have a Network System with accountability. Etiquette is a question of balancing that. I dont think there is a problem with having a single hierarchy. They dont have the capabilities to have the skip incapacity into deals with dealt with the conflict. You do not want the thunder, the commissioner being the one telling you what the results are. In doing the ethical clearance. You get confused messages and you get the wrong messages. Im not talking about just a loose market with no restrictions on them. There needs to be real accountability for whos going to actually invest in developing a new product. Who will insure against the financial loss. Do you actually track that. And actually get access to the new vaccines and drugs. You can do that through a lot of transparency. If the head if you have the set of functions. You can still have that. With the response and activating that. We havent really invested enough in making network. They have failed terribly. Its not like there is ever a single responsibility. We need to be more creative and inclusive in terms of how we bring this together. By putting it all in one boat. The person in the stands and the commissioner. It doesnt work very well. I think it is time to wrap up. I want to thank all of your participants. We are glad to be able to help in this process and we hope that it will be a continuing priority for that. We think this report points out some of the reasons why we need to prepare and now and not wait for the next epidemic and gives us some pathways and directions to which we can move and we need to do that fast. So thank you to all of you. [applause]. Saturday night in and book tv beginning at 9 00 p. M. Eastern the former marine Corps Officer tracy crow jerry bell talk about the history of women in their book. For so long womens stories and military stories have just been discounted. It was time to give these women a voice. We are not a social experiment. We are soldiers and failures soldiers and sailors. And coming home to a country that did not recognize many of us as veterans but with the same moral injuries as the men. At 10 00 p. M. Afterwards the arizona senator calls for a return to Court Conservative principles in his book conscience in a conservative. He has interviewed with the new york, columnist. It is an urgent matter that actually has realworld implications. You can win elections and if youre doing that just for the sake of that. We can do that. But if we as conservatives want to enact policy then had to treat an election like how do we set this up for governing in ways that we can move forward with our agenda. Then at 11 00 p. M. Robert oneil who participated in the killing of Osama Bin Laden and his military career and has participation and for other missions. Firing the shot that killed Osama Bin Laden in my years as a seal team warrior. He said dont take this the wrong way im going. I said were not going for that. Were going for that single moms who drop their kids off at school on Tuesday Morning and then 45 minutes later she jumped to her death. Followed by afterwards with senator jeff lake at 10 00 p. M. Eastern and robert oneil at 11 00 p. M. On book tv. Next week at 8 00 p. M. Eastern on cspan three a civil war a special featuring American History tv highlights on monday we are at the emerging civil war blog symposium where we look at the great defenses of the civil war including gettysburg and the siege of vicksburg. We focus on civil war leadership. What talks on general robert e lee. We are at the gettysburg college. Wednesday features them. Speakers include historians. And on friday we can include the conference with author tj stiles. All next week beginning 8 00 p. M. Eastern on cspan three. And the eagle a legal conference a Law School Professor discussed the future of law school. This is from the seventh circuit bar Associations Annual meeting. It is an hour and a half