The survivors lay dead in the field and they were fired on by machine guns at close range. Machine guns were fired at these men. They fell to the ground. December 17, 1944, an american convoy traveling to belgium is spotted and captured by german troops. Ginny parker on the massacre on sunday night at nine eastern and pacific. Part of American History tv this weekend on cspan3. Our special booktv programming continues in just a moment with peter piot in his career fighting viruses. And a little more than an hour, lori andrews on personal privacy rights and social networking. After that, the swearing in of the governor of new hampshire. It will be a busy day tomorrow for members of congress. The house meets at 10 00 a. M. Eastern to consider a bill regarding Hurricane Sandy relief funding. You can see that live on cspan at 10 00 a. M. At one eastern, a joint meeting of congress. He will count the electoral boards for Vice President and president. Now, peter piot on his book, no time to lose. From the council on Foreign Relations in new york city, this is a little more than an hour. Good evening. Welcome to the council on Foreign Relations. I am laurie garrett, senior official for the Global Health program. I am very pleased and excited about our discussion today. We have a very big treat. We not only have doctor peter piot, the founder of the United Nations a program, but we have the current director with us as well. We have a true continuity that stands for several decades. And i think youll have a lively and fantastic conversation. What brings us here today is no time to lose, a life in pursuit of deadly viruses, doctor peter piots memoir. It is not an attempt to write history of anything. But rather an attempt to describe how the world in the history developed through the eyes of a key player who is really on the front lines of each individual step along the way. Because the memoir is far more accessible, it goes through an adventure cycle. I suspect it will be a recruiting device for the next generation of epidemiologists and specialist in Public Health leaders. Because it makes it seem like one of the most fun things you can possibly do with your life. Many of the events that peter described we experienced at the same time, but from a different perspective. We were both on the front lines watching a new disease unfolds, which later came to be known as aids. We both watched as a series of events unfold that brought us to this collision course that we are on now in Global Health. Of course, i wrote in my first book a description of a full outbreak in which peter was a key player. We have a chance to talk about all of these points coming on. What we are going to do today is have a conversation for about 20 minutes. Then we will bring the audience into the discussion and open it up to all of you here in the audience. So if you have questions, try to remember them for later on. So, you were 27 years old. You have finished medical school, but you are just Getting Started with your phd efforts in microbiology in antwerp. A mysterious test tube sample showed up in terrible condition. Can you figure out that there is a new disease in africa. And you said, i know im only 27 years old, but i want to go there. I want to go to africa. I want to be in the middle of this venture. Just. Where did all this come from . Well, my mother always said silence is golden. But i had an incredible penchant for discovery when i was a child. I worked as a travel agent in turkey. The one goal i had in life was to get out of here. It was a very conservative sense of adventure. It was the despair of my mother and whole family. He drove everyone nuts that i always asked why. You know, and i really wanted to know. I did not have much respect for hierarchy and authority. So yes, that is why said yes. Its not because i was 27. Also, later on, most people who had no seniority, they were actually not jumping up and down to go along with this to they knew how hard it would be . Yes, that is true. Coming away from the way you describe the episode, there are four things that are key. Experiences or realization. Yamaha moment out of the a bullet in 1976 episode. Strange test tubes and his 27yearold find africa for the first time, first you experienced africa in a film of epic i. Just to then he discovered internationalism. And all of the difficulties of coordinating and working together with scientists and all sorts of other folks from around the world, you discover the relationship between global inequities and disease. If people the people are so poor, they dont have sterile syringes and then he discovered dogooders. That wed be better that they were there in the first place. Which i think are very underestimated today. When you look across the gdp, their rates are no longer. We see Natural Resources that are there, so i didnt outlaw these things in these days, but it was a combination of the godfearing and the human side, but also to send icon also very upset and angry because it eat inequalities. Zaire was then ruled by mobutu and a group of plutocrats stealing the country to death literally. And on the other hand coming to people, there is a Great University in the old days, but nobody was paid. There is even no let her city. People were denied some basic opportunities. But i cant explain it five. I was bitten by the virus of africa. Theres a lot of dancing in the book if you havent read it. As many times in theaters so ecstatic he breaks out dancing all over the place. This also is your First Experience trying to work with american and they came in and said per charge, particularly carl johnson from the cdc. And you found african colleagues to collaborate with them fellow belgians who came a little bit later after youve been there a while. Tell me what you learned and 76 that guided you forward about international cooperation. I discovered where it came from, that means they had financially intact weekly were far inferior to what was available here in the u. S. Wheres i resented that he had isolated the virus and then the folks cdc came and said okay were taking over, so i resented that. Its absolutely true. But then i saw that i could learn so much. I really still grateful for him. It was not only the u. S. , or deflating some of these jokes, there is a frenchman and a South African and a bridge and a belgian and some congolese and a plain. What happened, what do you do . The power of coming up from different perspectives, but i was very impressed by the technical superiority in strategic superiority of the american colleagues. So why was there i said i want to go to america and learn the next time we find a new virus, i can be in charge osa. Not only for myself, but just to share this cannot rather than to stay in america, i came back to belgium. Is that thing you discovered after seeing patients bleed out, the horrors that are ebola. If you havent seen that, its a very terrible disease, and offer ways for anyone to suffer before dying. A particularly sad thing for you to say flemish skated grownup indulgence at a time when french speakers were the dominant power structure of belgium and the flemish or a whole town. U. K. Htm buco, this very remote village in zaire and discover the responsibility for it all really rested with fellow flemish catholic militaries. Tell us what that meant to you. What did you discover . Im the one hand i was full of admiration for these women, particularly because they had this cool [inaudible] they were hardworking, dedicated, but they were running a hospital and there is not one person who had formal training in nursing or medicine in 110 deaths. So one of the things they learn if its not enough wine to do good. You also need a sick competence. You need some basic expertise of the race he wouldnt give injections to everybody who comes to this hospital when you only have three or four syringes and a few more noodles. So that was one thing. On the other hand, i also discovered it was like time stood still. So these were flemish who had left bell junior speefour and they were still inking of the motherland as if time had stood still and belgium also, which you find also but expatriates. They have an idea of the country of origin that doesnt correspond anymore with how it evolves. So it reminded me of my grandmother, my ancestors and that was something i hadnt expected. Mike winters sues on the equator, just where is very hot, very adaptive. Even today come you are still in touch with one of the priests and a still there . Partner carlos in mumbai on the congo river called now again with the river is 20 kilometers wide, just incredible. Hes fair, but now in contact with him by email. When i talk about this experience, they stare at me as if im coming from the stone age that there is not even cell phone, satellite phones, no fax, no internet, no facebook. The communication was very slow to say the least. But im still in touch with him and he really has started a secondary school. There is the hospital and congo, outside the nations is functional, so thats also the reality. To Flash Forward a little bit them in the last time anybody took a count that i saw in the post2000 era, 60,000 ngos related to a in africa alone have been created. And when you think back to those missionaries who thought they were doing there at thing, but goodness at the door behind these syringes properly and b6 and sterile and hygiene, perhaps it would be better you are at there in the first place. What lesson do you see looking forward to this explosion of ngos that can be informed that experience . The good news is in the Global Health, which didnt even exist until 30 years ago, i try to figure out what needed to appear for the first time. Global health was created by the aids movement and a sense. See the incredible in money is great news. But on the downside and often its not going with the most professional approach. See the keys combine and the csm, dedication, can rent with knowhow and strong evidence that may start as is. Thats not always fair. Thats one of the reasons i was so interested. Even if i said never again in academia, just like never again in the u. N. And now here i am because we want to train the next generation promotes the best institution to do that. In 1979 he participated in an autopsy on a belgian sailor any say in the book, i wasnt smart enough to seal the same reason drum, but i knew wed never seen anything like it before and it was . Gave us a today. What was so stricken that you knew just looking at this body before it that this is a new disease . It was someone who was a fisherman on one of the big lakes and congo and the person died but was called atypical mycobacterial infection. We know microtek curio and tuberculosis causes tb and that causes leper say. But most of an entire french, ubiquitous microtek. Come which dont create any problem. Publicly most of us here have covered it. When you are immune deficient, it can kill you. So weve never seen a good solid chassis car than the mycobacteria you can see under the microscope. Very strange. We started seeing others with other weird infections. Its the same way aids is described for the first time in this country. You decide that its sexually transmitted diseases are acutely important and if someone just are your top that is one of her major major interest in us anybody else would say sexually transmitted diseases and theres all these little cultural and you come to the united states, a whole bunch of training in that area, particularly from king Holmes University of washington who is still there in seattle still a real leader in. And then you go back in 1883 to kinshasa with some of the same same people year in 1876 ebola epidemic waves. During that massive, anybody whos ever been in kinshasa knows what im talking about, massive colonial hospital. You say in the vote, you wrote in your diary, incredible coming catastrophe for africa. This is what i want to work on. It will change everything. What was so incredible . But really cannot . Mommy and that is the way name of the mother. One of the assertion is there the error out there and in all things after them. Id been there in 76 and here i entered the internal medicine, men, women with young men and women in the states of my age and die, nbc did not kinds of infections, meningitis, you name it. We had like 100 cases and patients coming from Central Africa and belgium. Thats when i went with tom quinn and joe mccormick. It was so overwhelming because they knew it was not there before and also the head of the internal medicine manner had put aside for ice 55 patients are ready who had died in the previous month or so and this was the extent of it. The fact that it is slightly more women than men, which is very unusual. Lets not forget and 83 that this was a sub one thing. I never understood why you would care about a orientation. So jump from one host to another. That is the sex is about. I saw that said i cant believe its heterosexual and there are far more heterosexual sex in the world in samesex sex and knowing all set for my studies on sexually transmitted diseases that were very rampant and they said its going to be a catastrophe. Unfortunately, i was right. You together with john admin said percy sita, an aids project in kinshasa. The first time he met with 1985, the First International aids conference in atlanta, georgia, which fit almost in this room. Hard to believe because the coming aids meeting will have about 25,000 people. First of all, i think we could have possibly imagined in 1985 that that meeting that we were at the front end of something that would still be around in 2012, that would by then had sickened or killed about 74, 75 million cuban beans. That in 2012 would be 34, 35 Million People live with this disease on every continent on earth. But what i remember most distinctly about that meeting is there with a moment when this tall white guy was translating for a much shorter sire a fellow, dr. Pizza and a cluster of us were standing around you and the wall street journal reporter, who was absolutely sure that hav was a gay disease wouldnt accept the notion of general heterosexual transmission sent to dr. Pizza, isnt it true that africans have sex with monkeys . And i remember this guy trembling with rage. Your face changed colors and get you near you had to translate. What the capitas response . Yes, i was the tall white guy. Well, capita first pretended he didnt understand english so that gave him time to think. And then he said, well, im not aware. We dont do this or Something Like that. But ive heard about things here with dogs. Dont give a credit tijuana to see donkeys . But if you think about it, and i do want to bring the show and in a moment here, but to Flash Forward and frame that you can insert title is treated to. All through the book you express urgency to respond and regret that the response was a pastor. Feel it back to the critical period in 198790s, before we had effective treatment in 1996, we had many moments when interventions were blocked because of human rights issues so that we never could tackle hiv the way we did or. The rationale for not doing so was there was treatment, but theres no treatment for hiv. If you identify someone as hivpositive they will simply lead a life of discrimination. When you look at, do you feel theres Public Health that we fail to embrace powerful enough, putting aside the blame to public readers, but within the health arena, are there things the new look back that we shouldve done this, that any other thing other thing before we had to send. Would definitely a out of time. We wasted a lot of time by not recognizing in every country when you think how the Prime Minister could simply not even pronounce the word e. Until the very end, which im not a psychiatrist, but in psychology that means something. So the lack of willingness to do with the issue, also in publichealth circles, first dealing with aids because it was in the category of sexually transmitted diseases. But also later on when it came to treatment and i know we were going to talk about that later, but it was the publichealth community that was the biggest problem that they had all these reasons why its not possible. I think there are also some absurd to this demand like i was shocked in atlanta there is the Campaign Come in no test is best, which i didnt fully understand. Im the one hand it is true because of discrimination and stigma that all we can offer with negative comment death sentence, no treatment and discrimination, loose your job, insurance. But i think that retrospectively indeed we should have had a far more adult conversation about what can be done. You cant see publichealth by whats going on in society. We have a case example of tremendous victory and it didnt catch on. It didnt go viral, so to speak as we would say today. And that was thailand. If you look at the late 1980s, the Asian Development bank predicted thailand would collapse under the pressure of aids. The 17yearold person the military were running as high as three. Hivpositive at the age of 17 by the time time they were 22 in the military, the rate was way beyond my end that lets catastrophic and they had no tools and the product completely under control. Why didnt that become the model for the world . Why do we obligate thailand is that there was this isolated case . Is a good example of why did it work in thailand . Because of strong leadership and not worry too much about Public Opinion and said 100 condoms promotion. It was enforced but not only publichealth people, but it was of course to preserve thailands sex industry, which is what billions of dollars. It is something there is no willingness to do. Today, you see an ad for condoms on prime time in this country . On mtv we do. Okay good. But it is this double standard about sexuality and sex and not dealing with the issue. The next even today the example does not resonate. They are now dealing with gay men and injecting drug use for years and they dont want to go for Needle Exchange and methadone, but they were very, very effective, particularly with the office of the Prime Minister. The ultimate success in branding when your name comes thing, you know . Well, i cant have fun without giving you opportunities to hate to have your most remarkable encounters. First, if i remember right, mahogany lined, everything about it seems like youd gone to oxford. As is he jumped in and sipping expensive scotch and smoking a pipe and hes telling you great paranoid conspiracy theories and you cannot wake him up. Who is that gentleman from what did he cost african mice . President mbeki. Yeah, after a very late night conversation, he said dont you know this is a conspiracy of the western pharmaceutical companies to poisonous africans . Its always been a mystery why such an intelligent person whos done a lot of good things, a strategic thinker could believe such a thing. And that cost about 300,000 minus according to study from harvard because it delayed introduction of antiretroviral study, mother to child transmission in the country and maybe also in neighboring countries, although the colleagues, maybe they were sometimes listening pullet the, but they didnt follow him, fortunately. Now today, south africa has the largest hiv Treatment Program in the world and things have changed really to date and he was actually fired as president. But it is a tragedy and it must be i dont know what it is. I really dont know. In a very different mood, you are for somebody who offer it seems like todays avram if i follow the description, but an ample quantity of alcohol is consumed to discuss mandatory quarantine of hivpositive people in cuba and this should be listed out castro. Yes. I went to cuba already in the early days for several reasons. One, there was quarantine because in cuba, most of the cupids with hiv were former soldiers in the military who are fighting in africa and came back infected with hiv were locked up basically. In a conversation with fidel castro, human rights is not something that is discussable, so we talked basically that its not effect the comment that it does not work in today what happens in cuba is when you are found to be hivpositive, youve got to follow a sixmonth scores, this is a few years ago is still the case, to prepare you for life if hav, the drugs out there and then many people become hav educated since everybody is a state employee, basically it doesnt matter what you do. But i came that im the first time i met a gal was in the metal of some kind of tornado and he was talking about how many liters how many theaters per square meter per province. And i said after, dante, i came here to talk about aids. I express my solidarity with people affected by the floods and cuba. And then he started talking about how many cases in jamaica, how many they are, how many they are. Anyway, sometimes seeming to figures better than i do despite the fact is that a professor of epidemiology, i have a hard time remembering these figures. Since then he said okay, lets have a drink in my office. So we went in the office and asked for water because i said said i just arrived from europe jetlagged and i need to make sure i do my best here. He said no, you dont drink water. No detail, okay. We are in cuba. To make a long story short, we then ended up, as he does sometimes, you cant than half of the government and the Vice President and we had dinner and talk a lot about all kinds of things, including the imminent decline of capitalism. It will be dead in a second. My century still hasnt happened. I would like michelle to join us. You end up deciding to go for the job of creating this new agency and the u. N. Called the unaids. It didnt even have the names and come up with this new entity thats going to happen. Theres too african colleagues. Kofi ahmed says the foyer, d. C. Is full of sharks. Hes not secretarygeneral yet at the u. N. At that time. Said also, so dont fall into the water and if you fall into the water, dont leave. [laughter] and then a certain Michelle Dumay who is that unicef at the time to see the story the chameleon. This one if you want to tell, what was the chameleon . What was that of vice . That was when we met at the chateau. What was the story . I think this story when they are 14 years old, they asked them to observe it, don and then ask them, what did you learn . In general, the children would say that changing colors found in portend, the most important is they taught you if you listen for life, they say the first thing is that the commandant is always walking without moving ahead. So its very important to have an object case. Project is set in a very clear manner. Second lesson is its good to have an active, but if you dont put that in there with your strength and your weaknesses, you will never move. That is the second lesson is the third one if you are just as clear come you try to never make people always your target because they can to see once, too, that maybe one day they will not miss you. So what is important to really give some space for people to give you what they know so you can learn more. And thats third. Fourth he says you have to be present in mice. A stepbystep. The fifth one is that even this commandant, if hes just one second before his target, you will never change this space. It will always have selfcontrol. Life is very important to have selfcontrol. The last one is added