Transcripts For CSPAN Key Capitol Hill Hearings 20140808 : c

>> we are glad it's over. i think i know why. there are so many voters in our primary. one, the people of tennessee to the governor how proud they are of his hard work, and i want to congratulate him. [applause] secondly, those who voted in the republican primary wanted to send a different redge, that we're not happy, that we're disappointed with the direction of our country, and we're hopeful of having a new republican majority in the nited states senate. there was another message in this primary tonight. in a large primary, in one of the most conservative states in the country, tennessee voters nominated a "get it done" republican governor and a "get it done" republican senator. let me tell you what i mean by that. what i mean is that both governor haslem and i are conservative republicans. both of us know when we finish our speech, we're not done. in fact, we ought to just be starting to work together with others and try to solve the problems that face our country. that's how tennessee has led the country in academic achievement, in the lowest amount of debt, and in bringing new auto jobs to the state. the absence of that kind of get it done in washington is why why our borders are out of control, why we have a mess with our health care policy, and why it is hard to find a job today. so what i hope to do in a new term in washington is what i try o do here. recognize that if we want to change obama care, we have to pass something. to do something, we have to work ith others to get it done. i want to take tennessee's leadership to the white house. some people say we have bigger problems. i don't believe so. we had many more difficult problems in the earlier days of our country. we're just as strong as we ever were as a country, we just need get it done team. i want to thank all of you, the congressional delegation and the governor and the former republican state chairman and the hundreds of young volunteers that made a quarter of a million phone calls and knocked do not doors. steve smith of the finance team, thank you. thank you to honey and our family. taylor, wesley, and will are all here tonight. and thank you to the people of tennessee. i want to congratulate those who competed in the republican primary. i want to talk to democrats and republicans and say, if we want to fix the debt, control the rder, and we want to control and after we make our speeches, we have to roll up our sleeves and get something done. that's the tennessee way, that's the american way. thank you. [applause] >> senator lamar zandser with is -- zand are with his -- senator lamar alexander with his wife honey. thank you to wtvf tv for allowing us to use their coverage feed. we have a reporter here from thehill.com. let me go back to his comments tonight. interesting to know he stepped down from the senate leadership in order to play a different role in washington. >> he did. i got to ride around with senator alexander on the first day of his bus tour last month. i asked, do you want to go back to your leadership? he said he is looking forward to the republicans to do that. he's the chairman of the health education committee, which he's well suited to do as a former secretary and former university president. you heard those remarks that he said he's a get-it-done senator. both he and lindsay graham have a record of working across the aisle. you know, he wasn't afraid to say -- one of the things he told me a couple weeks ago is, i'm a conservative independent. he said the people of tennessee know me this way. his legacy in tennessee goes ack almost four decades. his remarks were, i vice president changed, you know him me. if republicans do get the majority back, i get the feeling from him that he really does want to get things done. one of the things i know he's passionate about is education reform and health care. he's worked on that before, too. so i think it really speaks that will senator graham -- this is essentially the end of the senate republican primary of two incumbents tonight. this is the first time since 2008 that the tea party didn't have an incumbent. i think if republicans win back the senate i think it gives them re free rean to maybe work across the aisle. >> jessica taylor, thank you for sharing your report. senator lamar alexander winning his primary challenge. thanks for being with us. is this a safe republican seat? >> yes. senator alexander is coming back . on the republican seats it really is down to mitch mcconnell and the georgia open seat. the rest will be played out on democratic turf. >> wendell from sulfur, louisiana. >> mr. mcconnell, he never did nothing for kentucky, to start with. what these republicans do on health care they want to take it from the people that need it. just like food stamps. they took billions of dollars in food stamps and gave it to the rich people. what would jesus do? these are satan. >> thank you. lamar alexander brought it up tonight saying we can't just fight against obama care, we ave to provide an alternative. i was talking to a republican strategist today. he said it is important to make the dimpings of how the law is hurting people's lives. they have to draw the connection. it is not just being against it. it is up to republicans in those 30-second ads to point out specifically what they think is wrong with the bill, particularly because they have to make that connection with independent voters. >> the headlines tonight, alexander winning, but in two of the house primaries, tennessee three and tennessee four it is a virtual dead heat. we will continue to have those results at the bottom of the screen. you can check those out on the screen. north carolina you have as leaning democrat but it could go ither way? the republican nominee, thom tillis was unpopular, and he was presiding, he still is. they just got out of a special session. his unfavorables were rising in part because of his affiliation with the legislature. >> and i think his association with the republican governor. >> there was a whole power struggle. lost a senate house primary. there has been a power struggle there. but all of that, i think -- the legislature has gotten a that they had gotten too extreme. north carolina is an extremely difficult state. there are multiple media margets markets. tough to get known as an incumbent, let alone as a challenger. the biggest problem i see is the libertarian. he needs 9% or 10%. i don't think he will get that. the libertarian normally gets 3%, 4%. >> we're showing some of the latest ads in these races. a reminder we will be hearing the debate in the competitive house races throughout the fall. you can check out our scheduling at c-span.org. we'll show you some of the ads. >> hi. i'm kay hagan. one of the things i love about basketball here is -- unless you are talking basketball, you don't need to pick a team. i am for middle class families. i approve this moslem because i was so proud when the nonpartisan republican journal ranked me as not too far left, not too far right. just right. obama care is a disaster, but the president won't admit it. the debt is out of control, and neither -- kay hagan enabled president obama's worst ideas. shely fuses to clean up his mess, so you and i have to clean up hers. >> the thing i have never understood about politicians is the difference between what they say and what they do. standing up for innocent life. instead of talking about it, i helped change north carolina's law. being conservative, it's not something you say, it's something you do. i'm thom tillis, and i approve this message. >> the billionaire koch brothers are supporting thom til lifment s. why? he thinks corporations should get tax breaks while seniors pay more for prescription drugs. thomtillis. he may not be a koch brother, but he certainly treats them like family. >> as you watch these ads , how effective are these races. >> i think when there have been millions in spending there will be millions more. i think there is a danger that swing voters get turned off and then there is the base, energizing your base. one thing about hagan that is different from some of her colleagues is she doesn't have that family name to fall back on o. even udall in colorado, they can fall back on this family name. you know my family or brother that serves. hagan doesn't have that. she's trying to define her epublicans to do it for her. >> at the moment mark prior is ahead. >> arkansas is a fascinating race. if you ask both parties how do you feel about arkansas? i think their candidate is in a stronger position and they are cautiously optimistic. in colorado i think both parties agree it is neck and neck. democrats are focusing on turnout. particularly african-americans , t haven't voted at all trying to get them to the polls. georgia, north carolina, a turnout operation is what democrats are relying on is a key component to holding the ajority. >> a loot of questions among republicans that they need to recapture the democratic seat. what's the latest in alaska? >> i think we forget, he was elected 6 months ago. not just indicted, but convicted. he won less than 60%. republicans are still working through a primary. a couple weeks ago, it could be daniel sullivan. the primary is competitive. then we have to wait and see how quickly republicans can consolidate and if they can . nsolidate enough >> a call from apple valley, california. >> i hope the republicans consider in 2016 cog what they to runget dr. pen carson for president. i think he has common sense, and some people say common sense doesn't apply, but it does. the other thing is, i don't mean this in a real negative way, but i was a democrat for several , but after obama got in with harry reid, dick durbin, but i hate to say it, but i think the democratic party has turned into a new communist party. >> i think there will be an opportunity for a true insider. there are -- there could be an opportunity for a true outsider getting in. that said, i think it is extremely difficult to build the campaign infrastructure to compete with these other people that will be in the race to raise the money necessary to compete. at this point i don't know why . u wouldn't >> book tv.org. he sat down with nbc's chuck todd. let be me go to one other race before we conclude tonight. that's colorado. that is a race where senator udall was favored early on. this polls are showing -- >> i think colorado in this race has been trending for republicans that swing and maybe find the democrats in the past two elections. this was a race that they were really basing a lot of the model in other states on what they did in colorado for bennett in the last election. his unpopularity is sort of baked into the cake. here is a true swing vote. troy gardner is too extreme on the issue of abortion. it has become cliche but suburban voters are going to play a critical role in the colorado race. >> it is understanding and expectation that each of us has the freedom to make our own choices, to live life on our own terms. you have the right to be an individual. i'm mark udall. no one, not government, not washington, should ever have the power to take your rights and freedoms away. that's why i approve this message. really e utter some sweet words, president obama! et me utter two really sweet words, "president obama." will that send a message to the world or what. >> my great grand dad built our family business. my dad and grand dad had bell big shoes to fill. so did i. all of us in colorado walk in footsteps of pioneers. we need to shake up the united states senate, put in a new generation. one that's accountable to the next generation. >> congressman gardner just doesn't get it. >> for some it is his history of supporting harsh anti-abortion rain or in cases of incest. for others it is his campaign to stop birth control. >> seriously? >> i'm mark udall, and i approved this message. >> this really is a microcosm of what's happening on a national scale, the campaign by democrats on gender issues and women. >> absolutely. the republicans want to be laser focused on the president and the democrats want to talk about any number of issues except for the president or specifically health are. i have to say, i think that ad from senator udall is one of my favorite in the cycle. he says it is about individual rights, freedom, eagles, children. it was so ambiguous, but it is probably effective, because how could you be against those hings. >> a lot can happen between now and early november. what are you looking at? what should those interested in politics keep an eye on when it comes to the senate? >> we have to look at north carolina, see what happens in alaska, iowa. i think those are some of the states to watch. south carolina, montana are already in the republican column. we have to look at the next states. will iowa be open? we'll wait and see. i think we are entering a new stage, and i think there is some volatility that will start to stick out in the next few weeks. >> more than 30 gubernatorial races, five house seats, and a third on the ballot in the new election. the president not on the ballot, but he's a factor for both parties when it comes to fund-raising for the democrats and a target for the republicans. >> whether democrats like it or not, he's going to be a factor in the race. declare your independence where necessary, using him to energize and voters where necessary trying to strike that balance. when -- >> when you look at these ratings, maybe democratic seats, what's the criteria? >> you know, it is not a magic -- that goes on, and that can put together a more complete picture of what's happening. >> the headline tonight, republican lamar alexander winning comfortably with 52% of joe carr. er let's bring it back to the race everyone will be watching in kentucky, allison lundgren crimes and mitch mcconnell. we'll show our viewers, in case they missed it, fancy farm able o show what alison grimes' response was when mitch mcconnell was speak, and conversely, when mcconnell was speaking, what alison crimes was doing. camera shot hat on reaction. you are seeing it played out on the air waves and the next few onths. >> what is the political eaction of kentucky. >> alison can't afford to get wiped out in coal country. that's part of the math in the equation. >> thank you very much for spending your thursday evening with us, nathan gonzalez j thank you. >> earlier tonight we sthode showed you the final hawaii senate debate. that primary set for saturday. up next, in case you missed it from last saturday,, from fancy farm in the southern part of kentucky, a tradition that dates back 134 years. our thanks to kentucky educational television for their coverage of senator mitch mcconnell and democratic candidate alison lundgren grimes. cheers and applause] >> thank you for hosting the fancy farm. i am grateful to be back in kentucky. and what a huge crowd for senator mcconnell's retirement party. [applause] you sure know how to throw a party. the barbecue smelled so good even jesse stopped holding his ose. with all this great barbecue, there's no way i'm going to leave here today. you know, it is not easy beating mitch mcconnell. he's been in washington, d.c. so duke and kentucky -- but i have good news for the folks in grover lake. if mitch mcconnell doesn't know where your town is, it just makes it harder for him to ship your jobs overseas. don't worry clore lake, you are not alone. mitch mcconnell forgot about a long time ns ago. 35 is my age. that's also senator mcconnell's approval rating. you know he is worried about the results in november when you see his campaign manager wearing a mitch for governor 2015 button. sorry hal, sorry jamie. when you finally see senator mcconnell and i on the same stage, you realize only one of us believe women deserve equal ay for equal work. if mitch mcconnell were a tv show he'd shall "mad men." stuck in 1968 and ending next season. seriously, i don't know what's more dysfunctional, senator, the way you run your campaign or washington, d.c. after three decades in washington, you have just given up. .ou don't care about us anymore thanks to you, d.c. stands for "doesn't care." hen it comes to giving kentuckyans that actually survive by raising the middle age, mitch mcconnell doesn't care. i do. it is not a minimum wage, as a living wage that the people of kentucky need and deserve. when it comes to supporting our seniors, mitch mcconnell doesn't care. i do. our seniors, like my grandmother, deserve to have a united states senator that can fight to strengthen medicare and social security, not dismantle it. and when it comes to our students being able to afford college, mitch mcconnell, well he doesn't care. i do. mitch mcconnell may bail out wall street, but i'll have the backs of our students and graduates, students like clay williams deserve the opportunity to earn degrees. when it comes to being a woman and being treated equally here in the commonwealth of kentucky, well mitch mcconnell doesn't care. i do. senator, the women of kentucky here today to are send you a message. the barriers for women -- you are standing in our way. 76 cents on every dollar is not acceptable, and equal pay for equal work is not preferential treatment. this is not a women's issue, this is a family issue. when it comes to labor, mitch mcconnell doesn't care. i do. you see collective bargaining is the fundamental right. labor unions have lifted millions out of poverty and will help us grow the middle class. when it comes to our kentucky coal miners, well mitch mcconnell doesn't care. do. i stand here -- they are standing shoulder to shoulder with me because they are tired of the hot air from senator mcconnell. they want someone who will fight for their jobs. when it comes to the jobs we so need here in the commonwealth of kentucky, well mitch mcconnell doesn't care. i do. while mitch mcconnell may not think it is his job to bring bs to the commonwealth, as your u.s. senator, i will. we did he seerve to have a senator that will put people back to work. i want you to put aside the partisan attacks, and you will see one of us represents the washington establishment, and one of us represents kentucky. one of us represents the past, one of us represents the future. one of us wants six more years, yet another term, while one of us knows kentucky deserves etter. the people of kentucky are asking if you are a woman and you wanted to be treated fairly, who do you think speaks for you? our students are asking, if you dream big and don't want to settle for second best, who do you think will share your vision? the people of kentucky are asking if you are a worker and you are worried about your job going overseas, who do you think will fight for you? kentucky has fell the pain of a washington, d.c. that isn't working for far too long. 30 years is long enough. from agricultural to education to manufacturing, it is time we had a senator that represents the people of this state instead of partisan political interests. now folks, i want you to take a look at the two of us up here on this stage because if mitch mcconnell has his way, it is the last time he will be willing to appear with me. senator i will be at the debates nd you should be, too. senator you seem to think that the president is on the ballot this year. he's not. this race is between me and you and the people of kentucky, and we intend to hold you accountable for our leadership. you can run from the people of kentucky, but senator you can't hide from your record and i intend to hold you accountable, and i don't need hound dogs to track you down. thank you. god bless the commonwealth of kentucky and each and every ne of you. [applause] >> all right. ok. for all of you out of towners, this is the place where epublicans tell it like it is. jack conway curses. governor basheer drones on about obama care. and alison undgren grimes unveils her foreign policy. you know, fancy farm is fun, but there are serious problems confronting our country. and the president acts like he's on a pga tour. obama wouldn't go down to the border to see the immigration crisis for himself. he said he didn't like photo ops. he's taken more selfies than flat stanley. i give my opponent credit. she knows barack obama can't be counted on to do anything about the crisis on the border. so listen to this. this week she came up with her keep folks from streaming into our country -- missile defense. the reality is that the liberal allies are making america weaker at home and abroad. by any standard, barack obama has been a disaster for our country. now, if you think about it, that's what you get for electing omeone with no experience. he was only two years into his first job when he started campaigning for the next one. ound familiar? his campaign ray raised millions from extreme liberals. sound familiar? he didn't lail have any altercations at all. sound familiar? and every trime he got in trouble and his inexperience became obvious, he called in bill clinton. sound familiar? look, the lesson we've learned is that we'll never make that mistake again. here in kentucky we need leadership that understands that burger isn't a reason to ruin our health care system. we can't afford a leader who thinks the west bank is a hollywood fund raiser. you see, kentucky is under attack from barack obama's ad mgsmrgs and we need to fight ack. there is only one thing barack obama needs to keep his grip on power. he needs the senate. that's why all these people from "the new york times" are out here in western kentucky. for obama and his liberal buddies in the media, coming to kentucky is like foreign travel. these guys can't tell the difference between a coal miner and a european male model. but, you know, they think they know what's belft for all the est of us. and they know as long as they can hold the senate with their kentucky candidates, they can do anything they want. they make fun of them at cocktail parties. they say we are bitter country folks that cling to our guns and our religion. i've had enough of that. we're not going to take it anymore. we know what obama needs to wage his war on coal. e know what we need to do to top him. they know they need to force obama care on us. we know what we need to do to repeal it. they know they need to keep continueing to mock our values, .nd we aren't going to let them tell them our convictions aren't just set aside for saturdays and holidays. we hold our values every single day. it is time, my friends, to rise up and fight back. we've got people who are hurting out there and need us. there is only one way, just one 2014. change america in to begin ly one way to go in a different direction. that's to change the senate and make me the leader of the new majority to take america in a different direction. [applause] >> president obama announced tonight that he's authorized the u.s. military to carry out two actions in iraq. air strikes against islamic litants if they advance, and to help humanitarian -- and humanitarian flights to help some reaks in the northern part of the country. the press conference was held at the white house in the state dining room. >> good evening. today i authorized two operation ns iraq. targeted air strikes to protect our american personnel, and a humanitarian effort to help save thousands of iraqi civilians who are trapped on a mountain without food and water and facing almost certain death. let me explain the actions we're taking and why. first, i said in june that the to rist group isl began march across iraq, and that the united states would take action against iraq if and when necessary. the terrorists have continued to move across iraq and are near e city near urbeal where american military personnel serve at our consulate. to stop the advance, i have directed our military to take targeted strikes should they move toward the city. we intend to stay ridge lent and t if they make any move toward our people in iraq. we are urging assistance from the iraqi government and kurdish forces so they can more effectively wage the fight against the terrorists. at the request of the iraqi government we have begun efforts to help save iraqi civilians tranded on the mountain. ounce these terrorists have marked across iraq, they have en increasingly barbaric against a small religious secretary. chinning reports describe militants rounding up families, onducting mass executions, and slaying uziti william. men, women, and children have fled for their lives. and thousands are now hiding up on the mountain with little but he clothes on their backs. without food and water, people are suffering and children are dying. these innocent families are aced with a horrible choice. descend the mountain and be slaughtered, or stay and slowly die of thifert and hunger. i have said before, the united states cannot and should not intervene every time there is a crisis in the world. let me be clear why we must act and act now. when we face a situation like we do on that mountain, with innocent people facing the prospect of violence on a massive scale. when we have a mandate to help. in this case from the iraqi government. and when we have the unique capabilities to help divert a massacre, i believe the united states cannot divert a -- cannot turn a blindite. we must act to prevent a possible genocide. that's what we are doing on that mountain. i have authorized targeted air strikes if necessary to break the siege of mount sinjar and protect the people trapped there. we have begun humanitarian air drops of food and water to help these people survive. arlier in the week one iraqi woman cried and said, there is no one coming to help. well today america is coming to help. along with other countries that have called for action to address this crisis. i know many people are worried about any action in iraq. even limited strikes like these. i understand that. i ran for office to end the war in iraq and that's what we have done. i will not be dragged into fighting another war in iraq. as we support iraqis, american combat droops troops will not be returning to fight in iraq. there is no american solution to the larger military crisis in iraq. e only lasting solution is reconciliation among iraqi communities and security forces. we comp can and should support forces that bring stability to iraq. so as we carry out these two missions, we will support a broader strategy to carry out these two missions. they can fight back against threats like isis. the iraqis have named a new president, a new speaker of parliament, examine they are seeking consensus on a new prime minister. this is the progress needed to reverse the momentum of the terrorists that pray on -- prey on iraq's divisions. once iraq has a new government, the united states will work with it and other countries in the region to offer support to deal with humanitarian crisis and counter-terrorism challenge. iraq's neighbors have an interest in stability in the region. we will continue to work with our friends and allies to help people get the shelter they so desperately need, and to help iraqis push back against isis the several hundred people i have ordered to help will do what is necessary to train and advise and help iraqi forces going forward. just as i consulted congress on the decisions i made today, we will continue to do so going forward. my fellow americans, the world is confronted by many challenges. while america has never been able to right any wrong, america has made the world a more secure nd prosperous place. our leadership is necessary to underwrite the prosperity our children and grirn will depend upon. we do whatever is necessary to protect our people. we support our allies when they are in danger. coalitions of countries that stay true to the fundamental norms, and we strife to achieve basic freedom and dignity that is common to human beings where ever they are. that's why people all over the world look to the united states of america to lead, and that's why we do. let me close by assuring you that there is no decision i take more seriously than the use of military force. i have been careful to resist calls to turn time and again to our military bauds america has other tools. we can lead with the power of diplomacy, our economy, and our ideals. when the lives of american citizens are at risk, we will take action. that's my responsibility as commander-in-chief. and when machine thousands of people are being faced with the possibility of being wiped out, and we have the capacity to take action, we will take action. that's a hall mark of american leadership. that's who we are. tonight we give thanks to our men and women in uniform, especially our brave pilots and crews over iraq who are protecting our fellow americans and saving the lives of so many men, women, and children that they will never meet. they represent american leadership at its best. as a nation we should be proud of them and of our country's enduring commitment to uphold our own l security and the dignity of our fellow human beings. god bless the united states of america. >> will this be enough to stop isis, sir? >> how many air strikes have happened? >> coming up on c-span, the congressional panel on the recent outbreak of the ebola virus. >> the subcommittee will come to order. good afternoon to everyone. i called this emergency hearing during recess to address a grave answer is health threat which has in recent weeks ripped the mass media and heighten public fears of an epidemic of the ebola virus. what we hope to gain from today's hearing is a realistic understanding of what we are up against while avoiding sensationalism. ebola is a severe and often fatal disease that first emerged or was discovered in 1976 and has killed 90% of its victims in some past outbreaks. since march of this year, there have been more than 1700 cases of ebola, including more than 900 fatalities in guinea, liberia, sierra leone, and nigeria. this time, the average fertility -- fatality rate in this outbreak is estimated at 55%, ranging from 74% in guinea 242% in sierra leone. the disparity in mortality rates are partially linked to the capacity of governments to treat and contain the disease and perhaps per capita health expending by effective governments. there is also concern giving -- given modern air travel and the latency time of the disease that the virus will jump borders and threat lies elsewhere in africa and even here in the united states. in my own state of new jersey, and a hospital just a few hundred yards from my district office, precautions were taken. a person who had traveled from west africa begin manifesting symptoms including a high fever. he was put in isolation. thankfully it was not ebola and the patient has been eleased. the new jersey health commissioner reiterated to me yesterday that new jersey ospitals have control programs in which they train and are ready to deal with infectious patients that come to their doors. she told me physicians and hospital workers follow specific protocols prescribed by the cdc on how to protect themselves as well as other patients and how to observe a patient if they have any concerns, which include protocols like managing a patient in isolation so they are not around others who are not appropriately protected. the commissioner also underscored that the federal government has u.s. quarantine stations throughout the country to limit introduction to any disease that might come into the united states at ports of entry like new jersey's liberty international airport. i hope our distinguished witnesses will confirm whether sufficient resources are available and are being properly deployed to assist victims and contained the ebola disease. are there gaps in law and policy that congress needs to address? to the government witnesses, my ledge to you is, if legislation is needed, i will work and i know i will be joined by colleagues on both sides of the aisle who will work with you to write those new policies. key symptoms of ebola include fever, weakness, joint, muscle ache, throat and stomach aches. hen vomiting, diarrhea, rashes and bleeding. these symptoms are seen in other diseases besides ebola which make an accurate diagnosis early on uncertain. earlier today, i had a full and lengthy reefing with the deputy chief of staff of the president of guinea. he said the virus has masked many other diseases, including loss of fever. many doctors, including those who have never seen ebola in this part of africa before, in other parts of the world, but just simply frica, did not think this would be ebola. many of them have died. ebola punches holes in blood vessels by breaking down vessel walls, causes -- causing massive bleeding and shock. most people cannot fight the infection effectively and as a result, there is massive leading within seven to 10 days. the infection too often results in the death of the affected person. fruit bats are suspected of being a primary transmitter of ebola to humans in west africa. the virus is transmitted to humans with close contact in the blood, secretions or other rgans of infected animals. some health workers such as the heroic air -- heroic american missionary aid workers dr. brantly and nancy writebol contracted the disease despite taking every precaution while helping ebola patients. both of them are now being treated at emory hospital in atlanta, georgia in an isolated unit after being flown to the u.s. in a specially equipped air air ambulance. while there is no known cure for ebola, the doctors have been give yep doses of an experimental drug col cocktail alled z-nan. developed by san diego company called snap pharmaceutical. they are reportedly both feeling stronger after receiving the drug but it is considered too early to tell whether the drug itself caused the improvement in their conditions will stop the pharmaceutical company has been working with an arm of the notary responsible for hounding weapons of mass destruction to ebola -- to develop an ebola treatment for several years. the drug attaches to the virus itself and it has never been ested on humans before the two , dr. brantley and ms. wrightbol, who gave their permission to be the first trials. they gave their consent to be treated. there will be great hope if z-tap works and if the two americans who bravely agreed to test it and it has a positive effect. that would been it would be produced in great quantities and sent to people in west africa. it is still an experimental drug. those who use it might the given complete information on its use but that's something our experts i hope will address. there's also promising research being done by a company who has come up with a drug and process -- one of the comments that has been made that it has never been tested on humans and that it has been provided 100% protection from an otherwise lethal dose of zaire ebola virus, but not in humans. it's been done in non-humans. unfortunately, it impacts the ability of the international community and assisting the government to meet the self -- health challenge. some of the leading doctors in those countries have died reating ebola victims. the nongovernmental and american personnel there say they are besieged not only because they are among the only medical personnel treating these exponentially spreading disease that because they are under suspicion by some people in these countries who are unfamiliar with this disease and fear doctors may have brought it with them. of course this is untrue, and myths do abound. the current outbreak as we know is unprecedented. many people are not cooperating with efforts to contain the disease. there is an information gap. despite the efforts through cell phone and radio to get the message out, there is a learning curve. as we consider what to do to meet this health challenge, i suggest we get funding levels for pandemic preparedness. this is for congress and the executive branch. in a restricted environment, funding has fallen from $201 illion in fiscal year 2010 to n estimated in 2010. we must not shortchange efforts to save these people in this country. our expert witness, tom frieden, is trying to assure the government we are doing what we can do to address the crisis. he announced the dispatch of 50 or more public health officials in the next 30 days. usaid, w.h.o., the british bank, african development bank, and many others, are joining in in trying to meet this crisis. to those who say we have no plan, i would say planning is definitely underway and is being done so aggressively. still, there is much more that needs to be done. have introduced legislation -- it is known as "end the tropical disease act" which establishes to support a broad range of research activities to achieve cost-effective and sustainable treatment and control and, where possible, the elimination of neglected tropical diseases. ebola is not on the top list of 17 neglected tropical diseases but it does fit the definition of an infection caused by pah -- pathogens that disproportionately impact individuals living in extreme poverty, especially in eveloping countries. ebola had been thought to be limited to areas where it could be contained. we know that is no longer true. we need to take seriously the effort to devise more effective means of addressing this and all neglected tropical diseases. i now yield to my good friend and colleague, the ranking ember. he ranking member, karen bass. >> mr. chairman, thank you for your leadership and calling today's emergency hearing to give us an opportunity to learn about and work to address the current ebola outbreak in west africa. i look forward to hearing directly from our witnesses on the work their agencies are doing to combat the deadly outbreak and how they have coordinated with the government of impacted countries. i appreciate their efforts at outreach to keep congress informed on this devastating situation. this outbreak comes as nearly 50 african heads of state join us here in washington dc this week as part of the first in history u.s.-africa leaders summit. i have been honored to join my african and american colleagues as we join together to reach the full capacity and promise of the african continent. we had several production sessions that further cemented the relationships between u.s. and african nations and highlighted opportunities for us to continue to work together. despite the meaningful dialogue and collaboration that occurred this week, there is still work to be done. the development of health care capacity and global security is just one area of collaboration for the u.s. and african nations. i was a little dismayed that with all the activities that appened this week around the summit, the crisis we are dealing with today is very important, but when it came to coverage on africa, the coverage centered solely around ebola. i want to commend the steps being taken by the government of liberia, sierra leone, nigeria guinea, and the u.s. and the great work of the health professionals throughout the world who are doing everything they can to help people who have contracted this awful disease will stop with over 1700 suspected and confirmed cases and over 900 deaths since march, the current outbreak is the longest lasting, widest spread, and deadliest outbreak recorded. it's also the first ebola outbreak in west africa and the first outbreak to be spreading in both rural areas and capital ities. the unique nature of this outbreak has made combating the disease difficult. west africa has not faced this isease before, and communities , governments, and health officials in the nations do not have the capacity to address the scale, spread, and proper treatment of the outbreak. this lack of logistical expertise, health care workforce and supplies has hindered the ability of governments to identify, track and isolate new cases and properly care for those infected. officials have had to fight against fear of the disease and culture -- the literal unfamiliarity with robert treatment which has really contributed to the spread and kept eople from seeking care. yesterday, i had the privilege to speak to president ellen johnson about the impact on her country and the work they have done to fight the disease. i asked what more we could be doing and one thing she talked about was the need for logistical support, the need for training of their health care workforce so they would know how to prevent the disease. i'm sure tom frieden is going to say we do know how to prevent the spread of the disease but that is where our efforts need to be directed. the other thing the president said was the problem with the outbreak is all the resources are centered toward the outbreak and then routine medical care has suffered because there has not been the workforce to be able to handle both will stop so the call for increased international assistance to provide food and water to impacted communities -- she said the communities that were most heavily impacted were quarantined and that there needed to be food and water brought into the areas, especially in situations like this where you have a concern civil unrest, there could be an outbreak in areas that are quarantined and feel they do not have access. she felt that was one of the ways the united states could help the best. it's in our interest in the world interests to continue to support nations as they fight this outbreak and work to develop. health care is a human right. we're hoping to prevent future health epidemics from occurring. both the chairman and i have ntroduced legislation to respond to this crisis and i look forward to your testimonies. i'm interested in hearing from all of you about what more congress can do to assist your efforts to combat the disease, outbreaks, and support international efforts to improve health care systems around the world. thank you. >> thank you very much. i would like to recognize in the audience the special representative to the secretary-general of the u.n. on sexual violence in conflict. thank you for joining us today. i would like to now yield to the distinguished chairman of the state department, commerce and justice department subcommittee of the appropriations committee, congressman frank wolf, who has had a 34 year career of tremendous support for the weakest and most vulnerable, and a matter of fact, the genesis of this hearing was a conversation with ken isaacs last week. we were planning on a hearing on the ebola virus force number and the sense of urgency and chairman wolf set up the conference call, the sense of rgency was so great that the thought was it that are now and we can have more hearings in the future and more action plans and the like. so i would like to thank the chairman for his tireless efforts on behalf of the weak and vulnerable. >> i like to thank my good friend for pulling today's hearing together amid the escalating outbreak of ebola across west africa, countries including liberia, sierra leone, guinea, and now nigeria. i also appreciate being invited to attend this hearing. although i am not a member of the foreign relations committee, i do serve on the state and foreign operations appropriations subcommittee which funds the state department and foreign aid programs. i would also say to the witnesses that if you need extra money, ask for reprogramming. you should not wait for september, october -- you should ask for it immediately and him confident the appropriate committees will allow it. but if there is any doubt, there should be request for reprogramming. the current ebola epidemic has claimed over 900 people. it was detected earlier this year and is proving to be the world's worst outbreak of the virus ever recorded. it now appears this alarming, contagious disease could be on the verge of spreading. on july 28, i received a call from ken isaacs. ith samaritan's purse. let me say samaritans purse and doctors without borders have done more to help the poor and suffering in many placiass than almost any other group around. so i want to commend samaritans purse and doctors without borders. wherever you go in africa, they will either one other groups have long gone. samaritans purse is on the front line, working to curtail the bola outbreak. the outlook via absence of the united states was bleak. the obama administration underestimated the magnitude and scope of the epidemic. despite well-intentioned efforts by local and international aid workers, actors and nurses working on the ground, it seems the international community in the u.s. had been noticeably absent in helping these west african countries to get out in front of the spread of this pidemic. for the first part of the epidemic, the international community led three of the most impoverished countries in the world deal with it ebola essentially on their own. it should be no surprise the health systems and night -- in liberia, guinea and sierra leone do not have the resources or capacity to deal with this epidemic on their own. despite early warnings from ngos working on the ground, there was little action taken to get in front of this problem and now we are seeing the consequences. nothing can bring back the lives that were lost and money and personnel deployed to help may not be enough to contain the epidemic. i spent much of last monday on he phone with the white house, tate department, c.d.c. just trying to understand what, if anything the u.s. is doing to contain the out rate and prevent the spread of ebola to the u.s. i was concerned no one could tell me who was in charge within the administration on this issue. no one could explain what actions would be taken to ensure the u.s. was prepared to respond. although more progress has been made over the last week since these conversations, it is clear the government is still trying to catch up. this requires efforts from agencies and countries, france, great britain, many of the countries in europe who are experienced in africa should be brought in. it has also come to my attention that there seems to be deficiencies in the planning procedures and protocols in response to the ebola threat , mr. isaacs will share today when the health care workers confirmed with ebola, getting guidance for returning health care workers soon became apparent there were ignificant gap in existing procedures for dealing with this. the cdc had no available registry of medical facilities capable of treating ebola patients in the united states. there are no quarantines or travel restrictions in place and there was concern about these gaps in protocol, and how do you eal with them? i appreciate them very much. i appreciate dr. frieden -- he took the cold call when his getting on the airplane. i hope you will talk about any deficiencies and how they can be addressed by the government and the congress of stop -- and the congress. i want to thank chairman smith for calling this hearing during the august recess and i also want to recognize the men and women of the cdc and other international response groups who are on the ground and soon will be on the ground in africa as well as the doctors and nurses helping the two patients n atlanta. i want to thank them because this is very dangerous, what a will be doing all stop and people we do not know their names, will be doing. i think we should tell them we appreciate them. i want to thank the state department and department of defense for their invaluable assistance as this thing is taking place. this is important and serious work and i knew if the american people if they knew what was being done would appreciate their efforts. this should be a very top priority of the white house, the political leadership of the nation. you know with the career people are going to do, but the white house, the american people deserve to know what their government is doing to prevent the spread of this epidemic and keep the country safe. with that, mr. chairman, thank you and i yield back. >> i would like to now introduce our first panel of two panels. the getting first with dr. tom frieden, who has been the director of the centers of disease control since june of 2009 and has worked to control infectious diseases in the united states and globally. he led new york city's program to control tuberculosis and reduced the multidrug resistant cases by 80% and worked in india for five years, helping to build a tuberculosis control program that has saved nearly 3 million lives. at the commission of new york city's health department, dr. frieden founded programs that increased life expectancies and is the recipient of numerous awards and honors and has published more than 200 scientific articles and has previously testified before this committee on drug-resistant diseases as well as other very important health topics. thank you, dr., for being here. we would like to introduce ariel pablo mendez, the assistant dministrator for global health at usaid. he's been in that position since 2011. he joined usaid's leadership team to shape the bureau for global health's efforts to accomplish scalable, sustainable, and measurable impact on the lives of people living in developing countries. prior to joining usaid, he developed on mobile health strategy in the transformation of health system and africa and asia and served as the director of knowledge management at the world health organization. he is a board certified internist and until recently was practicing as a professor of clinical medicine and epidemiology at columbia university. we will hear from ambassador williams, career member of the senior foreign service with the rank of minister consular of foreign service and deputy of affairs at the department state. she serves as ambassador to the republic of niger and has served at the u.s. in montana france and guinea. her postings have included director for international organizations in national security council at the white house and advisor at the u.s. mission to the united nations in new york. without objection, fuller resumes dished, but they will be entered as part of the record. r. frieden, the floor is yours. >> thank you so much, chairman -- h, congressman congresswoman bass for calling attention to this situation and your leadership and calling this hearing at this critical time. first, let's remember the lives and faces of the men, women and children who are affected by the ebola outbreaks in the four countries currently affected, especially the health care workers who account for a substantial proportion of cases. those are the people we must focus on. those are the people we must support, and it is in africa we can stop this outbreak and protect not only this country but ourselves as well. we focus on what works and i'm incredibly proud of the staff of the centers for disease control and prevention. and i think every american who would know the expertise, dedication of the disease detectives, laboratory experts, disease and intervention specialists who have an on the ground in the past few weeks and months and who are now searching for our response would be proud to know what we are doing there. i want to start with the bottom line. three basic fact. first, we can stop ebola. we know how to do it. it will be a long and hard fight and the situation in lagos, nigeria is particularly concerning, but we can stop ebola. second, we have to stop it at the source in africa. that is the only way to get control. third, we have to stop it at the source through tried and true means -- the core public health interventions that work and i will go through in a few moments. by way of background, ebola is one of several viral hemorrhagic fevers. there are others, but ebola is the most feared in part because it had a movie made about it. there are others that are just as deadly. the first ebola virus was identified in 1976 in what is now the democratic republic of congo. there have been sporadic outbreaks since the natural reservoir is not known but is believe to possibly be that which pass it to primates and other forest living mammals and humans may come into contact with them by eating bush meat or contact with bats. that is a theory. there's increasing evidence for but we are not certain of it. what we are certain of is when ebola gets into human populations, it spreads by two routes -- first, to people who are giving care to individuals who are sick with ebola. ebola does not spread from people who have been infected but are not yet set. it's only sick people the transmitted. second, it's transmitted only by close contact with exchange of body fluid. so a health-care worker or family caregiver who comes into contact with a patient who is very ill, maybe leading or have body fluids on the individual, that is how ebola spreads. in the outbreak in africa, there have been two main drivers -- health settings and other caregiving settings, including the family, and burial practices, where there may be practices that involve contact with the recently deceased person. those are the drivers of ebola in africa. ebola only spreads from people who are sick and only spreads through contact with infectious body fluids. it does not spread through asual contact. it is not an air borne disease, does not spread through water or food. and incubation time is usually between eight and 10 days from exposure to onset of illness. it can be as short as two days and possibly as long as 21 days. but in that time, it is essential any contact he closely monitored to determine if they have developed the symptoms of ebola and if they have, are followed up. we do know how to stop ebola. meticulous case finding, isolation, contact tracing and management. we with our partners have been able to stop every ebola outbreak to date. and i am confident that if we do what works, we will stop this one also. but it won't be quick and it won't be easy. it requires meticulous attention to detail. if you leave behind even a single burning ember, it's like a forest fire. it flares back up. one patient not isolated, not diagnose, one health-care worker not protected, one contact not traced, each of those lapses can result in another train of -- another chain of transmission. to control the outbreak, we have to work effectively. the challenge is not the strategy, it's the implementation. mr. chairman, we have provided how this can be controlled. if you will permit me, because i think it is important to get the fundamentals out there. first, to find the patients and diagnose them. that means fever or other symptoms. the only way to diagnosis ebola is with a laboratory test. we working with partners from the department of defense from the past with france, and from countries where the disease is present are scaling up the ability to diagnosis patients. so the first diagnosis is, suspect is with fever, test with lood, get it in the lab. that's the first step. the second step is to respond to those cases. we do that by i getting them in isolation, eliciting their contact, and by following each and every contact every day for 21 days. if a contact develops fever, begin that process all over again. isolate them. find out who their contacts are. it's laborious. it is hard. it requires local knowledge and action, but it is how ebloa is stopped. third, prevent it. prevent it through infection control, health care, safe burial practices, and producing the -- and reducing the consumption or unsafe consumption of bush eat and contact with bats. the current situation is a crisis and unprecedented. it is unprecedented in five different ways. first, it is the largest outbreak ever. in fact, at the current trend, within another few weeks, there l whether have been more cases in this outbreak than in all previous recognized outbreaks of ebola put together. econd, it is multicountry. one of the challenges is that epicenter is on the confluence of three countries. so that tri-country area is a particular challenge. third, this is the worst outbreak in africa. this is a disease that was unknown in that area before. because of this it has been a particular challenge. this also has been a challenge. fourth, many of the cases have been in urban areas and there has been spread in urban areas. this is something we have not seen to this ects tent before. we know to this date this doesn't appear to be a change in the virus, but it is a new development in how and where the virus is spreading, and it makes control much more difficult. fifth, it is the first time we are having to deal with it here in the united states. that's not merely because of the two people that became ill caring for ebola patients and were brought back to the u.s. by their organization. that's primarily because we are all connected. inevitably there will be travelers who go from these countries or from lagos, if they don't get it under control, and appear here with symptoms. those symptoms might be ebola or something else. so we have to deal with ebola in force for the u.s. in a way that we have never had to deal with it before. the u.s. is working to support partner governments and the world health organization. i have activated the c.d.c. emergency operation center at one for this outbreak. this is our highest level of response. it doesn't mean there is an increased risk for americans, but it does mean we are taking an extensive effort to do everything we can to stop the outbreaks. we can't do it alone. governments around the world as well as most importantly people in country will be key to stopping the outbreak. we will send -- the next week or two will have reached that 50 umber. i think it is important to understand, the 50 are supported at home base in atlanta by a much larger group. even today before the full surge of activation, we have more than 200 staff working on this outbreak response. we will increase that number substantially in the upcoming days and weeks. we will hear more about the agency for development where we are using an unprecedented model to work together and rapidly identify and call in for reinforcements and assistance. twh we finish this response, we are determined to not only stop the outbreak, but leave behind strong systems that will help prevent it in the first place. many in fact, if those zims had been in place already, we wouldn't be here. the outbreak would have been prevented. we don't have -- we have medications to care for it. you may have seen press coverage about experimental treatments. the plain fact is, we don't know if that treatment is helpful, armful, or has any impact. we are unlikely to know from the experience of two or a handful of patients whether it works. we do know that supportive care for patients with ebola makes a ig difference. supportive care saves people's lives. making sure they are not under their fluid balance. treating other infections that occur, providing good quality health care. we are currently coordinating with n.i.h., f.d.a., the department of defense and others to see whether there can be new treatments and whether these treatments can be effective and treatable thrfment is a lot we don't know about that yet. it is important that we keep in mind that we do know, even without medicines specific to ebola or a vaccine, we do know how to control it and we can stop it. i want to spend a moment to discuss what we are doing to protect people in this country. first off, the single most important thing we can do is stop the outbreak, stop it at the source. the second thing we are working on is to help these countries do a better job screening people who are leaving their countries so they will screen out people who are ill or who may be incubating ebola. third, because we do recognize that we are interconnected, we are working with state and health workers throughout the united states so they are aware that there could be people who come through these three countries that come in with fever or other symptoms, they should think it could be ebola. immediately isolate them in the hospital and get them tested at c.d.c. we have issued a level three travel advisory against all non-essential travel. yone, and sierra lee - s leone. we have issued a level two travel advisory about enhanced precautions on nigeria and we will reassess the nigerian situation daily or as needed. there is strict infection control possible in the hospitals in the u.s. there has been some isconception about this. ebola is not as highly infectious as influenza or the common cold. what is a concern is that a single lapse in control could be fatal. that's why the key is to identify rapidly and strictly follow infection control guidance. it is certainly possible that we could have ill people in the u.s. who develop ebola here while having been exposed elsewhere. it is possible they could spread it to close family members or health care workers if their infection is not rapidly identified. but we are confident that there will not be a large ebola outbreak in the united states. we are confident we have the facilities to isolate patients, not only the highly advanced ones like at emery, but at every major hospital in the u.s. what is needed is not fancy equipment. what's needed is standard infection control rigorously applied. we've released guidance for doctors and other health care providers in the u.s. on identifying, prodeviding, and treating patients, and guidance for flight crews, and cargo personnel. fundamentally, to end here, we have three roads before us. we can do nothing and let the outbreak rage. i don't think anyone wants to do hat. we can focus on stopping these outbreaks. that's something we will certainly do. we can focus not only on stopping outbreaks but putting in lace the laboratories, the emergency response systems that will find and stop future outbreaks of ebola and other threats. we face in this country a perfect storm of vulnerability like emergence of ebola, intentionally created infections which remain a real threat. but we have unique opportunities to confront nem with stronger technology, more political commitment, and success stories on real progress from around the world. earlier in year, the u.s. joined with the world health organization and more than two dozen other countries to launch a global health security agenda. that global health security agenda is exactly what we need to make progress not only in stopping ebola, but preventing the next outbreak. the second document that we've provided for you, provides a summary of what the mapping is between what we launched back in ebruary before this outbreak was known or reported to have been started, and what's needed to stop the ebola outbreak and they are closely aligned. the president's budget includes a request of 45 million to c.d.c. to l help with the detection and response. former under-secretary of state for africa said to me citing his decade of work that "c.d.c. is the 911 for the world." though i was happy to hear that, i realized that really what we want to make sure is that every country or every region has its own public health 911. that will be good for us, it will be good for public safety. expanding that type of work, strengthening global health security will allow us to not only stop this outbreak, but also prevent future outbreaks and stop them faster if they occur. thank you so much for your interest in this. >> dr. frieden, thank you for that comprehensive and insightful testimony. i would like to yield to dr. pablos mendez. >> thank you for that introduction. ank you ranking member bass, congressman wolf. thank you for your long-standing support to stop ebola. because this has never occurred in this region, and as we heard from tom, spreading to and beyond the region. i am, like many of you, sadened to see the loss of life by this outbreak but also by the broughter economic disruption this is nflicting in the region. what is really a series of fledgling democracies in western frica. i am, like many of you, sadened to see the devastation and loss of live from this outbreak, but also by the economic disruption that this is inflicting in the renalon on what is really a set of fledgling democracies in western africa. the good news, is we know how to deal with ebola, as you heard. since 1950 there have been 30 or so outbreaks in central africa. those situations have been contained. the conditions have to be per expect. -- perfect. uganda has a track record that is worth noting. in the year 2000 they had 435 cases during that outbreak. the support we provided allowed the outbreak to be contained. particularly outbreaks in 2008, nly 149 cases. two-thirds reduction. n the last outbreak in the number was only 32. so we can deal with this outbreak. we have done it many times. and we know what to do. usaid provides routine funding for the c d.c. to work in geneva and africa to have preparedness planning, response, and indeed that has been the machinery that is put in place here. we support about 22 laboratories in asia and africa where almost 500 new viruses have been detected in just the last five years. so there is a lot at c.d.c. going on all the time. this particular virus, ebola, is amiliar to us. and as far as we can tell from a biological-genetic point of view, it is really the same virus. it is not a new, mutant virus hat has taken on new powers. it is the same virus we are familiar with, but it has entered a new reen region, and perhaps that because that was deputied -- this ecological dimension of .he work has to be considered and also we need people experienced in dealing with the outbreak. usaid has also targeted in this year, the response in western africa. we started earlier this year supporting with our $2.1 million investment through unicef, and now up to $2.4 million to upport c.d.c. indeed, it is important to note to chairman wolf's comments, that the outbreak in siera leone, in libera, we can all see earlier on, cases that were identified in late march. and for a couple weeks, we had this outbreak. so that in the spring, the initial outbreak went down. if you allow one case in the remote areas, it can ignite the whole thing. that has been truly difficult to control. this investment has allowed us to work with unicef to allow to deploy 30 or so technical experts and provide additional operational support including 35,000 sets of personal protective equipment and supplies. also the basics -- soap, water, that sort of thing -- is important in this type of situation and taking place as we speak. health and human services and the departmnet of defense as well as the c.d.c. has lead in the response to the ebola outbreak but the coordination has been truly exemplary, and i want to really point that out. it has been something the last couple of weeks that that coordination has been working just to make sure that we actually support the countries to stop this outbreak. usad in addition has activated the disaster response team that we have deployed in other emergencies from fukushima to haiti, earthquakes, and provides the architecture for the response of the u.s. government once the u.s. ambassador on the ground has declared emergency and this has, indeed, occurred and it is now deployed and the team leaders and deputy team eaders are in place. c.d.c. is responsible for the health and medical part of the response. but there is plenty of other activities and planning and operations in communications in not only in the government but with the local government and with the other partners that i mentioned before. i spoke with our mission director in liberia and we have a large, a large platform for health work that works very closely with the minister of health. we have only one or so health staff in sierra leone. working and taking the precautions to include the safety but also to work effectively against this utbreak. and this preservation. not only in the huge setting to avoid the growth of these epidemic, but also the global hat we maintained so the viruses no bothered. in the short-term it is a human imperative and national security priority to contain this ebola outbreak as quickly as possible. it will take months to end it, but i think we can turn around the tables in the next couple of weeks if the response that is mounted is deployed and executed as planned. the u.s. government is fully engaged in the response and we are confident that we can stop he epidemic. as i said, it will not be easy and might take several months. in the long-term we must assist developing countries in strengthening their own health systems, both those dedicated to infectious diseases like this but also the capability of the systems to deal because it is about the frontline health workers in primary care settings in communities and this time is ebola in western africa, we have seen mexico, we didn't expect that or mers coming from south africa. the pathogens can jump anywhere and we have to be prepared to deal with these things as they occur. with your support, usaid will continue to make this our priority in africa, and also demonstration is working on the global health security agenda for which we look to work with you and in the plans because that would require support in the future and we look forward to working with you on that. thank you very much for giving me this opportunity and i look forward to your questions. >> doctor, thank you very much for your testimony and leadership. i would like to note we have en joined by augustine fullhahn, who is the foreign minister of liberia. thank you for being with us today. this is one of the most daunting diseases this country has faced. today more than 1500 cases have been reported including over 900 otal deaths. although the affected countries are home to many heroic and dedicated health workers, the rapid spread of the disease reflects the lack of national capacity, particularly in the three epicenter countries of liberia, and sierra leone. providing frontline medical care to patients is hard-pressed to ontinue to provide care in all ffected regions. the n.g.o. community has played a consultant role by providing frontline medical care to patients and hard-pressed to continue to provide care in all affected regions. compounding the problem, the patients' lack of understanding of the virus and widespread mistrust of health care providers and treatment methods have furlingt -- further hampered response efforts. in significant proportions of the affected regions local tradition such as public funerals and cultural mourning customs including preparing bodies of the deceased for burial have contributed to the spread of the virus and led locals to block access to patients, and in some cases, have led to attacks on health care workers. in one such incident in liberia, major care providers have begun pulling out of the region due to concerns for the safety of their staff. in addition to proper medical care, there is a critical need for effective health campaigns and public outreach as a crucial component of the response efforts. we are reaching out to ensure our response is coordinated with the w.h.o. and other countries that can assist both through ur representatives at w.h.o. headquarters in geneva and through directed discussion with other governments. guinea, liberia, and sierra leone are still recovering from lengthy conflicts. these conflicts destroyed lives, interests tutions, and infrastructure. this was especially acute in liberia and sierra leone where the fighting went on for years. they have taken important steps to reverse the deterioration and neglect. and to pled lasting stability and security. border control and other factors key to checking ebola spread also are challenging for the countries in the region. aside from our interest in making sure the ebola virus does not spread to the united states or farther in africa, we do not want the virus to erode the capacity of african countries to address other important national and regional challenges. we want to ensure these countries remain strong, strategic allies to the united states. in a region facing major security chedges. sadly, this virus already has impacted peace-keeping in somalia. the african union canceled a plan deployment of peacekeeping force due to fears that the virus could be introduce inside the country. given the critical importance of this issue, we are fully committed to doing everything possible to shore up each government's efforts to combat the viral outbreak and control its spread. we are confident that through the concerted and coordinated efforts of our government and our international partners we can contain and stop this virus. in fact, mr. chairman, the department has established a monitoring group on the humanitarian situation in west africa to monitor and coordinate information. the task force may be reached at he following e-mail address. taskforce-5@ state.gov. since the beginning of the crisis, the department has maintained close contact and coordination and closely monitored operational plans to combat the iral outbreak. set upone, the president a presidential task force to lead the government efforts. in guinea, improved messaging helped healthcare providers gain access to infected regions, and in liberia the president johnson announced a national task force to combat the spread of the virus. on august 1, the three presidents detailed their collective strategies for eradicating the virus in a joint communique following a meeting of the manu river union. we commend all three countries for taking the outbreak seriously and taking concrete steps to address it. this week's news of a case in lagos, nigeria make need for a national plan and national response more important than ever. just met today with those who told me that the health ministers of the three affected states will meet again at the end of this week on august 11 hrough 14. and that following that the health ministers of all of the states will meet on august 28. the intensified attention of the health ministers of the entire region is a good sign and demonstrates that the whole region is seized with this risis. assistant secretary greenfield has spoken to the presidents of guinea, liberia and sierra leone to offer support and assure them of our assistance to stop the virus. on august 4, the department hosted a moderated a meeting on the sidelines of the u.s. africa leader summit to discuss the next steps for controlling and ending the virus. h.h.s. secretary, c.d.c. director, and n.i.h. directors, assistant administrator for global health and the liberian minister and professor, the president of the nigerian academy of science participated in the meeting. representatives from d.o.d., and the world bank and private partners like the g.e. oundation also joined. in addition to emphasizing the need to focus on detection, isolation, and adequate training for health workers in the field, we also emphasized our long-term commitment to building the healthcare capacities of individual west african nations beyond this immediate crisis intervention. we continue to work with our international partners and the w.h.o. to assess what is needed to properly treat patients and to mount a sustainable response. such support has included providing financial and technical assistance to properly equip treatment centers and supporting communication efforts to help healthcare workers access affected communities. the w.h.o. subregional coordination center opened on july 23. and is coordinating all surveillance efforts, harmonizing technical support and mobilizing resources being provided to the affects countries. the organization has also launched a $100 million emergency response plan to search -- to mount a more effective response. we are in continuous discussions to find new ways to provide assistance. the department has no higher priority than the protection of u.s. citizens. we extend our deep sympathies to the family of patrick sawyer, a u.s. citizen who died in nigeria after contracting the virus in liberia. two additional citizens affiliated with the response organizations have been infected in liberia and are currently undergoing treatment. we are in close contact with the ponsoring organizations of those two individuals, and our thoughts and prayers go out to them and their families. u.s. embassies in the affected countries have disseminated security messages including the c.d.c. warnings to resident and traveling u.s. citizens. we continue to take steps to educate citizens about the virus. to disspell rumors, and provide intervention on safety measures. and we also take the safety and well-being of our staff seriously. to that end, the department's chief of infectious disease traveled to west africa to provide embassy staff with assistance regarding protection measures and case recognition. additionally, embassies in the affected region have organized regular town hall meetings to answer questions and concerns of mission personnel and u.s. citizens. embassies in neighboring countries like mali, senegal and togo also held meetings and to make contingency plans for embassy personnel and resident citizens in the event of an utbreak. in closing, mr. chairman, i would like to reiterate and assure this committee that the department of state takes the ebola threat very seriously and we are fully dedicated to working with our governmental and nongovernmental allies, the interagency community and host governments in the affected countries to respond to this crisis, prevent its spread and to restore stability to the region. i thank you for your attention to this issue and look forward to answering your questions. >> thank you so very much. ambassador williams. i do have a few questions to pose. to our distinguished panel. beginning first as, dr. frieden, you said supportive services are important with no vaccine or rug treatment, you noted how important those services are, including hydration and antibiotics to deal with some of the other co-infections. is there any disproportionality in result when it comes to whether or not he would are talking about an elderly person, a woman, a man, a child, a woman who happens to be pregnant or someone who has a compromised immune system? what has been the m.o. of that, if you could? secondly, i know that treatment centers, for example, in guinea there is three to four treatment centers but it is hard for people in that country as well as the others liberia and sierra leone to get to the treatment centers. a long trek. not only the person is very sick, others could come in contact with him or her. there seems to be an overwhelming need. one of the points that i think needs to be underscored that is underappreciated in many places is that in dealing with someone who is dying, especially in that part of the world, there is a sychological trauma alone. almost exacerbates the spread of the disease because people want to be around, near, touching when this person is highly infectious, that is when family members and others might get it if you could speak to that. the lack of testing. testing areas, whether as part of the treatment centers, whether it is a testing lab, it is my understanding especially since this masks and parallels what other -- looks like other things but it is ebola but unless you get this test back, how long does it take to do the est? i know especially through the work with the bush program and to followed up with obama, the building health capacity and labs in africa is a very high priority and now we are seeing where inadequate labs or lack of labs leads to people being sick and not even knowing it. the courage of the healthcare workers, i think needs exclamation points. i know you go on the frontline all three of you into contagious areas. but dr. brantley and ms. writebol and others who put their lives on the line motivated so often by faith in the case of dr. brantley. i read some of the things his wife put out and the prayers offered up not just for him but for all of the victims. n liberia there have been 60 healthcare workers infected. 35 are dead. in guinea, 33 healthcare workers infected, 20 dead. how does a country now attract or retain healthcare workers who say we went to that arena the prospects of me getting this are very real. is there enough protective equipment? the gowns, to mitigate the possibility of transfer? and finally, and i do have other questions but i yield to my colleagues. promising drugs. zmat is one of them. the phase one trials and the f.d.a. has a hold on it. they were contracted by the department of defense. from what i read, and it is only when i read the available data it was showing promise. i'm not sure if there is any way to accelerate knowing that you want to obviously put something out there that is risky because ebola is not 100% fatal, as we all know. we don't want people getting sick from the remedy or supposed remedy. what about accelerating this? is there an effort to do that. and my final we is about the safety of air flight. many people have contacted my office to as certain how safe is it to fly perhaps next to somebody who maybe changed flights en route to the united states coming from liberia for example? and are the efforts at the airports, particularly where there is a large population, i don't know if you have enhanced efforts there where there is people from west africa are more likely to go, but are they up to the task of detecting at point of embarkation passengers who might be sick from ebola? >> let me try to quickly give you clear answers to all of those questions. the first is a relative case fatality rate of different groups and in the current outbreak the data is still too foggy for us to give you clear data. there is not the kind of robust data that we will have ventually. there is one intriguing historical fact which i think is worth mentioning. in 1967 there was a laboratory accident in marburg, germany. the marburg virus was then dentified. it was a similar fatality ratetn identified. theoutbreaks have been in 80% range in africa. the case fatality rate in germany was 23%. have been because of the better supportive care. there is no antiviral treatment or because they were healthier going in. we don't know. but we do know that it was dramatically different. care ispportive health a proven way of saving lives and we should never lose sight of that. in terms of treatment centers, you are correct that there is a challenge in getting treatment centers. ,hat is the number one priority which is on the ground today in liberia to assess. the biggest challenge is both in the city of monrovia where there continue to be chains of transmission in the tri-country area.

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