Little conversation with the reader and you address the reader directly in your work. Is that something you think about . Totally conscious. Another big influence on me are my dads side of the family. Every holiday, it would end up that we would be down in the cellar at my great uncles house , at the bar, and everybody would be spinning these funny stories. So the context is, this guy is telling you these stories in a bar, and you are not sure whether to believe him or not. So ill is have that in mind when i am telling a story, even when i tell now i work my stories out on my twoyearold and my sevenyearold. I cant trick them as easily as i can trick everybody else. [laughter] david s. all right, jen, do you want to advance the thing every time . Jen sure. David s. this is a piece from jens where it is a series of panels and she is going to go one panel at a time. Jen this is hillary clinton, pro versus con. On the pro side, we will Keep Health Care reform, saving countless lives, on the con side, supported the iraq war using countless lives. Theing the flag go rainbow flag, she is also burning a u. S. Flag. She was partly cut by her husband deregulating lawsuits. Friends with obama, friends with kissing her with kissinger. Ofld want total destruction would want total support of the supreme court, cant do much about scalia. President ,a woman lives in the country where we cant even put a woman on a latenight tv show. She is the only realistic choice. She is the only realistic choice. [laughter] [applause] so the first thing that strikes me is that, you know, in the new yorker when i write a caption, captions are always these filaments that have to be in exactly the right place, and there is always the kicker at the end. You always try to nail it with the last word. You seem to have a lot of comedy chops in your work. Is that something you think about. Is that something that is important to you think about . Is that something that is important to you . Jen whether i can make it funny or not, sort of depends on how the process goes. Case, actually, one thing i found very interesting the controversy all aspect most controversy all aspects of this cartoon by far was that she was friends with bono. For me, i would say it is about making a point first, but catching it in a hopeful and hopefully amusing way. David s. you said something amusing about humor, you said that you think it is a much more persuasive and intellectually challenging thing in comparison to anger. Jen absolutely. That is one reason that i went into cartooning instead of academia. Something in at really appealing and amusing message, you know, people who might not be predisposed to side with you, they might have a little opening there were you can reach them once in a while. David s. i wanted to show you that a man can make a very interesting a powerful cartoon about womens issues. This is toms. Tom all right, this is this is. This is david s. youll have to Read Everything to understand what is going on there. [laughter] tom i give up. [laughter] tom the news this week was that someone is talking about putting a woman on the 10 bill, and the first question is, who should it be . But that was too obvious. The thing i didnt comment on in the cartoon, ellie satan think i did, yeah, i didnt, was, first of all, why not the 20 . Rid of andrew jackson, and i think we can mostly agree with that. [applause] tom there is no justification for him being on any currency, but i think it is like, oh well, the 20 is the best currency that everybody has. That is what comes out of the wall, so you cant have that, so immediately, they are talking about the 10 bill. So i i well, you can see where i went with it. Want you to get on where you are going with this, but some of the things that i added in, well, you are way ahead of me now, but the federal deserve note was i was, what i thought, a nice touch, if i could complement myself. [laughter] david s. ok, thats enough, tom. [laughter] tom it is enough. David s. another one of the cartoons of yours is next, so i asked these guys to give me to cartoon or, on one particular subject, and this is a particularly difficult subject, the subject of guns, and i wanted to sort of get a sense of each of how these cartoon ideas happen, what sort of moment happens where you get the information and then you have that little flash of insight and the cartoon happens . Origin story of the cartoons, and i thought it would be interesting to do them all on the same topic. So im going to start with, i am sorry, tom again. This one is yours and i want you to tell us how this one happened. Tom i dont remember. Only remember is you said this is the one i want you to put up about gun control. Wastually had one that i going to substitute for, but i could not find it. David s. unbelievable. It was somebody putting up a Second Amendment corkboard, and it had 1000 hashmarks, no, i am getting it backwards, the first thought was the number of tyrants overthrown, because this is the big argument on the Second Amendment side, they need big arms to overthrown the tyrants, and then the number of tyrants overthrown was covered with s and then the number of People Killed by firearms was , so it isth thousands an inversion of the expected imagery. An analogy tends to reinforce has the argument backwards and this have this has arguments coming out of the gun, and it is just a matter of the number of bullets, as you can imagine, being fired at a rate where these weapons are being misused for horrific violence. Jen, ive got your campus carry cartoon if you want to take us through that. , campus all right carry, it is a hot new trend sweeping campus colleges. Because no College Student is ever depressed, guns will only be used for protection. [laughter] jen enjoy and enhance theme parties. Hold still, brah [laughter] jen great for latenight sliced defense. Step away from the pie. The surprise of finding your gun in your messy dorm room. Oh, there it is. Oh, who are we kidding . This will be the real reality of campus carry. Kind of a downer. Did this idea just pop into your head or did it take some work and thinking. Work and thinking . I live in austin, texas, so that is a start, and the university of texas, well, the state of texas just passed a law earlier this year allowing guns on campus, and basically, insisting upon them to some capacity, i think they could still banned them in certain places, but basically, allowing concealed weapons for permit law of and that is the the land now. I guess it will begin on august 1 next year. Been protests to the university of texas, and the chancellor of the school, william mcgowan, actually, the of the hunt for bin laden, that is what he did before he was the chancellor of ut, and he was opposed to it, all kinds of people were not wanting more guns on campus, so there is a big protest gathering for when this actually happens next year. So i mean, that is the thing. David s. keith, i am actually going to put two of yours up, one specifically about guns that you made that you gave me and secondly, the other one is also about guns, and you can talk about either or both of them in terms of how they work for you. I am going to show you both of them. Remember, folks, hugged them extra tight before going to sleep tonight. You never know when they are going to be taken away from you. And this one is a more serious cartoon. David s. what you tell me all about this one . About it is interesting this one, because if you are not a nerd, then you probably dont get it, but basically, this is, i did this just after the dylann roof shooting in South Carolina, and a week before, what gave me the idea, a week before in South Carolina, the kid who played Anakin Skywalker in the phantom menace was pulled over a highspeed, 100 mile per hour chased by the South Carolina police. The kid is so traumatized from it being in that movie that he is like, a mess now. So when dylann roof happened, and a posted some of his pictures on facebook or wherever, he had the same sort cut from the bowl and iom phantom menace, thought, that can look like in a can skywalker, and so there was that connection. Cut andhrough the bowl i had these three little flags, and the gun, and it just sort of made sense with the shadow and everything. David s. what kind of response did you get from the cartoon . Keith just, it was one of those were a lot of people say, wow. Some people say, that was one of your best. One nerdy blogger guy put it really, really well. And i forgot to take his quote and put it on my website, i cant remember it now, but it was like yeah, yeah, that is what i want to hear. But now people see it and say, what does that mean . In thees you do stuff moment, and it doesnt really last, but the strip before, you know, you always hear the hug them while you can, and i just afterhat over and over every shooting, hug your kids, hug your this, your that, and i just automatically thought of guns instead of kids. David s. this is interesting, because humor is really just about the position of putting together two things and kind of exploding this into a joke, and i think you all have shown aspects of that in your work. Me twou also gave cartoons, and for a specific reason. Did you want me to show them both right away or just the first one . Do you mean signe . Signe the other woman . [laughter] david s. you know, at the new we looked at the number of women cartoonists, and it was in a tiny number, and so the same is refunded in the number of women we drew, so we have been rushing to raise that number. Lets just keep this amongst ourselves. [laughter] tom at the last convention on last convention i was at, someone said, keith, you should submit to the new yorker, and i said, why . And they said, i think they are actively seeking women and people of color. I got the secret email. [laughter] keith if anybody wants it. [laughter] spec work. T of david s. it is a lot of spec work. But we are not here to talk about me. [laughter] keith that is the great thing about being a cartoonist, you come up with all of these cartoons, and just because they dont run in the new yorker, it doesnt mean you cant use them. Tom yeah, it does. [laughter] myth one of my fairness favorite exhibits that i have ever seen was rejected new yorker cartoons. I could see them being inappropriate for the new yorker but theyew yorker, were hilarious. Now with selfpublishing and youre on websites, things have changed, there is all this stuff. Even if you do 10 a week that get rejected, that is 10 that you can put into your next book. Of pain, it is a lot keith, it is a lot of pain. Keith but were used to rejection. Signe, i am going to move onto yours. , and one focuswo is on the gun issue, and i live in philadelphia, and we have always been in competition with baltimore to see how many more people we can kill than baltimore, and we were a head , im sois last year proud to say. So i was looking over my cartoons about guns and about what i would choose, and i was of roughly sort counting them up. There was approximately 160 cartoons on guns. I hate it when there is another shooting because i think i have already done all i can possibly say on this, and yet, it still shocks everybody again when it happens. So im going to show one, and im going to show you it to show you how pointless cartooning really is in the grand scheme of things. One of them is a cartoon after a particular round of shootings in philadelphia, and it is the kind of cartoon i have done, 100 60, or maybe 70 are like this one. David s. want me to put it up . Signe yes. My opinion is that the citys lead Abatement Program still needs work. These are obviously kids living in a poor part of the city that are getting killed, and that poor,ts the numbers of africanamerican kids in the city getting killed. As a cartoonist, this is a super i didntsue, but if draw these characters black, it wouldnt be the reality of what we are experiencing in the city. But i got tired of trying these cartoons, and people said, oh yeah, this is really nice. Can we put this in our newsletter or our Church Bulletin or whatnot, and two days later, there would be another bunch of killings, and it just seemed sort of pointless. I felt like people were really talking around the issue. Now, this is very many years before black lives matter, so , butis when it was worse this was one of the most controversial cartoons i did. Of youngnt great views black men killing each other, then use ku klux klan traveled to come to philadelphia. You are not laughing. [laughter] signe most people did not laugh, and particularly African American activists really went after me in a fairly major and direct way. With calls anded pickets and whatnot. Then showed this because what happens when you draw really controversial cartoons they get at something pretty fundamental that a lot of people are thinking about but dont have a way of discussing is that these letters in the newspaper and we gave all opeds toople gave people who objected to it, and then there was this second wave of people who said, wait a minute. That is what is happening in our city, she is right, even though she is a white woman. This is what was happening in the city. And then the discussion takes on a life of its own. It has nothing to do with the cartoon. The letter writers cap going back and forth amongst kept going writers back and forth amongst themselves. This is preinternet chat rooms. There was a discussion in the city about what we ought to be doing about violence. Laterended up some months on a panel, and the guy who sat down next to me was one of my were on ars, but we panel on something different, and we both agreed on that, and we got talking about it, and he says, well, my opinion has really actually changed after the whole discussion that we went through. And again, even having gone , it became of that more of an issue that our mayor, mayor nutter, in his inauguration a grant inauguration address, was on gun violence was violence in the africanamerican community, but still, we had 250 murders so far this year. Cartoons, while they can draw peoples attention to things, they in and of themselves, cant unfortunately solve anything. David s. just, i also have one of mine on this issue. This one, for me, happened after shootings, and i was in my studio trying to squeeze my brain all day about what can i do about something so painful, how can i make a joke when i felt the need to make a statement about something, and i finally gave up and turned on the radio and John Hockenberry was doing interviews with gun owners and the midwest, and one of them said the exact words in this caption, and the image popped into my head, fully formed. People not from here dont understand, it is not a weapon, it is a way of life. So next i am going to show a few , and what i was wondering about, in my memory, i dont ever remember the country being quite as divided as it is now on every level and how tough the discourse is, so i am going to dish going to show a few cartoons in a row and then maybe we will talk a little bit about how that affects your work. The first one is by thom, and it is just a really interesting cartoon. [laughter] tom do you want me to say anything about it or do you want me to just [laughter] tom well, again, this is simple and complicated at the same time. Read a situation, the purchase of national and sometimes the imagery falls and aligns right in the place, and i dont need. O add much to it im going to show one of keiths. [laughter] so i actually do talk about gun issues, and i also talk about Police Brutality issues for 20 plus years. One ofar as i was doing our ferguson, i was thinking, i cant believe how every time i do it, i wonder if this is the last one i have to do, and i would be psyched if that were the case, and it never is the case. So i put all of my heart is together in a slideshow and i started touring the slideshow. So now i have presented 20 years of my Police Brutality cartoons and it is kind of sort of the modern era of Police Brutality, starting with rodney king in 1992. One of the interesting pieces they came towards the end of that slideshow. The great thing about social alwayss that someone does or says the right thing about this stuff. Talk about all lives matter in the black lives matter movement, someone put it on twitter, and i will always when i have a Bumper Sticker that says save the rain forest, it doesnt mean forests. The other it means all the other rain forests are getting cut down at an exorbitant rate and we should do something about it. [laughter] so thats what we mean by black lives matter. It doesnt mean that nobody elses lives matter, it is means itething is happening means that something is happening in a very bad way. When somebody gets out of shape because something says black lives matter, you got to think about what it means when it says lack lives matter black lives matter. Moved to chapel hill, north carolina, and i have started to write about the south because i have never lived there. Now that i live in the south i can write about it. Had written into the newspaper, and he was a very angry white man, and he wrote saying that there it black community making him feel guilty, i said, it is not the black community making you feel guilty, sir. It is youreyes, y it is your eyes, your hearts, and your it is your eyes, your heart, and your brain, and what you are hearing is bullshit. So the question is, what do you think about that feeling . Do you write about justice, or do you write a silly oped to your newspaper . [laughter] [applause] mentioned social media, i am wondering, do you guys obsessively follow comments . You all moved from print to digital in a lot of ways, do you guys search for reactions to your work when it appears . Does it bother you . On that learn early youre going to get clobbered. [laughter] tom i mean just clobbered. Worse, butgotten luckily by the time it had gotten worse, the skin had already gotten pretty thick. I used to look at them just to rangee myself as to the of opinions, the intensity of opinions. You cannot take it personally and you have to understand that you have to picture of this person, trying to think of the words that he can find that will hurt you the most. [laughter] sweatou can feel the beading on his forehead. What can i say when i have heard it all . Wow. David s. have any of you guys regretted something that you published afterwards, thinking maybe you had gone too far . , andthe regret is when there are some examples, it is when the cartoon is read opposite of what is its intent. That you spend enough time thinking about what you want to say and why you want to say that. Somebody being upset about that will not make you change your mind. Misinterpretation does give you a moment of pause. The new yorker closes on friday and comes on monday. Aboutissue, i did a joke a beheading. Over the weekend, there was a he heading, and on monday the magazine was inundated with outraged people, none of whom could understand there was something that could be done about it. I sure wish i had not published that cartoon. Say that ilike to have never found one of the cartoons funny with guns. Seehen you watch tv and you csi or whatever, there are guns in the movies and television. What is it about cartoons that make that an issue for you . I dont know. It is just visceral. Ok. [laughter] i will just show one of mine. [laughter] ask to havei will us taken to another one. This one is called advice conservatives never give themselves. [laughter] i did this after the sandra bland incident, the woman who died in her jail cell. Reaction so much coming from people saying that she should not have stabbed that cop. Theou compare that to rightwing response to the rancher who had an armed standoff, a lot of people thought he was a hero for standing up to authority. There seems to be a bit of a double standard there. Thats also around the time the Confederate Flag was being debated. That was the impetus behind the cartoon. Questions to move to from the audience. I want to show one more cartoon by someone who is published everywhere. I notice there are no conservatives on this panel. I just wonder what your reaction is. Do think this cartoon is funny. . I dont think anybody here is finding it the to gilly funny, so what does that say about the issue of preaching to the choir, that your work is always directed to people of the liberal persuasion, and that is something you think about at all . News andof all, fox Rush Limbaugh, they dont worry about preaching to the choir much, so i dont worry about it. Ok. [laughter] [applause] philosophy ofne cartooning that i try to follow is do no harm, just like a doctor. I feel like it is my response ready to and lighten and not add to the suffering and misrepresentation in the world, so i would say that this cartoon fails. I couldnt agree more. [laughter] one more quick question, you guys have been watching the debates . Its funny. I sort of missed the last two, even though i wanted to see them, but i forgot they were on. It just shows you how boring they have become. Liked it when they were crazy, saying crazy stuff. Want to leave this as the last image up there. I will put one of mine up. This is the cartoon i thought up when i stopped watching the debates. [laughter] i may take questions from the audience. Go to the microphone to ask your question. Ok. We used to some bad language. Thanks. I was hoping you could take your last question and take it on more seriously. The absence of a conservative on the panel is not a problem, but conservativef viewpoints in political cartooning in america is very noticeable. I would love to hear a serious consideration of why is that. Andke your point that fox Rush Limbaugh dont apologize, but i would like to know why in political cartooning, where are they . There are a lot of very good conservative cartoonists, including glenn mccoy, whose image david showed. Ithink he chose it because was one of glenns not so great cartoons. [laughter] if you look at people, they were always come at me and say they never get prices to the conservative cartoonists, but the Pulitzer Prize has gone in the last 1015 years to several very conservative cartoonists, they dont appear in the washington post. I dont know. You have a deficit situation. Doy are out there, and they their work just like we do ours. I remember someone writing to me saying that if you did conservative cartoons, you would make so much money. [laughter] i didnt know that. [laughter] yes . So iam a librarian come have a dorky library in question, which is how do you especially the three of you, tom, i know you are at the post, so i think there is some archival stuff there happening with your work. How do you keep track of your stuff and organize your stuff . Do you tag them . How do you find the ones about guns . Anyone who wants to be answered, that will be great. Nobody is interested in that question. I can guarantee it. Nobody else is standing up to ask questions. [laughter] fair enough. Mine just go into boxes. Youarchival sophistication imagine, if it exists, they have not told me about it. [laughter] i feel bad about the situation. They are one match strike away from oblivion. They are not water damaged yet. I think that is a really interesting question. Tag my blogthat i posts on my own website with different tags for each cartoon, and i do a search on my own website. That is the only way i can remember. Your hard sit on drive and there are certain titles and everything, its easy to remember. My originals are splayed across , but its a mess. It is all over the place. I do have a few pieces in the library of congress, so those will forever be protected. [laughter] at least three or four of them. Yes, you have a question over there . Could you talk about striking a balance between an ambiguity that provokes and having a crystalclear message . , howuch do you want oblique do want to be . What do you want readers to figure out for themselves and what you want to tell them directly . That is a great question for which there is not a good answer. Exactly what everybody on this stage deals with every to find thatow balance point between obvious and clever come because the humor clever, because the humor in the cartoon is right there. Thats where it is, where it is not so obvious, not hitting them over the head, but not soaps gear that you have people scratching their heads. But nota matter so obscure that you have people scratching their heads. Not always missing the same place. Some readers will find it too obvious, too puzzling. I bet nobody will argue with me about that. Maybe only yes, no . Since i do different ones. I do a daily comic strip called the nightlife. The one thing i started it was it is similar to the fact that there are fictional characters mixing in with real stuff, like doonesbury. The one thing i took from doonesbury was that it is hard to look at stuff from the 1980s or 1990s, so when i went ahead to do the davies, i make references to stuff in obscure ways to do the dailies, i make references to stuff in obscure ways. I very rarely name the president. That will always stay fresh. Beefully, they will always in the present. I try not to get to specific, or when i make reference to certain things, it is always there is specific, because somebody will open it and go this is from 20 years ago. Obscure be as sort of with the dailies. You cant do that with a lot of editorial cartoons. There are certain things that sometimes you have to drop. I self published most of my books, and the ones that have the shortest shelf life are the editorial cartoons, so i print the fewest of those. Is ink what tom says think that striking that balance is how you get into peoples heads with your work. If you had them too hard over the head, it does not have the thatimpact as the subtlety can get people to think like you came up with the idea themselves, which i think is a crucial way to communicate. The 10 patient to be didactic, temptation to be didactic like an oped columnist , but thats the game. You have to make it more complicated. You have to bring concepts into the fold. A challenge of cartooning. It is an extra step. Cartoon depends on a lot of people knowing exactly what you are talking about and having this same information that you do. Lot of my cartoons, what theyhave no idea were about if you did not live in philadelphia. Also, the difficulty is that people get their news in so many different places. It is hard to say what everybody knows. A lot of people just dont read the same way that they used to in the good old days when i was growing up. [laughter] yes . I was wondering how much work goes into a cartoon. I saw the debate last night and i want to draw a cartoon about it and doing the sketching, playing around with the captions how long does it take to get to the hot moment to the moment where you know what the cartoon is going to be . David was saying that he heard that line and the image popped right into his head. Reading, andoften writing is really helpful. You come across this phrase and the images right there. Those of the great days when it comes up like that. There must be some days when you decide you want to make a cartoon about something and you have to figure it out. Im not sure its that complicated. [laughter] it comes all different ways. Sometimes it is a sketch, you hear something. It is just all different ways. The toughest part is to kind of train yourself to be open all the time, constantly open all information,ng in just sort of having a sketch ink there or typing information so you remember it. If you put it down on paper, it allows for more stuff to come into your head. If you feel clearly about the subject, it is often easier to do a cartoon. I admire cartoonists who have that its like a direct pipeline to their viewpoint, and they make it clear. Now i will have to when they were proposing the iraq war, tom is in the vortex of the discussion, and he was one of the really consistent voices saying the iraq war is going to be a nightmare, dont do it. Nobody listen to him. Back to my point about cartooning. [laughter] ok. Yeah . Something stood out to me about the attacks in response to a religious figure without naming the religious figure. I just wondered if there is anything offlimits when you are drawing cartoons, or how do kind of edit your work given certain sensitivities of your readers . That is another great question. Not to say that all the questions havent been perfect in every way. [laughter] might as well. There is lively debate, and sometimes he did debate among cartoonists on this very subject. I say the spectrum runs from First Amendment. To the most shallow. [laughter] its the place a cartoonists ought to start. Firstural ground zero is in ament absolutely, and way im there, but as a functioning cartoonists i am not there. I opt to feel like i have and do have and would explain to have the right to say any damn thing i want to. For me, it is what i want to say. There are things i do not want to say, and if i see another , i amnists saying them often extremely conflicted in my support for their right to say it. My vigorous disagreement with the judgment that was shown in there saying it, and then i am , which webad position got into all of us with the bdo cartoons. Is it desirable for you to in the reprintingt of an image that you personally thought was very ill advised for a variety of reasons . I found myself in a real quagmire of trying to explain the subtleties of my position on that. Those cartoons in particular support freeu speech, then you have to support those cartoons and the reprinting of those cartoons. My answer to that is this, the history of political cartooning contains many many very shameful, shameful chapters, and no, i dont support a broad brush it with every single thing that has transpired under the rubric of political cartooning. The two obvious examples, there have been vicious antisemitic cartoons drawn that have real consequences from extravagantly racist cartoons that have real consequences, bad consequences for real people in the real , and i cant just say that anything goes and i support anything that any cartoonist does. I support the right to do it, but honest to god, there are things i would not do and i am upset when some cartoonists have done things showing very bad judgment. I think you state the dilemma we all struggle with really well. There are two separate more questions here. There is the question of free speech, which is very simple and straightforward. Obviously we should all be free to express opinion no matter how vile without repercussion, without being killed, repressed, persecuted by the government. There is the question of representation, which is an important moral question and does have real world consequences as well. I think a lot of people are getting confused on this issue thesee they are missing two separate moral questions, and they are saying you cant have one without the other. I dont think the two are necessarily mutually exclusive. We can completely support the freedom of cartoonists to draw what they want, but at the same time we can have a conversation weaponspresentation, cartoons mean, because that is a part of free speech, too. We have time for two more questions. Which side . I will go to that site, and then you, sir. Yes . In a society where we tsmmunicate more with tex and tweets and people have a lower Attention Span now, how do you think political cartoonists how have political cartoonists change its ways of informing the public where people dont have the Attention Span to read a 5000 word expose in the New York Times for example. . Is the bestdia thing that ever happened to cartoonists and the worst thing that ever happened to cartoonists. Our stuff is being seen by more people than ever, and we are getting paid less for it than ever. [laughter] it is sort of a combination of the two, where it is like, yeah, great, im getting emails from people all over the world saying, i saw this and all this is thatut what is nice we are starting to catch up in the sense that there are so many more ways now for cartoonists to make up the lost revenue from all the print media that has gone away. 75 of my newspapers and stuff like that, but i made it websites. Art patron i make it up there selling and i do a lot of shows where i go to schools and present my Police Brutality slideshow. Those are the types of things that are totally enhanced by social media. Again, it is the greatest thing that ever happen and the worst thing at the same time. And peopleunity knowing about something, editorial cartoons were traditionally newspaper based, and people just are not reading newspapers the way they used to. Look at this audience. Most of the people here who know and like cartoons are of a certain age where you dont even think about subscribing to a newspaper. My children would not. Got throughhey college and they wouldnt even by my newspaper. [laughter] rate, the downside of it yes, you get your stuff out to lots of places, but he goes to places where people agree with you or they like that subject. Where as a broadbased and newspaper, you have people who did and didnt like your point of view, and again, how do we get a conversation started, how do we go back and forth on issues, if people are in their silos and not even seeing the same material . Lot,nk, yes, we get out a but we get out in a much more narrow bandwidth a lot of times. I think that is not a great thing. Ok, we have time for one more question. You covered most of the stuff. [laughter] whered you get your ideas . [laughter] i get mine on dday. I dont think there has been ine and answer to that i just want to touch on one last little point. That is driving the content now more or less, and how you think that is affecting cartoonists coming into the field . Not draw a cartoon and i am syndicated, i have try to sell it to somebody. It has a short shelf life if i have to try to sell it to someone. Will i build an audience by drying things that people want to see so i can get my voice heard . Im thinking of the young cartoonists today trying to find a voice. Findere audience going to them through the internet and they will find funding . Where the something marketplace is moving in this direction, so people was start drawing cartoons they think they can sell . I dont think cartoonists think that way. I think cartoonists think about being artists and creating what the voice inside them tells them to make. I dont know about everyone else, but i dont think too much about my audience. I think that is a dangerous way to go in terms of developing your own voice. I think it would be hard to get started today. I started in the late 1990s when alternative newspapers were a growing industry, and it seemed like there was some real potential there. I started doing an alternative weekly strip and started to get it in a enough papers to support myself along with freelance work on the side. The Great Recession was very scary. Fortunately, there are some websites that have begun paying for cartoons like daily post and others. And so they have stepped into path itut that never seemed all that clear, but it seemed like there was a path in the late 1990s. Now i dont know what i would say except to be highly diversified. In addition to doing my weekly strip, i edit a comic section on a website. I do freelance work. Ive done graphic journalism work. It really is it sounds like a cliche, but its about being entrepreneurial and having lots of bowls in the air basically. Balls in the air basically. We started around the sign the same time. It is really diversified. I have more hope for people starting out now. As long as you are doing a strip that you want to see and read, how manybillion are there . There are a lot of people in this world. [laughter] all you have to do is find the 1000. You have 1000 fans. Here has 1000 hardcore fans, and you just have to and you willork find those 1000 fans. Have to convince those 1000 fans to give you 75 a year. [laughter] and you do that by providing them an opportunity to give you money, like reading books or having a site for them to support, just different ways in Different Things. In addition to those 1000, there will be peripheral folks who buy a book every once in a while. Of have to continually sort yeah, it really is a hostile, a constant hustle. Ive never had a steady salary gig. I have been in the industry for 20 years. On thising two kids wacky cartooning thing that my dad is like, where are you making money . [laughter] there, and when people see that you are doing something that you are passionate about and they see some sort of truth or sincerity in it, they are willing to support you. Think you go for it. There is axample is young lady who all she does is review sex toys with her husband has gained this crazy following of people and she makes time of money tons of money. She gets free sex toys. [laughter] makes comicsem and out of them. It is amazing. Seriously . [laughter] i will show you. No. [laughter] on that note [laughter] reachedthink we have the end of the program. Thank you all. [laughter] [applause] the polls are closed in louisiana and the vote count is underway in the governors election in that state. Facing john edwards. The winner will replace bobby jindal. With 42 of the precincts counted, edwards the democrat is 55. 72 . We expect to hear from both candidates tonight and will bring you those remarks as soon as they are available here on cspan. Journal,xt washington former Counter Terrorism official, rick nelson, on the Security Council examines the potential attacks on soft targets in the United States read Tom Hamburger talks about the fundraising methods of bill and hillary clinton. The council on American Islamic relations discusses the syrian refugee crisis and concerns of ke ofms and the wa terrorist attacks. We will take your calls and you can join the conversation on facebook and twitter as well. Washington journal live at 7 00 a. M. Eastern on cspan. Sunday on q a. To reache first woman the rank of four stars in the United States navy. I had only been a threestar i was11 months when down in norfolk, and he asked to see me, and i presumed it was about the next job i was going to. That is when he talked to me about, we are looking at you for being a fourstar. Here are a couple of opportunities where we think you would do well and benefit the navy. Vice chief of naval operations, admiral howards, talks about becoming the first fourstar admiral female and the history of the navy to cheat talks is about a career prior to the employment, including rescue ahe mission to pilot captured in 2009. I became the head of the Counter Piracy task force. Kidnapped,llips was so it was our responsibility to get him back and get him back safely. That was obviously a surprise mission and a challenge and we got him back. Sunday night at 8 00 p. M. Eastern and pacific on cspans q and a. Earlier this year, the Manhattan Institute released a paper critical of the fda for approving new disease treatments based on Precision Medicine. Joining in this discussion was the authors of the report, a cancer patient advocate, and a medical geneticists. Were invited, but declined. This is one hour and 15 minutes. Hi, everybody. We will go ahead and get started. Thanks to all of you for being here today. Im the senior fellow at the Manhattan Institute and the new opinion editor at forbes. We are here to discuss bridging the gap between Precision Medicine and the fda. I know a lot of you know me as the obamacare entitlement reform guy and thats what i worked on in my time at the Manhattan Institute. What you may not know is before i came to manhattan, i spent a dozen years on wall street as an investor where i looked at Clinical Trial data and fda regulatory actions to figure out which companies we should invest in based on development in medicine and science. This is an area i have long been interested in. I am glad to have this the chance and i was glad that all invited me to help moderate this discussion today. We talk about how to pay for health care and how much it costs. We dont spend enough time talking about how innovation is transforming the quality of life for millions if not hundreds of millions of people in america and around the world. The Manhattan Institute has been a thought leader in this area. We have this institution that is called project fda, which is centered around fda reforms. That has probably been one of the most productive areas at the Manhattan Institute in the sense that i dont know of any other think tank doing the kind of work the Manhattan Institute is doing on this issue. The question we will talk about today is one of the most interesting areas in terms of how we think about how to reform the fda. People always complain that the fda is too slow in approving innovative, new treatments. One of the areas that has come up recently is this area of Precision Medicine. What is Precision Medicine . There are these things called biomarkers. When you go get your cholesterol checked at the doctors office, that is a biomarker. Thats what we mean. A biomarker is a lab test. It is something we use to correlate something going on in your body with a particular outcome of disease. In the case of cholesterol, there is decades of research that indicate the high cholesterol levels, particularly protein or ldl, high levels are highly correlated to Heart Disease and heart attacks and other problems. That is a biomarker. 50 years ago, maybe we had a couple of dozen biomarkers. But because of advances in genetic science and all things we are learning about how different genes in our body regulate and produce different proteins which regulate cellular processes, biochemical processes we on the verge of having , hundreds of thousands of these kind of lab tests were biomarkers. They can help us determine many things. They can help us advance more quickly drugs to market that affect certain lab tests or biomarkers. They can help us design Clinical Trials. For example, there are many people with lung cancer, but it is not all the same. Different people have different kinds. It might be responsive to different treatments. The fda and Drug Companies are trying to figure out how to tailor their investigation into the individual patient and the individual patients clinical and biochemical and genetic position. These are the kinds of things that are going on scientifically in the world in the private sector. The question is, is the fda doing what it can do to take this scientific knowledge into account in the way it regulates . He development of new drugs in that light, peter huber and paul howard have put out a new paper which you have in your folders there. It argues that the fda is a little behind the curve in addressing how these new developments, these new scientific developments can help accelerate the discovery and development and approval and marketing of new treatments for disease. We will hear from both peter and paul today, and we have brought two additional panelists with those who i think can illuminate a lot of this discussion. We will also hear from you meal emile kackus who is the ceo of ultragenex who specializes in the development of treatments for ultraRare Diseases. Before he was there, he was with another company that specialized in this area called biomarin. Ultragenex has had some success. It went public last january and as a market cap of 2. 3 billion, which 10 years ago was unheard of but has become more common as , companies have gotten more sophisticated at how to develop these drugs. He will talk about the trials and tribulations he has had in this field. We will also hear from lynn matresian from the pancreatic cancer action network. She will tell us at the patient level what some of the challenges have been in trying to work with companies and work with people doing critical trials if you are a patient to take advantage of personalized medicine, Precision Medicine, to develop new treatments. With that introduction, i think we will go ahead and start and maybe get the ball rolling. I want to go through that each of you based on your expertise maybe we will start with lynn you have had experience in the pancreatic cancer world. Tell us from the patients point of view, what are the challenges . How do you think about cancer varies between patients and what are the challenges in getting the fda and Drug Companies to respond to the unique characteristics of individual patients . Thank you very much yes, i will tell you about that through a story. So marjorie called our call center, the patient central at the Pancreatic Action Network a few months ago because her husband was diagnosed with pancreatic cancer. Our associates at the call center gave her lots of information about the disease and physicians who saw a lot of pancreatic cancer and nutritional information and that type of thing. And then they offered her and charlie the opportunity to get his tumor molecularly tested and do a biopsy and do something that learn something about a test that will tell us something about what was causing his particular cancer and therefore how we might treat it. That made marjorie pretty happy because she read the statistics and she knew that only 76 of people were not going to be alive in one year and only 7 were going to be alive after five years. She said this is something i can try, because the current standards of care are pretty crummy. They agreed to do this. About a month later, they got back a report and it has mutations and alterations in genes that underlie charlies cancer. He has been luckier than 55 of pancreatic Cancer Patients based on this molecular profile. So now there are some options that this physician would never have thought of before. Some of those are off label treatments so they are drugs that have been developed and other cancers that are for a mutation that charlie has in his cancer. And some of them are Clinical Trials. Here is where they were faced with not really medical problems but system problems and problems , with how does he get access to these drugs and how does he decide what is working for him . There are no real Clinical Trials in pancreatic cancer for any of these drugs. There are 50,000 patients per year of which 4. 5 of them go on to Clinical Trials. Then this mutation is only in 2 or 3 of those 50,000 patients. 3 of that going to Clinical Trials so how do we learn about what to treat charlie with human that we have this molecular information . What happens is that even if he can get on a Clinical Trial or get off label treatment and there is all sorts of insurance issues and being out of network and those kinds of challenges that he will face even if he can, what usually happens in these Clinical Trials is that he is treated with the drug and then three or four month later, they take a radiological scan and they look at the tumor if it has grown are shrunk. The overall result is whether charlie lives or dies and how long he lives. In the meantime, they are checking whats called a a biomarker in his blood called ca199 which if it goes up, the tumor is probably growing but we are not 100 sure that is always true but there is good data that says that is often the case. If it goes down, thats a good sign. You cannot act on that information. There has not in the proper studies to know whether the drug is doing charlie any good or not. If its not, he could go on another treatment. I think that is two examples where we do not have the information to determine what treatment we should give charlie and we are not able to act fast a biomarker to determine whether we should change that treatment or not. I think those are both opportunities for the fda to Pay Attention to a disease that is lifethreatening. Charlie does not have a lot of time. Survival is measured in months and weeks and this disease. When he to act faster and we need to change the system so people like charlie can benefit from the science that we have around Cancer Treatment these days. Let me introduce peter. He is the senior fellow but i like to call them the resident genius of the Manhattan Institute. He has a phd in Mechanical Engineering from m. I. T. And a law degree in harvard and writes about Energy Policy and legal policy and tech policy and is the author of the cure and the coding of 20thcentury law is undermining 21stcentury medicine so he is equipped to talk about this topic today. How do we take that every day patient example and translate that into better policy . The first thing to understand is the example that lynn went through. There will be a test for a device that will check for these oscillations in a patients bloodstream and what it tells us about the drug. It does not get to the market without the fda say so. I have a number of oncologists that tell me if they were not allowed to prescribe off label which they do, oncology would , shut down. Explain what that is. That means the drug has been approved for something but not , for what you are prescribing it for. I dont know what the off label drug was in your case. The fda is not capturing every possible use of every drug. Your life depends on people who do not believe that. There is hope for a lot of off label work because it is happening all over the place. Cancer can look different in different parts of the body and have the same underlying ing thesms and repurpose thin drug and prescribing drugs based on their molecular effects and the etiology of the cancer is widespread in this area. It has been used in other areas but this is where it would be most effective. If a drug company walks run and says it does this for pancreatic cancer and if the owner of the drug tells you, they will probably get prosecuted. They will certainly face a civil suit. These are billiondollar issues for Drug Companies. It is a pity because they know an awful lot about this. They are compiling the data. Doctors who share this can and the fda has not gone after them but they very well may. The fda questions these uses. It has not certified it to be true so it wasnt true and they had to shut down half of their business in the state. The fda has plenary power over how much of this biomarker information you use in a drug in and the vice approval process. You have to persuade them that this biomarker is good and valid and can be used. This is especially painful because the best people at the fda and i would start with dr. Woodcock who is the head of the center for Drug Development and research, they know exactly what is right here. There are excellent presentations that were given 10 years ago. She says biomarkers are the foundation of evidencebased. Dicine they determine what happens and what we should prescribe to home and outcomes happen to people not populations. There is an indictment of what the fda has been doing for 50 years. The fda Clinical Trials are trials or populationbased trials and are overwhelmingly based and looking for empirical correlations. If what you have defined as the disease is 25 different diseases, the drug does not get through. There is a core problem with the fda and their existing trial protocols which statisticians call the reference class problem. If each of you represents 1000 patients, the simple question is this. If this row here, if i round you ,p with your pancreatic cancers who is to say you are predictive of the rest of the people in this room . If patriotic cancer is an absolutely identical disease, its probably a pretty good answer. There are in no most of genes. Ons in the fda issued its first guidance for data and 2003 or early 2004. Agenciess one of the and the washington that does a lot of research. Said tell us what you mean. What are we supposed to be gathering . Research andl this we set up an internal standards for what is good. Nih, the premier Scientific Institution in washington. One year later, the fda did issue its Critical Path report saying that biomarkers are something that we have to do, and they set up an institution what is a cold . Critical path institute. There are good people saying the right things. Meanwhile, we have an anonymous amount of taxpayer and Health Care Money going into sequencing. Getting new sequences every time doctors treat patients. Youre developing huge databases that say we see these profiles associated with these effects. Isolate the links between microbes. Now you can work out molecules. Molecules are way more complex. They work in very complicated networks. We have fantastic Computing Power today and no one less than andy grove has decreed this. Apple knows this and google knows this, and thats why theyre getting into this business. Theyve got incredible computing tools. You give them enough data and they can unravel pathways. Suddenly berpa interested in cancer . They issued a big mechanism notice a couple of years ago will give you a complex data set and we will give you some technology. Why is darpa doing this . Database. S a huge if you can send drones all over the world to blow people up, you im quite sure the nsa would not want to share its database. This is terrific news for oncology. They got it exactly right. If we left the analysis of the stuff to the nsa, we would be in good shape. This is what it is all about. I think you found a political platform. Just validating biomarkers. They are very good at it. I think what im taking away from these discussions, there 3 ,these patients, 2 or small subpopulations within a Larger Population of cancer who may have a unique genetic signature, but that is a tiny number of patients. To show statistically and a tiny number of patients that your drug is having an effect. Ceo, how dompany you negotiate that . That you found a correlation between your drugs ability to target this subpopulation . Then, how do you take this big isa idea that revolutionizing the rest of the economy, and had you convince the fda to adapt that technology into their own thought process . Weright now we dont, but would like to. Dealing with small subsets, and we have been struggling with it for a long time. Of the mosts one important ways to gain power and determine what is going on, allowing you to determine what your drug is doing in the small population. The challenge has been, and there are thousands of Rare Diseases, many of them that you would not know how to spell or say, that they are 10 of the u. S. Population. You probably know somebody with a rare disease. The truth is that we should be doing more translating what we do have. Being able to get the power to determine what is going on in these patients with biomarkers is critical. Im president of a foundation focused on rare disease issues. We focus on how to accelerate biotechnology and innovation. We believe that biomarker story is one of those key pieces that could help people with pancreatic cancer and the stories that peter has been talking about. That since the acceleration of approval in 1992 , in thataids crisis time there has only been in the rare genetic disease area only to in the early 1990s, so there hasnt been anything new. The question is with all the Genetic Information we had and all the Rare Diseases that are out there and the science that has been done that we know and , understand what has been going on. How can it be that there are no biomarkers based approvals for more diseases that could require them . I know doctors had them because i working on a program for disease and it type seven, that disease is a slight disease. Only 20 patients in the United States perhaps with this disease. Yet, we have a treatment that has been around for 20 years. It works beautifully and not translated because we cannot detect or do a study with 10 patients and prove it is working. If you used the biomarker, how much material they have in their bodies, we could do it immediately. With a biomarker, we can run the study with 12 patients and get the study to work. Based on all the signs we have, showed that is a reasonable treatment and get these kids treatment. What is the point of all the nadh research we have been funding . The billions of dollars we have been spending and if we find the treatment, we do not turn them into products for someone to get . That has been a tragedy for nps seven. I have made it my mission to get that through the process to show white should be done to make the process better. We continue to work on access and policy and legislation. Writing and policy and legislation. It has been challenging and i think my manhattan students are trying to figure out a way to make something actual happen on the biomarker friend. You bring up the case of your company of trying to study disease with Clinical Trials basically impossible, because you cannot ethically do a study where you let the patients died. You have to treat them in the way that you know how to treat them. The only way to measure progress is through the biomarker or lab test. The broader problem is if Janet Woodcock were here or representative of the fda, she or he would say, well, it is great that you have all these biomarkers, these test that may correlate to better clinical outcomes, better performance on disease or measurement of disease, then they probably would have otherwise had, but we do not necessarily have that. We do not necessarily have a have conclusive proof that the biomarker is correlated to better disease outcomes and longer lives in statistical the typical situation. Pushback on that. Tell me why the fda should not be cautious, should not be scientifically conservative and say, you know what . Yeah, this biomarker sounds like it is a good thing to test, but there is no definitive evidence that it actually means a patient who does bad on a lab actually going to have a longer life or do better on a disease. I think one dimension of that problem, if the industry would say, it doesnt make it easy, you can make it hard, but tell us exactly what the standard is for validating that particular biomarker for the particular context and use. We would go out and we would develop these Evidence Base or find cities that do that. I think the agency is concerned to Something Like this funded researcher runs a study, discovers a biomarker for cancer or some other disease, publishes or nature in science by technology, declares victory and moves on. The agency will look at that and say gosh, that is not a , biomarker, it has not been reproduced, how do we know that is good science . How do we know it has been validated . What is the reference class control that would prove he would hit something that is really important for that particular disease or indication or context of use. I dont think that is what were talking about here. There is an interesting study that we did one year or two years ago, researchers out at stanford, what they did was to achieve expression profile, looked at classes of drugs that were already approved by the fda and then compared them to cancer expression profiles across a number of different tumor types. What they found was a match between the genes that were hit by a 50yearold class of drugs of antidepressants, some of the first antidepressant that came online, and a very red class of lung cancer called Small Cell Lung Cancer, about 20 of cancers. I think it was called the endocrine tumors, a small class of pancreatic tumors. They said this was interesting. The pathway that these drugs inhibit, it seems they are implicated for this class, particularly in Small Cell Lung Cancer but other cancers we know about that are endocrine. Lets do the science, so they ran and looked at tumor cell lines, they looked at knaus models where they grew tumors in mice and then they hit them with the drugs, they hit them with other drugs. It was a neat experiment, and they said, you know what . We are to launch a Clinical Trial. Right now, those drugs, 50yearold drugs, are in testing for efficacy and escalation. The interesting thing here is that unfortunately these drugs are 50 years old and have not been used very much. This is a more recent class of drugs. We have lots of data on observational data, so we will look at these positions and see how many patients have been taking lithium or some other drug with rates of brain cancer slowing or a better response or , no endocrine tumors for lung cancer or other cancers and do they have good Response Rates . There is a range of other dad is taken years to valid there is a range of other dad as they can use. It is observational data. They can be used to enrich a Clinical Trial for a particular class. If you can get down to a little the level of knowing what it is exactly that is causing the cells to selfdestruct, then we can use that as a circuit in point. I think what we are asking the fda to do is hand out that evidence of development which they have said they are not equipped to do, or have been reluctant to do, to the people who are capable of doing it, which is the research community. Would that be a particular professional society over that the or what they deputized certain academics . How that process go . How about getting it to the people who are spending billions a year on taxpayer money . The nih has characterized them as characterizing genomic variations that have medical impacts. They do not just say to anybody who would like to send it in. I would add in contrast to that, the one database that i know that they monitor is where they invite people from all of the country to send in reports about adverse effects of drugs. It is so poorly monitored, i googled it they tested that they , have done vaccines that transformed into incredible hulk, so that is the one you should be worrying about an apparently got a call sometime later saying, oh, that is would you please withdraw this . Anyway, look, first of all, people talk about drugs doing a biomarker. Endpoints are not drugs pointing toward a biomarker, they are drugs changing the level of some biomarker, ok . Certain endpoints are about understanding. If youre going to do a collective, it is understanding the pathway which will often be a whole series of interactions and alzheimers is probably dozens or hundreds of proteins in a chain. It can be any number of them and each one will have the same effect because it is a chain effect and the weakest link is what causes the disease. You have to understand these mechanisms, that is why im glad dartmouth is looking, they deserve a nobel or something. You are talking about mechanisms of action. If you contact those down in much smaller data sets, in fact, you dont really have to use of statistics at all. You can simply wake up and this is leading to that, leading to that and these are a lot of experience. I would also add that the tumor typically for the more common effects you can find 10,000 mutations in a cancerous and they can go crazy. They mutate in every possible direction. They just do it wildly. These analyses are sophisticated methods. These tumors have they call it days and network analysis, i have some of them in my book, they look like this huge spidery web with links between them and you can quantify the links and it is important to note that these are hierarchical networks. Theyre clearly important almost all variations and others are playing alongside try they map our system systematically and for a long time, they have four major categories, depending i think there are four major but more recently become of the database is [indiscernible] but nonpatent statistics that nonbasics as his six, they do have these large databases and it does it very well. The drugs are developed to be oriented toward these therapies and they work. Very red diseases nobody can with the number that is collectible from a molecular perspective. Very strong correlations with very Rare Diseases associated and the effects that are often one to one. Sometimes you have to double up get better effects. Once you have it narrowed down, you can do very good studies on the mechanism and it is a very long Chain Reaction and more difficult. We can know how to deal of complexity. That is of modern computing is. I think two takeaways from your paper, actually, that i thought were very interesting was one, first call, the fda is very restrictive in the ability to talk to Drug Companies and Biotech Companies because of conflict of interest that prevent them from talking. Even the National Institute of health, which is the major governing agency that runs a good academic biomedical research, even nih does not have a lot of cross channel medication with the fda about some of these advances and maybe as you said, that they could work with nih and use nih as the intermediary to help develop some of these standards. The second thing that you talked about in the paper that was very interesting was the fact that their european medicines agency, the em ea, european equivalent of that day, actually spent more forward thinking on some of these issues relative to the u. S. Fda i thought, paul, maybe could talk about a little bit and, emil, the reason we have this 2. 3 billion market cap is because the em ea has been more forward thinking on some of these issues than the fda has been, so maybe you could touch on that, as well. First paul and then emil. Paul just a look at one of them and say, there is a foundation for the nih. Theres Biomarkers Consortium which is a private profit Nonprofit Foundation that works because Academic Researchers and are companies have an Interesting Partnership that we talk about called the advancing Medicines Partnership looking up for diseases or five diseases. Some are alzheimers and lubitz. They do exactly what we are talking about, you go through, validate biomarkers, and debunked evidence. Develop the evidence. I think it is a big step forward. And then i think the emea has something called Innovative Medicine initiative which is making biomarkers one of the key projects and sending hundreds of millions of dollars compared to fda costs a few tens of millions of dollars a year and that could breakthrough, the key is getting this outside expertise that the agency is usually walled off from, involving critical standards so that people like lynn and emil and academic medical community and the Drug Companies can say, this is all the evidence we have. This is how it can validated and we should go about validating so we can affect and check things off the list. Move the science forward. Emil i think what i would like to say about the market is it is not all based on biomarkers. [laughter] and i do not own it all, to the clear. We do have one program that is looking into by margaret approval. I think in general what we can say about the ema and the agency, the last few years, they have been more scientifically based in less regulatory precedent base. Theyre willing to look at what youve got to make Intelligent Decisions about it. In the case of mps7, we showed them the plan and how we present the data and that is based on qualification criteria that we just published for qualified by margaret. We created a very thorough, thoughtful set of on how to qualify a biomarker and we present it in that format to them. They were convinced we have a we had enough data pieces to put together so be impossible that the marker is not correlated with disease activity in the patient and would not predict, as i said to them, and there is also the drug approval that made sense. What they told us is that this is the only way you can do this study, that is what he said, the only way to do the study in the disease is of the urinary substrate measurement and there is no other way to do it. So their view is that this is the only way forward and we will accept your plan because we think it is reasonable to do given the rarity of this , disease. I think that is the basic fact, at some point in the rule and regulation policy in the country, we have to make it practical or realistic. Otherwise things will not get , done. To say that i want a clinical endpoint driven center and i want walking test and this test and that test, unit 100 patients or something to do this study and there are only 20 in the United States, youre basically saying that i figured out a way that we are never going to find the science for the patients to be treated. We want them all to die rather than risk hitting treated with a biomarker in point. That fundamentally is no one us would agree with that. That is sort of the ultimate outcome of that decision and that is what we need to change. I think there are ways to do this in a the way and we proposed them. Some of the low group of industry, academic and foundation people, developed the criteria and wrote a paper on it. It is not trivial, it is not quick and dirty, it is there a, comprehensive, and the key thing is it does not require things that are impossible. There is little to require you to know the cardiovascular outcome in the disease that has less than 100 patients 10 years from now. Youre never going to get that data. What about the data you do and how good is that . Work off of what we know. What the law said, and this is important to remember, they had a piece on approval that said it was to include ways to qualify a biomarker endpoint by using pathological and pharmacological criteria were other types of data, in other words, outcome data, was impossible or impractical to collect. So it really struck me that you need to be practical hearing your choices. You are not creating unrealistic and if possible barriers that will cause the disease is not to get treated. I think that is where the differences. You may see the practical and scientific side and i dont think that they did theft is a can of precedent and concerns. I think their concerns come from the fact that a couple of drugs and the harder area and circuits did not play on people were hurt by that. There are these big fancy cases of drugs in the big market area that did not play out. It is causing them to flinch and move away from diseases where we know a lot more about what is going on with a specific biomarker and the clear genetic condition. It is just not the same situation where biomarkers have failed in the past. We need to get over that story. I love bob temple, he is a great guy, he keeps telling that story and needs to stop telling that story. Needs to get on with, you know, new science and where were going now which i think is much more soundly based. When i introduced lynn, i neglected to mention that you are president of the National American association of Cancer Research which is the most important Academic Society in Cancer Research and the country and she also worked at the National Cancer and the National Institute of health as a phd in molecular biology from the university of arizona. Please, talk about and it is obvious points that you have been hearing. Lynn well, there are lots of ways that i could do that, but what occurs to me is that what we are duly saying is that the fda looks like one of those Human Resource departments that you roll your eyes at that says, onesizefitsall. Youve got to do it, these are the standards, everybody has got to fit into these groups. You know and for those of you who have been in that position where you just say, come on, we have a mission here and there is something we need to complex and there needs to be some flexibility around, so i think for historical purposes, the fda has this onesizefitsall. I am not not a real Big Government agency and in order to gain efficiency, everything has to fit in the individual little silos. I think that is what has to change. This idea that not all diseases are the same, they have a very Important Role in protecting our society. And protecting us around drugs that are out there that thousands and thousands of people take who are relatively healthy. Blood pressure controlled medicine, those types of things, that is a very different story than Rare Diseases or deadly cancers. It is that ability to be flexible enough and yet stick to the principals of some sort of Scientific Validation and overlaying exactly, as you are saying, emil, the principality of it. What is really required here. In a population that we are addressing, what is their risk tolerance . I can tell you that think ready Cancer Patients are, in general, much more willing to take risks with their treatment because what they are facing is really virtually certain death, otherwise. It is overlaying all of that into the decisionmaking that goes into what is approved and what is the level of validation that we need for those biomarkers that seems to be the mindset that has to change within the agency. Roy how good is the science or, lynn . A paper came out of johns hopkins, suggesting or indicating that sometimes when we do these profiles and a tumor in a particular patient that we are not actually getting good data because if you do not benchmark that to the baseline genetic profile of that patient, maybe you are not getting Accurate Information about how that tumor is distinctive. There is a lot of commentary out there that, ok, yes, it sounds great in theory to do this genomic work and biomarker work, but at the very basic analytical level, are we at the right level . Are we mature enough windows analytical tools that we can actually say, ok, we are actually measuring accurately the genetic profile of the patient and being able to make the decisions on that basis . Lynn it comes down to dont throw the baby out with the bathwater. It comes down to the Research Component of it and the practical patient treatment component of it. Right now, yes, it is not what hundred percent certain that it will respond to a receptor like pancreatic cancer. I have no evidence of that, but i have seen it work in other cancers. This patient has very little options. I see no reason to say, well, i really have got to check their genomic dna and they should that this is right. You know, it is the perfect standing in the way of the good and moving forward. Now in a research setting, yes, we should be doing that. In a research setting, you should be sequencing both the tumor as well as the normal dna, looking at the difference, understanding what is specific for that tumor versus what is normal background for that person. That is all absolutely true in the research setting, but and that will eventually inform the patient treatment setting. Give us a little bit of time to move things from the research lab into the clinic, but for right now, the thing that would scare me about that kind of the statement is that people would still up their hands and say, well, we should not be doing any of this because it is not good enough. It is a whole lot better than shutting your eyes and treating the patient exactly like you treat every other pancreatic cancer patient, and you know you are only giving them a couple months to live. They have a biomarker with their product because they see i know how the process works, we know what to expect. If there is clear evidentiary standards for the qualification of biomarkers and the industry will suddenly say, we can reduce the cost of development, the time it takes to bring new products to market, and they can invest in bringing Academic Research and other tours up to the level needed to meet that, so i think that is another half. When there is a clear pathway, as there is for accelerated approval for cancer and hiv and some other drugs that have basically 90 of the approvals which use surrogate in points are three classes of drugs for cancer, hiv, and anthrax. We need to move beyond that. Avil we are going to go to questions. There is a microphone circulating around. When you get the microphone, give your name and your creation your affiliation because this is going to be on cspan, i believe. While the get the microphone moved around let me ask one question to the floor there , is something going on in Congress Called the 21st century cures initiative. It is through the house energy and Conference Committee led by chairman upton. Theyre planning to develop some of these ideas into a concrete congressional bill that would push the fda in the right direction. I opened it up to the floor, have you all been following that process, how do you feel that is going, are they doing the right things . Are there things that you want them to do that they are not currently thinking about . Emil my foundation is working on one part of it, the open act, which is a provision which allows companies to repurpose them for Rare Diseases as an incentive to get more of our science that we have already created for rare disease patients. The goal is extremely long. I think it is more than 400 pages and a lot of sections. It is a very ambitious effort and i think what fred upton was trying to do was get all the best ideas that he could, but the in, work through them, and come up with something that would really change the way things get done. Side, there is Something Else that is being put together that would be comparable, but i think there are things with patient input into the drugs process. There are incentives and a number of other aspects of it that i think could improve. I think it is a good discussion to have because it gets different stakeholders outside of the fda to Start Talking about fixing and improving things as we need to. Paul i think we would not be having this conversation without chairman upton and the commerce and the congresswoman. We are focusing on the biomarker piece of it and i think that is a good direction because it is recognizing that evidentiary stands for particular context for use of a particular biomarker and that would incentivize investment and bringing in those other expert bodies can be those groups and make each of the patients are at the table, industry at the table, to develop standards that ensures everybody the science is done correctly and the fda will recognize it. Peter i might add it is quite stunning how bipartisan this has been. They have equal numbers of democrats and republicans and i might add taking obamas count through Technology Two years ago which gets all this right through, as far as i can tell. A lot of people believe that this stuff is science about saving lives. And medicine. It withrd to pollute political attitude. Thats what is politically wonderful about this. It looks really well on this and the Responder Project that polymeric that paul and i wrote about several weeks ago, as far as i can tell, they are doing retrospective studies of Clinical Trials of cancer drugs that fails on fda standards and going back to reanalyze that for drugs that can in fact work well. I think it is truly wonderful. Anything else . Lynn 21st century cures is a step in the right direction, getting perspectives at the table, the devil is in the details, and there will be an awful lot of working through the details as to go forward, but it is certainly it is delightful to see the effort being put into that. Avil lets go to queue and q a. Remember your name and affiliation. Yes, sir . I am harry lewis, im a lawyer here and new york city. I just would like to ask the panel, listening to the discussion, i have read complements about darfur and nih, but i have to ask, to what extent has fda outlived its usefulness . They do some things that remain useful what are we better off limiting the jurisdiction at a macro level and permitting the market to take this on and move with it . Lynn to me i would assume that is a step or could be a step backwards in terms of safety. I think we rely on somebody to determine the things that we can buy and get prescribed for us. That we understand what those safety parameters are anyway. In my mind, it is a matter of dialing in the flexibility. The flexibility we need to look at specific situations as opposed to the one step for all. Emil if you ask any of the biotech investors are i know, pretty much everyone, they would say that getting rid of the fda would disaster. Avik the fact is, companies are companies sometimes lie. Sometimes they do studies are of a time not disclose what went wrong with the patient or a be the base like your district for patients with different. The journal of medicine does not have the Regulatory Authority to audit this patient records. They have to rely on the on the of people who submit those instead to the new england journal of medicine, lets say, where the fda goes through with a fine tooth comb. Maybe they go too far, but they are able to do things in terms of the rigor in which they analyze Clinical Trial data that civilian institutions are not able to do. For me personally, and a lot of people in the Investment Committee would say, there is an appropriate role for the fda but should the fda role be modernized . I think that is why were competing at the meeting. Paul the fda is actually necessary. Emil i think they need to help recruit more people that are connected to the academic world as they were when they had more people which would help them be more creative, connected to the science than they are now. The easiest thing to do to help them get better, i do think they need more funding. I think they need to figure out how to better organize and look for people that can keep connected to what is going on, drive the science down to the review level. I think they need fewer political in the shares on programs where they hire people and need to get more money into their drug review and the quality of people involved and appropriate as for biomarkers and other things. I think there are ways to make it work and i definitely think it would not work well without them. Peter i dont think there is a single major drug company that would say yes. It would be a stockholm syndrome problem. [laughter] they are well aware that a lot depends on confidence and social miss. I will add that the rise in medicine is progressively moving power away from the fda. I do not know if obama was aware of this when he endorsed medicine in the state of the union address, but it darfa can do it, and awfully the world, the fda has not said it is ok to prescribed is canceled drugs off label, but they will be prescribed as off label. The problem is getting them to market. Once it is in market, that they the fda has lost grip on it. Avik lets say you have a drug identity has approved for breastcancer, once the drug has actually been approved by the fda for any disease, a doctor has the liberty to prescribe it for anything. In theory, the the drug that has been approved for breastcancer, your doctor can prescribe it to you for high cholesterol. That would be stupid and super malpractice, but he has the Legal Authority to do that. What happens a lot is what peter refers to, doctors actually have a certain amount of liberty once the evidence is out there in the Public Domain to say, yes, this is out there. There is evidence that it may work for your pancreatic cancer or your lung cancer or your high cholesterol, so im just going to prescribe it to you for that. That is where the fda once it approves a drug, loses control of the story which is why it has become more conservative in cases of approving drugs because they are worried. They know that once the cat is out of the barn, they do not have the complete control anymore. Peter they have more than you are suggesting. Such incredible courage, i assume you know about the drug thalidomide from the 1960 that caused birth defects across europe and australia, it was a licensed drug in the United States but they put on a lot of conditions. I might add it scare them even more. [indiscernible] and looked at your genes and said it predisposes you to this, that, and other things. People are doing the diagnostics and they are doing it on the huge scale of much more data and specific recommendations. Im side, the federal drug law is written so broadly that everything google sets up in the country is a technical and medical device, telling doctors to treat patients with that. They have not dared to hold their fire. If they do, [indiscernible] i think they will lose on First Amendment grounds. Im a recently retired oncologist. I want to talk about what mr. Howard said, this goes back to the very 1969 when we had the fourdrug combination of approved ticket hodgkins disease, to cure 62 of the people, the single drug that we used was assisting ninemonth remission. We discussed it at that day never approved combinations of drugs but we went ahead and did it. We never got bothered and we still laugh about it years later. It was really it was really well to has the mutations caused by other diseases, but the key issue that has to be addressed is that when we went down to the American Society of clinical oncology to lobby congress, they told us that just get some patients, put it in front and said it around, they cannot argue with Cancer Patients. When you come down here, they think you are a bunch of moneygrubbing guys, you want to make a lot of money and im sure the same goes for biotech people. My question is im so glad to see you, what more can we do to get patients involved because it is very difficult to do, especially with pancreatic cancer, but the people who have gotten involved, the breastCancer Patients, people listening to them, we need a patient approach because Congress People think one way and it was sad to see john dingell against president obama. He was one of the people must who was most against it. He went after david and that is sitting next to the president when he approved something for health care. We need patients involved and please, tell me what you guys are doing . Emil almost everyone is going to be a patient at some point. Technologies 23 and me i think only does few. Paul i think it is about 1000 now, but the price is prevalent to the program that it will get at the clinic and at some point, they will get pricked, and look at it and say, we see predisposition for Heart Disease, diabetes, or potentially colon cancer. That level at which everyone suddenly becomes a patient advocate or potential patient advocate i think is a game changer. Lynn the advocacy organizations have a very important moral and role in exactly what you are talking about. Using the power of the people, the power of the patient in order to influence change. I know for specific example that recalcitrant Cancer Research act was passed into law of january 2013 as a result of the efforts that started out as pancreatic Cancer Research act. We could get 600 patients, not usually patients but family members of patients of families who had lost someone to the disease, all dressed in purple on capitol hill year after year, so this is important to us. The end result was asking the nci to come up with a scientific framework for the deadliest cancers which are the major cancers with fiveyear survival rates of 50 or less. That is something the nci is acting on in terms of looking at that from a more strategic viewpoint as to what can be done with what disease. I think those are the types of things that take a long time. You need a lot of organization in terms of making sure the message is consistent. That you know that what you are asking for is what you want. A lot of those things, but that is clearly one way to affect the kind of change. Emil at our foundation, we actually organize the Rare Disease Community and we have about 80 rare disease groups that are behind our campaign that we call the cure the process campaign. Every year, we bring about 200 patients, go through a conference to tell them what is going on. Have lobbies, and train them to know how to talk to congress and staffers and we set up meetings with their particular congressman or staffers. We send them out on the hill, we put ads in politico, and we make it a big where disease week and we have a premier movie where we do a rare disease caucus and you make a big event out of it and we do it every year now. They know we are coming. Actually, congressman with rare disease issues feel like these are good events for them. We work both sides of the aisle. They are very aware and some of the 21st century cure said is basically where disease focused work. It is not just the company. It definitely has to be the patients that are affected by these for diseases telling their stories on the capitol hill and we do it in an organized way with enough firepower so that they can feel the presence of those groups by having them contact the hill on one day every year in february. Avik any other questions . Amy my name is amy and i teach at the university of pennsylvania. I am wondering if one possible way for the whole ind ticket and it is a slow ticket would be for the fda to have Something Like a recalcitrant Disease Program just carve out specific diseases with dismal diagnoses. A lot of them would be cancer and create a much freer, much looser regime for treatment protocols. I can see one obstacle to that is this kind of conceit that existing treatments work and everything has to be compared to existing treatments. I think that is probably pernicious for diseases like pancreatic cancer and lung cancer but it might create some tension to say that the really works. But nothing really works, so we should just try anything. Lynn i think that is exactly along the lines of trying to open it up so it is a onesizefitsall. Even if they have to lope some diseases into those that are particularly difficult and really recalcitrant and nothing to do for them, that might be easier for them to do then to really think about it each disease individually, although it certainly at some level, that needs to come to play. Avik next question. Jonathan im jonathan, network for excellence and health innovation, can you comment on if you are doing any work or have any feelings about the payment side of this . Certainly in another reason why do has not been a lot of activity in the biomarker industry, i do not think you could even get something approved by the fda. You have to go through another threeyear to five year odyssey before you determine what you are going to get paid. It tends to be very depressing for number of projects that get financed. With the exception of a drug company with absolute positivity that it will get its drug approved and has an essential requirement for a test trial on the door, have you looked at all what the incentives are for Product Developers and what they get through the fda . Peter i think it is a Major Economic problem for reasons slightly that you suggested. I know there are only two ways to monetize that can serve in an point. First of all, lets put it this, if you come up to an end point for alzheimers, a good one that fda approves, it would be 1 billion discovery at least. Definite all summer drugs with conventional fda trials would be [indiscernible] it is too slow of the disease. It is interesting in response to an earlier question, people across the United States and huge debt of gratitude to the Gay Community with their activism in the late 1990s and my team night and 1980s which is physically the primary military primary way of introducing from logical and pharmacologic and basically, molecular stuff. But the two tools for monetizing these discoveries are the diagnostic devices. If youre going to have a targeted drug that is prescribed in these conditions, and you will have to have a diagnostic look. Im not sure if they still do it but the fda required a companion licensing of the device. The problem is that if you are good pioneer and you find a new target and you find a way to accelerate the approval, so now you have a lubricated pathway for rapid approval by the fda, it is easy to follow up and someone to steal your invention. They work out the mechanism of actions of your drug, the conduct of studies, and they ride on it. The classic story are statins. The japanese researcher worked at the basic chemistry and discovered the first but did not work out the chemistry but his grandfather was interested and looked at the wonders of nature that produce all these medicines and he figured, they be some microbes might have found a way to disrupt cholesterol because cholesterol is also used in nature, so meanwhile, in the United States, they were working out the molecular cholesterol pathway, and they got no buffer that. They caught the most decorated molecule in history, anyway, [laughter] these people did incredibly valuable work. The whole staffing industry sort of hinged on what they did. Statin industry sort of hinged on what they did. One British Company came out with another patent but it did not go far. So pfizer ends up with about three or four drugs later doing lipitor which is a billiondollar debt. We have no way to monetize this Expensive Research into chemistry. We need some kind of intellectual property and researchers want everything shared with everybody, but this stuff is expensive and you have to have some incentives. Paul some kind of a compulsory license, you could say like. 5 of revenues that would be any product that is approved using a validated biomarker would flow money back into diagnostics industries, back into the academic medical community and would encourage companies to share data. If they say, we could pool our data and pulled revenues and that would allow us to get biomarkers validated that much faster, so much the better. Avik any other questions . One more . We done . Lets do one more. Mixed signals from my governors over here. Sorry told everyone up. I am genvec from the Parkinsons Disease Foundation and i really enjoyed your discussion today and it focused a lot on cancer. I represent neurological parkinsons disease and other diseases like ms and alzheimers. I think it is important to recognize that this is a rising tide which can raise both, and we focus on the genomic area and how it helps people to recognize that something as simple as mri scans or pet scans can really help these other neurological conditions which currently represent barriers for drug approval. There is a scan for parkinsons to indicate whether someone has or does not have parkinsons, but people who are negative for the scan still have to be included in Clinical Trials even though they do not have parkinsons disease. The fda wont allow it, so how do we increase this in order to get fda to say, we recognize these people do not have parkinsons disease, you connect with them from your tiles, therefore, in short that drugs which can help will actually get to approval to help People Living with the disease they have today . Paul a big chunk that we did not discuss is actually located in the slips these and starting point. I mean, is there profile that tells us hopefully well in advance, yes this is subject to both of this disease. Peter there are quite a number of Rare Diseases where the profile is crystal clear. You can scan and a number of other things. From what i have read, a lot of would you call parkinsons a neurological disease . They are very complex from molecular perspective because you have changed propelling the signals and numerous signals and so on and be multiple molecules in those chain and variations in any number can lead to the same disruption that causes the same clinical symptoms. And the institute for dental health recently for Mental Health recently tossed out standard definitions of neurological disease as we are setting that anymore, we are not funding that. They actually used the analogy for precision neurological medicine that we will isolate the pathways in the brain that affect pain, emotion, and some finite numbers and they will work on those as much as possible. The use of biomarkers, it was the fda and the city is choosing its own name, [indiscernible] of course, we should not be testing someone who does not have the disease. The second problem is that there are quite a few people with the genes but they happen to be really good and not succumbing to a disease even if they have been affected. There is a microfraction of people that get infected with hiv but it never progresses. A rather small number but they are the elite controllers and so on. There are other markers like this with cancers and so on. You do not want to test drugs on people who are not sick because it stacks the deck wrong and makes the medical trials incomplete. Thats the best i can give you on that one. Avik i think we have covered a lot of ground here and i want to thank all of our panel for being here. The particular emil. [applause] i want to thank the reporters at the Manhattan Institute for helping us invest in this important and neglected area of policy, so thank you very much. [applause] [indistinct chatter] on newsmakers, georgia congressman tom, chair of the budget committee, talks about new Republican Leadership under speaker tom ryan. And, what to do about fighting isis. Challenge and he will problem is, the United States does not have a strategy. The United States does not have a strategy, they refuse to make it in a way so we actually defeat isis. Did this se house week was to say, because the Homeland Security secretary and because the second director of the fbi says we do not have to be certain that folks who come in the Refugee Program are actually coming here not having association with terrorist groups, we have to pause the grandma or stop the program right now and then on a posture of making certain that they are ine to vet these individuals a way. That is what the American People are clamoring for. But obama says he is going to be know this. To the American People need ask themselves is, what does it mean when a president vetoes a legislation that is solely for the present acting the. It is a very troubling time. Those i call on those who voted for this to recognize the concern in American People have on this issue. This is not childs play. This is a serious issue. The president say, even in spite of his Homeland Security secretary saying they are not able to appropriately bet these issues. That is not a republican senators. That is not republican governors. That is his security secretary. Two of the president say he is not going to listen to that end he is going to allow people into this country that he cannot say do not have ties to terrorism, that is very troubling. Priceresentative tom 10 00 up on cspan at a. M. And 6 00 p. M. Eastern time on cspan. John doe edwards has been declared the winner in the louisiana governor special election. Assessor. D twotime they have not elected a democrat since 2000e office eight. Both candidates address supporters after the results. We start with the senator who announced he will not run for reelection to the senate next year. Then we will have remarks from the governorelect, John Bell Edwards. [applause] thank you. Lost one i have campaign. Ironically, it is the campaign i am mostcal effort proud of, particularly these last few weeks fighting shouldertoshoulder with you. Thank you so much for that honor. I call John Bell Edwards and wished him our sincere congratulations and best wishes. Sincerelyi really, hope he leads all of us with the right solutions and to succeeds. Wish him and his family are only the best. Lets give them a round of applause. [applause] as for me, i am a good to refocus on the important work in the United States senate. [applause] and applause] but i probably going to do that for one more term. When i decided to do this with wendy, i decided i was going to pursue other things. We disappointed those challenges butnot leading the state, to im genuinely excited with wendy are about starting a new chapter with my personal life a and all of the fun and reward and challenge that will bring. We are looking forward to that challenge very much. And, in saying that, i am also very confident that we are going to elect another strong conservative to fill this senate seat next year. [applause] and, i will certainly be working with all of you to make sure that happens. It is important for louisiana and for our country. I begint said, how can to express my thanks. I am so blessed. So enormously blessed. To wendy, thank you for being such a fabulous spouse and mom and partner in this important work, and best friend. Thank you so much. [applause] [chanting wendy wendy wendy] gov. Vitter to my children, thank you for your support. I hope i have encouraged you to always take on new dreams, always take on new challenges, never settle for the easy or the comfortable. Never do that. [applause] vitter to our family, they are almost all here tonight, thank you for your love. You will do so much for us and give is so much support, including all of that great signwaving today. Thank you for that. [applause] vitter two hours senate staff and Campaign Staff, url, bar none, the best staff in louisiana political history. Thank you for that work. The people ofd louisiana is so amazingly well, and i am honored to have worked sidebyside with you. All know, like wendy and i certainly know, staff, you have had the best team leader and imaginable in kyle. [applause] vitter that is my Campaign Manager and chief of staff kyle rocker. Kyle rucker. [crowd chanting] Kyle Kyle Kyle we love you and ritter governor victor we are honored to of worked sidebyside with you, we will always love you, and thank you so much for this enormous honor of service. Thank you all so much. [applause] [crowd cheering, whistling] thank you. What a great night. Is this a great state or red . We heard a prayer while ago. We are supposed to glorify god and i but that we did. So i will say right now, to god and the glory for tonight. First and again, with words of deep and profound gratitude for all of those who worked so hard. Who were willing to believe that we could confound the conventional wisdom that this victory just could not happen. And yet, thanks to all of you, here we are. It did happen. [applause] live out our great state and its wonderful people. I am especially grateful tonight. 26 years. [applause] cheering] yes. She is a Public School teacher. She is the last person i talked to every night. I want to thank our children as well. For over two years, they did not see much of their poppa. I have missed them tremendously. They are the best children i could ever have hoped for. I want to tell them i appreciate them for everything they have done. They sacrifice like you would not believe, but they new tonight was possible. Think my tell you i family. I am standing next to my mother. A Charity Hospital lot nurse. [crowd cheering] who Charity Hospital nurse taught all of our children compassion for their fellow beings. I love you very much, mother. Tonight, i cannot help but think about my daddy. Poppa who i lost in april of last. A great man. A great public servant. Who, along with my mother, raised eight children. A wonderful man who loved his hotel room we are right now and whos daddy came here 1927 when he ran for sheriff and one. And spent the night here look up the next day and read the Times Picayune to make sure he would really want the race had reallyt he running race. Dont feel sorry for my sister, she was the oldest and she was plenty mean. [laughter] but my brother and my sister, i am joking they were so incredibly hard. They came, they volunteered, they did things i never knew they did. They traveled the state, putting up signs, moving signs, talking to voters. I could not a fad it more supportive family. If my wife, my kids, my brothers, my sister, my mother. Nothing they did and nothing you did was more impotent and the prayer shall offer it up. Not just for me and not about the great state of louisiana into our people. So, thank you so much for the prayers. It takes a lot of to do the footwork that to a Campaign Like this requires. Calling people, telling our story. To those who contributed money to read a Campaign Like this cost, and it discussed a lot of money, but most of all for those people who voted for us, god bless you. I am eternally grateful. I am humbled. Thank you so much for the confidence you have shown in me. I will not let you down. [crowd cheering] i want to thank the hundreds of committed volunteers all over the state of louisiana and i want to tell you i have the best Campaign Staff that has ever worked in the state of louisiana. And it was the smallest Campaign Staff in the history of the state of louisiana. [indiscernible] i want to thank my Campaign Manager right here. She did a wonderful job. [indiscernible], i want to thank also my legislative colleagues, alike. Tic, republican you always get in trouble and you do this, but i want to single out my seatmate, salmon jones. He worked tirelessly throughout. He was the first true believer. In god i want to take just a and, i want to take just a moment and thank jay darden. Put louisiana first. I am said to have had his and doors meant. Proud to have had his endorsement. The people have chosen over and negativity and over a distrust of others. I did not create this breeze of hope blowing across our beautiful and beloved state, but i did catch it and i think that god i did. Did. Think god i these spirituals of our american ourches, the faith of italian antigary and strawberry farmers and the energy of native americans and hispanic immigrants. No, i did not start the breeze of hope, but i did catch it and so did you. So did you. Thank you. That is why we are here tonight. Because we all caught the breeze. The people of louisiana have chosen to believe we can do better. And by doing better, we will be better. I submit to you, we will be better as of tonight. Know, struck by the words that nature can do, but down by attacks on education, itsrrassed by the vanity of leadership, the people of louisiana have chosen hope over business as usual. And, i pledge to treat their trust is a sacred obligation. Hard work tok of do. We must unite and work together. Party,r, regardless of gender, geography, we are together. We are one louisiana. Together, always putting louisiana first. Always tackling our biggest challenge together. Restoring opportunity and prosperity for the great people of the great state of louisiana. Now, let me tell you it is going to be difficult. With gods blessing and your hard work and your prayers we is ourevail whether it finances, education, job creation, transportation, taking care of the environment. We are going to prevail. And i want to thank all all louisiana ends of all persuasions, all ethnicities, i dont care where you are. I want to invite all of you to ton with us to work hard, work together, to pull together, to move louisiana forward. Said, tom lincoln once call on the better angels of our nature and catch this breeze of hope that these deep and abiding issues can be dealt with in ways that speak to the common good. I am going to be the governor of all the people. And i am thanking everybody in louisiana right now. Whether you voted for me, did not vote for me, or did not vote. I am going to be your governor and i am going to work just as hard for you as i am working for those who supported me from the first day. Im going to work with you and for you just the same. And that goes for senator victor, too. Senatorhat goes for vitter, too. And he wase tonight very gracious. I am going to work with others all across the state of louisiana. And i am going to work for senator with senator vitter, too. That henced tonight will not seek reelection to the senate. Does my hope and expectation bad tee and i worked together to serve the state of the commonto promote interest. I look forward to that opportunity. Tonight remains the same as it has been four months. I will always be honest with you. I will never embarrass you. Day fighting every to print the great people of the great state of louisiana first. God bless you. God bless the United States of america. [cheering and applause] is cspan has the best access to congress, with live coverage of the house. Over thanksgiving, watch our conversations with members of congress. Two nights, republican from georgia and the only pharmacist serving in congress. Then, a new jersey democrat and longtime electrician. Then, a california democrat and former restaurant owner. , an, congressman mark Walker Baptist minister. And saturday morning at 10 00 a. M. , a republican from california who interned in a college, d. C. , as didnt. Then, a harvard graduate and marine who served four hours in iraq. Your best access is on cspan, cspan radio, and cspan. Org. Did i care . Yes, i really did. First of all, i was not elect that so did not make that much difference. I did notice the difference but being the Vice President s wife and the than spread was huge, he could is the Vice President s wife cant say anything at. Say something you as incidents five, you have made the news. That was a lesson i had to learn. Barbara bush used the office of first lady to create literacy. She earned her way into the history books to become only the second first lady besides Abigail Adams to be both a first lady and the mother of a president. Ladys,ns first influence and image. Examining the book and of a life of the women who served as first lady. Sunday at 8 00 eastern sunday on cspan3. Now, political cartoonists talk about their work at the National Archives. They discuss what inspires them to create their work and what inspires them. This is 90 minutes. This is the 11th of annual forum. With president ial election fervor percolating and jousting position, this is an appropriate time to discuss freedom of speech and political cartoons. How do political cartoons make a difference . A can probably agree that picture is worth a thousand words and that the pen is mightier than the sword. This can powerfully advance the argument of others and advance conversations. As far back as 1754, ben franklin published his timeless political cartoon, join or die. It was a woodcut of a snake cut into segments, representing the divided colonies. Franklins metaphor became a rallying cry for unity first in the french and indian war and then during the Political Revolution the american revolution. Todays brilliant political cartoonist can take advantage of a myriad of portals. But freedom of expression must , never be taken for granted. We recall the 12 people, including four prominent cartoonists, who were murdered in the offices of the paris satirical weekly, charlie hebdo. Hebdo. We wonder, are cartoon artists intimidated or energized by such violent responses . Olveshts program inv discussions of the artform for today and the future. With done in partnership the National Archives. I have had the privilege of being a member for the fun of the fund since 2008. The mcallen fund was has been around since 2003. Through its grant programs, this helps protects societys most vulnerable members. We support programs supporting food banks and clinics and help promoting initiatives. Since its inception, it has provided over 130 million in health care and research and education. Mcgowan theater and in 2003, it honored his memory by providing the public archives the funds to build this theater. Here, films are screened and important ideas are discussed. This forum was quickly added by the fund to supplement programming at the theater. 2008, the forum focused on spotlighting women in leadership. Believed in a frank and open exchange of ideas, and he loved to debate with his nieces and nephews, which we were tested on on a regular basis. Only in such a democracy, could upstarts corporate at t, whichrthrow had a virtual lock on phone services in 1982. A verdict in the Federal District court affirmed his companys right to compete, and the at t monopoly. History is repeating itself. It has paved the way for global advancements in information technology. Our distinguished moderator will take full event is here to share perspectives here on the vibrant and vital process of political cartoons. To yourorward conversation and the discussion to follow. Thank you very much. [applause] good evening, it is a pleasure to welcome you officially to the National Archives tonight. An official welcome to those of you joining us on cspan and honor youtube channel. Since this years topic is cartoons, i thought it would mention that some of the and the holdings of the National Archives contain cartoons. We have thousands of archives of cartoons related to political events. Oldeste oldests political cartoons are in our president ial library. We have dutch cartoons from 1719, and thomas nast cartoons from the early 1800s, but most of the political cartoons are in the subject matter of dealing with the actual president s. Even and especially the leader of the free world is not immune from being skewered each morning from a morning a newspaper editorial list. With from the job the job. And as we see daily, it is probably something that is wanted with the job also. Also what we have are the original pen and ink drawings from Clifford Barrowman barryman. He was one of washingtons bestknown and test political commentators in the first half of the 20th century. He drew for the post and the evening star until his death. His cartoons touched on a variety of subjects, both world wars, and even washington weather. This is in titled the post season parade from 1915. It highlights the departure of lameduck people from congress. The lame docs in this cartoon lameducks in this cartoon are democrats, heading to the white house, hoping to receive an appointment from president woodrow wilson. [laughter] our panel will be moderated by david tsipras. David went on to earn a masters in soviet history, and after two to pursue aed out career as a cartoonist. In his words, it may be strange, but it made perfect sense. I was able to i was able to combine my sense of humor with what i viewed in life. His first cartoon appeared in the new yorker in 1998, and he was the new yorkers daily cartoonist for a number of years. He has lectured on the art of the cartoon and he was the writer and host of conversations onh cartoonists, a series artists who work for the new yorker magazine. He has also published both fiction and nonfiction on the , and aner website anount and that includes account of his familys experience of the kennedy assassination. And now i will turn the microphone over to david, our moderator, who will announce our panel. [applause] we salute the audience [laughter] [applause] good evening, i am david cyprus, and i am moderatiing tonight. [applause] i asked them to put up this thomas nast drawing, unfortunately, it is cut off at the bottom. This will give us a little context of the long history of cartooning in our country. I want you to look at this. Tom, that is how you draw an elephant. [laughter] david t. just a few words about what i am doing here. I am a new yorker cartoonist. Being a new yorker cartoonist is tricky business, because we cant advocate directly for anything, we cant quite finger any political particular politician or policy, all we can really do is point to the reader and say, isnt that ridiculous . Characterscovers, no cartoon. Ew yorker so i developed some strategies to deal with that. One of those things is develop tropes, and one of those is the figure of the king to represent government itself or a particular politician. I have chosen one to show you tonight. It is one that i did back in the 2012 election. There was a lot of chatter about how the president would affect future generations, and how they would view his presidency. I am concerned about my legacy. [laughter] historian. [laughter] i had a little taste of this, as i mentioned, i was a daily cartoonist on the new yorker website, and i wrote a topical cartoon every day for two months. Camene thing that i really to appreciate is what it is like to deal with the in norma of information that you have to take in in order to come up with your ideas, and this cartoon was kind of a result of that. Bedesire to eat to wellinformed is at odds with my desire to be paid. What these guys do is cut through the noise and all information with the tools of words and pictures together, and conciseo some simple, truths to help us all figure out what is going on. And im going to show you some slides, you guys are probably going to kill me, but the question that you have asked so many times and we have bored you to death, it is not, where do you get your ideas . Later, but i that wonder if anybody would share their view on their role as a political cartoonist. Is it to explain, is it to make people laugh, is it any combination of those . Does anybody have anything to say about that . No. David t. ok. [laughter] we are not going to be of answer every question by the way. [laughter] i think we are going to talk about it when we get to particular topics, because every cartoonist is different. You do Different Things in different cartoons and you make different points. The day after somebody blows up paris, a sympathy cartoon is a good idea, and yet, you are not doing sympathy cartoons all week long and then you are moving on to other things. Right, then lets go right onto the images. This first one is toms. Tom do you want me to talk about it . [laughter] because the answer is no. [laughter] david s. i have one question, do you have a television all day where you sit at work . Tom yes, but i dont always watch it. I have a pretty good idea as to what is going on, and this cartoon, i sent this one along for the reason that, i mean, traditionally, what people look to a cartoon to do is, to a certain extent, analyzes a situation, and this one, i wanted to simplify a complicated situation in a complicated way. [laughter] say. Thats all i have to [laughter] tom no, the obvious idea is that the benghazi hearings were not going according to the political agenda that republicans had set out for them to be, in other words, a big takedown of hillary, so the simple, shortest version of that is that it backfired on them, but there are simple are ways to do that then i chose to do. [laughter] cartoon that was a some people said they had to look at it for a while. [laughter] tom because there are several things going on there. And you know, some things complicated simple is better than simple simple. And i think it is the complexity that got it all in there in a kind of engaging way. And if you look at it, it is a static image, but it is potentially alive with all emotions and all kinds of consequences, so this is an example of complexity rendered complexly. David s. i have an example of sorry, jen. Jen i just had a question. Tom oh. David s. i was just surprised as to how cuddly your elephants are, you soften them. Tom it is the same sort of ,lement that fishermen uses they dont make the hook look sharp and horrible, like a high harpoon. [laughter] and i certainly enjoyed feel strongly about putting this element into my cartoons, but, i dont know, you have to make choices as to how you present what you have to say. I mean, that is really half of the job. For me, i want my cartoons to personal way of being with information and i just feel if you make it look sweet and nonthreatening, and does it invite you in rather than stiff arms you away . Then all of a
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