The current epidemic, which africa struggles with, is something that we should have thought about. They do not have a healthcare structure that can deal with the regular issues that good on over there from a healthcare perspective. Now were adding to this injury by ebola, or nature is adding to the countrys with ebola outbreak. The first focus needs to be on relative simple things to decrease mortality in west africa. Intravenous hydration, managing nausea, fever, and superimposed bacterial infections will relatively inexpensive measures that can be part of a package that can be delivered do west africa. Theres critical need of beds in the most affected countries. Proper training and protective gear needs to be provided to the hospital staff, and the staff dealing with the corpses. Their complex ethical challenges which abound and are related to the use of untested interventions, quarantine, special care and other issues. The u. S. , u institutes of health played a critical roll in improving the health of the american and the globe. Funding has been the cornerstone for nih, funding of nih has been the cornerstone for the american Biometric Research center that leads in innovation. And just being stagnated after 2003 and declined after 2010. The cost of conducting Biomedical Research has rapidly increased also at the same time. This was further hurt bit the recent bubble tear cuts and sequestration jessica in order to secure americas position as a Global Leader in Biomedical Research for foreseeable future, Congress Must produce significant new investments. Theres no evidence so far we have appreciated in the scientific literature that says that closing borders will cause the disease to stop to come to a specific nation. We also need to deal with some of the other ethical factors in terms of ailing foreign healthcare workers. We must make special arrange. S and special commitments to healthcare workers working in these particular countries, front line, dealing with the disease that is extremely deadly. These doctors and nurses must be promised not only high quality of training and protective equipment, going forward, but also that if something happen we must take care of them. Someone must take care of the heroesnot just the civilians who are there but the 3,000 troop wes have in the heart zone, when they come back. We have to make sure that they are taken care of. In summary, although there are signs the epidemic is slowing down, if not for Sustainable International response it will cause a bigger devastation than we could ever think about. Safe and efficacious vaccine i believe is the on hope only hope for containing the outbreak but the u. S. Research is a drop in the bucket. A unanimous partisan effort in the u. S. Is need teed increase funding support to nhi and the u. S. Department of defense for research and development and advance development of vaccines and therapeutics as well as diagnostic devicesment we also have to make a considered effort to develop manufacturing facilities right here in United States. For diseases such as ebola and other infectious diseases. Countries, ngos and funding agencies, public and private, need to fulfill their policemens. Only 40 17 of the pledges so far have been fulfilled. Countries promise and pledge private institutions promise and pledge, those pledges never come through. They need to stand up and fulfill their commitment. And the last word is, remember, diseases do not observe boundaries so we can have these diseases come to the United States or any other part of the world if we do not if we are only reactive and not proactive. Thank you. [applause] thank you. With dr. Alexanders permission and our media colleagues approval, im going to speak from the table here rather than the podium. I appreciate the opportunity of being here. Ive been asked to speak a bit about terrorist and insurgent groups that are operating not just in africa but also in other parts of the region. And a little bit about how that affects humanitarian the potential for humanitarian temperatures as in the region. Theres been plenty of literature analyzing these groups. Some of the best has been done right near this building. So home not going to go into what al qaeda or isis is all about, except for just little bit. But what i want to do is talk about the activities of these groups and the potential for the development of true humanitarian crises in the region, and thats primarily through the issue refugees and displaced persons. I have statistics ill rattle off. The sources of these most of the uted nations either the High Commission for refugees or the undersecretary general for humanitarian affairs. In africa, boca haram, a group that has certainly made headlines recently. There are probably 10,000 nigerian refugees in cameroon. I dont know if anyone would go to cameroon to seek refuge but there are 10,000 nigerian refugees in cameroon. Probably 50,000 nigerians in niger and there are a displaced persons within nye nigeria, maybe up to a million because this numbers keep changing. Moving further north in the mali situation and in the activities of al qaeda ask the islamic in the north, mali and nigeria, there 300 are hundred thousand internally displaced people within mali. I mentioned 50,000 niger. Some of those come from mali inch both situations the u. N. Is mon doering for yellow fever, cholera, and this sort of thing. I want to emphasize that the humanitarian disasters that can happen are certainly more than just medically related disasters. In libya, which one can argue is kind of the beginning of this whole process, especially in Northern Africa. There are 60,000 internally displaced persons within libya, a country where the any sort of government, whether it be the Central Government or regional governments, their reach does not stepped very far beyond the building in which theyre meeting. There are also a million refugees, according to the u. N. In tunisia. Libyan refugees. The president of few nyeshia, who will be d few tunisia, says its up to two million libyans in few nyeshia. A third of the 2011 population. Tunisia has medical capables, and this is a bit of a joke about that. Ill tell the joke about few nissan thank lets talk at isis a little bit and talk about the refugee situation in isis, which dwarfs these other numbers relatively. And then ill talk about isis. The u. N. Says there are 3. 2 million registered refugees. That is, registered with the u. N. , from the isis Syrian Civil War ask sectarian fighting within iraq. There are refugees, more than a million each in jordan, from both iraq and syria. And jordan has been has seen successful waves of refugees from 1948 right up until this year. About 1. 3 million in turkey. These are registered. 1. 2 million in lebanon. 500,000 Syrian Refugees in iraq. They went from syria, from the frying pan into the fire, or the other way around, depending on your perspective. And they sought refuge in iraq, and there are 900,000 internally displaced people in within iraq. Syria, the numbers suggest, there are 4 million syrians that of displayed within syria. Now, some go to cities and livewill with relatives, not necessarily all in refugee camps, but this is a lot more tn 3. 2 million rev. [engine revving] fujiis. Is a winter gets closer, 4. 2 Million People will be in need of humanitarian assistance. Fuel, shelter, that sort of thing. And in iraq and syria this is a bit of a chilling statistic, and ill talk about that towards the end there are now about 10 Million People living in areas controlled by isis, the Islamic State. 10 Million People. In syria and iraq. In both countries. Thats larger than the populations of most of the states in the region. Now, this, of course, creates large refugee populations, camps, emergency needs, and there are, as we heard, by our previous speakers i dont mind going after previous speakers. I launch a learn a lot from the folks who speak before me. There are obstacles to governments and International Organizations and ngos. There are obstacles to their providing the necessary humanitarian assistance. Ranging from the well, seemingly ridiculous. Teams that are vaccinating for polio in pakistan are actually there to sterilize your daughters so dont let them into the village, and in fact several have been killed. Medical workers are actually bringing ebola into your part of the country. So stay away from those people. Reminds me of the black plague picture with the vinegar. Its misinformation and its also propaganda that we have to counteract. Obviously there are terrorist attacks and insurgent attacks going on in all these countries that i mentioned, and that threaten, especially foreign ngos but not just foreign, indigenous or native ngos also in niger, the government said any ndos, any humanitarian teams providing assistance, need armed escorts outside of the capital. That certainly inhibits people flocking to help the victims there. There are kidnappings and abductions of humanitarian aid workers in mali. Isis has targeted humanitarian workers also, and weve soon the beheading of two britts that were there for humanitarian purposes. The undersecretary general of the unites nations for humanitarian affairs ill quote her this is in syria civil war and isis we have had 66 humanitarian workers who have lost their lives since the start of that conflict and hundreds more have been kidnapped and abducted. This is what she says. Within syria. That is certainly an obstacle to bringing the assistant necessary to take care of these people. And, as we have seen in refugee camps in jordan and probably elsewhere, the war in syria or the sectarian fighting in iraq, can spread to the camps themselves. In other words fighters from each side can infiltrate the camps and carry on the fight within the camps, which stresses both in the National Security services, trying to police the camps, the u. N. , or other organizations. So we have this situation with millions of people facing it wouldnt take much to have a medical humanitarian crisis, but certainly other crises in terms of food, water, shelter, in these camps. Now, let me talk a little bit about isis because this represents a new situation. We call it isis. Thats what our government insists on calling it, and im no longer part of the government, im an exfed, not a fedex but an exfed. I actually retired, and so im speaking just for myself, but our government insists on calling it isis, Islamic State in iraq and syria. But isis has its eyes on a lot more than just iraq and syria of. Their map of the worldwide caliphate resembles no caliphate that existed in the history of islam. Most of Northern Africa. Into subsaharan. South asia. It is a very globally looking whether they have the capacity to execute it is another story but they have this vision of this worldwide caliphate. This is the First Organization of its kind that has been able to control territory in the daytime as well as the night, and this is key territory. These are cities, these are infrastructure. Roadways, rivers, that sort of thing. Key territory. 10 Million People live in the area that they control. They have we can say that aqim and groups and roam the desert and strike at well and thats truitt, but these people control territory. They have displaced the governmentsing are both the national governments, such as they exited, and the more traditional tribal authorities, that sort of thing in the places they control. But they havent filled the vacuum, the governance vacuum that they themselves created, or that had been growing before they even came upon the scene, such as places like in iraq and in syria. Theyre not providing services to the people, these ten Million People that live in their area. They dont even seem to care about providing services to these people or interested. Now, i dont surf the jihadi web sites to see what is going on but i havent seen anything from isis that seeks to show how they have made life better for the people in mosul, now that almaliki and this corrupt Iraqi Government are gone. Theyre all all their propaganda is about behead examination that sort of thing. This is a totalitarian organization. In the classic sense of the word. If youre not one of us, well kill you. Even if you are one of us and you dont toe the line and believe we do, well kill you, too. So this is a different a very Different Organization of al qaeda. Al qaeda never really took that line. And now were seeing isis sort of clone type organizations in Northern Africa that are swearing allegiance like they did before to al qaeda, al qaeda central to isis. In mali and in Northern Africa. Certain elements, boca haram are doing that. So, were getting these sort of almost nihilistic totalitarian organizations controlling a lot of territory. Very little is getting into these places that isis doesnt approve. The International Committee of the red cross says that it did manage to provide some medical equipment to a hospital in mosul, which isis controls, and the icrc says it has established contacts with some people inside fallujah in iraq but these are very, very small efforts. So thats the situation as i see it. In that particular region. And were facing a very difficult situation underresourced as our two previous speakers said. Thank you. [applause] we can do that during q a. And foreign fighters. Im a grandfather. Young men. Worldwide, find ways to get in trouble. I dont care where theyre from. And tunisia and other places nor except. It could be through video games or through drugs or alcohol or Something Like this, but fortunately at least in the west and in europe, the outlets for getting in trouble are much wider and much leslie than that they are in that particular it is not surprising young men of that age would see something everybody wants to be the person in the video games. A lot of thank tunisiaens. And they went for a better life and were attracted by these groups by because they were separated from their real families, they had to find a virtual family, which was on the internet someplace, and they get sucked into these groups. A lot of them went to syria. Now theyre recruiting within tunisia itself. A lot you can blame on the economic, the social despair they have, but essentially theres always a group of young men that are going to find ways to for excitement and to get into trouble. Would you like to make any commends now . Okay. Many of you have come to these programs [inaudible] is that okay . Is that live . Many of you come to those programs and theres always one golden thread that runs through them. Its the sheer, the gold, the richness of what is said. I sometimes find it difficult to pull it all together in my head. I think today we have a fairly common set of themes. I thought initially we would be talking about the fear, but i think were really talking about the underlying reality so we dont have to get into the excessive reaction. Someone mentioned the core fear. And i think both let me talk about isis briefly. We have had a program on isis before, called isil at the time, and i think yonah or someone called it a terrorism. But i think its probably deeper than terrorism. Terrorism is simply one of the things that is spawned. This is something we really have to be concerned about. I think we have seen the collapse probably of the middle east. Its interesting. Someone mentioned that yesterday was the 91st anniversary of the establishment of the turkic public, roughly the same time at the end of the caliphate. I think theres a real unraveling there. The problems are profound. I think, as so many of these problem, when america fear comes from ignorance, but on if youre knowledgeable and not afraid, its very hard to get a total grip on the underlying reality and this is something to come back to again and again. Yonah has been drawing the arc, and the arc keeps growing and its definitely there. On the other side, i didnt see how we link ebola to this but now i see. Its really the inadequacy of our ability to cope. Yes, difficulty in coping with isis, but maybe even a greater difficulty coping with ebola and then possibly bioterror, and i think there you get to something very deep and american, which is our priorities. Im a republican, certainly not a peaparty republican. Now, the disinclination of americans to spend money on public goods, the belief that private life is what its all about, the buildings, beautiful houses, meals, we think theres something wrong with our manhood in wanting to spend money on public goods, and yet we do that at our peril. Its not the same as what yonah said before. He said before as we cope with security problems, we mustnt neglect of civil liberties. I completely agree. Im a lawyer and lawyers tend to be concerned with that. Theyre not the same. But in regard to our liberties is related to our regard for our untrampled freedoms, unwillingness to sacrifice in the sort and longterm, and i dont know whether even in the face of emergencies, crises, what we are not is marines. General gray is a marine. The military has a discipline. The civilian publics of owest do not have it. So i think were going to lurch and lurch and lurch and do incrementally, your word, little better, but were just going to have to put up with and it i hope we dont succumb to fear in the process. Open up the discussion here. Its not just a question of fear. Its the question of hope. So, the big issue is that we tend to exaggerate sometimes the fear and the hope. We pray, we hope that things are going to improve. So, we have to start some sort of a realistic [inaudible] not be surprised all the time. I think you raised your hand. Would you please identify yourself. Thank you very much. Mike craft. I spent many years in the counterterrorism state and have been working on the ebola issue with a group called the Global Health response reliance. I think theres some parallels. In fighting terrorism one of the things, especially by president bush, was we fight them ove