Resolutions that will expire sometime middecember. It will be up to a lameduck session of congress right before congress to take defending that right before christmas to take the funding. Host thanks for the information. Is twitter handle abettel. Midterm elections two months away, the Associated Press reported today that there will not be an executive action when itident obama comes to immigration. At least not until after the midterms. There continues to be congressional reaction to that news. John boehner releasing a statement that reads there is never a right time for the president to declare amnesty by executive action. The decision to simply delay this deeply controversial and possibly unconstitutional unilateral action until after the election instead of abandoning the idea altogether smacks of raw politics. Responding to the president not taking executive action. Bill nelson tweeting this was the right immigration called by the president even the tea Party Struggle hold on the house gop. Scalise with another take saying the president must abandon attempts to issue blanket amnesty by executive order and focus on securing the border as the house did. , everylexander tweets voter this november should take into account this shameful president ial action. With congress returning monday, here is a message to congress from one of this years cspan Student Competition winners. The foods most often genetically modified are tomatoes, corn and soybeans. According to the usda, approximately 90 of all corn and cotton and 93 of all soybean crops planted in the United States are genetically modified. Despite suggestions of noble intent they are genetically modifying rice to treat vitamin a deficiency throughout the world. There are people starving in africa. If we can get them food they need, why not . The safety and nutritional value of gmos is inconclusive and highly disputed. Theres no difference between if you ate all organic or regular. It will not improve your life or nothing. Who is responsible for determining whether or not gmo foods should be labeled, band or simply ignored . You decide. Wednesday fort the student cam documentary competition. The director of the National Institute of allergy and Infectious Diseases predicted that the Ebola Outbreak in west africa will soon be recognized as a security issue. It was part of a discussion on Political Health challenges come specifically in developing countries. Hosted by the center for strategic and international studies, this is 1. 5 hours. The summer is over. We are off to a very good start here. Thrilled to come together as a celebration of and this major opus on Global Health law that has come out this year. Mary raised the idea about having larry raised the idea about having a book event. We are honored to be able to do that. He has done so much over the years. He hasic output had so much influence over all of us. Such a constructive, forwardlooking, gracious way that we just thought this was a great occasion. Thank you, larry, for letting us picked this up. We are thrilled to be able to do it. This as aand do conversation around the big question. The big ideas. Lets try to bring in some of larrys closest friends and allies over the years who can help in this celebration and a deliberate, proactive, brisk discussion. That and hasto , the leader of any naiad. We will be joined by tim evans from the world bank. The way we are going to go about doing this, we are going to run up to 4 30. We will see how things go. We are going to open up with larry saying a few words about his work. It is the culmination of many years. Large,t just the only comprehensive, encyclopedic, analytic work. He has done this in a bunch of other areas. I wanted to have him offer a few quick reflections. The genesis, the experience of building the book and what it taught him. We will morph from there into our discussion. Our discussion will be structured around two big questions. That our very future oriented. Pretty much trying to get us thinking about the future. ,he first one is going to be what is the single biggest challenge or problem we need to keep our focus upon, looking ahead over the next 510 years . What will that be and why . We have an International Law expert and tony coming at this from the perspective of someone involved deeply in the science, research and development of technology. Whose life iseone centered in the science delivery and implementation programs. That firstin with question and then morphed from there into whether we believe to biggest idea will be spur innovation. Welcome her to thank you all for being with us. Welcome. Thank you all for being with us. You are all folks we call upon constantly and debating in debating any dimension of health. Congratulations. Its a great occasion. It is a great occasion. I want to start by thanking you for doing this. There is no place like this in washington. You have built something incredible. Friend. A longtime i feel like im surrounded by friends. Surroundedhat, im by two of my heroes that have worked so hard in Global Health. There is no book on Global Health law and governance. We tend to think of law as an esoteric field, but in fact the governance of Global Health is really critical. Think about the Tobacco Control or ebola. The who declared up government emergency of International Health regulations and evoke various powers and the like. What really drew me to the book was the idea of two local health marriages operating out there. One is what you hear from the really great thinkers in Global Health indicates foundation and who. That is the story of remarkable progress where we were to where we are now with incredible achievements through the Millennial Development goals of the Sustainable Development goals. That is a true narrative, no question about it. If you look at age and Mental Health and malaria, we have done very well. I also have done work Civil Society around the framework for Mental Health so i have talked to people on the ground. Their experience is completely different, a different narrative. Theirs is a narrative of deep impoverishment. And narrative few can see in west africa today quite frankly of food insecurity, human rights violation, ebola. People are afraid to go to the hospital. We are really facing a crisis there. It turns out both Global Health narratives are bright. You have improvements in Global Health, but those improvements are not equitable across the board. Equity and justice is a really major theme in this book. Basically i asked three basic questions and then i will move on. The first question is what would a perfect state of Global Health look like . If we could imagine like what we aspire to, what would it be . For that, i try to place a premium on Public HealthPublic Health services. Disease prevention and control are really important. Things that we do not think of as Global Health but it is. Clean air, sanitation, hygiene, vector control. All of those things make life much more livable. The second question is what would Global Health with justice look like and the third is how we would get there . If you do manage to pick up my book from the outside, i think the best part of it in the best advice from harvard, they said do not get someone like bloomberg or bill gates to write the forward, no one cares what they think. So i did. What we have in the beginning are Global Health narratives, stories from children around the world in their own words. It is really powerful. It is really important for us to capture the idea of what it is like to live in a poor country filled with injury and disease. Without further a due, we can get on to the important part. I did not mention at the outset that over the course of the discussion we will open things up and hear from you. Please think about your comments and questions as we move through this dialogue. We will get through this quickly. Do you want to begin by offering a few minutes of thoughts about the most important problem and challenge . Come on up. We are just getting rolling here. Welcome. Great to see you. Why dont you kick things off with a few things around what is the biggest challenge we face in looking ahead . I think the biggest challenge is equity and justice. I mean this tobacco guru lipservice is very small. They argue with one another. I do not know how i got part of it, but i was. They talk about and games and tobacco. They are very popular with aids. Talk about end games. You can get it with all these different areas. I asked them an ethical question. I said suppose you could get to the end game in tobacco, which means you have a prevalence rate of percent or less, but you still have mentally ill, poor, workingclass with relatively high rate. Would that be ethically acceptable to you . Every single zealot said yes, it was acceptable because the main goal was Health Improvement. I think the biggest goal was Health Improvement with justice. Trying to look and make the world a place where it does not matter if you were born income paul a or new york in apollo or new york or mail or female or with child or an adult or sick or healthy, disabled or not. What matters is that you have equal opportunity and to live in the conditions which are healthy. One thing that really struck me, i came back while i was doing the last chapter of the book from a very typical subsaharan african city. I came back and i realized i really was not feeling well. I did not have malaria or anything like that but my throat was bad from the fumes. My tummy was a little bit bad. I just realized when i came back from any of the lower Income Countries i did not feel well. And that told me something. Thats when where euclid makes a lot of difference. It was not the doctors i concede that the environment in which i laid in which people live every day of their lives. Thank you. What i picked out is the single biggest challenge or problem for the next five or 10 years is one that is certainly not new or creative but very real. It really has to do a bit with what i am as an Infectious Disease person in dealing with the problem as i stated is the disparities in health and developing versus developed world, which relates very much to the justice that larry was talking about but i am particularly involved in this with the arena of ebola. Let me just take my 2. 5 minutes that i have left to go over that with you. I always talk about disparities in health. You talk about malaria, malnutrition, lack of clean water all of the things related to countries that are not resource rich or are limited in resources resources related to health. The thing that has impressed me like nothing else is what i have experienced over the past couple of months with ebola. Some of you may have heard me say, and i always get the question, should we be worried about ebola here . The answer is someone look it on a plane from west africa and end up in west africa or london and be well on the plane get here, get sick, go to an emergency room, get sick, maybe die in infected nurse or doctor and everyone will realize it is ebola. There will be isolation and the proper precautions in the outbreak would end their. In west africa we are dealing with a situation where we are seeing an exponential case with 1500 plus deaths and the projections of going to 10,000 cases is not hyperbole because now the curve is exponential. The reason it is happening is because of the disparity in health care capability. That is the only reason it is happening because you cannot have infection control, no infrastructure for isolation. No infrastructure for quarantines and properly and no infrastructure for Contact Tracing. If there were the first two or three cases that were in the United States, it would be very frightening to everyone, all over the newspapers but it would stop. So i was adding prepared to get my three minutes of what i think the granite greatest challenge is is just that. There would not be be ebola academic if there were not absolutely does an stunning disparities upheld in the west african countries compared to our country. Great. This is going to be a bit of a repetitive theme. There may be selection bias at work. Let me first apologize for being late. It was something called ebola consuming many of us that are directly or directly involved in the response. I do not think today there is a greater challenge, because i think it is symbolic and indicative of the vast disparities that continue and which not only threaten the countrys and the economies and stability and security, but certainly has made it clear the west african context is increasingly shaky with respect to containment of ebola and the rest of the continent and therefore the rest of the world. But i wanted to first begin by saying congratulations to mary. To larry. I do not know larry as many as well of as well as many of you but i have always thought from a distance he has been a massive leader and really writes what he talks about so eloquently and that is bringing the discipline of law to Global Health and i feel this book that i have not read but will give it a glowing endorsement based on your reputation, but congratulations, i am delighted to be here. Having wasted two of my three minutes now or spent them on more important things, add my two cents on this. To me, the biggest challenge is inequality or in equity. In between countries and within countries, the fact that you have major gaps in Life Expectancy and Health Achievement in this country with all of the means that it has to is an assault on a fundamental sense of justice. I think it is also one that civilization needs to move increasingly to evaluate equally, no matter where they are based. I think that i ethical principle needs to be much more fundamentally ingrained in everything. The challenge of that is multifactorial. I think we will have more time to chat about the points of entry to really allow the principle to manifest itself in a meaningful way. I would say, however, that relative to where we were 20 years ago, there has been a massive mobilization and something called Global Health or around Global Health that has multiple manifestations, which i think embodies to a significant extent this sense of impatience and intolerance of local inequities in health, and i am personally encouraged we are moving but when you look at the ebola crisis today, it is clear we could move an awful lot faster, and i think we have to look at how we can do that. When ebola first came to our attention earlier in the spring and the initial response was it did not look that different and we moved into april and june and perceptions began to change, there was a certain confidence in the ability at that time to still use the tools we had to address this. There was a recognition that the inequities and gaps were feeding along with distrust, mobility and speed that was happening. Inequity was recognized in west africa. But i do not sense people made the leap from that to say the inequities of that kind were more than and normative consideration, that they were more than something to lament as a reality of life versus something that is normative and ethical. Also something that strikes security considerations in a way that would motivate people to see inequities as something that requires much more aggressive action. Today, when you look at what is happening with the exponential leap over the past six weeks, one of the stunning things to me is that it is not registered as a security issue. It is competing against some ready formidable geopolitical crises, in which there are no fewer than three major ones. The field is very crowded. When you all raised these issues and reference the ebola crisis as a very poignant and excruciating example to witness and our lifetimes, the backdrop of dramatic gains made in the past years, how do you make the case, the security case . The inequities are the ones that have to be addressed. I think we are still struggling today as this crisis unfolds. We are still struggling how to make this for not just our government but many others. I think you are very insightful. You raise a lot of important questions. Undoubtably it is a geostrategic security issue. The whole region that is destabilized. Ebola is first and foremost a Health Crisis but has traveled and cut off food security, employment, the economy, to that he. All of that is down. Focused on the whole region of the world. There has been international spread. The who has invoked a Public Health emergency. And yet government has and basically left to itself with the u. S. Government and others but not at the higher u. N. Level that we need. I think it is clearly a security issue. I think my worst fear is this could be another haiti where it mobilizes a huge humanitarian response. Then when the humanitarian response gets up and leaves, the same conditions exist. You still have the fragile Health Systems. You still have enormous deficits and doctors, nurses, midwives. Already there are places like sierra lyons and liberia that have Something Like one 20th of what they would need in terms of health work force. And yet they have lost a lot of nurses and doctors to ebola. What will happen when we do contain it . We will eventually and then move onto the next thing. This is a Development Issue as w