a real treat because we not only have the founder of you in a, a united nations aid program, but we also have the current executive director. so we have that's true continuity that spans several decades, believe it or not. i think it will have a very lively, fantastic conversation. what i, of course, brings us here today is no time to lose, of life in pursuit of deadly viruses. i think it is important to recall that it is a memoir. it is not an attempt to write in the definitive history of anything, but rather, an attempt to describe how the world and the history developed through the eyes of key players who really live on the front lines at each individual step along the way. because it is far more accessible, at times, almost a roller coaster read through an adventure cycle. and, i suspect it will prove to be a recruiting device for the next generation of epidemiologists, infectious disease specialist and public health leaders. it makes is seen, while, one of the most fun things to possibly do to life. one of the temps, we experience it at the same time, but from a different perspective. we both were on the front lines watching and the disease unfold which later came to be known as aids. san francisco. we both watched as as series of events unfolded that brought us to this collision course that we are on no in global health. and actually, of course, i wrote in my first book, the description of the 1976 about break in which peter was a key player. get tense talk about all of these. we're going to do today is peter and they're going to have a conversation for about all of -- 20 minutes. then we will bring michele into the conversation and open it up to all of you here in the audience. if you have questions try to remember them. so, you are a whopping 27 years old. you have finished medical school, but you were just getting started your ph.d. efforts in microbiology. thence into the of tropical medicine and antwerp. the mysterious tested samples show of in terrible condition, and you figure out that there is some new disease in africa. you have the heads but to turn and say i'm only 27, but i want to go there. i want to go to africa. let me go. i want to be in the middle of this adventure. where did all of this come from? >> i am actually a pretty timid and cyprus in. >> oh, yes. right. my mother always speaking. i think i am a bit different. first of all, i had an incredible urge for discovery from when i was a child. well as a teenager i like to have worked for a travel agency and when mount -- one month to morocco and one month to turkey at the time when there was no terrific infrastructure and only one goal in life. the combination of the sense of adventure, but also their curiosity for things. when i was this allies sy also at not much respect for anarchy and authority. so, yes. that is why i said, let's go for it. the steward. twenty-seven. also, later on most people, they actually would not go jumping up and down. >> the hellhole. >> i guess so. bricks coming away from the way you describe the episode there are four things that i think are the keys, experiences are realizations, the moments for you out of the ebola in 1976 episode. because this strange test-tube and 27 year old flying taffeta for the first time is as it turns out the ebola epidemic. you experience africa and fall in love with africa. >> right. >> secondly, you discover internationalism and all of the difficulties of coordinating and working together with scientists and all sorts of other folks around the world and you discovered the relationship between global inequity and real disease. if people are so poor they don't have a sterile syringes there will be spread of disease, and then you discover a do-getters. to better if they were up there in the first place. the stick is a part. what was it that this one from a study several flow of wind be. >> i think it was the people, you know, that human side, the creativity. i cannot hide also the music. >> so much to do, incredible need which is still there. and the will to improve. so i saw opportunities which i think are very underestimated today in africa. when you look at just growth of gdp today, the highest rates are no longer in asia, but africa. announcing that effort as needed, we have seen it natural resources that are there. if i did not know all these things done, nation and the want the people, the human side, but also to my gut also very upset and angry because of the inequalities. there was a group of people stealing the country to death, chilly. on the other hand, young people, a great university. you know, but nobody would stay. no electricity. so people were denied basic of obscenities, but i cannot explain it. i was bitten by the virus of africa. >> a lot of dancing. many times when peter is so ecstatic he breaks out dancing all over the place. now, this also was your first experience trying to work with american scientists. the americans came in and said, we are in charge. particularly kirk johnson from the cdc. and, you found african colleagues to cover it with and fellow belgian scarpa to go some accountability after you'd been there while. dahlia of what you learn in 76 that gatt is euphoric about international cooperation? >> when i discovered that where i came from the means we had both financially and technically were far inferior to what was available here in the u.s. and whereas i resented that hebron, the folks from the cdc came. they said, okay, were taking over. and so i resented that, that's absolutely true. then i saw that i could learn some much. really initiated me into field epidemiology. i am grateful for him. and it was not only the u.s., but that is like in some of these jokes. i mean, a frenchman and a south african and britain and the belgian and an american and a plan. what happened. the power of coming up from different perspectives. but i was very impressed by the technical superiority and the strategic superiority of the american colleagues. so i was there a set, i want to go to america and learn just see . next time we find a new virus i can be in charge also. it was the only for myself, but just to become a unit, to share this. i came back to belgium. >> the sad thing you discovered after seeing patients bleed out, the horrors that are ebola, if you have not seen it, is a very terrible disease and an awful way for anyone to suffer for dying. particularly sad thing for you as a flemish kid growing up in belgium at a time when french speakers were the dominant, you know, power structure. all hell down. and you get out into this very, very remote village and find out the responsibility for it all really restive behalf with fellow flemish catholic missionaries. >> right. >> tell us what that meant to you. what did you discover? >> on the one hand i was full of admiration for this woman. hard working, dedicated. they're running a hospital. not one person who had formal training. not enough wanted to do good, you also need basic confidence. you need to have basic entities. everyone who comes, you only have three or four syringes and a few more neals. so that was one thing. the other hand, i also discovered that it was like the times to still. these were flemish who had left the years before. there were still thinking as if time had stood still in bills and also, which you find often with expatriates'. they have an idea, the country of origin that does not go as far anymore with how it evolves. and so that was also, it reminded me of my grandmother, my ancestors. that was something i had not expected. winter, the equator. that very adapted. >> even today you are still in touch with one of them. >> yes. the congo river. the river is about 20 kilometers wide. just incredible. he is there, but now in contact with him by e-mail. and when i talk about this, they stare at me as if i'm coming from the stone age. not even cell phone. satellite phones to not exist, no facts imagine that, facebook. so communication was very slow to say the least. but now i'm still in touch done and he is really, has started second school. in some sort. you know, in theory in condo outside the nation's nothing else is functional. so that is also the reality. >> to fast forward a little bit, last time anybody took account that i saw in the post 2000 para 60,000 ngo related to aids in africa alone have been created. and when you think back to those missionaries to thought there were doing the right thing but to my goodness, if you don't know how to use syringe is properly and the basics of sterile hygiene, perhaps it would be better you get there in the first place. what do you see looking forward to this explosion of ngo that can be informed by that experience? >> the good news is that global health did not even exist until 12 or 30 years ago, i try to figure out when it appeared for the first time. global health created by these movements. but so the incredible interest and money, great news. but on the downside, not always going with the most professional approach. so the key is to combine the enthusiasm, dedication, commitment with know-how and with strong evidence based practices. that is that always there. that is one of the reasons i was so interested to move. even if i said never again in academia. now here i am. now we want to train the next generation of leaders in global health. >> in 1979 he participated an autopsy on a belgian sale warehouse. you say in the book, i was not some smart enough to see it was a new syndrome, but i knew we had never seen anything like it before. and it was. >> aids. .. but when you are immune deficient, you can conclude so we've never seen that can't they were cut in these microbacteria. very strange and then we started seeing some others. it's the same way that aids was described in this with other opportunistic so to use the nicu decided in the sexually transmitted diseases are acutely important, and it's so interesting that you adopt that as one of your major interests when almost anybody else -- and there's all this culture, and you come to the united states and you get a whole bunch of training in that area the never city of washington he's still there in seattle and a leader in s tds. then you go back to 1983 with some of the same people in the 1976 able lot epidemic. you're in that massive -- anybody that's ever been there knows what i'm talking about massive colonial hospital, and you say in the book -- you wrote in your diary incredible catastrophe. this is what i want to work on. it will change everything. what would change everything? what were you looking at? >> one of my observations is they've lost their mother and they have all kinds of things, but i've been there in 76 and here i enter internal medicine, men, women who would young men and women in these days of age all kind of these opportunistic some we had like 100 cases and patient coming and that's why we went there. it was so overwhelming because i knew that it was not there and the head of internal medicine hat put aside for us like the 65 patients in the previous month or so and this was the extent of it. the fact that it was slightly more women than men let's not forget that in 83. i never understood why the virus would care about its host because the purpose of a virus is to jump from one host to another. so i saw that and i said i can't believe this must be -- it's heterosexual is one thing i said and there's far more in the world and the same sex sex and women from my studies on sexually transmitted diseases they were free rampant and it's going to be a catastrophe, and unfortunately i was right. >> host: you together with a jonathan mann said of the aids project and the first time we met was 1985. it was the first international aids conference in a land of georgia, which had almost -- >> hard to believe because the upcoming had about 25,000 people. and first of all, i don't think we could possibly have imagined -- i know i couldn't -- in 1985 at that meeting. but we were at the front end of something that would still be around in 2012. that would by then have second or killed about 74, 75 million human beings. but in 2012 there would be 34, 35 million people live with this disease on every continent in the earth. but what i've remember most about that meeting is there was a moment when this very tall white guy was transmitting for a much shorter fellow, and a cluster of us were standing around you. and a wall street journal reporter who was absolutely sure that hiv was a gay disease wouldn't accept the notion of general heterosexual transmission. so, isn't it true africans have sex moore i remember this region your face changes colors and you knew that you have to respond. >> why was this call white guy and it gave him time to think. then he said i'm not aware -- we don't do this. but i [inaudible] [laughter] >> don't people go to see donkeys. but if you think about it, and i do want to bring michelle and in a moment. but to flash for word and frame that period because your title is no time to lose, and all through the book you express the sounds of urgency to respond and regretted that the response wasn't faster. and if you look back to that critical period in the 1980's and 90's before we had effective treatment in 1996, we had many moments when interventions were blocked because of the human rights issues. so we never could tackle the we that we did syphilis or gonorrhea. and the rationale for not doing so was well, there's treatment for syphilis and gonorrhea. there is no treatment for hiv. if you identify someone as hiv-positive, it will simply be a life of discrimination. when you look back, do you feel there are tools of public health that we fail to embrace powerfully enough putting aside the blame to international political leaders but within the public health arena, are there things that we look back and feel we should have done this, that and the other thing before we had madison? >> we definitely wasted a lot of time buy not recognizing how the presence or the prime minister's capture could simply not even pronounced the word until the very end which is that means something. so the fact that the lack of willingness to deal with the issue it was in the category of sexually transmitted diseases. >> also moved later on he when it came to treatment, and i know that we in the government talk about that later but it was a public health community and was the biggest problem we have all these meetings. i think there will probably somewhat absurd activist demands, like i was shocked in atlanta there was a whole campaign which i didn't fully understand. on the one hand it's true that because of the discrimination and the stigma that all we could offer was a - the sentence and then you would lose your job and insurance and so on. but i think that is prospectively we should have what can be done but you can't see public health for what's going on in society. >> but we have a kasich symbol, a tremendous victory come and it didn't catch on. it didn't go by role as we would say today. and that is tolerance. if you look at the late 1980's, the asian development bank has predicted thailand was going to collapse under the pressure. the 17 year old rickards into the military running as high as 3%. hiv-positive at the age of 17, and by the time they were 22 in the military, the rate was way beyond that, and looked catastrophic. and if they had no tools accept condoms and they brought it completely under control. why didn't that become the model for the world. why did we all look at thailand as if it were this isolated case. >> i think that is a good example of why did it work in thailand because of the strong leadership and not worrying too much about public opinion and 100% condom promotion. it was enforced in a way, you know, with not only public health people but it was of course the preserve time which is worth billions of dollars. but it's something there was no willingness to do. even today you see an ad for condoms on primetime and tv. >> on mtv we do. >> it is this double standard about sexual out with the and not wanting to deal with this. islamic even today the example doesn't resonate. >> but it's also published for example they are not dealing with gay men or injecting drug use and they don't want to go to the new e elections maza they were effective with the office of the prime minister and it's not the ultimate success and branding. >> i can't move on without giving you the opportunity for two of your most remarkable. first, an office if i remember right was mahogany line and everything about it seemed like it's gone to oxford. there's a gentleman sitting expensive scotch and smoking a pipe coming and he's telling you great paranoid conspiracy theories. and you cannot we cannot. who is that gentleman and what did he cost african lives? the encounter in conversation he said don't you know this is a conspiracy that the western pharmaceutical companies and it's always been a mystery why such he some good things come strategic thinker could believe such a thing. and that has cost about 300,000 lives according to the study because it delayed the introduction of the antiretroviral therapy of the prevention of mother to child transmission in the country, and maybe also some neighboring country although the colleagues may be sometimes they will listen politely but they didn't follow. now today south africa house and the largest hiv treatment program in the world, and things have changed. but it's a tragedy. and it must be -- i don't know why. i really don't know. >> in a very different mood, you are with someone who seems like today's of rum follows the description but an ample quality is consumed to discuss mandatory quarantines of hiv-positive people in cuba and this is with fidel castro. >> yes. i went to cuba in the early days for several reasons. one, there was the quarantine. most of the cubans with hiv or former soldiers in the military who were fighting in africa and can get infected with hiv and were long lockdown basically. and in a conversation with castro, human rights isn't something that is discussed, so we talked about it basically that it's not effective. that it doesn't work, and today what's happened in cuba is that when you are found to be hiv-positive can have to follow a six month course i don't know if it is a few months ago in the case to prepare you for the drugs are there and then many people become hiv educators for the state employees it doesn't matter what they do. but the first time i met him it was in the middle of some kind of a tornado so i knew he was talking about how many leaders. how many liters per square meter and then also i said i came here to talk about aids and express my solidarity affected by the floods in cuba. >> and then they start talking about how many cases in jamaica, how many there and so on. and then anyway, despite the fact that it had been the professor i have a hard time remembering these figures. and then he said okay so we went to the office. i just arrived from europe, jet lag. we don't drink water. okay, mojito. in a long story short, we ended up with he called and half of the government and the vice president and we had dinner and we talked a lot about all kinds of things. including the decline of the imminent decline of capitalism. >> well, i would like michele to join us and as she is coming to this stage it's interesting, you end up deciding to go for the job of creating this new agency in the human called united nations aid program. it didn't even have a name and then that it's a new entity that is going to happen and there are two african colleagues that offer smart advice. kofi annan says the where the sea is full of sharks he's not the secretary-general of the u.n. at that time. >> go ahead. >> if you fall into the water [inaudible] [laughter] >> then he was at unicef at the time. >> was th