Were in their height, the number of private security contractors outnumbered the us troops. How did that come to be . Again, i think we are like that one of the unintended consequences of relying on the all volunteer force and allowing the country to slide into a condition of permanent war. We ended up with too much work, too few warriors and so policymakers and the pentagon turned to the notion of defense contractors to try to fill the gap. At a very high cost. At a very high cost and i would argue with little evidence that they that they were worth the money. I know youre going to stay around and sign some books i want to thank you, colonel, professor,. You know, we barely scratched the surface of this book, so i really encourage you to pick up a copy and you will have a very indepth although somewhat pessimistic understanding of the wars of the middle east. Thanks again. [inaudible conversations] [inaudible conversations] this is book tv on cspan 2, television for serious readers. Heres our prime timeline appeared tonight starting at 7 00 p. M. , Richard Sachs reports on mark twains trip around the world and at 745, three war correspondents share their experiences and the challenges they faced in the field. On afterwards at 9 00 p. M. Eastern, former inmate shares his experiences during his 19 years in prison and his thoughts on prison reform. Then at 10 00 p. M. , a panel on and we wrap up the tv in prime time at 11 30 p. M. With Charles Kesler of the claremont review of books. That all happens tonight on cspan twos book tv. [inaudible conversations] welcome, everyone. Can you hear me . Im rebecca from the university of virginia and im delighted to be moderating this panel today, dark tales of contagions with two outstanding journalists and authors who are both currently living in baltimore, and have come down to share their stories with us. We are going to be on a tight schedule, which i am responsible for keeping. We will look forward to about 15 to 20 minutes presentation from each other and then there will be ample time for questions. I would like to remind, request that everyone silenced their cell phones. Would also like to especially since i would like to remind everyone that the virginia festival of the book is pleased to keep most events free and if you would like to help with that , please, consider a donation. My third request is to please evaluate this session as the festival is always working to improve its offerings and finally, we will have books for sale here and in local bookstores throughout the festival and we hope you will be interested. So, without further ado i would like to introduce sonia shah to my far left. Sonia shah has written the book under discussion today, pandemic as well as other books. She is a prizewinning author and a science journalists. Her has appeared in the New York Times, wall street journal, Foreign Affairs and she has and a stout outstanding talk on eliminating malaria. If you want to take a look at that also. She focuses on the intersection of science, politics and human rights and will be discussing her new book with us today. We also have Karen Masterson who is former political reporter for the Houston Chronicle and the Washington Bureau of the Houston Chronicle and she actually left newspapers to pursue a interest close to my heart into the hearts of many in this room, microbiology. She won in 2005, the knight journalism fellowship to study malaria at the us centers for Disease Control and prevention in atlanta in rural tanzania. She has a masters in journalism from the University Maryland and also a masters in science writing from hopkins, where she is now a teacher of science journalism. She we are delighted to have you here, so again welcome. Please remember to keep those cell phones quiet. I know we will have a fascinating discussion and i would like to turn the microphone over to sonja. Is this on . Know, okay. So, when i wanted to do with this latest book this is my fourth book and i wanted to look at how it is that microbes, which are these little microscopic things that have no independent locomotion cause these highly disruptive deadly events that we call pandemics so the past 50 years we have had about 300 infection pathogens that have either newly emerged or reemerged into new places where they have never been seen before. We have had in bullet in west africa, never seen there before. We have the zika virus now washing over the americas and has never been seen here before, novel kind of influenza, new kinds of tickborne illnesses, highly antibiotic resistant pathogens, thought id try to do is track the origins of these things and what i found is a lot of them are coming out of that environment. About 60 of the pathogens that are coming up today come out of the bodies of animals. Over 70 of them are coming from wildlife and so its happening is as our population expands, as our industrial activities expand we are disrupting and invading and destroying a lot of wildlife habitats. So, this of course, means we lose a lot of wildlife species, but the ones that remain coming to ever closer contact with us. With this novel intimate contact allows the microbes that live in their bodies to spill over into our bodies. So, from bats we got it bore the need the virus. Rumba rodents we have monkeypox and lung disease. From monkeys and chance we have hiv, malaria, probably zika virus. From birds we are getting west nile virus etc. So, these pathogens are moving into human populations and then wear allowing them these great opportunities to amplify in our cities. The process of urbanization that first started in the 19th century is reaching its peak now , so by 2030, the majority of the human population will be urban. We are going to be living in a giant cities and they want to be cities like lovely charlottesville. It will be more like monroe the country town with a lot of ad hoc developments, a lot of slums , poor of the structure. And we had already seen new pathogens take advantage of this. Ebola is a great example where we have had people are breaks since at least the 1970s, but they were always rather small and selflimited. One important reason why is because of those viruses never infected a place with more than a few hundred thousand inhabitants. What happened at the end of 2013, is that you bullet virus emerged in guinea and within a few weeks was able to reach three Capital Cities with a combined population of nearly 3 million. Thats an important reason why it became such a huge competition where we lost 11000 or more people. More people died in that outbreak than all of the previous people outbreaks can mind. Similarly, the zika virus. We have had the zika virus around since it needed at least the 1940s possibly before, but it was in the equatorial forest of africa and asia. Carried by mosquito that most of animals, so we didnt have a lot of infections in humans. But, what has happened recently is the zika virus has arrived in the americas where we have massively expanding urban populations in these tropical areas and that means we have massively expanding territories of 80s egypt, this mosquito that thrives in cities. Is an urban mosquito, not a forest mosquito. To listen human garbage and can breed in a drop of water in a bottle, so all of our plastic garbage around a little rain gets in them and this allows the mosquitoes to breed end of this mosquito is a very efficient carrier. It only bites people. But, we are not only crowding our cities together, we are also crowding our animals together. So, its not just about people. Its also about our livestock and right now, we have more animals under domestication them out last 10000 years of domestication until 1960 combined. This is because i populations are getting more wealthy, bigger and as we do that we demand for protein and more meet our diets. A lot of these animals are living in the equivalent of islam. So, we have 2 billion People Living in slums by the year 2030. But, we already have millions and millions of animals living in slums and those are factory farms where we have a million or more animals crowded close together, exposed to each others fluids and excreta. This is one important reason why we have this increase in frequency novel kinds of influenza. These influence of viruses near normally live in wildlife lower and dublin because animal sick at all. Windows viruses are able to reach these factory farms full of captive chickens and birds, they can replicate quickly. They can spread faster and they often become more virulent this is why we have seen eight increasing frequently of more forms of influenza a curried most at a major wear what must part waterfowl live. They are advancing way too fast. We are like five slides ahead. Im not sure why. Yes, thats why want to be. Thank you. The last one, just last year we had Avian Influenza patched in the giant Poultry Farms of asia regional america for the first time, cause the biggest outbreak of animal disease in us history. So, along with the crowding of our animals we are also getting how do we go next your . Okay. This is what happens when using macbook all the time. It becomes stupid. Thats my rule selects thank you. My goodness. Its that one. Number five. So, we have we still have a sanitary crisis of human waste in our planet right now with 2. 6 billion people around the world with no access to modern sanitation. They are still living in the equivalent of 19th century slums. But, what we also have now is a new kind of sanitary crisis and it is with our livestock excreta our livestock are now producing 7 billion pounds of waste every year. This is far more than our croplands could possibly absorb. So, whats happening is farmers are collecting them in things like this, mineral lagoons, essentially giant unlined pits of untreated amylase. So, when it rains or there are storms all this material can leak out into the environment. We dont have just a few airports in a few towns, but we have hundreds of thousands of connections between thousands of airports which means when a pathogen breaks out in one part of the world, it can rapidly spread to the rest of the world. This is a simulation of a flu pandemic on a geographic map. So you can see how quickly us disburses across. But the if you plot that same pandemic on all the cities connected by direct flights, you can see when it comes up that a pandemic will resolve into a series of waves, because you can actually predict where and when a city will get infected just by looking at the number of direct flights between infected and uninfected cities. Okay, this is slide is going fast. Is there something we can do . Okay. So one of the things i did in my book is not only do reporting to look at where emerging pathogens were coming from, and i went to haiti and south china and new delhi and elsewhere, but i also looked at the history of some of the our most powerful pandemics. And the i one i focused on was cholera because its one of our most successful ndemiccausing pathogens, its caused seven global pandemics since it firsted first emerged in the 19th century. We think of it as a disease of poverty, and it is that today, but when it first emerged [inaudible conversations] oh, there we go. Okay. So this is, this is a map of epidemic in 1832 of cholera in new york city. Thousands of people died. And, you know, this happened again and again over the course of the 19th century. And these, and it wasnt just new york city, it was also london, paris, new orleans, a number of cities were plagued by cholera epidemics during the 19th century. So what i wanted to look at is how that happened and then, also, how we responded and how that could shed light on the challenges that we face today as we face our own era of new pandemics. So back in the 18, back in 1832 yeah, we can show that, thatll be good. Doctors collected this data. It shows a pretty clear picture. Choleras coming down the hudson river, coming down the eerie canal erie canal, headed straight for new york city. However, nobody in the city of new york wanted to quarantine the rivers or waterways because this was the time of the robberbarons, huge amounts of commerce coming down those waterways. So they refused to quarantine the rivers. Oh, my god. [laughter] yeah, just make it stay there. I dont know how to do that. [laughter] my powerpoint wants to give you the talk all by itself without me saying anything. [laughter] its very annoying. So they didnt want to quarantine any of the waterways. And they didnt. And doctors went along with this x they said, well, you know, they looked at this map and said, yeah, it looks like choleras contagious and coming down the waterways, but in fact, its not. In fact, cholera is caused by these stinky airs that rise up from decomposing vegetable matter, organic material. And this is based on a 2,000yearold hippocratic theory. And so they said, no, no, its not the waterways, its just these bad smells, and you know whos to blame for these bad smells . Well, its the poor, its the immigrants, its the drunks. So cholera came down the waterways and affected new york city again and again over the course of most of the 19th century. So theres actually companies that were making money selling choleracontaminated water to new yorkers in the 19th century. The epicenter of a lot of the epidemics at the time was in a slum called five points which is pictured here. And this is a slum, this is a slum that if anyones seen the Martin Scorsese film gangs of new york, that was about five points. Very crowded, very dirty, you know, very, very crowded place. About 77,000 people per square kilometer, six times more crowded than tokyo is today. But this slum had actually been built on what was once a pond. That pond had been filled up with garbage. And then the slum had been built on so much that. On top of that. Now, there wasnt a sewer system in 19th century new york. There werent even rules that you had to empty out your yes, sir pools and privies. It was cesspools. Now, of course, in this area the groundwater underneath this slum in particular would be extremely contaminated because the ground underneath it was lowlying, it was filled with garbage. It wasnt bedrock like the rest of manhattan. Now, the company that the state of new york charter ored to deliver chartered to deliver Drinking Water to the people of new york rather than tap upstream sources of water which they knew at the time would be cleaner, fresher and would taste better, they tapped a well right in the middle of that slum. And they delivered that water to onethird of the residents of new york city. And they did this over the course of centuries through repeated epidemics of cholera. And the company that did this, as an interesting aside, they did this because they wanted to save money. Sort of like what happened in flint, michigan. They wanted to save money. The reason they wanted to save money is because they wanted to start a bank. The companys called the manhattan company, the bank was called the bank of the manhattan company. Does anyone know what the bank of the manhattan companys called today . Jpmorgan chase. Yes, thank you. If i click the mouse, its terrible. Sorry. That one. [inaudible conversations] okay. So ill end the story just by telling you how cholera vanished from new york city, because i think its instruct i. Instructive. Eventually, new yorkers moved the well from there to up there. But they didnt do it because they wanted to uplift the Public Health. They didnt do it because the people of new york were screaming for better water. Which they knew would make them more healthy. They did it because the local brewers wanted better tasting water for their beers. They felt like this stinky water was putting their beers at a disadvantage, especially to all the brewers in philadelphia. So finally they moved the water intake, and cholera vanished from new york city after that. A century of cholera pandemics ended. And this spread throughout the country and throughout europe as well. So the question i have is, of course, we can do a lot better today in our era of emerging pathogens. But its really as this story to me says, its not necessarily about our technology. Its really a about whether we have the political will to do it. Thank you so much for listening. Ms. [applause] okay. So now were going to welcome Karen Masterson, the author of the malaria project, and i am going to switch with you, sonia, so i can imagine the pc. [laughter] [inaudible conversations] im a mac user as well. [inaudible conversations] okay. So i came to Global Health issues and microbes by accident. I was actually a political reporter. I was an environmental reporter before that for the philadelphia inquirer. But i was looking for something completely different, and i stumbled upon some records that talked about how our researchers during world war ii infected State Hospital patients with malaria so they could test new drugs on them. And i, this was shocking to me, and i couldnt find a whole lot of historical treatment of this. And as i kept pulling threads and searching through boxes in the archives, i realized i was in uncharted territory and that i had to tell this story. I didnt know much about world war ii or malaria, didnt know much about bioethics. But i got up to speed because this was a fascinating story that i wanted to tell. I actually wanted these slides to be deleted because i have 60 slides here for 15 minutes, but ill whip through them as fast as i can. These boxes look like this, the records, a lot of them were stamped top secret because this was a secret project. The world was at war, and nobody had a good malaria drug. And before normandy, most of the fighting happened in highly ma lair yous areas. If you had a weapon against this disease, you had a leg up on all the ballots. So our government battles. So our government, the Roosevelt Administration opened the spigot for this project, hired 400 scientists, 50 universities. Most of the American Drug companies came together to find a bomb. It was funded under the same Umbrella Organization of all the wartime science projects including the manhattan project. There were, the reports were in blackout, they couldnt be published, so they were written by the lead investigators and sent to a central clearinghouse at Johns Hopkins university, and there they met every month, the scientists, so that they could compare notes. I figured out how to not be totally judgmental of the scient