Thanks for this amazingly but. [inaudible conversations] will come. Clearly universities the virginia then i am delighted to be moderating this panel today. With two outstanding journalists and authors to both currently living in baltimore and share their stories with us. We will be on a tight schedule which i am responsible for keeping the will look forward to about 15 or 20 minute presentations from each author than ample time for questions please silence your cellphone i would also like to since i am so excited about this panel to remind everyone that virginia festival of the book is keeping most events free. Please consider a donation and my third request as the festival is always looking to improve offerings and then we have books for sale here in local bookstores throughout the of festival so now i would like to introduce our speaker to my far left. Sonya has written the book under discussion today as well as others a prizewinning author and a science journalist. Per work has appeared in the new york times, wall street journal, Foreign Affairs and the outstanding ted talks on eliminating malaria if you want to take a look at that. She focuses on the intersection to be discussing the book with us today. We also have Karen Masterson from the Houston Chronicle and to pursue that interest close to my heart and on microbiology and to study malaria at the u. S. Centers for Disease Control and prevention. She has a masters in journalism and also masters in science writing where she is now a teacher and a science in journalism and she lives in baltimore with her husband and twin daughters. So again, welcome. Please keep the self homes quiet we will have a fascinating discussion i will turn the microphone over to sonya. I want to look at how microbes which are the little microscopic things these highly deadly events that we call pantex so we have had 300 infectious pathogens better newly emerged or were they have never been seen before. From rodents we have lung disease, from monkeys and chimps we have hiv, malaria, probably zika virus and birds are getting west nile virus etc. So these pathogens are moving into human populations and then we are allowing these great opportunities to apple if i in our cities. Now the process of urbanization that first started in the 19th century is really reaching its peak now so by 2030 the majority of the human population will be urban and we are going to be living in giant cities. They are not going to be cities like lovely charlottesville. They will be cities like monrovia in freetown a lot of ad hoc development, a lot of slums and poor infrastructure. We have already scene these pathogens take advantage of this ebola is a great example where we have had Ebola Outbreak since at least the 1970s that they are always rather small and selflimited. One important reason why is because those viruses never infected places more than a few hundred thousand inhabitants. What happened at the end of 2013 is ebola virus emerged in guinea and within a few weeks was able to reach three Capitol Cities with a combined population of nearly 3 million. Thats an important reason why it became such a huge complication where we lost 11,000 or more people. More people died in that outbreak in all the previous Ebola Outbreaks combined. Similarly the zika virus, around since at least the night he 40s possibly before that, but it was in the equatorial forest of africa and asia carried by a mosquito that mostly dead animals so we didnt have a lot of infections in humans. But what has happened just 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 this mosquito that thrives in cities. Its an urban mosquito. It lives in human garbage. He can breed in a drop of water in a bottle cap so all the garbage around a little rain did send them it allows them to breed in this mosquito is a very efficient carrier of diseases because it only bites people. But we are not only crowding our cities together, we are also crowding our animals together. Its not just about people its also about her livestock. Right now we have our animals under domestication that the last 10,000 years of domestication until 1960 combined. This is because our populations are getting more wealthy. They are Getting Better bigger and as we do that we demand more protein in our diet but a lot of these animals are living in the equivalent of slums. So we have 2 billion People Living in slums by the year 2030 and 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 really close together exposed to each others fluids and excretions. This is one important reason why we have this increasing frequency of influenza. These Avian Influenza viruses are only live in wild waterfowl. Doesnt make animals sick at all but when those viruses are able to reach back tree farms full of captive chickens and birds, bacon wrapped locate really quickly, they can spread faster and they become more virulent and this is why we have seen an increasing frequency of the much more beer went forms of Avian Influenza emerging mostly in asia where most of the waterfowl live. The slides are advancing way too fast. We are about five slides ahead, im not sure why. Thank you. The last one, just last year we had in Avian Influenza hatched in the giant Poultry Farms in asia, reach north america for the first time caused the biggest outbreak of animal disease in u. S. History. So along with the crowding of our animals we are also getting getting thank you. Its that one that we want, number five. There we go. So we have a massive, we still have a sanitary crisis of human waste in our planet right now. We have 2. 6 billion people around the world with no access to modern sanitation so they are still living in the equivalence of 19th century slums but what we also have now is a new kind of sanitary crisis and that is what their livestock excreta. Our livestock are producing 7 million tons of waste every year and this is far more than our continent could possibly absorb so what is happening is farmers are collecting them in things like manure look is essentially giant unlined pits of untreated animal waste so when it rains or when it storms all of this material can leak out into the empowerment and this is one reason why we have an increasing problem with virulent forms of e. Coli. There is an e. Coli strain, it doesnt make the cows sick but because cattle manure contaminates so much of our food and water we have about 70,000 people, americans coming down with this virulent form of e. Coli every year. So in all these ways we are driving these pathogens in term garment carrying them around in the most efficient way possible. We dont have just a few airports and a few towns but we have hundreds of airports in small towns and cities and hundreds of thousands of connections between them which means where when a pathogen breaks at one part of the world that can rapidly spread to the rest of the world and this is a simulation of a food pandemic on a geographic map and you can see how quick we disperse his. But if you plot that same pandemic on a map like this which is all the cities connected by direct flights you can see when it comes up it will resolve into a series of waste. You can actually predict where and when a city will get infected if you look at the number of direct flights between infected and uninfected cities. One of the things they did in my book is not only 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 our most powerful pandemics in and the one i focused on was cholera because its one of our most successful pandemic pathogens. Its caused seven Global Pandemic since it immersed and merge the 1970s. We think of cholera is a disease of poverty and it is that today but when it first emerged, there we go. This is a map of an epidemic in 1832 in new york city. Thousands of people died and this happened again and again over the course of the 19th century. It wasnt just new york city was also london paris and new orleans in the number of cities were plagued by cholera epidemics in the 19th century. What i wanted to look at is how that happened and how we responded and how that could shed light on the challenges we face today as we face our own era of new pandemics. Back in 1832 doctors collected data. It shows a pretty clear picture. Cholera coming down the hudson river coming down the airy canal heading straight for new york city however nobody in the city of new york wanted to quarantine the reverse through the waterways because this is the engine of economic growth. This is the time of the robber barons, huge amounts of commerce coming of the waterways so they refuse to quarantine the river. My powerpoint wants to give the talk all by itself without me saying anything. Very annoying. They didnt want to cornstein in a the waterways and they didnt and doctors went along with it. They said well you know they looked at this map and they said it looks like cholera is contagious and coming down the waterways but in fact its not. Backed cholera is caused by these decomposing vegetable matter organic. This is based on a 2000yearold hippocratic theory so they said its not the water its just these bad smells and do you know who is to blame for these bad smells . Its the poor comets immigrants, its the drunks and so cholera came down the waterways and in fact did new york city again and again over the course of the 19th century. So there are companies that were making money selling cholera contaminated water to new yorkers in the 19th century. The epicenter of a lot of the epidemics of cholera in a which is pictured here, this is a slum that if anyone has seen the film gangs of new york, so its very crowded very dirty, very crowded place about 77,000 people, six times more crowded than tokyo today but this had been built on what was once a pond. That pond had been filled up with garbage and the slum had been built on top of that. There wasnt a sewer system in 19th century new york. There werent even rules you had to empty your cesspool so all the human waste was allowed to spill over into the streets into the alleys and into peoples Drinking Water into peoples wells and down to the groundwater. Of course in this area the groundwater underneath the slum would be extremely contaminated because the ground attorney that was lowlying and it wasnt bedrock like the rest of manhattan. Now the company that the state of new york chartered to deliver Drinking Water to the people of new york, rather than task up chain change sources of water which they knew at the time would be cleaner, fresher and would taste better, they tap that well right in the middle of that slum and they delivered out water to one third of the residents of new york city. They did this over the course of the century through repeated epidemics of cholera. The company that did this as an adjusting aside they did this because they wanted to save money sort of like what happened in flint michigan. The reason they wanted to save money was because they wanted to start a bank and the Companies Call the Manhattan Company in and the bank is called the bank of the Manhattan Company predicts anyone here know what the bank of the Manhattan Company is called today . Jpmorgan chase, yes, thank you. So i will lend the story by telling you how colorado in new york city because i think its instructive. Eventually new yorkers move the well from there too out there on the crimson river but they didnt do it he cut his they wanted to uplift the Public Health. They didnt do because the people of new york were screaming for better water which they knew would make the more healthy. They did it because the local brewers wanted better tasting water for their beer. They felt like the water was putting their beer at a disadvantage especially 12 brewers in philadelphia so finally cholera vanish from new york city. A century of cholera pandemic links ended in the 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 as the story to me says its not necessarily about our technology. Its really about whether we have the political will to do it thank you so much for listening. [applause] now we are going to welcome kessler the author of capture and im going to switch with you so i can see. I came to Global Health issues and might grow by accident or as a political reporter. I was an environmental reporter before that but i was at the National Archives looking for something completely different and i stumbled upon some records that talk about how our researchers during world war ii infected patients with malaria so they could test new drugs on them and this was shocking to me and i couldnt find a whole lot in the treatment of this and as i kept pulling threads in the archives i realized i was in uncharted territory and i had to tell the story. Didnt know much about world war ii or malaria and 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 the leadin but i will whip through them as fast as i can. Her records were stamped top secret. The world is at war and nobody had the good malaria drug and before normandy most of the fighting happened in highly malarias area so if you had a weapon against this disease you had a leg up on all the battles so our government, the Roosevelt Administration opened the spigot for this project. 50 universities, most of the American Drug companies came together to find a bomb. It was the same Umbrella Organization of all the wartime science projects including the manhattan project. The reports were written by the lead investigators and sent to a central clearinghouse at Johns Hopkins university and there they met every month, scientists and they could compare notes. I figured out how to not be totally judgmental of the science the scientist he did this work. I was taught by this man bill collins. I got to sit next to this man and listen to his stories and dissect mosquitoes. He had been around long enough to study the disease and test drugs on their induced infections. The problem back then was you couldnt throw malaria and a petri dish. You had to have life infections and asthma lariat dried up in Northern Europe and the northern states of the united states, it was hard to come by so to infect people you could to study it and he called those the good old days. I said you were talking to reporter, right . Im going to write this and he was in fear. Those were the good old days. Now you have to infect monkeys and they were difficult and expensive than they tried to bite him and monkey malaria student extrapolate all that well and they had to write all the new vaccines on these monkeys so he did call them the good old days. A roomful of archives that no one had seen before from world war ii and the years immediately following world war ii and he used the data and that was collected from these infected patients to inform todays vaccine researchers. The data they had have on life infections remained valuable to this day. He and one of his colleagues. So we actually got me thinking like a malariologists and i came to the story with a little bit more objectivity and not as much judgment and i tried to let the story speak for itself. This is a blood slide taken from an american soldier during world war ii. This is the blood stage of malaria. With the parasite does is in sundays talk she called them a shapeshifting parasite. Immediately gets into your liver and i thank you baits and hides from your immune system until its ready to launch an attack on your red cells. When it does that your red cells end up looking like this. You have truly is the parasites in your body sicker than youve ever been. Its a terrible weeklong infection. At some point during this time when you are feeling the most sick for some of these parasites mature and they become distinct and migrate as it cannot collect tracks mosquitoes. The mosquitoes drink demand and the mosquitoes week or two later depending on temperature they burst into microbes to get get into the saliva and they migrate again. I tell the story about the world war ii project for several reasons. For one ive really liked them and i didnt want to spend my whole book on one of the scientists who i felt that there biological linking dialed up a little bit too much without really having enough empathy for their patience. I identified with him. After the war he was 18 of the university of Chicago Medical School and Vice President there and he advised the eisenhower frustration on medical education. He said we are teaching our medical students to specialize to focus on body parts and that is unsafe for us we should be focusing on the whole body. We as medical professionals and he was called a communist ford in the 1950s. Before the war he was a malaria expert. He started out as a Large Network of american researchers trying to get a handle on the u. S. And pandemic will area. In leesburg georgia the infection reached 80 . He worked in places that look like this where the cypress trees were being ripped out to keep up with the Development Going on and they were left with these gaping holes of larger producing swamps that filled the skies with mosquitoes that carry malaria. Throughout the course of the 1920s and 30s he worked with , this was samuel darling. He was the brain behind the effort to build the panama can tell. Samuel darling was responsible for which the americans attempt to build the panama canal and next him as paul russell. He is one of malarias most favorite sons. Through the new deal and tie Poverty Progr