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>> so if you have been following pandemic related news and the united states over the past few years, and i am guessing that if you are here or watching it online most of you have been, you will have noticed a focus on the u.s. center for disease control and prevention, or cdc. if you have looked at the headlines at all you will have seen a great deal of criticism from a range of publication types over the agency's response to the covid-19 outbreak. why the cdc botched its

coronavirus testing from the m.i.t. technology review in march of 2020? cdc, slow cautious messaging on covid-19 seems out of step with the moment from 2021. cities he criticized for failing to communicate promises to do better on npr, in january of 2022. cnn, in february of that year, the u.s. still is not getting the covid-19 data right. and in august of last year, even as the cdc director, rachel walensky, announced along the findings for the moving forward initiative, the cdc admission of dysfunction misses the big problems from national review. then, in a rule kalimantan go, post pandemic, the cdc faces up and kill battle for new congress. the agency plans for overhaul comes as public trust has dropped. so indeed over the course of the pandemic public confidence and public health agencies

including the cdc has dropped significantly, with trust in the cdc's communications and guidance breaking down along party lines. in december of 2020, 73% of people surveyed by the kaiser family foundation vaccine monitor said that they had a great deal, or at least a fair amount of trust in the cdc to provide reliable information about covid-19 vaccines. but by april of 2022, that number had dropped to 64% with 89% declared democrats saying that they had confidence in the cdc, and just 41% of republicans saying that they felt the same way. a key research center survey released in october of 2022, showed that nearly half of people surveyed said that public health agencies, including the cdc had done only a fair or poor job in responding to the pandemic. many respondents said that they felt the political pressures got in the way of good policy and decision-making for public

health. the agency we know as the centers for disease control and prevention was launched in 1946, it was located in atlanta, georgia and originally was charged with controlling malaria transmission in the united states. mostly in the southeast. but over the past 30 years, the agency has grown significantly by every measure. its staff, budget, and geographic footprint to name just a few indicators. its mission has also expanded from an emphasis on disease surveillance and control to encompass work on hiv, tuberculosis, influenza, maternal and child health, non communicable diseases, and occupational health among many other areas. today, in addition to his domestic work, it also has a significant overseas present with staff and offices, assisting ministries of health and responding to disease outbreaks, strengthening laboratory systems and training

epidemiologist and health leaders. so in the sense, the agencies mission to prevent, prepare ford response of disease outbreaks that do or could affect the united states population, make it a critical core asset of the u.s. national security. but as the cdc's pandemic related challenges have deepened over the past three years, have to rebuild the agency and restore their trust in public health and science have become important questions to consider, and are the topic of today's discussion. so welcome, i am kathryn, a senior fellow with the global health policy center and it is my pleasure to moderated discussion today, centered around a new report issued by the commission on strengthening america's health and security, called building the cdc, the country needs. now, this report argues that is significant reset of the cdc is necessary, and possible if carried out through building

actionable recommendations across branches of government, and across party lines. no small task. the commission is a bipartisan group of experts, it's co-chaired by a former cdc director and current ceo of the foundation for the national institutes of health. and by former congresswoman in indiana, susan brooks. in august, the commission launched it working group on the cdc to consider the following questions. what are the most important near term steps that would drive a significant reset with the cdc, within the cdc as the agency continues through a period of heightened pressure and scrutiny. what concrete measures could the cdc and other stakeholders take to improve performance and regain popular trust across political divides. what steps could the agency take to be more flexible, fast acting, accountable, and better

equipped to respond to the uncertainties of emerging and involving infectious disease threats both at home and overseas and what kinds of actions will be needed in the organizations that oversee, fund, or a partner with the agency's. the commissions working group was co-chaired by steve morris and, director of the global health policy center, and joining me on stage, also by tom angle speed, director of the center of global health security at john hopkins university. last week they released a report endorsed by nearly 40 working group members. it contains a serious ever commendations focused on clarifying the cdc's core and global missions. enhancing congressional and executive dialogue on the future of the cdc. and changing the way that the cdc carries out its operations to ensure greater timeliness and action orientation. so, in many ways this report is really a capstone of the commission on strengthening

america's health security, which had its last meeting in december of 2022. and as the commission ones down, the report also serves in many ways of a bridge to the work of a new bipartisan alliance on health security which would be launched later this year. you will hear more about the bipartisan alliance in the months ahead but briefly it will carry on much of the commission's work, while integrating a greater focus on hiv, routine immunizations, anti microbial resistance among other topics of importance to america's health security and the years ahead. for today we have a busy agenda. first we will hear from the commission co-chairs, who will offer some of their reflections and insights on the report. next i will turn to steve morrison and tommy gillespie to discuss the report's main findings and recommendations. and then we will have a roundtable discussion bringing in gary absent who's also joining me here on stage, the president of the covid

collaborative, tom finney, former director of the cdc and president and ceo of result to save lives joining us virtually from new york. and chief medical officer for the state of alaska, and president of the association of state and territorial health officials joining me from alaska. and that is our group joining us virtually today. we will have a hybrid discussion and towards the end of the event we will have some time or questions and comments from the audience here today. first, julie gerberding, let me talk to you. i will offer some thoughts on the findings and what you see as the critical steps in the road ahead and thank you for joining us from europe. >> thank you so much. i think my co-chair, susan, and steve, and tom for their incredible leadership in pulling those together with such robust input. i've met really wise people it

was a wise crowd that came together, thoughtfully, and every effort was made to provide a balanced perspective. i actually really also want to thank the cdc, dr. walensky, and the team there who contributed a lot of staff time to go deep into some of the data to help the group understand some of the nuances and subtleties of what was going on behind the scenes, and in a really honest and candid way, laid out an appraisal of what they had learned from their own internal review of what is going on in the agency. so several conversations with senior leaders at the cdc, including dr. walensky, we could not have had a balanced report if we did not have the broad perspective. you really laid out the big picture here as we all see the need for a reset of the agencies. some of the reset has to be structural, some of it needs to

be activity that only congress can really man into it, it has to do with the budget, structure, and the flexibility to use or lack thereof. and some of it has to do with anything modernization. really looking at how the cdc can take advantage of the data science, and opportunities to build better systems, more inter operable data systems and really complete the trajectory that they have already started with the data modernization act. but stepping away from the actual contact of the report which we will be going into more detail in a few minutes i do really want to emphasize that while there is substantial opportunity for evolution, modernization, and performance at the cdc, it has done a lot of things well, and in the midst of a pandemic, there were many other public health activities going on. the cdc teams were deployed all

over the united states and internationally to assist with local response efforts. the cdc foundation stepped up and some 3000 or more people were helping the workforce shortages and so forth. there are a lot of very positive things have happened and we got to make sure that we do look at the very critical things that need to be fixed, but also to appreciate, and respect what our public health system has been able to accomplish for the past three years. it has a daunting challenge and i think that we would agree while we had our own outbreaks and challenges to deal with, the scale of this pandemic was significantly magnitude more complex. thank you for that, and as i turn this over to susan i really want to thank her as my co-chair for the wonderful experience that it has been for me to be able to work with her these last couple of years. >> susan, as co-chair of the commission you really brought

your perspective from serving in congress during the first phase of the pandemic, while that was unfolding as well as your perspective of serving on reviews and really the perspective from indiana. what do you see as priority actions for the reset coming out of this report. >> thank you, know i want to think my co-chair, dr. julie, i have always been amazed, not only by the depth of her insight and her knowledge about whether it was the cdc, the nih, anything having to do with hhs, she has been a champion for public health, she has been a champion really for all sectors of our health care system. and as a lawyer, and as a member of congress, we rely on people like julie. people like dr. angles be, dr. freeman, all of those alaska to really inform us, and so my

role in this commission has really been to be a reminder to all of the experts that have been a part of putting this incredible report together to remind everyone of the importance of educating the elected officials at all levels of government. from a local elected officials to state and federal because all the incredible experiences that you bring, it is not something that most of us know. citizens take so much of this for granted, and hill our country or communities are presented with these incredible disasters like this pandemic. and so i just finished my services as well on our governor from indiana, a public health commission, to really look at the public health in state of indiana. and i must say that the work of this report and i want to commend tom and steve for the

really aggressive steps they took to get this report done and the number of really incredible experts they brought together to this report, now the goal is to get the report to members of congress. the members of congress in particular, members of congress that have been engaged in this issue is because it really impacts the city so greatly and it is a year of reauthorization, it is going to be very important. with this new congress, that we do have education, and this report is a fabulous tool to help them with actionable steps to help the cdc tell the story, to help all of these stakeholders around the cdc, tell the story and explain the story of what needs to be done in the reset. not only at the federal level but i would say at the state and local levels as well. public health really needs a reset as i have seen both here at home in indiana, as well as in the country, and i want to commend csis and the leadership

of steve, and really for bringing this together, and getting this report going. congratulations, and we look forward to hearing from our experts today. it has been my honor to serve, it has been one of the most important pieces of work that i will have done well in congress and i was proud to support it after i left, and i will continue to. >> thank you both for your leadership as co-chairs of the commission, and first importing the work of this working group. i want to turn to you, congratulations on the release of the report last week and the arrival of hard copies for those of you and the room to be able to look at the report and its final form. but in one of the first chapters of the report, the cdc is not equipped to be the highly effective and reliable force within the u.s. government at home and abroad

that americans need and rely upon corrupt disease detection and containment. so, can i ask you to discuss the origins of the working group, the process of consultation, and how you arrived at this conclusion, and the main recommendations? then tom, i will turn to you to say a little bit more about where you see the reforms, the proposal moving, in the near future. >> thank you catherine, thank you for taking on this role today. thank you for all of the members of the working group in the commission, who are organizing this. quick note, thank you to a few people who really contributed enormously to this effort and to our activity today. they have really been things lump laureate every step of the way and deserve special things for that role. the research associate with our

program, also variant a girl to our successes. i want to second dino that actually, pat the cdc leadership was very generous and forthcoming with us in that enriched quality of all of the work that we did. we are very attuned to what susan said in terms of trying to reach members of congress. we have a plan, we are reaching out to those who have, within our staff, who are directing our congressional relations, and will be very aggressively doing that. to catherine's question, around the origin of this, the commission has been ongoing since 2018, spring of 2018. and different moments in the course of that commission we visited this issue of what was happening to the cdc from a note of concern, and sympathy, and around such an important

institution in what was happening. and i think when we met back in june we had a commission meeting on june 14th, and we tabled the idea and said that the storm clouds are forming, that criticism is coming from multiple directions. this is not going to get better. it is important for us to take this on in the right spirit and with the right focus. i will say a bit more about how we went about the business. but not too much what's at stake. america cannot afford to have an agency that is not able to perform at the highest level to protect all americans. and that cdc public health is an issue. and that is at risk. so it was in that spirit that we won consent within the commission to proceed in this way. and we launched at the end of august, it was an intense surge of effort. we had four full meetings. we had two rounds of edits of

the report that you have today. and this was somewhat record speed for such a complicated enterprise. but we are able to drive it forward in hopes that we would have something as the new year opened that could be a source of serious consideration. within the administration, among state and local authorities, and the broader constituencies concern. so we had the surge of activity with many private consultations, senior ranks of the white house and other executive branch agencies with serving governors, former governors, leaders on the trump, obama, and bush administrations. and those this, and many of those folks are acknowledged. we he deliberately composed this working group as a highly diverse and broad group. we have several cdc former directors, heads of other public health agencies.

we had those who served in senior positions and both republican and democratic administrations. those who understand and have authority as state and local public health leaders. those from the foundation in the public health world industry. our operating promises that this is a serious problem. there is no delight that. with the trust and confidence that has been referenced. and the action is needed in order to reverse course and reset. the current situation we are arguing is a matter of national security. this is not something that is a side issue that we can afford to live with. it is something that is anti medical to you as national interests. and it is not good news. if we wish to protect all americans reliably, in this period. we focused on key areas, we will hear about those. data, communications, guidance, the global emission,

partnerships including state and local, authorities including the way in which the cdc itself operates within the executive branch, and with external allies and partners. this is not an x cycle p take effort. it is focused on the pandemic preparedness and response agenda, and it is really intended to help start a reset. and we proceeded with -- lucas on what the problems are, and find actionable solutions that could attract support across the aisle. it had to be very bipartisan in nature. and that accountability, equity, speed and transparency and better communications, those are all central themes. they mean different things to different audiences. and different constituencies. and we needed to be sensitive to that reality, and listen carefully to what that meant. as we saw what the concrete

solutions are, this is not an easy task that we have taken on. it is politically-charged, as we all know, but it is many different complex issues that do not lend themselves too fast and easy solutions. and as i said, it has been fundamental to the existence, and over the ages, as well as public health institutions it will be essential to these solutions. we will hear that we have said that much of the solutions lie within cdc leadership choices, but much of it, the majority of power around reaching solutions lights outside the cdc. we need to focus on that end forging a combination around white house, that pretoria of a dhs, senior figures and leadership in the house, and senate on both parties. we make the reference that when

nasa stumbled badly in 1986, and the challenger exploded, when fema stumbled badly and 2005 with the katrina debacle, there was a rallying across party lines, across institutions, to devise solutions to come up with a plan that was a multi-year plan, and to execute. these lessons are relevant to us today as we think about what the path forward would be like. my last comment is, we could not have gotten where we are today, without -- and a real sensitivity to the nuance and complexity is of all of these issues, and i am very grateful for all that you brought to this, and as i said i think that we would be in a very different point were it not for you agreeing to join with us on the way that you had. >> you are back at the center

of health and security, but you completed service with health and human services within the white house. so i wanted to ask you to reflect on the recommendations and the report and to really, trying on your perspective, what are you most optimistic about in terms of change and reform, where it can be carried out? >> great, thank you so much. first of all i would like to say thank you to the team for inviting me into this process. i have great admiration for the work that you all have been doing here, and it is really not -- and i also want to echo what others have already said which is that i start with the greatest emigration for the cdc's mission, it is people that we all need to acknowledge that organization has gone through in the last three years and pressure has been on edge, and think about what we can do from the outside to help strengthen this critical institution. i think in that spirit we

undertook this study with the hope of being able to help in that the cdc has initiated this summer and that we are hoping to help propel and provide momentum for it. i think just a few words about some of the priorities that came out of this effort and what we recommend in the report and then we can think about the overall context but i think at the highest level, the recommendations breakdown into strengthening and clarifying integrating the mission, making sure that we all are on the same page around the community, around's mission as compared to other nations in the federal government and improving leadership and accountability at a general level and we will talk about that and strengthening operational capabilities within the cdc. if we think about some of the particulars around that, the first area around mission, even now after the country has gone through this really searing

experience, there is still a lot of misperception about what the cdc is charged to do on what is agencies are responsible for. so there is policy makers, and what dccc should have been doing around contracting with the public center, or around moving or distributing products around the country. we know that other agencies in the federal government has specific responsibilities to do that so as we think about strengthening the cdc's mission it is important to keep in mind what it's extraordinary and unique capabilities are and what we are asking them to do. we also have to think about its critical role internationally there are other agencies that work internationally, and they have in some ways many more of the processes in place that they should have for that work. we need to make sure that the cdc has the staffing, the

hiring capability, fc processes, the cultural training that is afforded to other u.s. agencies that work overseas and make sure that that is available to the cdc as it does its critical work. when embassies overseas get emergency calls about new outbreaks that are occurring in one country or the other, the first call that they make is the u.s. cdc. we need to make sure that the u.s. cdc has the people in place, the assets, the tools they need to be able to respond to those calls. those urging calls. thinking more about how it is moving towards leadership and accountability, they've referenced the importance of congress being on the same page. we called for a high level dialogue about the future of the cdc there. the purpose of that recommendation is to recognize that power for much of the change that is needed in the

cdc, it rests in congress and in the white house. so if we want the cdc to do big things going forward to think about its mission and to accelerate, or strengthen is operational capability as they are going to need help from the powers hunters in washington. we have called for that dialogue. the cdc is obviously critical participation and that but it can't do it alone. thinking about the experience of the last few years, one of the things that i think the cdc has been criticized for is its guidance and development process and so one of the things that we talked about in the report is the importance of the city sleeping able to reach out to the private sector, state and local agency says it is moving quickly to develop guidance around emergency issues. that is easier said than done because we want the cdc to move as quickly as they can we are also asking them to test visibility, and to get input from outside the federal government so that is important

to recognize that some of the things have happened around the pandemic, issues of the economy and schools, we need to make sure that the inputs round that decision is also not just the cdc news to make. they have extraordinary capability but they cannot be responsible for all of the decisions that have impacted across society and a pandemic. it is not just the cdc about the federal governments to fix how we think about guidance development and crisis. and also rounding out some of the recommendations, we also called for strengthening of the cdc's presence in washington. the cdc, for the reasons kathryn described because of its mission, it pushes up a substantial disadvantage in terms of easy access to policy makers, interactions with federal agencies, that kind of collaborative work in the federal government is going on all the time every day.

and to have the cdc to hours away by plane even with its washington office it needs a substantial increase in its footprint in washington and its ability to interact. its ability to respond to all of the congressional inquiries and information request some to make sure that congress has been informed at all times with what it needs to know. we called for increased to washington presidents and we called for strengthening the cdc's partnerships outside of the federal government which means tighter relationships with state and local agencies. i think that they hopefully will say more of that but that means i'm betting the cdc, experts and local organizations where they could do good and they could learn from each other and learn from the local level and bring the expertise back to the cdc and make much more of a living partnership between federal and state entities. we think that the cdc needs to make sure that it is able to reward operational excellence

and the way that it already award scientific excellence. they need to recruit the best in the country and to maintain the substance of scientific excellence around the world but also needs to be able to increase its ability to respond quickly and that requires different kinds of skill sets. in addition to the best scientists in the country, we need the best operators and the country to be working at the cdc so that they can respond immediately and get into the field and crisis. and finally the last two things i would say and then we will move on to the other parts of this conversation, are that we recommended a real focus on increasing the ability for cdc to gather and to organize data from around the country and crisis. we expect the cdc to have moment to moment understanding of what is happening across the country and to deliver that back to policy makers. but we don't have, the cdc does not have the authority to do

that and does not have the authority to get that for the rest of the country in that way. we need to change the authorities around that relationship and that also comes with contracting authorities that our president and other agencies of government but have not yet been with the cdc. a federal contracting authority, and other agencies have had for a long time. the cdc does not have that. we need to be able to give them the tools if we want them to move as quickly as i think we all do. and finally back to your point about budget, the cdc's budget issues in 13 different treasury accounts, 160 different specific lines. they do not have these flexibility to move things around. we have asked in this report for congress to consider a real change in the way that they provide budget flexibility as to the cdc. i think that the director walensky has called for this a number of times in the last

year, and that final part of that is making sure that the cdc has the flexibility that it needs at the start of the crisis. there is certainly a fund that was created for that purpose but has not been provided resources for the cdc to do that work so at the beginning of any crisis the cdc finds itself having a real struggle to spend money that the need to to get out of the field. that's a very quick wrap up of the different categories and recommendations that we made in the report and hopefully we can go into it in more detail. >> thank you, this is a bag agenda for a roundtable discussion. budget, communication, cdc relationships, and fortunately we have a wonderful panel of experts to help us get into these. i want to start with the question about data and the

cdc's state relationships. a lot of the recommendations, as you pointed out, center around the cdc having access to the most up-to-date accurate data in order to guide decision making and forecasting, the reason the bill authorizes the cdc to continue activities related to the development of capabilities for the forecasting a public health emergencies and infectious disease outbreaks, and it refers to improve collaboration among the federal departments and it even directs the secretary to help the states territories and tribes between federal agencies and public entities but it really stopped short of mandating states and localities to provide data to the cdc and we have seen a great deal of tension and practice between states and the federal government when it comes to sharing that data. so i want to start with you if

we could, our former director, the cdc is in new york in the past so we bring the perspective from the agency and the regional perspective. does the cdc need to reach out to states directly to governors and others to really initiate it better and improve relationship or dialogue about the use of data? the report recommends a series of congressional executive dialogues and could this be -- what could this accomplish, could this be a way forward? >> i think it is a really important issue. it is not a straightforward one. when it comes to legal authorities who are going to have controversy and some misconceptions and some politicized action of the issue. you have seen that already with vaccine status, for example. so that is going to have to be very delicately addressed in this hyper partisan time that we are living through where we

are very sensible measures to share risks that may be multi--- may be difficult to establish. i would hope for more progress in this area and other cdc directors have editorialized on that. realistically speaking, it is hard to imagine that getting through congress anytime soon. so, barring that, the broader issue including data, is the public health enterprise, the connection of federal, state, city and local health departments. all too often it is not well aligned and i think that this is something that we can -- as years as the cdc director, we tried hard to address. we did make progress but much more progress needs to be made. and as i think about it if you

kind of look at the broad scope of history, it used to be until around 20 years ago that almost everyone in leadership positions in the cdc, especially in the administrative side have spent a few years, often five or ten years, but at least two years working in the state or local city health department for various reasons, that was discontinued and we now have most people at the cdc not having work on the front lines for prolonged time. that is important, because the result of that is sometimes a lack of the practicality that is needed not because people aren't hardworking or dedicated but because they do not have that multi year experience of dealing with things at the local level. as we mentioned i was health commissioner in new york city for nearly eight years before becoming the cdc director and that gave me an advantage

point. but that is the case for really the range of public health programs. so, one of the most important things that the cdc could do is to increase the hiring of people who have spent a few years on the front line at the state and local level and when we are doing that, it is to greatly expand programs that the cdc has, like the public health associate programs which could easily double, or triple in size or even more and over years then, more and more of the leadership of the cdc would have spent that time at the state and local level, it will be a shared vision. from my perspective having thought about it a lot that is extremely important. that and the budget issues are the most important issues to try to strengthen the cdc's issues. >> let me turn to you from your

panel. you've been working with the association of state and territorial health officials. when you think about the state and cdc relationships, as proposed increasing the connectivity around the local experience and working with the agencies, would early career cdc officers at the state level and arguing for greater financing for the work force helped create a more positive state cdc relationship particularly around the data issues and what are some of the other areas of tension that you see? >> thank you for the question and thank you for the opportunity to be there and thank you for including states and local government in the process. really we have a federation of states that come together to make our system. i appreciated how the report

started off outside of the cpc itself and that is not just the federal agencies but that is the relationship to the states which honestly have a lot of the power and data sharing and that has been enabled by local government and local decisions that are made so i really appreciate that early recognition and being able to provide a state perspective on this space. it has been an honor to serve throughout the pandemic and that has been both a success and a challenge throughout that time. i pushed back a little bit on the question of the relationship. i think that most officials have a good relationship and we want to do the same thing we really want to work well together and have good relationships. and i see limitations and one is just the state laws many times are state laws -- the second big thing was the agreements that were highlighted in the report. i would take it even further

and not just talk about the use agreements but the government. the data has been used by the cdc or other federal agencies and plays back towards states, it really needs to reflect on the ground what that looks like on the state to make sure that people see themselves within the data. i love this quote about that everybody wants to see the need within the data and we have such a big and diverse country that what may look really good in new york will not look good in alaska and may not be useful. making sure that we have valuable tools that allow us to take the data that is there, just like the weather forecast would be super helpful in alaska and what is happening in different areas with similarities but also limitations on larger countries and we need to take that into account. the third thing is the physical limitations of the data entry and this gets called out multiple times in the report. we hired the national guard to enter three different data systems. so oftentimes our ability to

share data was not because of a lack of interest or even data use agreements. it was physically people entering them into different systems because the systems don't talk to each other and connect. that goes back to the things that have already been highlighted and if we have very limited uncontrolled budgetary items for the cdc and creates their own individual databases and the states have too entered into all of these different databases. i might have someone who is hiv positive as well as covid positive and working through there one person de entering multiple different data sources and multiple systems. the other thing is that both politics and public health are based on people. and the relationship de, early at the beginning, comments about the way that we make sure that we are accountable and that we communicate and partner up with local state and federal authorities i think that that would then help to change it and increase the compatibility. moving forward with data, just making sure that we are doing

all that we can to standardize, as mentioned previously, the amount of funding to create that infrastructure, i am a practicing medicine physician as well as a public health provider and my colleagues think it had emerson hospitals are about, they should try state governments. it is a whole level of dysfunction, and we need to think of our health care partners as partners, in that space. so what ways can we learn from our health care colleagues and partners with public health, and building workforces, i think specifically the question would be helpful to have more city see people in states 100%. it really helps us understand what the cdc's thoughts are on and ask are questions, and vice versa. it is a world of difference when you are working with someone at the cdc who has been in your shoes and understands the challenges and limitations that you are going through. then it is just mentioned previously that funding sources created a full picture because one data system or sources going to be able to provide the full picture.

it is great to see the report call it much of that. i want to really think the report forward diving into these issues and coming up with some really >> concrete recommendations. thank you. you've highlighted the importance of data with modernization and standardization. also the challenges that exist at the state level around legislative differences. it's not just a budget issue or a matter of political will, but there are also legal differences. one of the states in the federal government that may need to be -- i want to turn to you, gary edson, you are with the organization that was started during the pandemic to address and do outreach and advocacy around the pandemic response. the report really points to and the reform or overhaul of federal agencies like nasa and fema after the challenger in 86. and then fema after the

hurricane katrina response in 2005. it's evidence that a reset or a rebuild of a federal agency as possible. as the report acknowledges, those cases require recognition, acknowledgment of the problems, the relevance for national interests and really require meaningful inter agency communication, close communication with congress and the public, and multi year commitments and budgets to really move those agendas forward. what do you think it would take to launch an initiative of that scale for cdc? what would be the optimal timing for it really moving on the rebuilding agenda forward? >> in terms of timing, there is no time like the president. let's be clear, the issues are urgent. it's an issue of national security. i am not sure those are the best examples. i don't know whether nasa is an example of successful culture

change or the poster child for how difficult culture change is. we had the apollo one disaster in 1967, lasting 27 years later you had challenger, less than 20 years after that we lost columbia. i think that is an object lesson that this is hard work. it's going to take an enormous amount of commitment on the part of the cdc. but getting to where we need to go is a two-way street. as the report points out and as folks have already mentioned, the great majority of the power to strengthen the cdc lies with congress, in terms of the new authorities the cdc needs, the authority to collect data so we can mount a successful defense and target inequities. budget flexibilities, so that we can surge resources to where

they are needed most. hiring flexibility so cdc can attract at the talent it needs going forward. but, frankly, i don't think congress, especially republicans, are going to be eager to put new wine in what is perceived to be an old and broken bottle. i think it is now up to the cdc to step up. it needs to first own the failures of its own making. everything from the amount of masking, the debacle of our testing, the inability to produce swift and clear guidance, to the sometimes breathtaking lack of humility and transparency in the face of scientific uncertainty and a pernicious virus. and it needs to step up and address those with fundamental reforms. what we learned from nasa and

fema is that culture reform involves new priorities. people, incentives, and the systems to support those. thus far, what director walensky has said is she's offered a public mea culpa and initiated this internally led as opposed to at nasa, and externally led investigation. and internally led effort to change the culture and reform the agency. that is great. but if that results in nothing more than moving some boxes around on an org chart, or tinkering at the margins, it's going to be dead on arrival. on the same token, if congressional investigations are nothing more than a witch hunt, that's not going to make americans any safer either. we need to fix the problem, not

the blame. i think that is the tone of this problem -- the report calls on as pointed out a high level dialogue between the executive branch and congress. i think that is the path forward. i think the report can lay the foundation for that. >> so you pointed to the potential for executive congressional dialogue. but also the importance of operational change or operational reform. julie gerberding, and tom frieden, i want to go back, if i could, because you have direct experience in this late relationship with washington. this points to the challenge that cdc, which is located in atlanta, has for undertaking these kinds of dialogues and making the case for its -- certainly as the report recommends cdc can deploy more policy related staff to washington to represent its capacities, its achievements

and interests within the inter agency in congress. should it relocate to washington in order to better make the case? or have a new building, something like that? and then, susan, i want to bring you into this as well, what more can cdc do with congress to demonstrate that it is up to the task of improving its performance and delivering results in a timely matter? tom frieden, let me start with you, then let's go to julie gerberding, and then susan will weigh in as well. >> i think the likelihood of actually relocating the agency with thousands of employees and billions of dollars of buildings is zero. but the necessity of strengthening its presence in washington it is definitely there. as cdc director, i have calculated that i made over 250 troops to d.c. from atlanta.

basically to answer questions, to testify and ask for more resources. the national center for health statistics is in the d.c. area, and maryland. there is a washington office. but it needs to be much stronger. it's a structural weakness that cdc is not there to frankly make its case to hhs, omb, congress, two advocacy groups in the kind of force needed. there are a few ways to do that but the bottom line is that you have to show up and be there, even hundreds of trips don't replace having high-level staff they're getting to know people. nadia is also in a washington area, when then i asked director mentioned to me that in the past quarter he had had

lunch with every single congressional staff member on one of the committees either authorized or funded nayausheeng. i thought, that is great. that is one -- but i have not done that, and cdc has done that for the agency has a whole, and that's one small example we. >> i think you can think about this in multiple levels. when i started as a cdc director, the washington office was in the humphrey building. a decision was made without consultation that perhaps at the cdc and washington office should be moved someplace else, so it was to colocate with the niosh, headquarter's which is a who -- few blocks away, you might as well be in a remote island. fortunately, for a period of time, we were able to maintain a physical office in the humphrey building. i put my name on the door. i was able to rub elbows with the secretary and the other hhs

leaders. that was critical. i had lunch with them. we could interact and at an hhs level really engage with my colleagues that helped with a number of collaborative issues so that when we were in a response mode, whatever public health emergency was occurring at the time, i could operate just as easily. that emergency operation center in atlanta, i was physically there. tom is absolutely right. the broader presence in washington, we need a really strong leader, a deputy, if you will, of the cdc to manage washington presence in a strategic manner to develop the relationships with the whole of government including the white house but also with the congress, of course. it is just not possible to do that by flying people up occasionally from atlanta. i think the broader issues washington is more in the government and there are a number of surround sound opportunities that i'm sure the pandemic is part of this, but i'm sure dr. walensky has

really struggled to interact with the broader policy environment in d.c. and really understand and interact with the number of the broader state holders and constituents who have certainly helped the cdc in a lot of ways in the past. if you want to play, you've got to be in the game. the game is not played in washington, the game is not played in atlanta unless, you know, you are a fan of the baseball team there. i think the structural issue of the washington presence is important. as i think it's a good opportunity to make the point that what we need in our government is the whole of government response. when i think back to the incredible and intensive effort that cdc made to exercise and prepare for the influenza pandemic, a big part of that preparation and effort was coordinated by the white house.

every cabinet participated. cdc had clear understanding of what its mission and role was in the context of operating plan at that point in time. somehow, through the years, there has been a dissipation of that clarity. the mindset about what it will take in order to manage the pandemic for more than just a public health perspective was defused over the years. while even if cdc performance had been optimized, there was still a great deal of lagging in other areas, what to do about economic support for people, what to do with schools and so on and so forth. having a whole of government with cdc included in that conversation, i think, is one of the frameworks for how we should think about how to define the washington presence for public health system. at least in the context of public health emergency. and another time, we can talk about why that was possibly important for a number of other

public health issues that also -- in washington d.c. as well. it should not be hard to accomplish this but it will take a realignment of the center of gravity. and then a lot of work on the part of the build out of the washington office so that it really can be more than just a very small handful of people. >> thank you. susan brooks, let me turn to you. you mentioned earlier the importance of educating congress about the public health and health security issues when. we've heard about the potential for increasingly washington presents a cdc in order to better engage with some of those congressional offices. gary emphasized the importance of really bolstering and executive congressional dialogue on cdc. what do you see as the potential for really moving dialogues around cdc but --

what will it take to really enable the agency to make its case to members of congress, particularly people who are new, who are learning for the first time? >> first of all, i want to completely agree with everything that everyone has said. as a fairly recent former member of congress the only reason i went to cdc one time was because i was a speaker at another conference in georgia, in atlanta. the representative had it on the opioid crisis. when i was going, there i realized that here i was working on cdc related issues around pandemic preparedness. i had never been invited, i really did not know much about the cdc operation in atlanta and i was overwhelmed when i took the tour. i had had similar tours of other agencies, i have the nih,

of asper and b.a.r.d.a.. i don't think you can understate the importance of actual site visits and of understanding the magnitude of what the government officials are trying to do in these agencies and having those types of visits are very important. i think we also can never under state the importance of educating our staff but. what tom just talked about relative to an agency that did a great job educating the staff, the staff, our staff, members of how's and senate both are the ones that truly dig deep and have the time and are the ones that you need to find who are more interested in these issues because they are the ones that really tee up off in the agendas for us and help us with the details of what we are working on. developing those relationships

with our staffs are critically important. i will, say and i completely agree there needs to be a much stronger presence in washington d.c. ballistic, you see, rather than just in the hearings, they appear before and, yes, there are going to be hearings. i certainly hope they are not viewed as witch hunts. they will ask a lot a very difficult questions about what we just went through with respect to the pandemic. i think that it was explained so, well all the different positions that were taken and why they were taken and why there appear to be so much uncertainty and lack of readiness when it came to the testing, the math, the guidance. it was very difficult. those are issues i think the american people want to know the answers to, they want to understand better. members of congress, both sides of the aisle, want to understand them better.

i think it is very important that, when meetings happen, that they are bipartisan at the time, that members are identified who are really interested in these issues and help educate them at the same time. democrats and republicans together. those are often the most effective site visits but is also very incumbent on the administration to promote the importance of what the role of the cdc should be and what julie was saying about the cdc being in the mix at even hhs, there is a lot of jockeying within hhs, which then finds its way to congress. i certainly saw that, you might have champions of different agencies or different agencies within the hhs. those things off and make their way as we are really grinding up those difficult pieces of legislation, and most

importantly there's -- respect to their budgets. i would often, quite frankly, what i said i am a lawyer, medical for fresheners within congress, they are growing. i think they are, those of us who are not medical professionals and don't have that background off and look to the medical professionals to give us that advice. certainly, starting with anyone who has been in public health, who's been in the medical profession, i think those are the members of congress, house, and senate to work with. we have a very robust docs caucus on the -- and then as well i think those numbers of the georgia delegation i've always said they have the best vested interest in trying to make sure the cdc is strong and continues to have that presence because you will not move thousands of folks from atlanta. i completely agree with tom. that georgia delegation is critically important. those are my thoughts about how we can take this report and a

lot of great solutions and ideas and put them before those members of congress in a bipartisan way to really put some of these recommendations into motion. >> thank. you susan brooks has really emphasized the importance of education and the potential for an enhanced dialogue between congress and the executive branch. but also, susan really raised the issue of communications. i want to turn to the issue of communications for a moment. the last three years, building on previous years, we've seen an explosion of misinformation and misinformation about covid, about the pandemic, about cdc, about any number of different -- this has been amplified across social media. it has served to undermine faith and trust in scientific methods and evidence based guidance. but effectively addressing rumors and conspiracy theories is, i think we've, seen not

always just a matter of providing additional scientific evidence and the scientific paper. in many ways it has to be accessible but too -- appealing in the same way that the conspiracies and rumors might be. i want to turn to our panelists. let me start with you, anne zink, if i could. i will ask for your reflections in terms of the capacities required not just by cdc but also by state and local health authorities to address some of these issues around misinformation and disinformation and to really ensure that guidance is made available to people in a way that they can appreciate it. >> i appreciate that. in so many ways, i can't think of a topic that is more important because at the end of the day we can come up with amazing science, we saw this with the vaccine, but if someone does not trust, it does not want to take it, it's not effective. if you are not willing to take that vaccine, if you are not willing to trust and that

science, you don't trust the data, you are not going to move forward. a couple things that breakdown in communication, communication is built on trust. trust is really accountability as well as clear communication. this has been a huge challenge from a state perspective and i think local jurisdictions as well and from the cdc. two-way dialogue, i, think needs to continue to happen in finding ways to provide timely resource rich information that also makes sense for the public, as well as being able to have the dialogue at a state level, a local level so we can have to a dialogue with cdc and say, why did we make this decision? we don't understand this. that allows us to be able to go back to our constituents insight, this is why this decision was made, and this is what you need to know about. it is how you do it. come indicate that. >> when it is just a doctrine on high that comes down and says, this is the way it shall be, it becomes really hard to communicate that. that really robust communication needs to happen. it allows us on the same local level to have that two-way communication with our governors, our legislators, but most importantly the people that we directly serve.

secondly, we have got to find a better way to bring health care again with public health, i had mentioned this before hand. if you look at the data and science between health care providers, it can take years to get change and practice. what ways you control insulin, how do you treat a heart attack, and when you've got something like a pandemic moving really quickly, we just don't have really good systems to learn from what's happening within the health care sector to understand what vaccine resistant strains are we seeing, how many people are being hospitalized because of x, y, or easy? we don't have that unified system within our health care and it is not integrated into public health. we'll show just don't have a great way to communicate with our health care providers. there is not a lot of education that happens to health care providers to understand what public health is and what it does and how we are all able to be connected. that individual person to person relationship with your health care provider is fundamental to being able to understand and individual person's health, their choice, the decision they made on an individual level.

i think there's a lot we need to do to build that relationship between health care, as well as public health. we see some work on this with the pharmacists and pharmacy lineups, so much more work to do on those lines and then making sure that communication is two-way, both for the public, our policy makers, our governors, and our large institutions and agencies, but so we can understand the y and we can also explain the implications and weaknesses of a particular decision so that those of us on the ground trying to action said decisions can have it be meaningful and make it make sense. i appreciate the focus on this. >> thank. you, tom inglesby, let me turn to you. you are working on the very -- chapman issues earlier last year, in 2022. i know you have thought a great deal about the challenges of communicating, about some of the changing kinds of guidance and the capacities needed to

move that forward. in terms of thinking about what cdc needs to better communicate with the public, where do you see some of the best opportunities for improving the agency's ability to carry that out? >> yeah, i think even in the course of the pandemic that within cdc there was a recognition that a lot of the communication efforts that go on within cdc were aimed at speaking to professionals, health care providers, public health agencies, and that comparatively underdeveloped portion of the communication efforts cbc was aimed at the public. cdc has begun to really reassess the way it does large-scale communication. that's again dependent to some extent on the power outside of cdc. if you look at that and infrastructure this easy has to do that work, we expected to be able to communicate to the public, to all of the technical community, to congress, policy

makers, the private sector. it is a huge set of responsibilities and then throw in that critical area have challenge, misinformation, disinformation that's happening all the time, not just here but around the world. that is a very substantial set of challenges and i do think cdc, to the extent that it has the assets and the contracting authorities could really use private sector partnership there. we have a lot of communication technologies we blossoming around the u.s., around the world that cdc could take advantage of. i think there were examples within the government about successes, for example, in the testing world there was the example we have the program that provided testing for the public through the u.s. postal service. that was very -- the driver of that program was this needs to be directed at the public and simple as possible, as precise as possible. i think it was commented on by

wired magazine, the cool kids are back in governments. it is possible for the government to be a very sophisticated communicator. but we have to make sure they have the right, partners the right people, all right technicians within the government to do that work. >> it's not just communicating with professionals but reaching the american public. >> the public medication is a different strategy, and additional one. >> thank you. so data, congressional dialogues, communications, addressing disinformation and misinformation, reforming operations, a building staff in washington, this all requires budget. it requires a greater budget. tom, you mentioned that the cdc budget is highly fragmented across multiple different treasury accounts and very little wiggle room for responding and pivoting in the moment of crisis. gary, let me turn to you for a second.

the report really underscores the many challenges cdc has faced already in securing aspects of funding for the domestic response and the pivoting challenges that tom outlined earlier. in the current context, how difficult do you think it will be to gain budgetary support for this proposed reset agenda we've been talking, about the agency itself is beginning to undertake? and do you see -- are there any aspects of the reform that you see as low hanging fruit in terms of really being able to secure bipartisan consensus and secure funding in the near term? >> my guess is that it will be easier to get the budget flexibility than it is to get more money. i think the argument for the budget flexibility is strong. i think there are cases within the federal government of

agencies that have secured the same flexibilities, the straight jacket, the cdc budget and just constrained so much of what was needed for an adequate both peacetime and wartime response when we are faced with a threat. i think that is an area to push on. i also think that the data piece needs to continually be pushed on. one of the angles there that we don't hear enough about is the equity issue. covid laid bare so many problems in this country and one is the persistent inequities. there is no way to address those inequities without adequate data about where -- which communities are being most affected, which individuals are most vulnerable. then we can target our resources and response towards them. you need this aggregated added

to do that. i think this is a confident -- what we need our confidence building measures between the cdc, the administration, and congress. those confidence building measures can start with things like budget flexibility, they can start with things like pushing on the data needs. because i think that there is bipartisan support for addressing inequities. i think there will be bipartisan support for being able to surge with sources in a timely way to where they are needed most. that is the kind of process i would engage in. i think getting more money, dramatically more money, overall, goes back to what i said earlier. i think it's going to be dependent upon congressional perception, that the cdc has gotten its own house in order and is deserving of more money

and can spend that more money acts effective. >> great. thank you. so, steve, i want to turn to you first on this question. the report really focuses largely on pandemic repairing us and response but cdc, of, course has many other areas of work that are of great concern to the american public. long term chronic diseases, environmental health, mental health, maternal and child health we. but it also has a very significant global health presence that we have not really talked about yet. so i want to talk about that global footprint for a moment. cdc has country offices and staff around the world. they play a critical role in the programs that oversee the field epidemiology training programs. -- it's regional entities. there is not necessarily a straightforward career path within cdc. we talked a little bit about

some of the training around international relations and cultural competencies that other agencies have that may not be relevant for cdc, or have not been so far. i wanted to ask you to reflect on this process of the visa that has been proposed here. what steps can be taken to better integrate and strengthen cdc's global and domestic health security agendas? and what will it take to win, i guess from the budgetary perspective, but also an operational perspective, to really ensure and protect that global health action cdc undertakes and that is really so respected around the world? >> thank you, catherine. there is lots of knowledge among our other speakers on this. i would just say that cdc has performed very well in its overseas missions over many

years. that work, as you point, out has been predominantly driven by the hiv program, pepfar. when you added those funding, and that funding and staffing, we are talking about fully a quarter of cdc's budget and roughly 2000 employees, when you count all categories employees. it has become a many many missions around the world. the u.s. embassy that cdc presence has become a very important element of our foreign policy and the promotion of u.s. foreign policy team. it has been a proving ground a training ground for a generation of diplomatic leaders coming out of this easy background. we have seen that in some of these sterling folks, mitch wulf and others, who came through that regional have. there is now a new offices on building a regional presence. we know that cdc is playing an

integral role in the ukraine response at the moment. but it has been treated, at a macro level, as a bit of an afterthought or an ad on. it has not been seen as an integral element of mission. the systems have been missing, which we enumerate in the report, in terms of recruitment, staffing, promotion, career development, integration, backing it, and the domestic and international integrated in terms of funding. right now, yes, the pepfar program is foundational. but there are many other global health security functions that need to be provided in many countries where hiv is not a top priority and where that capacity needs to be enlarged in this next period. that is part of the challenge. i do believe that's bringing across the value and the achievements and the performance to congress and to

the american people and two others will go a long way in trying to build up that, but there is not a very good appreciation of that and i think we can do much better. some of that may involve what was referenced earlier by susan and others in terms of understanding by visiting some of the transformative changes that happened around pepfar, gary can speak to, this was involved but partisan missions coming out to some of the key countries and seeing this at work and having quite a dramatic transformative impact on attitudes and opinions, and we may be in a period where a repeat cycle with the global health security would make a lot of sense. thank you. >> thank you. so i want to give our speakers an opportunity to offer some final reflections for. if there are one or two

questions from the floor, i would invite you to share those. i can ask our speakers to take those into account as they offer final reflections. but i think, if not, then i want to ask, first i want to thank our speakers for joining us from near and far today, and to ask each of you to, you know, really reflect on one or possibly to have these steps and that you see as most promising in the next 6 to 12 months that you see making a difference in restoring and rebuilding trust in cdc as a core asset of u.s. national security interests. i start with our panelists, and then we will go to tom and steve, the report authors, and finally back to our co-chairs. i'm sorry?

oh, gosh. okay. well, while we are waiting for the system to reset, let me invite gary first, here in the audience. >> i have the first and maybe last reflection. you, know i'm going to start on a pessimistic note but and on an optimistic one. there is a view that we heard and some of our working groups from some in the public health community that everything would've been okay if the response had not been, quote unquote, politicized. while there is some truth in that, i think it misses the mark. it obviously ignores the cdc's own unforced errors, which undermined confidence in the

agency as much as political interference did. but more importantly, it ignores the fact that pandemic response and mitigation are inherently political. they involve major societal trade-offs between health and the economy, between in-person remote learning, between individual freedom and collective responsibility. instead of pretending as if the answer is to do the impossible, namely, insulate the cdc from political pressures, what we need to do is come together and better manage the inevitable political nature of the response when, to balance transparently in the science with the social, educational, and economic impacts. my optimism comes from the fact that we heard, in our working group, and some of us have

experienced, as susan did in indiana and alaska, tom with marilyn, we saw states coming together during the acute phase of the pandemic with ad hoc collaboration's, fusion cells, bringing together scientists, public health officials and elected officeholders to manage the response together. i think what we need is to translate that now into the federal stage and i think that's what the report is talking about in terms of this intensified engagement with congress and this more robust executive congressional dialogue. so i have hope for the future, and i think we ought to look at some of the state models and lift them up because they've succeeded with a bipartisan approach that i think we've got to try and drive the same thing

at the federal level. >> so we really need to embrace the political relationship, or the political dimension of the pandemic and move that kind of dialogue forward. do we have our online folks back? >> we are back. >> all right! let's see. tom frieden, let me turn to you. one or two reflections. what are you most optimistic can be achieved in the next 6 to 12 months? >> first, i wanted to mention the reports highlighting the health defense operations approach. this will not happen in the next 6 to 12 months, but over time, this kind of approach that takes what can be accepted by both parties, both houses of congress, as core issues for our health defense and insulate them from the budget dance,

this is a good idea that has now been included in legislation introduced, and good idea sometimes take a few years to mature. i think this is essential. i think the ability of congress to be able to give resources to cdc, i think i made -- to give resource to the cdc without taking them from other entities, that would enable us to greatly strengthen our health defense, on which we currently spend about 1 to 500 on what we spent on our military capacities. >> so, legislative processes at work. we may have just lost anne zink. >> i'm here. >> are you still there? >> yeah, i'm here. >> okay. i thought we lost you. sorry, let me turn to you, please. your thoughts. >> i appreciate the reports specific call. it's the one thing i would mention about budget is i would

again think about health care and public health. i don't go into a shift and say, i can only take care of so many heart attacks tonight because that is all the funding i have to take care of heart attacks. i go to my day job, i work in state government, we only have so much funding to take care of so many -- so much contact tracing i can do. those to go really closely together. so i think we need to think about the prior payment structures for health care and incentivize public health as a part of health, care as well as finding the academic and understanding the climate. i think we did this at a nation in the 80s to say it's not okay to show up in an emergency department without stabilizing in treating. i think we need the same thing with public health. it's not okay to not have the very basic data information and public health response because our economy, our schools, our security are all key dependence of that and it has to be built into the way that we address health care as public health at the same time. thanks. >> all right. thank you. susan brooks, let me turn to

you. >> good. thank you. i think in the next 6 to 12 months, just reminding members of congress in particular that the public health issues, so much of what we are talking about his national security. trying to make sure that they understand particularly the newer members trying to make sure they understand in the intersection between national security, our military preparedness, our -- which includes our national guard, men and women in our own neighborhoods that are going and serving our country as well. just making sure they understand that it is all connected. and that the bio threats are really significant and we have

to make sure that public health have the resources they need to detect and test and be far better prepared than we were during this pandemic. i think that is something that brings both parties together and if we can just continue to educate on what is needed in a humbling way, in many ways, because so many things did go wrong but so many things, as julia reminded us, did go right. so many things public health has done right in the past, we need to remind people what those are. with the right resources and the right mission at clarity and types of things we are talking about, we can really get back to the. we have to be ready for tomorrow and what tomorrow brings. we don't know what that next disease is and how it might impact our neighbors and our communities. >> thank you. julie gerberding.

>> thank. you agree with everything that has been said. i do hate to say it but, it's not over yet. why we all want to put this in the rearview mirror and think about but learning from it and go forward, we do need the humility to recognize that there is still a certain, and uncertainty about what is ahead of us. i also vehemently agree with ed, the cdc needs to fix the things that are within its control to fix and work with state levels to make sure that there is clear understanding of what those priorities are, not just from the inside of cdc, but really reflecting a system's perspective what can we do right now to execute what has already been defined by dr. walensky and cdc, but also extend that into some of these other areas, particularly the areas that begin the process of expanding the deployed workforce because that will serve us well no matter where we are, to build a strategy for

the d.c. presence of cdc, even if they don't have the resources to execute it entirely. they can get a start on it. they can begin to move forward so, that when we have good news about the improvements made in the agency, we will have ways to communicate them and really engage with the new congress. with that in mind, i think the pop-up, that we authorization is a critical opportunity that almost sets a deadline. we need to have the house in order as we go into the conversations about the importance of -- what that means to the agency so that we can ensure that the opportunity to shape that reauthorization and have it perhaps but -- solve some of the problems we were talking about is an opportunity that does not get lost due to the timeline. i want to end with a very positive note because there is a lot of incredible talent, passion, and capability at the cdc.

i've seen them do miracles. >> our time has come to a close. i want to thank the c s i.s. streaming and broadcast team -- for their efforts today, particularly mckayla and -- who managed the commission secretariat and keep it going. i thank, you the audience, for joining us today. i -- both online and in person to please join me in thanking our panelists for joining us from places as near as baltimore new york, to as far away as indiana, alaska, and europe. of course, right here in washington. so thank you very much. [applause] and we are adjourned. thank you. >> friday, congresswoman marjorie taylor greene, 2024

presidential candidate nikki haley, and donald trump jr. are scheduled to speak at day two the conservative political action conference. watch live from the national harbor at 10 am eastern on c-span. you can also watch on our free mobile video app, c-span now, or online at c-span.org. >> live sunday from the tucson festival of books, investe journalist jeff green will be our guest on in-depth to take your calls on americanry and outlaws. he has written books about bonnie and clyde, charles manson, and the mexican border war, as well as his latest book, waco, about the standoff in texas in 1993 between federal agents a david correctors bran didians. join the conversation with your phone calls, facebook comments, texts, and tweets. in-depth with jeff going, live this sunday at noon eastern on

book tv, on c-span two but. >> united states of america was originally built on two important documents. the first, of the declaration of independence, was signed by 56 men in the middle of 1776. the second, the constitution, was signed by 39 men in september of 1787. six of those men put their john hancock on both the documents. others denise karen and joseph have written short background stories about 95 of the signers in two books, signing their lives away to the declaration of independence and signing the rights of way to the constitution. >> these authors on this episode of booknotes+. booknotes+ is available on the

c-span now app, or wherever you get your podcasts. >> c-span is your unfiltered view of government. we are funded by these television companies and more, including spark light. >> the greatest town on earth is the place you call home. that spark light it is our home as well and right now we are all facing our greatest challenge. that's why spark light is working around the clock t keep you connected. we are doing our part so it's a little easier to do yours. >> sparklight supports c-span as a public service, along with these other television providers, giving you a front row seat to democracy. >> up next, a look at a secret service report aimed at helping communities identify potential threat of violent attacks. we will hear from secret service director kimberly cheatle, and lina alathari, chief of the national threat assessment center. this report released