provided this committee with documentation showing the department of defense have provided false information to congress. this committee will now conduct another round of interviews and will turn over our findings to the house committee on oversight and government reform which award has an ongoing investigation into this matter and department -- the department of defense inspector general. finally, we've asked for data on all intelligence personnel and major support contractors at the combatant commands this request was made in december and this is information that should be readily available. ..
cyber threat, intelligence information center. we need to ensure that the new law is implemented properly and the new center operates effectively. additionally, the latest challenges the government has met in gaining access to the iphone is emblematic of the growing problem posed by encryption. finally, we need to educate members of congress on the importance of reauthorization of section 402 of the foreign intelligence surveillance act. i look forward to hearing witnesses have to contribute , and with that i recognize the ranking member
for any comments. >> thank you, mr. chairman. i want to join you in thinking our witnesses. we are grateful for your efforts and for those of the men and women of the intelligence committee. the threats we face are diverse and daunting, from cyber to terrorism, from threats to space to threats from below the sea we are living in a dangerous world. because of technology, some of these threats are knew. unique moment -- unique vulnerabilities. other threats are more traditional but still potentially devastating. north korea's january nuclear test and three's no space launch, russians interventions, china's activity in the south china sea and regional power
struggles in the south china sea power reminder that threats are getting worse. still, other threats are shifting. even as coalition bombing has expanded, isis has sought to incite attacks in europe and to inspire attacks in the united states. many of these threats are interrelated. isis virulence is compounded by its use of technology. russia's terrestrial ambitions and china's naval designs are supported by a desire to counter us predominance in space, and our greatest cyber capabilities are also our greatest vulnerabilities. we look to the ic to sound alarms and defined and enable solutions. after the senate's version of this hearing many were
saying that the world was going to hell in a handbasket. given the myriad of challenges we face i want to emphasize we are highlighting threats and have faced and overcome far greater challenges. we have begun receiving and reviewing budget submissions and look forward to more sessions to ensure you have what you need to protect against these threats and a do so in a way that is why -- lawful, cost-effective and in keeping with the highest american values. some solutions will not come easily. exemplified by this month's case involving apple. one thing is clear, the court's ruling will have ripple effects that will significantly impact the law enforcement community, business community, and all of us individually.
this case implement -- the congress to discussions must carefully weigh the competing policy considerations and drive it sensible solutions. as a 1st step, we need facts. that is why the chairman and i will report on this issue. it's also our support the legislative commission on encryption. a harda hard look at the most commonly advanced claims on all sides of the debate would move us further from abstractions and toward solutions. we need to honestly acknowledge the complexity and not engage in absolutes as this committee has shown with its leadership. privacy and liberty can and must coexist. there is no doubt terrorists
are exploiting cheap and widely available encryption technology to do us harm and will continue to do so. there is no doubt we are under relentless attack from nationstate and hackers. we can all agree law enforcement and the intelligence community have a responsibility to investigate crimes and protect americans. american companies have obligations to shareholders to maximize profits and other customers to safeguard privacy. our job is to reconcile legitimate obligations and priorities and draw lines. i'm not advocating a broad mandate on encryption, but nor my advocating law enforcement be shut out. what i am advocating is a cooperative fact-based approach.
congress can pose the solution if it must,must, but it would be far better to arrive at a resolution through negotiation with all the stakeholders that sets the standards. yes, we are living in a dangerous world, as well as a complex world. but it is also world a great opportunity. some of the challenges we have today are born of incredible talent, creativity and innovation. we also have the best intelligence community and the world working tirelessly to make sure these advances are not used to propagate hate, violence, and terror. the challenges and answers lie in finding solutions together. >> the gentleman yields back. mr. clapper, you have an opening statement and will speak for the entire panel. i want to thank you for your 55 years of service.
i don't know if this is your last hearing, but if it is, i am sure your happy about that. with that, your recognized. >> yes, i am. we are here today to update you on some but certainly not all of the pressing intelligence and national security issues. in the interest of time i will cover some. my mobile the only opening statement. when back next week on the 3rd of march i will address budget and management issues. i said last year, unpredictable and stability has become the new normal. violent extremists are operationally active in about 40 countries, seven are experiencing a collapse of central government,, and
14 others say regime threatening or violent instability. another 59 face a significant risk of instability. the record level of migrants arriving in europe is likely to grow. migration displacement will strain country's in europe, asia, africa, and the americas. and the americas. some 60 million people i consider displaced globally, the most since the end of world war ii and the united nations for started keeping such records. extreme weather, rising demand for food and water for poor policy decisions and inadequate infrastructure will magnify that instability. infectious diseases and vulnerabilities of the global supply chain and medical countermeasures continue to post threats. the virus has reached the united states and is projected to be the cause of over 4 million cases in this
hemisphere. i want to briefly comment about technology. technological innovations will have an even more significant impact. this innovation is central to our economic prosperity, but it will bring new security vulnerability. the internet of things will connect tens of millions of new devices that could be exploited. artificial intelligence: ever computers to make autonomous decisions about data, potentially disrupting labor markets. russia and china continue to have the most sophisticated cyber profile. china continue cyber espionage, and whether their commitment moderates remains to be seen. iran and north korea continue to conduct cyber espionage. nonstate actors also pose cyber threats.
isil has used cyber to great advantage. as a nonstate actor isil displays unprecedented online capability. cyber criminals remain the most pervasive cyber threat to the us financial sector. turning to terrorism, there are now more sunni violent extremist groups and safe havens than at any time in history. the rate of foreign fighters over the past few years is without precedent. 38,200 foreign fighters including italy's 5900 from western countries have traveled to syria from at least have traveled to syria from at least 120 countries since the beginning of the conflict of 2012. as we saw in the november terrorist attacks the first-hand battlefield experience posts a dangerous operational threat with
demonstration of sophisticated attack tactics and tradecraft. isil including its eight established and several more emerging branches are become the preeminent global terrorist threat. teeseven has attempted to conduct scores of attacks outside of syria and iraq in the past 15 months. the estimated strength of isil exceeds that of al qaeda. the leaders seek to strike the us homeland beyond inspiring homegrown violent extremists attacked. isil external operations remain a factor of threat assessment 2016. al qaeda affiliates also proven resilient. despite counterterrorism pressures it is largely decimated the leadership. affiliates are. affiliates a position to make gains in 2016. al qaeda and the arabian peninsula and the al qaeda chapter in syria are the two most capable branches.
the increased used by violent extremists of a cryptic and secure internet and mobile -based technology enables terrorist actors and serves to undercut intelligence and law enforcement efforts. iran continues to be the foremost state sponsor of terrorism and exert influence and regional crises in the mideast to the islamic revolutionary guard force commits terrorist partner and proxy groups. iran and hezbollah remained a continuing terrorist threat worldwide. we saw firsthand the threat posed by homegrown violent extremists in the july attack in the attack in san bernardino. in 2014 the fbi arrested nine supporters and in 2015 that number increased more than fivefold. moving to weapons of mass destruction north korea to continues to conduct test
activities that concern the united states. earlier this month a satellite launch. additionally in january north korea carried out its 4th nuclear test claiming it was a hydrogen bond, but the yield was too low for to have been a successful's test of the stage thermonuclear device. they continue to produce fissile material to develop a submarine launched ballistic missile and is committed to developing a long-range missile capable of posing a direct threat to the united states come although the system has not been flight tested. russia continues aggressive military modernization. it has developed a cruise missile that violates the intermediate range treaty. chinatreaty. china continues to modernize its nuclear missile force and is striving for a secure 2nd strike capability and continues and no 1st used.
the joint comprehensive plan of action provides us greater transparency into the nuclear fissile material production. iran has a means to reduce sanctions. this perception will dictate the level of adherence to the agreement over time. thus far the iranians appear to be in compliance. chemical weapons continue to pose a threat. against the opposition on multiple occasions. isil is also used chemicals in iraq and syria. the 1st time we used a chemical warfare agent since
sarah and in japan in 1995. in this basin counterspace route 80 countries are engaged in the space domain. russia and china understand our military sites. we are each pursuing anti- satellite systems. china continues to make progress. moving to counterintelligence the threat from foreign intelligence entities is persistent, complex, and evolving. us information by foreign intelligence services continues unabated. russia and china pose the greatest threat followed by iran and cuba. as well the threat from insiders will remain a persistent challenge.
with respect to transnational organized crime i want to touch on one issue, drug trafficking. southwest border seizures have doubled since 2010. over 10,000 people died of heroin overdoses in 2014, much laced with fenton fentanyl which is 30 to 50 times more potent than heroin. more than 28,000 died from opioid overdoses. cocaine production in colombia has increased significantly. let me quickly move through a few regional issues. pursuing an active foreign policy while dealing with slower economic growth. the most ambitious military reforms in existence. regional tension will continue as china pursues
construction of its outpost. russia has demonstrated its military capabilities to project itself is a global power commanding respect in the west to maintaining domestic back and advanced western interest globally. moscow's objectives remain unchanged include maintaining influence over. putin is the 1st leaders and stalin to expand russia's territory. it's for into afghanistan, significant expeditionary combat power. its interventions demonstrate the improvements in russian military capabilities and the kremlin's confidence in using them. moscow phrases the reality of economic recession driven in large part by falling oil prices. russia's nearly 4 percent contraction last year will probably extending the 2016. the mideast there are more cross-border than at any
time. in iraq anti- isil forces will make incremental gains. isil is somewhat on the defensive the initiative having made strategic gains north as well as and seven so. they continue to undermine the ability to accomplish strategic battlefield objectives. the opposition is less equipped and its groups lack unity. some 250,000 have been killed as the war has dragged on. meanwhile, humanitarian situation continues to deteriorate.
as of last month approximately 4.4 million syrian refugees and another six math million internally displaced persons which together represent about half the syrian pre- conflict population. despite the september agreement you have established security with hundreds of militia groups operating throughout the country. isil has established its own branch and maintains a presence. will probably remain stalemated. meanwhile they have explored of the conflict and the collapse of government authority to record and expand territorial control. the country's economic and humanitarian situation continues to worsen. iran deepened its involvement in the syrian, iraqi, and yemeni conflicts
and increased military cooperation with russia highlighted by battlefield alliance. iran supreme leader continues to view the united states is a major threat. the viewsthe views have not changed despite the rehabilitation of the jcp away. and south asia afghanistan is a serious risk of a breakdown. political cohesion increasingly asserts global power and sustains countrywide taliban attacks. needless to say, there are many more threats. i will stop and address your questions. >> thank you, director clapper. i am going to go 1st two director call me. a lot in the news as you are well aware.
what exactly are you asking apple to do? out is this differ from the other times you have asked apple to help you lawfully obtained communications? >> thank you. in the case in san bernardino a federal judge has ordered the maker of the phone to do two things, disable the auto erase function so that if the fbi is trying to guess the pascoe to the phone does not automatically delete the content after the 10th try and 2nd, to disable the delay between tries function so that we will try to guess the code it does not take years and years and years and to do that through the remote pulsing.
and i don't know whether this particular relief has been sought in another court proceeding. i do not think so. it is possible. >> more questions from the committee. this has been an ongoing debate. i want to switch to director stuart. on february 15 the daily beast ran a report titled whistleblowers worn. shortly afterward our committee was contacted and briefed on the survey results. which indicated that over 40 pe. the troops and the war
fighters fighting all over, is it appropriate we wait 18 months or longer for the general report before we begin to rectify problems? >> mr. chairman, i have no control over the pace at which the team does its investigation. good for all involved, exactly the extent of this allegation, we have no control over the process. i probably will not comment further on the investigation, but the survey itself represents a symptom of the 16,000 plus members and an enterprise where you put very strict measures to ensure we can apply the standards and have a process where those who believe there views are not being heard, devils advocate
program, seem to have a pretty good standard to look at the quality of our analysis and i will leave it at that. >> it appears like at least there was a process in place to get input from the analysts and to me it seems like 40 percent of analysts, that is just something that cannot be ignored regardless of the investigation. if you have 40 percent of the analysts, you going to go back and pulled him again? is this an annual process? what changes can be made in the short-term with the unhappiness of the analysts? >> this is an annual dni process.
we will continue to look at ways we can improve and have done so already. >> would you consider the 40 pe. >> i would consider that unusually high. >> want to ask you about the application, the facts of the san bernardino case are obviously compelling in terms of wanting to know what is on the phone call whether there were other parties involved were plans were targets of attack. and while that is focused solely on that phone call when i read the emotion in
support of the application i don't see a limiting principle, and by that, i mean, if that argument is accepted by the court in this case on the lead district attorneys and other prosecutors to essentially make the same argument in their cases command some of those may be compelling. a pregnant woman who was murdered in arkansas and that phone may be the only kid who her killers, but nonetheless the application may be good misdemeanor cases. while the result may only affect this phone the president will be there for many others. i would like to ask you is, is there a limiting principle here? is there a way through negotiation that we can arrive at places where it is appropriate to seek this relief in cases where it is not?
do you acknowledge the broader policy implications of the uniform application? i realize this may be mooted by the next generation of operating systems but nonetheless if it is technologically feasible for apple to help with the opening of the phone it seems to me the argument you're making would apply to new operating systems as well. is there a limiting principle here? at least we need access we have warrants and the other side is saying we can never provide access because we do it here we have to do it everywhere. >> i very much agree with the way you friend. this and all cases are important, but there is a
broader policy question far larger than any individual case. first, i think the answer best comes from a technical expert and good lawyer. i am neither. i think it is potentially comeau whatever the judge's decision is, a matter of how it ends up. then there may well be other cases that involve the same kind of phone in the same operating system. with the experts have told me, the combination is sufficiently unusual that it is unlikely to be a trailblazer because of technology being a limiting principle, but a decision by a judge will guide help other courts handle similar requests. the tool i use as a young prosecutor has been used for hundreds of years.
how judges interpret that is not binding on others but will be important. the larger question will not be answered in the courts and shouldn't be. it is really about how do we want to be as a countrya country and how do we want to govern ourselves. >> from the bureau's perspective can you live with the policy, can law enforcement of the policy that says only in certain cases where their violent crimes or other serious cases, terrorism related that we will allow this to apply? is that something the law enforcement community could negotiate? >> i think conversation and negotiation is the key to
resolving this. it is going to require negotiation and conversation. i am keen to keep the bureau out. we have two roles comeau what is in the cases. we must do an investigation and will use whatever lawful tools are available, but i think our role is to make sure folks understand what are the costs associated with moving to a world of universal strong encryption. i love privacy. it really does save people's lives. they do that through court orders and a whole lot through search warrants of mobile devices.
the war will not end, but it will be different. we have to make sure the bureau explains what the cost are. >> thank you. i defer to them. one other matter i wanted to raise. deeply concerned that is the size of the tumor there seems to be a concerned with taking more aggressive military action that it would somehow interfere with the ongoing never-ending negotiation to try to get
the two political parties together and form a common government. for mental perspective do take more aggressive action in parallel or do you think we have to choose the tween them? i am concerned that the pace of those negotiations may come to the.where isil is so firmly entrenched that we have to embark on the same multi- your project that we are undertaking in a rack in syria. >> i think you have aptly characterized the dilemma in terms of a more robust military intervention.
we would like nothing better than to have a government in place in libya for engaging militarily in libya. that is a subject of active discussion. >> there is recognition between government build out and counterterrorism operations. recognize that what you do in one environment affects the other. the purpose is to try to pursue both of figure recognizing you cannot put off countered terrorism operations. >> just to drill down further, do either of the political factions, do
either of them take issue with the necessity of military action? trying to get an understanding as to why anna never that i hope would be more fully integrated with european military leadership in the more aggressive approach but somehow interfere. >> the two competing governments also 25 they are a spectrum of political views. i think there is this represents a threat to the country.
a wide range of views among the political spectrum. >> thank you, chairman. i yield back. >> as the chairman alluded to, there is a lot that will be taking place. director clapper, if you would please elaborate briefly how important section 702 is to your perspective agencies. >> i will start out also that the deputy director of the nsa, 702 represents a vital capability. non-us and the current law
expires in december of 2017. and so we are already embarked on an education campaign to ensure people understand what a little tour the cities. >> thank you. i agree with what the director said. does not permit the targeting of us persons. in the course of conducting election under section 702 if a us person is in contact their minimization procedures that are used to minimize the disclosure and
those are reviewed annually by the court. >> 702 is a critical tool for the collection of foreign intelligence as well as operational activities there have been rumors, instances where 72 has been instrumental in our ability to uncover and help disrupt activities that are affecting the interest. it is difficult to go into those, but let me mention one, and late 2014 a longtime libyan extremist operative was arrested by authorities in europe following several trips into syria and libya only met
with extremist operative's. at the time of his arrest the cia assessed he was involved in external operational planning and then assisted local governments in their investigation leading to the arrest of an individual. that is, i think some of the way that 702 intelligence is used working frequently in concert with partners around the world to disrupt activities. >> reasonable people could and did argue about how important telephone metadata collection was. this is not even a close call. if we lost this tool it would be a bad thing. it is important to have this conversation early. >> thank you. yield back. >> the gentleman yields back. >> thank you, mr. chairman.
i want to pick up the line of questioning on the apple fbi. the facts are compelling in this case. some of the issues are novel and challenging. it is this body that should be determining the answer to the questions and resolving the judiciary. we will once again use our constitutional duty as we are preparing to do and will again on this issue. it leads me to two questions about the thinking of the fbi and the 1st question is a follow-on. itit is my understanding the position of the fbi is a very narrow one, the request of apple pertains to this device in this instance. there is a legitimate worry that this could be the narrow end of a white rope.
the legal domain of cases to which this might apply has been inquired about. if the fbi prevails apple be required to write code at the behest of the government. where is this authority end? for example, is it the position of the fbi that it has the authority to compel the inclusion of code into a new device? can you paint of bright line for us with respect to where you think that authority ends of my reassure those people that say where does it end? >> i don't think i can by virtue of expertise or should by virtue of my role. i think the lawyers are best situated to do that. these are reasonable questions because judges are going to have to interpret the meaning and what is reasonable assistance, and i am not qualified to offer good answer.
>> so it is not at this point in time and belief of the fbi that the authority could go beyond? >> i actually have not thought of it. it is true, the san bernardino litigation is not about sending a message of establishing a precedent. it is about trying to be competent with an active investigation. i don't know how lawyers and judges might think about the limiting principle. >> my 2nd question is about a different way to think about this. they are having is primarily between privacy and security , but if this code
is written presumably it would be a subject of requests for law enforcement. and that creates a substantial threat, if this code exists presumably become the target of adversaries and we don't need to think too hard does been ugly scenarios. terrorist entities we know my precise location and get photos of my children. i wonder if you could give us a sense, how did you think about the trade-off between the very compelling desire to get the information on this particular san bernardino case with the risks posed by the existence of this code should exist and ultimately get out? >> that is something the court will sort out. i am tryingi am trying to be
cautious because i am not an expert. with the experts have told me is the code the code to have the code the judge has directed apple to write works only on this one phone. the idea of it getting out in the wild is not a real thing in the 2nd thing is that the code would be at apple which have done a good job protecting its code. they were able to unlock any phone before 2014. i don't remember any code getting out that let that ability loose upon the land. >> bullet to thank you for raising the issue of cyber security. i wonder, agreements were made when the chinese president visited hours, and i wonder if you can characterize whether those agreements have been effective.
>> we did go into that in detail in the closed session. i think the jury is out. i don't think we are in a position to say whether they are in strict compliance. >> thank you. >> the gentleman yields back. >> two or three questions. one is what our negotiations leading up to? >> very helpful, by the way. there are no demons in this dispute. apple has been cooperative. we just got to a place where there were not willing to offer the relief that the government was asking for. >> secondly, i have heard
people say the fbi could if they wanted to put trying to establish a case. >> the product of people watching too many tv shows. >> are you back. >> thank you, mr. chairman. diving deeper, some sense of the strategic goals here, obviously the impact of sanctions is dramatic to the economy. is this, ithis, i guess, a frozen conflict and what else can we anticipate? >> well, what has have a greater impact on russia has been the drop in the price of oil. kurt is running around 37 or
$38, if that a barrel in the planning factor that the russians have consistently uses $50 a barrel. so sanctions have contributed, but the major impact has been with oil. i think the russians consider you create. deeply steeped in history and culture. there going to attempt to sustain influence, particularly in the two separatist republics and obviously the russians most fear and are most concerned about is you can gravitating to the west more than it already has. becoming part of the european union or worse nato. russia will continue to be a
proxy, sustain influence in ukraine. >> the status continuing the way it is? obviously there is renewed conflict at different times, but no dramatic change recently. >> that is right. they will for now maintain more or less the status quo that is creating issues among the separatists. a lot of the incidents that are occurring along the line that has been drawn are occasioned by of star separatists from the russians do not completely control. >> there has been movement as far as negotiations. there are still shortcomings as far as implementation.
i think there is still certainty about how the russians themselves will extricate. >> given the economy, prudent feels that they have their hands full or do you have concerns about efforts to destabilize the baltic region? >> well, there are concerns. right now the informational operations in the cyber realm, i do think the russians are preoccupied right now with syria. they are confronting the possibility or considering whether they will put more
ground forces in. i think the constraining factor for them is the memory of afghanistan. i think that does affect russian thinking and is one of the reasons why there is a cessation. >> thank you, john. the gentleman yields back. >> thank you, mr. chairman. director call me an audible no different of the process them what you do for pfizer or any other you want to get to check. you were just trying to get where you could get
influence. is that correct? >> that's correct. >> thousands of other criminal investigations across the country, go to a federal judge will make a showing of probable cause to believe there is evidence relevant to the investigation on the device get a search warrant from the court. then because the devices unable to be opened the judge issued a separate order to try to give effect to the core search warrant so that they can try to guess. >> i would think it is different if you have got to people and your just trying to get through security to
get into the device versus somewhere trying to find out i think the american people sense that this -- these are people who have committed a crime. you know, we have been going through a lot of the iran nuclear in a given them a large sum of money, varying figures on that, but i know that a lot of your agencies take part in monitoring the financing. libya, iraq, syria and how are we monitoring with the iranians are able to do or are doing as far as what
these funds are connected perfect opportunity, just another great opportunity to launder money. >> go into detail, i don't think up and say here that of the money that was released freedom by virtue of the jcp away that much of it is encumbered i forget or the demanding domestic needs of the iranian economy. some money has flowed to the organization we worry most about the best left.
threats either planning attacks. in our forthcoming budget as to what we are actually investing for asking for what i think the general threat environment both from the standpoint of the capability of the nationstates and then nonstate actors. there is an inverse relationship between the ability, the capabilities the countries out, china and russia thing the most formidable, perhaps less
intelligence to bring to bear. >> our ability to defend against anti- satellite. >> again, this is a subject best left for closed session. personal and diverse sets of capabilities in the space. and this has prompted a lot of attention on the department of defense as well as the intelligence community to provide an array of defenses and resilience and reconstitution if necessary
this is a commentary on both russian and chinese insight and understanding. >> thank you. >> thank you for a. here today. not to beat the issue to bed, but one quick question. as apple clearly articulated what the reasons are to not cooperate? is it the slippery slope 4th amendment civil liberties are more of an economic issue with our cooperation intheir cooperation and showing the world that they might be able to accomplish what is requested makes the device less than desirable and therefore lose market share? >> ii don't think that is a question i can or should answer.
i know there has been a bunch of stuff in the press and they will have an opportunity to file in the court to explain why they do not believe the order is legally or factually appropriate. >> i appreciate that. >> mr. carson. >> thank you, mr. chair. without getting in the classified territory, can you describe how the fti makes a determination to determine which communities warrant proactive outreach and engagement to prevent radicalization and improvement? >> any committee were either we or the community believe there is a risk of people turning toward violence and sometimes that is an ethnic
>> has the citizens came been an effective tool and create something kind of buy-in with the communities? >> yes. there's the citizens academy, which you know well is an effort the fbi runs in all 56 of our field offices. we invite in people from all walks of life to spend time getting to know how we do our work. to connect us to all different part of the community so it's a vital tool. >> thank you, mr. chairman. i yield back. >> thank you, mr. chairman. i do want to thank all of you for being here and as dr. heck said, all those you represent and what you do. one thing i think we can't ignore as we sit here on the side of congress, admiral mullens spoke years about about our debt being a throat our
common security. and want to ask you, director clapper, as we face increased threats to our nation how does this basically, an internal threat of our debt, affect our capabilities and the work that you do? >> well, it's -- it affects us if -- to the extent that has inhibition on our resources, meaning our funding. so, that's why we have been very concern about the impacts of sequestration, which we're not through yet. so, in that respect, it is a concern. i have to say that, thanks to the congress, we have done reasonably well in our funding requests, and i hope the same is true in 2017. certainly i'll just say as a citizen, i think i too worry -- i do worry about our debt as a
country and i worry about it from that respect. >> well in the line of national security, i think that we need to continue to address your needs and it's helpful to us when you discuss whether you have the appropriate wherewithal to do your job, as we make decisions here. thank you for that input and i yield back. >> the gentleman yields back. mr. stewart. >> thank you, mr. chairman. and to you, gentlemen. i express my appreciation and gratitude and sincerely on behalf of millions of americans who may or may not recognize the really wonderful work that your organizations do and the many dedicate men and women who are sacrificing to do that. thank you. i would like to -- i suppose i could ask this question to nearly all of you, although director brennan and perhaps mr. comey as well you might be best suited, although, identity
probe issue opinion, in this conversation with apple which is taking a fair amount of time, the longer the problem has an opportunity to talk about this with all of you -- is the prospect of within a few short years we may be, use the phrase, dark, with heavy inrepresentation that doesn't allow us to -- encryption that dunce allow to us use law enforcement mechanism's national security tools, and i'm wondering if you would elaborate on what that really means. can we help the american people understand that the encryption which way not controlled. it is becoming wildly available, and how that's going to make it more difficult for you to keep us, as we expect, keep american people safe? >> director comey, if we could -- >> this is a problem that all of news the intelligence community have been talking about, to sound an alarm because we see increase anything our national security work, and the bureau
has significant criminal responsibilities, in our criminal investigative work, increasing situations where we ÷ñ orders, read the communications of terrorists, gang bangers, pedophiles, all different kinds of bad people, and with, again, lawful court orders and search warrants, incareer creasingly unable to make that search warrant effective, and enter a device with a court's per commission get what is on there that affects all of our work. you have seen it. this committee knows a lot about it. most prom lent any on the counterterrorism side with isil, which is reaching into the united states, trying to motivate people to either come to their so-called caliphate or kill in the united states, and when they find someone they think will either come or kill, they move them to a mobile messaging app that is end-to-end encrypted that we can't read with court orders and that is a big problem for is there. substitutes around the edges of it. people talk about metadata, the
information about who contacted whom. that's useful but no substitute for knowing what they're talking about. sometimes physical surveillance is useful. sometimes informants are useful. but there is no substitute. anybody who knows or work will say there is no substitute for a judge ordering access to content. we're just here to tell you there's big problem, and the darkness is going to grow and grow and grow, and change our world. >> director brennan, would you elaborate on that for more of anber national perspective and the work we're trying to do overseas in encryption and how that affects that? >> i'll start and i know rick will have some comments. one of the most important missions for the cia and -- is the terrorist threat we fails we need to get that intelligence that'ses within the intelligence organizations. the ability of these terrorists to communicate with one another in manners that make it very
difficult for us to uncover has been creasing and it is very -- has been increasing and is very frustrating and very concerning because they follow the press, they follow the discussions, they are very sophisticated. a lot of them have grownup an era of technological revolution and have been able to take advantage of that, and it has made our challenges very difficult. so, from my perspective, on the foreign intelligence front, the more intelligence that we can obtain through our lawful authorities, the better able we are to protect the american people. >> yes, thank you, sir. >> we track, when our foreign intelligence targets talk about the communications -- their security of their communications and we see a growing number of
them, because of the information that is in the press about the value of encryption, moving toward that in a way that inhibits our ability to understand what they're doing and what dreck director comey said about the difference between metadata and content it hugely important and often over looked. one thing to know a person is in a particular place at a particular time. it'sing? else entirely and necessary to understand in defeating terrorist plots to know what the target its, what the timinges, how the attack is going to develop. >> and in conclusion, i would just say this itch appreciate your conversation with apple and, director comey, you, i think, stated it well. this is a conversation the american people need to have. talked a little bit about 702 and at the pathway forward with that. but seems to me technology contractually some of these conversations may become moot because we may not have access to that information regardless because technology makes it impossible for tuesday the
>> the washington directyear of the organization moveon.org will talk about campaign 2016, their endorsement of bernie sanders and their thoughts on the back and fort between the congress and the white house on the supreme court nominee. be sure to watch c-span's "washington journal" tomorrow morning. join the discussion. >> c-span's campaign 2016 is taking you on the road to the white house, and saturday as the south carolina democratic primary. our live coverage begins at 7:30 p.m. eastern with election results and peaches from the democratic candidate, hillary clinton and bernie sanders, and get your reaction through your phone calls and tweets. join us saturday for live coverage on c-span, c-span radio, and c-span.org.
[applause] >> every election cycle will remind us how important it is for citizens to be informed. >> the home floor political junkies and a way to track the government as it happens. >> i think it's a great way for us to stay informed. >> a lot of c-span fans on the hill. my colleagues are going to say, i saw you on c-span. >> there's so much more that c-span does to make sure that people know what is going on inside the beltway. >> president obama took part in a discussion today about his enough initiative to find until treatments that are tailored to individuals such as a person's genetic makeup. it's called precision medicine. from the white house, this is 40 minutes. [applause] >> hello. it's such a pleasure to be
hosting this discussion today. we get to hear from panelists who are coming to us from very distinct backgrounds but all have distinguished careers and unique perspectives that unify around precision medicine. i will row dues them and they'll come out and we'll get started. our first panelist is trained as a lawyer and then decided to become a ph.d student, and studying biology and specifically the mechanism of a rare neurodegenerative disease. so, please give a round of applause for sonya volleyed. [applause] >> another sign 'tis with a nontraditional background, he worked as vp of software at
amazon before now creating an open source data platform which is devoted to helping treat type 1 diabetes. howard lock. applause. >> next we have the chief of urological surgery at the national cancer institute. he is responsible for discovering or being part of discovering half of the known genes that cause kidney cancers. mark lynnen. [applause] >> and it's my pleasure to introduce the president of the united states, barack obama. [applause] woo-hoo! [applause]
>> i want to get things started by asking you, mr. president, to kick things off. you have been talking about precision medicine since 2005 but a lot of us are still new to it. can you fifth news on the background. >> well, this is an incredibly exciting time in medicine generally, and the biological sciences and a lot of this traces back to the incredible progress we have made threw the human genome. i'm sorry, i have to talk with the mic. >> when it comes to the audio sciences. let me start again. this is an exciting time for medicine and the biological sciences and a lot of this traces back to the work that was done in mapping out the human
genome which is an enknow mouse endeavor. people in this room were involved in this process, chul the head of the nih, francis collins and at the time it was enormously expensive for us to do that. with the advances, computers, big data, we are now seeing a rapid acceleration in making that process cheaper. it is spurring on a whole knew set of fundings how diseases operate and how the human body and our cells operate, how areas like cancer, show that each cancer may be unique, even if it's in the same organ, and so all these insights promise the
possibility of us being able to cure diseases that up until now we couldn't figure out. we could often times with real blunt instruments treat, but it was very ineffective, or in some cases at least inefficient. and -- but we're now seeing the possibility of us identifying diseases, targeting them, individualizing treatments for a particular patient, and operating with the kind of precision that promises to reduce costs, provide much better care, make our entire healthcare system much more effective, and the key to all this is for us to be able to build up databases and because all of us potentially could have electronic medical records that
voluntarily, with strong privacy protections, we pool together so that researchers, practitioners, scientists, can share. we may be able to accelerate the process of discovering cures in ways we have never seen before, and our precision medicine issue in fifth has been designed to get -- initiative has been designed to get all these various building blocks brought together so that the whole is greater than the sum of its parts. so that, for example, the va, which has been gathering genomic data on the men and women who have served this country in the va system, can connect with researchers at a particular university who are focused on a particular disease. and can we use big data to
accelerate the research process much more rapidly. those kinds of opportunities are there, and the good news is that over the course of the last year, we have made this announcement about pmi, or precision medicine initiative, what we have seen is huge interest from the private sector, from the public sector, from the not for profit sector, from the medical community, from researchers, and today, what we're able to announce is that 40 more organizations or -- large number of other organizations are joining us in this process. there are whole new set of initiatives that will help to drive this even faster, and my hope is that this becomes the foundation, the architecture, whereby ten years from now we can look back and say that we have revolutionized medicine in areas like cancer, or alzheimer's, or some diseases
that cause so much pain and suffering for so many families across the country, and there's no better place to do it than the united states of america, where r & d has been the hall mark or driving not only our economy but improvements we have seen in life expectancy and the quality of life for people all around the world. >> thank you. want to go now -- [applause] -- i want to start by talking about successes we have had, from people on the panel, in the realm of precision medicine and go to some of the challengees we face moving forward, starting with sonya, who several years ago your mother was diagnosed with a rare prion disease and passed away. the disease is known as fatal,
insomnia. you have essentially devoted your life to making that name obsolete. you chose to get tested yourself. for the gene. how have you been motivated to be so pro-active? >> it's a great question. i would say deciding to get tested once i learned that my mom had died of a general nettic disease and i was at 50-50 risk of inheriting the same fate, which was mid-life onset, very rapid, neurodegenerative decline. these diseases are always fatal, currently untreatable. once i had that knowledge in my hand, and these decisions were all made hand in hand with my husband, eric, who is here today. through the two of us, the decision to pursue testing and resolve that doubt was clear.
we made that decision instantly. because we knew there was no going back to a time before we knew about our risk so we wanted to know what we were up against. what i couldn't have predicted is what would happen next. so, as you mentioned, i've been trained as a lawyer. eric had been trained as a city planner and engineer, and i don't think either of us went into the task with a vision of how it would change our lives one way or the other, but when we came out, with that positive test report, my life broke into two pieces. there was before and there was after, and what happened after is that we set about trying to learn everything we could about these diseases, and like everybody looking for answer we started with google, with wick e -- wikipedia. we read what we could fine on the internet, called up researcherred out of the blue, some of which were kind enough to take our calls etch we started attending conferences and started blogging, and four years later we're both
ph.d students at harvard medical school, and today we work side-by-side at the lab in cambridge, and there were devoting ourselves to developing treatments for these diseases. i'm so proud to be doing this but i have to say we have been immensely luck. the institute has adopted us. we have had some brilliant people take risks on us, like eric lander, who advises the president on science, sometimes advises us, too. amazingly. amazingly. but even with the best people backing us, there is no guarantee that we'll be successful in the lifetime. we're running this race day-by-day, and we still have to see where it takes us. i would say, in terms of re-defining the disease, as you mentioned, the diagnosis that was handed to me was fatal
familial insomnia, and from this variant in the gene has acquired that clinical designation over the years. so that name was given to it good a time when we didn't know what was at the root of these diseases. what we knew was. what doctors saw in the clinic, so some genetic prion diseases were named for symptoms like insomnia which some patients have and some don't, and some defenses were named for the doctors who observed the symptoms. but i think it's symbolic of the era we're in now that i think we can rename these diseases on the basis of what we are. now we know the molecular mechanism of our disease. this our greatest weapon. we're coming in knowing what our enemy is. we have molecular resolution on our target, and i think we do ourselves a disservice by clinging to names that obscure the mechanism of these diseases and the things that unite
patients with, quote-unquote different diseases that have flown under different names for many decades. i think of us as patient with general fret tick prion disease and that's the patient cohort i identify with and those are the people i want to help. >> while your studying a disease that affects 100 people worldwide, you're also studying this entire mechanism as people continue to share their data. >> absolutely. >> i know that you're supposed to go next but i'm going to hijack this just four one second. we're in my house. [laughing] >> but there's something that i should have mentioned that sonia's story, i think, highlights, and that is so often what we label as a healthcare system is actually more of a
disease-care system in which the patient is passive. you wait until you get sick, a bunch of experts then help you solve it, and one of the promise that precision medicine is not just identifying or giving researchers and medical practitioners tools to help cure people. it is also empowering individuals to monitor and take a more active role in their own health. now, in sonia's case obviously there's a very particular genetic variant she has to worry about, and the extraordinary strength and tenacity that she brings to this makes me really optimistic that she is going to help drive for a cure in this particular area. but for many people who may not have such a clear, specific
concern, you may still have genetic variants that alter how you think about your blood pressure, your likelihood for diabetes, a whole range of other potential diseases that if we get this right, if we do precision medicine well and we get the information, that data, to consumers, give them the ability to stay healthy for long periods of time and that is usually promising, and it's good for those individuals, it's good for society generally, because it will save on a whole lot of healthcare costs if we can prevent diseases from manifesting themself nets first place. sorry to interrupt. >> no it's -- >> but it's an important one. >> it's a perfect segway to howard, who is working not just as a patient advocate, your own
daughter has type one diabetes, but in terms of data sharing, you have worked to create a platform for data sharing, and you recently built for your daughter a pancreas, which imimpressive for someone with no train thing the medical sciences. how did you manage that? [laughter] >> no training required. it turns out i'm a geek dad. and when my daughter was diagnosed in 2011 the first thing i realized was, how, here are these medical devices, a continuous good luck coast monitor that measures glucose every five minutes minutes and n insulin pitch which delivers a deadly holmon, which you walk a tightrope of just a little too much insulin and you can have a seizure or go into a coma where
one in 20 people will die from too much insulin while they sleep itch realize it we couldn't get the data out of the devices easily enough. each device came with it own proprietary software and it was too hard to get the data out. it's kind of like imagine you bought a digital camera and you had to use the software that came with the camera in order to vie your pictures. so founded a company which is open source and nonprofit, and a bunch of other people also built open source efforts. a gentleman named john cossack who reverse engineered the continuous glucose monitor so we could read dat off that device, and another gentleman named ben west engineered the insulin pump. and dana lewis here with her artificial pancreas system and this community came together and
wrote software that allows those decisions, those precise decision about insulin delivery to be made in software0. so i put one of these together for my daughter. many other people put it toth for themselves. what it means is she gets the precise doses of insulin in a much safer and much more effective way. so basically what happened is by liberating the data from the device, we were able to come up with a much better way to deliver therapy, and i think it just shows the power of engaged patients and how important it is to liberate the data, not just electronic health record data but also device data. patients with type 1 diabetes shouldn't have to outsmart the very companies that they depend on for the life-saving devices and that's what we -- [applause] -- seen this community do. [applause] >> i want to move to
dr. lynnhand. you have been for decade doing research in reena cancer. when you trained as aing ourologial slush was only one disease, kidney cancer, had the same treatment, and you said this isn't working. these are different diseases. half of which you basically discovered yourself. you were doing precision medicine before it was cool. how -- what led you to senate what was your moment of saying, something needs to change. >> very easy in a way. i'm a urologic surgeon so if a patient comes to me with a small tide any tumor, we can cure 95% of those patients, but if they came certainly 34 years ago when we started with advance disease, 82% of them died within 24 months. so i said, we have to do something.
so we decided to tried -- we thought it was a gene for kidney cancer. we had no idea what a mountain this would be to climb. so we started out to look for the gene for kidney cancer. there was no human genome project at the time. it took ten years to find our first gene with worked on one thing for ten years to find that. we now know that kidney cancer is not kidney cancer. a number of different cancers that happen to occur in that organ. they look different under the microscope and have very different courses, some are very aggressive,/2x and they respond differently to therapy, and we know they're caused by different genes. and we use that now, and our management of patients all the time. i'll give you an example. we start with studying patients who had kidney cancer, and there was very difficult -- no technology to really do at this time zuo started studying families with rare forms of
kidney cancer, and our hoch was the genes would be the main genes for the noninheritted kidney cancer. that turned out to be the case. our first gene is the main gene for the mon hereditary main type of kidney cancer. an example. a young lady came up -- a young woman came up from charlottesville, 18-year-old, and she had a big kidney tumor. she came up with her mom. and i took out that kidney and that tumor on may 23, 1989. and even with my surgery, with our surgery, we still lost her. she died on february 1, 1990. seven months later. and her mom died 14 months after that, of kidney cancer. it ran in the family. took us 18 years to figure out actually what she had. we now know that gene.
we now know that disease. we manage those patient very differently than we manage patients with other types of kidney cancer. so, i saw a woman yesterday who was very nice woman, 42 years of age. she and her husband went to -- she had a very large kidney tumor. went to a very well-known medical center in the south, and they looked at that and they said, gee, that big kidney tumor, and that tumor has spread to her liver and to different parts of her abdomen, and they said, you know, we don't think surgery is going to help here and there's not a lot we can do to help you. they contacted us because they knew we had an interest in this. so we saw this lady and agonizedded what to do, and decided to do surgery, even though we knew we couldn't get all the tumor out. but we had seen people like this do well. we took out a lot of tumor and still a lot of tumor left in her liver. she is now 16 weeks on therapy
targeting -- we know the cancer gene that causes her cancer, that runs in her family, and yesterday we saw her and we couldn't fiend any cancer on her in the x-rays. i'm not saying this won't recure and i'm not saying we don't have miles to go before we sleep, but we are really encouraged by this, and we're encouraged -- we're seeing with the other types of kidney cancers, the first gene that we identified, that pathway, the fda has now approved seven drugs that target that cancer chain pathway. now, again, we've got a lot of work to do, and i couldn't practice medicine, really, without what we now call precision medicine. i couldn't do it. helps us decide what operation to do, whether to do an operation or not. what drug to give. but most importantly, our real goal is prevention, and the
president mentioned this. once we understand the genes' pathways, then we ought -- well, we hope we'll be able to provent those, and so it -- prevent those, and so it is incalculable to us what this has meant to how we manage these patients, and it has huge effect on what surgeries we do. what drugs we use. we saw this lady yesterday, the drugs are nope in my field not to work on kidney cancer, but i say this is a different type of kidney cancer. i think we have great future ahead. >> when you talk about prevention, is there an example mugniyahologyic therapy. how to keep that gene from being expressed or remove the gene? >> there's a number of potential strategies like that but what is was really thinking about here was understanding that pathway, and then, for example, if we could get to the day -- i say this to patients every week -- that we're not giving up and
we're not stopping until we have a way to prevent this, and i'd say a nice lady y like you, we can give -- if we had a 21-year-old, we could give a pill and say you take this pill for a month a year, and call us if you need us. so that's one strategy. >> and so what we have found here is what we thought to be one disease appears to be how many diseases. >> we know at least 16 different types for sure, we have more genes to find. >> to go into the thousands. is every tumor its own individual -- >> well, we'll have to see. i think so. i think every different tumor is -- i don't want to do -- is going to be a fight to the death, but just about. each gene pathway to different cancers could potentially have a different strategy. we say to ourselves and our patients, this is a marathon. it's not a sprint. >> so the question that raises
in my mind is how does that not become an ex-huge cost when pharmaceutical companies need to move away from a drug that treats many people to drugs that are treating small amounts of people, just because of scale and production. >> what the doctor is identifying, think, is the fact that we're just in the infancy of all of this. we're just beginning to understand at the molecular level and genetic level, what is happening in various diseases, and the goal of the precision medicine initiative is to figure out how to break down some of the structural or institutional barriers that prevent us from making the big leaps over the next several years. so i'll just give you a couple
of examples. with respect to being able to map out what is happening with different diseases and the similarities and the differences. why are some people doing okay with, why are people not. the more samples we have, the more data we have, the more we'll be able to learn. part of the problem we have right now is that every patient's data is siloed. it's in a hospital here, hospital there, a doctor here, a lab there. and so the goal here is, if we can pool and create a common database of ultimately a million people, that's diverse, so that they have a lot of genetic
variations. we can now take a disease that may be relatively rare, but because we have a pretty large sample size and start seeing patterns that we might not have seen before. but a couple things that requires. that requires first of all us understanding who owns the data, and i would like to think that if somebody does a test on me or my genes, that that's mine. but that is not always how we define -- [applause] -- these issues. so there's some legal issues involved. in terms of the model we use for health records, that hopefully will be digitalized more and more, companies help hospitals keep and collect that data, and they should get paid for that.
they're billing an infrastructure. but we don't want that data just trapped, so if i'm sick and i want to join with other people who have the similar disease than mine and donate our data to help accelerate cures, i've got to be able to work with the electronic health record companies to make sure that it can do that easily. and there may be some commercial resistance to that, that we have to talk about, although we're seeing some terrific participation now, and that's part of what we're announcing, of those companies in terms of helping that happen. there's privacy issues. we have to figure out how to make sure that if i donate my data, to this big pool, that it's not going to be misused; that it's not going to be commercialized in some way i don't know about. and so we have to set up a
series of structures that make me confident that if i'm making that contribution to science, that i'm not going to end up getting a bunch of spam targeting people who have a particular disease i may have. and so across the board, what we're trying to do is just make sure that all the various players in the healthcare system, including the researchers themselves, are invested in us building this broader capacity, because this can potentially also change how we do research. right now what happens is, the best researchers and the best universities often times are kind of hoarding their samples because apparently -- i'm not a researcher but that -- >> never too late, mr. president. [laughter] [applause]
>> good point. i'm not as smart as you. so the transition may be difficult. but -- >> you can try software. >> right. but my understanding is that the basic model of research at universities is having your samples, that's really valuable because that how you get grants and -- on the other hand, if we have a million samples that are accessible to researchers from all across the country and all around the world, and they're all able to at least shorten the lines of inquiries, and collapse them so that they can eliminate those things that are less likely to work and pursue those things that are more likely to work before you start getting into the more detailed aspects of the research, that ended up
being a cost saver. now, you're identifying one less point, which is something that we got to have some big brains out here to figure out, and that is the economics of treatment, because right now, if you have a big blockbuster drug, it may work really well for this individual, not so well for that individual, in the aggregate it works pretty well, and as a consequence it gets prescribed a lot, and the drug company can make a lot of money. if it turns out that we start knowing that it really works well for you but doesn't work well for francis, francis is no longer buying it, and we now have a smaller group of potential customers. and so there may be some pause in terms of making that
investment, and what we have to be able to do is to think about -- much in the same we we have to think about vaccines and right now we're working -- we just had a meeting about zika, where we actually think there's a promising pathway for diagnostics and veeps on this. it's -- veeps on this. it's not a real complicated virus, apparently. but how do we figure out a production cycle that makes sense, and this is where senator lamar alexander is taking great interest in this. this going to be part of the arraignmenttive process we have -- legislative process, ways where the government says we step in not to pay for every drug but there may be areas where we subsidize drugs that are really effective for ay
problem with the opiode epidemic is in 85% of rural communities we don't have mental health or drug treatment facilities. so i want to make sure people understand precision medicine is not a replacement for making sure people have just basic health care. and -- [applause] -- >> and we have to mike sure that's still in place but we don't get -- the genetic basis for addition, in wayeds we may discover ten or 15 years from now so it could have an aim impact. i think short term the opiode problem has more to do with the fact that a lot of people don't have basic health care. they put off getting help on pain management, the easiest way
to do it initially is just to get some pills. the pills run out, and then sadly it turns out that heroin is a cheaper way to refill your prescription and people are getting hooked. so, i think that's actually a different category of problem, but what it does speak to is the fact that the more we know about how to treat a particular problem, the more effectively we treat that problem. over time, the more efficient and cost effective the healthcare system will be. >> turn to sonia and howard, who are -- this is my final question -- talking about barriers to sharing, both in very open, advocates for donating dat, what has -- how do you encourage people to donate data and feel safe about it,
understanding the scorns what -- importance and what are the beyers to people feeling safe going forward. >> think it continues to be a challenge in the sense that we have come a long way ask so great follow the people behind gina and be people working to make sure that people with genetic diseases like mind don't fear discrimination but they still do, and i hear from patients all the time who are really concerned about even letting their pcp know that this disease runs in their family. it'sic with a disease where the phenotype is lurking they've don't have a health problem right now and kind of want to coates, and -- to coast and hide among the general healthy population as long as they can. what i hope to convey to people when we talk about this is the sooner -- we don't have a treatment now but the sooner
they become plugged into a system that is working on one, i think the better for everyone. having baseline data about what is your particular body like today will help enormously down the road if we have a treatment and want to ask, is it making a difference, or if they think their disease is beginning, and in rare disease is think we depend so much, all research depends so much on patient participants, and rare diseases, every person who. cods forward to participate is like a quantum leap in the amount of data we have. so i hope we keep working on the legal framework behind celebrating facials who come forward, and i think we're headed in the right direction. >> so, in the type 1 diabetes world, fortunately finding people who are willing to go forward is not a problem. just tell me how to do and it you can have my dat because it's for the greater good. the challenge is really twofold.
one is, with both devicemakers and also cloud service providers who house the data, there's this fear where they may say, we don't know what people are going to do with the data and we're worried about the liability if that data gets out. so one thing we can do is make it very clear that by publish are your data protocols you're not accepting any new liability. it is up to the people who take the data downstream to mike sure they're using it in a safe effective way. another challenge -- this is an easily fixed one -- is just making the inner faces available. device companies could person the data and control protocol ford theirs diseases, and cloud service provide efforts can use very simple well-known apis, mix programming interfaces. the president and i are both wearing our fit bits. there are apys that let us pull our data, and there should be
ones that let us pull our diabetes data. >> the president mentioned things like tissue banks and things. my assistant the other day said to me, you work with 140 people from -- on this kidney cancer. 29 different labs and branches at the nih. and over the years our approach has always been the same. that you shouldn't be surprised the progress people can make working together if you're not quite so concerned about who gets credit for the work, and i think that -- [applause] -- that's always -- you get so tied up. but we all think, those in science or those clinicians, all think, why did we go this field in the first place? oh ten patients and then you get involved in promotions and who knows what, publications or something, but the leadership comes from the top. the good news is we have great
leadership. leadership comes from the top and i think we can change the culture. going to take a little bit but we can do it. [applause] >> and just -- one of the charges i've given all the federal agencies working together on this is looking at the regulatory framework we have that was designed for another era of medicine and make sure we update it, and there's good bipartisan support for how we think about this. so, for example, we have a new fda commissioner, robert carter, congratulations. [applause] >> but the fda traditionally has thought about protecting the public health in terms of these are medical devices, and these are drugs, and there are certain categories and here's certain protocols we go through, and when it comes to gathering data,
disseminating data, making sure it's accurate, and valid, figuring our how it's communicated to the patient, or the individual who is interested in it, sometimes we're fitting square pegs into round holes and we may have to reconceptualize how to think about is to open up this space. i mentioned researchers earlier. part of the reason people are worried about getting credit is because research dollars and grants flow in the direction of who gets credit, and so rethinking how we design the nih and other agencies redesign their grantmaking. they encourage collaboration rather than siloing. so a whole -- privacy ask
security of the data that being disseminated. there may be other areas where we need to break down regulations that might have applied and made sense in another era of medicine but wont apply now and that's the kind of evaluation we're doing, because ultimately this is going to be successful because everybody in this process starts rowing in the same direction. this won't work unless we have the private sector coming up with innovation, and that includes the drug companies, and that includes manufacturers. ultimately, something that is just tracking your heart rate, may be able to track a whole bunch of other stuff that is giving you a constant flow of information on a daily basis keep your healthier. we want encourage that kind of innovation and don't want to
have bureaucracy stand in the way of that. and on the other hand we know there are possibilities for abuse, and really making sure we have private sector providers, researchers, doctors, academics, government officials, agencies, all figuring out what is the basic architecture and having an open mind about continually updating it, modifying it. it -- if we get this right now -- and this i includes the cancer moon shot that vice president biden is initiating, because a lot of the progress is going to be in this same space. making sure that we're all working in the same direction. if we do that, i'm confident that at least for malia and sasha's generation, they're going to be able to make progress in ways and live healthier lives in ways we could not imagine.
>> that's all our time. can we get a round of applause for the panel? [applause] [inaudible conversations] >> booktv has 48 hours of nonfiction books and authors every weekend on c-span2. here are some of the programs to watch for this weekend. saturday, at 7:30 p.m. eastern, david randall of the national association of scholars talks about of the books incoming college freshmen are asked to read before the first day of class. on sunday night at 9:00 on "after words" former cia director michael hayden gives an
inside look at national security in his book" playing to the edge: american intelligence in the age of terror." he is interviewed by james woolsey, former cia director in the clinton administration. >> metadata is the outside of the envelope for an electronic communication, and as you said, american law enforcement traditionally has been able to look at the outside of the envelope temp supreme court decided that the fact of your phone call, who you called, when, for how long, also was essentially the outside of the envelope. >> watch booktv all weekend, every weekend, on c-span2 2. television for serious readers. >> how can we best get people to pay attention to wasteful spending so we can define things that are interesting, different, easy to understand, because the government is so large
billion in 2006 and every year we can find earmarks in the appropriation bill it is released. >> sunday night q and a. >> tonight, house minority leader nancy pelosi talks about the refusal to hold hearings on president obama nominee. and speaker ryan talks about the budget and then a house hearing on the defense budget. today senators discussed the senators of republican leaders not to hold conformation hearings for president obama's supreme court nominee. the president said it is his