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tv   Public Affairs Events  CSPAN  October 17, 2016 12:40pm-2:41pm EDT

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>> that's an easy act to follow. >> he got all the hard questions. >> i want to talk to both of you about drug policy but also about largely the opioid problem, the abuse of opioids, prescription opioids. i want to start on a personal level. secretary vilsack, most people don't think of the agriculture department necessarily as the place where you would work on drug control policies. can you talk a little bit about why you've invested so much of your final year on that topic? >> i think there are two reasons. one, because this epidemic is ravaging rural areas that i care deeply about, and it is most difficult in rural areas because we have such a lack of treatment capacity in rural areas. so it's the people i care about
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that are being impacted. and it's personal. the reality is when i'm suffering prescription drug addiction and alcoholism, i understand a little bit about the pain and agony that those addictions can cause. i'm deeply concerned about the attitude that we collectively have in this country towards this issue. i will tell you, if there was another illness or disease that costs 28,000 lives, that costs the economy $25 billion in lack of production, that created $25 billion of unnecessary health care costs, i would believe that the congress of the united states would be falling all over itself to provide the resources to expand treatment and deal with this issue. they have not done that and they need to do that. >> and this is a bipartisan issue. when you're talking about rural america, you're not just talking about a democratic party that's more inclined to spend more on
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domestic legislation, domestic programs, you're also talking about a republican party with a lot of members who represent rural communities who are fighting. i know chairman rogers has dealt with drug use a lot in terms of his appropriating, but we have all seen shrinking budgets. how much is a budget a factor to treat this versus a lot of the other policy and individual challenges? >> that's nonsense. you fund your priorities. if you have 10 million americans who are currently misusing opioids, if you have 2 million americans addicted, 28,000 who are dying, 44% of america knows someone personally that is abusing opioids, it is a massive problem. it needs to be a priority. the president has made it a priority in his budget. he has found the resources in his budget. he said this is a priority. we have to expand treatment. we have to expand personnel. we have to expand prevention.
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congress has not yet made this a priority and what's even more irritating is that they've passed carp, the bill that authorizes what we're doing now. continue to do what you're doing but not providing any resource, any real resource to implement that bill or any aspect of the president's budget. again, 28,000 people. this is more than die in automobile accidents. what do we spend on highway safety every year? what do we spend on trying to deal with the situation of gun violence. this is a huge problem that is destroying families, that is crippling our economy in many areas, many rural areas in particular. it has got to be addressed. michael has been dealing with this longer than i have been. it's frustrating to hear politicians talk about this issue. it's really time to fund it. >> i would just chime in here and say not only is it appropriate in terms of the
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magnitude of the epidemic, but we can't afford not to do it. so why is it okay that we incarcerate someone for $50,000 a year but yet we can't find the resources to spend, you know, 1/10 of that on treating people? [ applause ] >> it is. it's about not should we have the resources but it's a priority. we know that substitutes in general in this epidemic have taken a huge toll on our child welfare systems, on our health care systems and on our criminal justice system. we need to reframe this as a public health issue and not a criminal justice system. we can't afford to keep doing things we've been doing. >> this is a big point. you don't get to the public health debate and discussion until you recognize what this is and what it isn't. it is a disease. not a character flaw, not a weakness, not something that
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someone with low will power can overcome. this is a disease and it has to be treated as such. if i came to you and said one of my two sons, we just found out he had cancer you would say, oh, my, that's so sad, what can we do to help? we need to be able to have that same attitude if someone comes to us, we need to empower them to come to us who says, i have a family member who is addicted or i am addicted. i need help. >> i call you michael because czar seems so informal and scary. >> to me, too. >> you come at this from the perspective of somebody who has battled addiction and you look at all the way up to the policy level for the entire country. you're talking about somebody who wakes up in the morning, millions of people wake up in the morning with a craving that is stronger than their desire to eat, stronger than their desire to stop. whatever the addiction is, it's
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that strong. all the way up to the doctors prescribing. talking about the criminal justice system punishing people for their addiction. what are the keys in terms of solutions for the future? you talk about the public health. i think a lot of people are ready to do that. what are the keys to trying to solve this problem in aho lis stick way all the way up to the change of the person who wakes up struggling with the addiction to the policy maker? >> sure. first and foremost, how do we prevent more -- particularly the opioid epidemic. one of the main drivers of this epidemic has been the vast over prescribing of prescription pain medication in the united states. a lot of people have roles to play in that. the pharmaceutical industry has a role to play but physicians have a role to play. so in 2013 we are prescribing enough pain medication in the united states to give every adult in america their own bottle of pain pills.
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many have their own experience. part of my efforts have been to have more training for prescribers around safe and protective opioid prescribing. the cdc wrote about how to prescribe these. we need to intervene as people's use becomes more chronic. we have been working more diligently to have faith based prescription monitoring systems. we have been looking at disposal. we know people who start misusing pain medication get them free from family and friends. we've been taught as good consumers, if we get a prescription and we don't need it or only need a few, to just stick them in the medicine cabinet. we know that's the start of problems. i will go back to what the secretary said.
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the administration is not doing everything they can. we know that there are too many people who don't get treatment in the united states. we just released data that show only 11% of people with the substance abuse disorder are getting care and treatment from this disorder, 11%. we know that those other people are over represented in all the areas that we talked about. and so while we can do more, the president has been adamant about making sure that people who need treatment are able to get it. you know, i can't agree more with the secretary. i just find it inconceivable that in the height of this epidemic that congress -- not only did they not fund the bill that they passed but have really not stepped forward in a meaningful way to make sure that people in all parts of the country have adequate access to treatment. >> mr. secretary, when you look at rural america and you look at the opioid abuse going on right
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now, opioids are not the only drugs that are being abused -- sorry. as you look at rural america and look at all of the abuse of drugs going on right now, how much of that is driven by economics -- economic factors, the ability to see doctors, to have solutions in health that aren't necessarily tied to medication. how much of it is -- drives economic issues in rural snerk when you have people who otherwise might be gain fri employed, addicted and not -- >> it is complicated everywhere in this country. i think it is more complicated in rural areas. in part, the nature of work in rural areas makes it more likely you'll confront a physical illness. that physician may not have been adequately trained about proper pain management alternatives. they may not be available. physical therapy may not be available. there may not be a hospital
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nearby. the second issue is if you have a situation where someone needs treatment, there's no place to go. there are over 1,000 behavioral service centers in the country that are located to provide to provide services with substance abuse disorder, over 1,000. only 25 of them are located in rural america. that's why the president said we need resources to expand treatment. the department of agriculture needs to be creative about the way we use our resources. you wouldn't think we're in the business of funding mental health facilities but we have. over a quarter million dollars has been allocated for that. you wouldn't think we'd use technology to link up remote rural areas for folks in need of help with experts who are located in urban centers there telemedicine. we announced millions in that space. we need a significant infusion. not just one off.
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we need hundreds of these clinics, hundreds of these opportunities in order to get that 11% to a more acceptable rate. >> your friend secretary clinton has talked about rural drug use on the campaign trail. has she made any commitments to you about what shield do as president investigate vee president obama is doing or a-- vis-a-vis what president obama is doing or any other policies that you see forthcoming that might be helpful for her? >> it's hard to answer that question because this is an official event so i have to be careful. very careful. here is what i will say, you cannot travel in any rural community in this country and any region of this country for any period of time without running into someone that will tell you a heartbreaking story about how their family is wrecked by addiction. you just can't. and then when you talk to professionals if there are any in the community you'll learn how limited the resources are to
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deal with it and how hard it is in rural areas for people to acknowledge that they have an addiction. >> it's self-reliant, self-independent. we're tough. we don't want our neighbors to know all of our problems. it's hard to break through that. in addition to everything michael indicated and in addition to budget, we have to have our faith-based communities and community at large, make it easier. make it acceptable. make it okay to talk about this as a disease. so that it's easier for people to seek out. i know in my mom's situation, she made the decision but in that magic moment when she made the decision she had a whole lot of help. she had a treatment center she could go to. multiple aa meetings that were available and sponsors that were there. just a phone call away. she had a supportive family. you don't necessarily find that in rural communities. that's why it's necessary for us to make this more of a priority than it has been. >> i also think, one of the things that we know is you can have as must have treatment capacity as you want but fundamentally if we don't change the way we perceive
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people with substance abuse disorders, we know shame and stigma plays a huge role in people not seeking care and delaying care and contributing to bad public policy and public laws. so that's why i think both of us talk very publicly about our own sperns with this. experience with this. so it empowers other people to be able to talk openly and honestly about our own struggles. secretary vilsack and i have talked to countless parents, and i have to get give parent a lot of credit, talking openly and candidly about their struggles, about solutions to this. we have got to create an atmosphere where it's acceptable and non-judgmental for people. to ask for care in the united states. >> if i could, and secretary vilsack, too, because we're running out of time here. are you finding there is more openness and there is less stigmatism overtime and that's not happening fast enough. what do you think folks here can
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do to try to destigmatize this disease? >> a couple things. i probably have a skewed perception but i do think that we're seeing people in recovery and parents being much more open and candid about their own struggles. i was actually just in philadelphia for -- september as recovery month and marching with 26,000 people to the streets of philadelphia and talk openly and honestly about this issue. we just hosted in the roosevelt room parents and children that have come together to talk about this issue. i do see it's changing. we have a long way to go. i still read too many articles where people feel like it's okay or question why we're reviving people from an overdose. like really? is that the best way we can spend taxpayer dplars? dollars? so we do have a ways to go but we have turned the corner in reframing this as a disease and not a moral failure.
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>> i just add for folks in the audience, you need to ask some tough questions of local officials. do you have access to reversal drugs so you can save lives. are your first responders are they equipped? if not, why not. are your schools thinking about ways to create sober schools and sober locations so kids struggling with addiction in a high school don't necessarily have to be returned to the environment immediately after they receive treatment. that they are given space to strengthen their ability and capacity to withstand the temptations that occur with any addiction. asking those questions and asking members of congress, what's up with no money. what's up with no treatment? why aren't we addressing this as aggressively as we have addressed zika. as aggressively as we've addressed ebola, other things that have been in the news. [ applause ] you cannot spend time with a mother or father or grandparent
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who has lost a son and daughter or grandchild. you cannot spend time with one of those families without being impressed with how much we have to do and how quickly we have to do it. there's 78 to 80 lives lost a day from this. not to mention the tremendous pain families are suffering today with kids they are scared to death they are going to open up that bedroom today and their child is going to be gone. we have to make this a national priority. we have to redefine this in terms of a disease and not a character flaw. we have to have resources so when that magic moment occurs, and it does, you have resources, you're in a direction that you're in a position to get the help you need to save your life. >> thank you very much. >> thank you.
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gentlemen, i want to thank you for being with us today. it is wonderful to get a report from the front lines of a battle against cancer we all have a stake in. i want to start with you, dr. dalton. i keep hearing that this quest against cancer is no longer a matter of curing it but trying to get into a chronic illness. is that right? >> not entirely. we would all hope we could cure the disease. i think the issue will be not so much, if you will, cure but accept. understand who is at risk for developing cancer. then if you can detect it earlier, the earlier you detect cancer, the higher chance of cure. actually call it cancer interception. >> there will be those that we
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can cure by totally eradicating the disease depending on when it's diagnosed the earlier the better versus when we hope once the disease has progressed to a certain degree control it. and make it a chronic disease. so i'm answering your questions by saying yes to both possibilities. >> does that sound right? >> of course. we're not going to be able to cure every cancer. but even the fact that we're using the word now, a word that in the field of cancer research has been avoided because of the fact that we couldn't deliver i think is important. the fact that there are now cancers we can cure there are now new interventions that are tremendously changing the way we live with cancer and, in fact, getting rid of it has changed the conversation. so certain cancers, some people with melanoma, lung cancer, for the first time they can change their survival from less than 5% to in many case 20, 30%. >> it's pretty year you have
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genuine excitement around cancer, but in the last five to ten years immunotherapy has taken off. can you give the audience a sense of why that is? why are people excited about immunotherapy as a treatment for cancer. >> it's changed the way we think about treating cancer. in fact, immunotherapy is not new. it's now 150 years ago people first started noticing that, people like william coley if you got an infection, your tumors went away. the idea your immune system could be used to cure cancer. what's changed with geno sequencing and knowing a what must takings are the immune system could see in part with the development of new drugs which changed the way we think about tumor immunology, take the brakes off t cells and allow them to attack the tumor. we moved from directly attacking a tumor with surgery, radiation, drugs and chemotherapy to now
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enlisting the most powerful system in our body, immune sister that protects us against viruseses, bacteria, find the immune system to seek out and destroy cancer. that's a total change in paradigm how we treat cancer. >> what have been the most startling successes and which particular cancers? >> probably people hear most about the successes in melanoma and lung cancer. that's because these are cancers that are are known to have a lot of mutations. sometimes tens of thousands of mutations. that's just prime soil for the immune system. they love to find mutations. so as we learn how to take the brakes off the immune system and how to get it turned on, you hear stories like about jimmy carter. you hear stories about people. melanoma had a less than 5% survival rate in ten years for stage four. now people are talking about 30 or 40% because of this new therapy.
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>> i know it works with some cancers. even then, something like in certain cases, 20% occasions, have researchers identified particular challenges and where it only works in a fraction of patients. >> yeah. i think we're right at the beginning of that. i think there's some really great clues of what's going on. i already told you, there's a correlation between the amount of mutations in a tumor. and pancreatic cancer where there aren't a lot of mutations. it's much harder to get the immune system geared up to be able to take it. what we're learning, and even in cancers where people could respond and aren't, there's a whole series of ways that this the immune system is being shutdown by the tumors. soluble proteins and microenvironment. new breaks or checkpoints being turned on by the tumor to escape the immune system. it's a battle, a constant battle in the body. and as we learn about these new
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molecular targets and two -- developing new antibodies, two classes approved. and probably another ten in clinical development right now. >> dr. dalton, are you noticing when you deal with patients sort of the good news about these kind of treatments has trick he would outward. are people coming in and saying, am i going to have a shot because of the new treatment? >> it created a lot among patients, it created hope. there are diseases we historically haven't done well, melanoma, gastric and pancreatic. the excitement of turning on one's own immune system, which was there to prevent disease and organizing it, if you will, through the systems that creates excitement and hope. >> i want to ask both of you, is there a risk? you were telling me, doctor, back stage that you're just
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coming off of a big meeting, a year ago or two years ago there was only 300 people at this meeting and now there are 1400. is there a risk that immunotherapy will take the spotlight off of other promising emerging therapies? >> i always worry about too much hype. i think we have to deliver. i spend my career on delivering and not on expectations. but i think what we learned at this meeting, and there's many, many talks about this is some of the older tools that we had in the tool box for cancer like radiation, like chemotherapy turn out to be a great interface with the immune system. so now combinations are being brought together where older therapies which on their own weren't successful now might be able to dove tail with immunotherapy. so i am constantly worried that the hype and deliverable are not going to go in line. i really think it's going to expand the other efforts and not in exhibit them.
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as we now see immunotherapy as standard care tool in the toolbox, to bring other therapies together with that to try to amplify it. >> i want to ask you a little about that meeting. what was the most exciting thing you saw there that you didn't know about before you arrived? >> i'll start on the first half because i know about a lot of things before they get presented a at meeting. i think there are two big things going on right now. one is that we are, in fact, following these new drugs into the clinic and showing patients that aren't responding to one of these drugs alone are now responding in connection with another drug. this combination therapy idea, the idea that you use molecular analysis is not just a random pick one from column a and one from column b but using molecular analysis, figure out which patients to treat with which drug at which time. this became clear at the meeting
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and mutations identify who to show to go after. another thing that excited me, something we might talk about later, progress in cell therapy. taking out immune cells from the body, growing them outside of the body so they become killer cells and putting them back in to attack tumor. >> is the gene editing technique involved in this? >> it will be. at the current time its not being used. it's taking t cells and manipulating them to put in molecules to help them target the tumor. other pathways we've talked about being damaging to the immune system, progressive checkpoint pathways. and there's now trials being designed. we're using this gene editing tool which can knock out single nucleotides out of the 3 billion in the genome so we disrupt one gene and one protein and that's
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a very exciting new area we're getting into? theoretically could it be used to identify different kinds of cancer. >> i think crispr, identifying targets to attack. it can one geno nucleotide at the time. you can start identifying kinks in the armor of a tumor cell, where it might be doing something it doesn't. crispr a new tool coming up with new pathways and targets. >> i want to ask you those that read the headlines, we're hearing about vice president biden's moonshot anybody tiff. you're aware of the data sharing aspect, which is the main thrust. can you give me an idea what
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kind of tangible effect it's having on the field right now? >> i think the moonshot effort led by vice president biden is absolutely essential. number one, it's created awareness of the issue. number two, it suggested some solutions. part of that is actually sharing. breaking down silos where much of the information and data is generated. so a major emphasis on the moonshot is on how do we create an environment for sharing and ultimately collaborative learning. it's necessary. what we want is collaboration among brilliant scientists coming together and looking at the same data and saying what if. what if we understood why some patients respond and others don't and collectively begin to pursue that. >> are there examples in the history of cancer research where you can point to and say a lack of data sharing actually hurt research. >> unfortunately i can think of way too many.
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>> unfortunately i can think of way too man? >> unfortunately i can think of way too many., i can think of way too many. most diseases are actually very complex. it's very unusual to have one gene abnormality and one disease. i can only think of one and that's leukemia where the gene is rearranged to create one target. and fortunately different groups found a chemical, a compound that hit that one target. now patients with this leukemia are taking a pill, which before required a bone marrow transplant to have a chance at a cure. what's happening, the complexity of these diseases, again, you may make a discovery but it's only part of the problem. what if we were to organize something so we can all see it and then share the observation. >> what would be the big disincentives to share data historically?
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has it been structurally, academ academia, how people advance their careers or an ip issue? >> pring you can categorize challengeses in sharing. one technical and the other more cultural. the technical side is truly addressable. we still have a loot of work to do. all of these are using different type of electronic medical records or different forms of data and they don't speak to each other. you can't really compare because they're speaking different languages. what we must do is create a more common harmonized approach to address the issue of interoperability so we can actually share. so there are some technical issues that need to be worked out. the other side is cultural, yes. historically faculty are advanced when they make discoveries. >> we are going to leave the discussion at this point. remind you can see any time in
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c-span library, video.org, take you to the white house for today's daily briefing. here is spokesman josh ernest. >> is that something the president expects to be over and done with before he leaves office or does he expect that will continue into the next administration. >> darlene, i'm not aware any sort of specific timeframe has been laid out for when that operation would be completed. obviously this represents the next important step in our campaigns -- our campaign against isil and iraq. the united states has mobilized 67-member coalition to support the iraqi government and iraqi security forces as they seek to rid isil from our country. mosul is the city -- it's the second largest city in iraq. it's the city where isil's
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leader announced their unfulfilled intent to form a caliphate. it is now the last major center of isil in iraq. the beginning of this campaign has been months in the making, and there have been a number of important steps that iraqi security forces have taken with strong support of the united states and our coalition partners to prepare for this assault against mosul. but this is obviously an important part of this broader effort to degrade and ultimately destroy isil. it's an indication that that of the is moving forward, but there's still a lot of important work to be done before that goal will be realized, even inside of iraq. >> does the president also see
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the operation as a test of his theory that you can defeat isil on the ground without putting u.s. troops on the ground? >> i would describe it as the next test. because the trust is, there's important progress that's already been made on the ground in iraq. there have been cities like ramadi and taken from isil. these were significant cities, significant in population size, that iraqi security forces did succeed in dislodging isil from. they did that with support of united states and coalition partners. this would be the next test of this strategy. the president would be the first to acknowledge this is a significant test given how the population size of mosul, large geographic area it encompasses
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and symbolic support isil has in control of mosul. dislodging them from the city would be a serious strategic game. that's why iraqi partners have been working closely over the last several months to prepare for the operation. >> does the white house have a message for individuals over the weekend to vandalize local republican office in north carolina? >> to advance a political age a agenda. on display in the presidential campaign, the significance those differences can never be used to
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justify violence. the president had the opportunity to speak at the 50th anniversary of the events in soma in the spring of 2015 a year and a half ago. the president acknowledged, championed and praised political activist activists to sought to overcome significant differences through the use of nonviolent tactics. their success is something that benefits all americans. their success has also been lasting and consistent with values we have long prided in this country. so that's the model that we should all aspire to, even in a season of rather heated political rhetoric. let me also say, i also saw the
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reports of democrats who are using -- at least self-described democrats who are using online tools to raise money among themselves to rebuild that republican campaign office. that's consistent with the values that we lift up in this country. that's consistent with the kind of political debate we should be having, which is neither side benefits from vandalism and violence. both sides benefit from vigorous debate on the issues. as long as we're guided by those values and guided by those kinds of generous sentiments we've seen from some self-described democrats, then our country isn't going to just endure this heated election season. we're actually poised to benefit from it. we're poised to move forward in a direction that is consistent with our values.
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that self-organized online campaign, i think, is consistent with the president's optimistic vision about the country and about the sense that for all of our differences, focusing on our shared values, we can make a lot of progress. our commitment to those shared values is what makes the united states of america the greatest country in the world. >> the president was talking about education today and he did that at a high school here in d.c. it reminded me past years he's given a back to school address and even spoken at graduation ceremonies. why did those go away? >> he did that a number of times earlier in his presidency. the president gave several commencement addresses this year. we squeezed as many onto the schedule as we could. >> thank you, i want to ask about the visit tomorrow from
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italian prime minister lindsey. i wanted to know, talk about what's on the agenda between he and president obama, some of the key things they are discussing. >> president obama is looking forward to welcoming prime minister renzi and his wife to the white house for a state visit tomorrow. i know the president and first la lady looking forward tomorrow, also the state dinner they are hosting. they will sit down to discuss a range of shared challenges united states and italy face together. some of those challenges include international response to fight carbon pollution and climate change. italy has been an important partner and made a constructionive contribution to the global effort we've seen to confront that threat. italy is a key member of our global coalition i was
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discussing with darlene. italians, for example, have made an important contribution in terms of training local law enforcement in iraq. to allow those cities taken by isil to establish order and basic civics in a community that would allow citizens to return home. italy played an important role in trying to help european partners confront immigration crisis. italy played an important role in the situation in syria. they are a founding member of the support group. italy has an important relationship with libya. that is important to international earths to try to navigate the situation in that country with regard to establishing and setting up a
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valuable government there. many issues we spent spend time talking about here and the international community are issues which the united states benefit from italy's support and friendship. and holding a ceremonial event tomorrow like a state visit and state dinner to memorialize that friendship and partnership and alliance is something the president felt was important before leaving office. >> another topic, prime minister modi called pakistan a mothership of terrorism as tensions are heightened. i wonder, does the white house have any response to that rhetoric regarding pakistan? i have to admit i have not been briefed. we have encouraged india and
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pakistan to resolve a number of issues. we have discussed on a number of occasions the significant threat that exists in pakistan from extremists. we also see pakistani people have been victims of extremist activities on far too many occasions. united states and pakistan have an important relationship in the region particularly when they come from extremist groups. united states and india. the relationship between united states and india, prime minister modi and president obama have allowed our countries to enjoy significant benefits. not just when it doss our shared security concerns but also when
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it comes to intertwined economies as well. >> i wanted to ask first, talk timing, obviously president, you guys have been talking for sometime trying to get going. i'm wondering why now and if you're confident you've done everything to prepare. >> significant groundwork has been laid. you point out this is an operation months in the works in terms of laying the groundwork to prepare for the operation. our expectation, it will take some time. in part such a large city but also in part because isil spent the last two years digging in to defend that city. we would anticipate that they will not hesitate to put innocent civilians in harm's way in an effort to protect that
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city. they will use a range of what we anticipate will be deeply unethical and dangerous tactics to try to hold onto that city. so we anticipate facing some significant resistance. what we also know is this is an effort that was organized by the iraqi central government, security forces against mosul operating under command and control of iraqi central government. they will benefit significantly from support of united states and coalition partners in terms of carrying out airstrikes. they have already benefited from training and many of the forces who have benefited from the training by united states and our coalition partners are taking part in this operation, so there's a direct tie between our investment in the professionalism of the iraqi security forces and likelihood of success that they are -- they will have. against isil in mosul. so this is an important
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operation but one that we anticipate is going to take some time given how significant the city is both strategically and symbolically, how large the city is and how long isil had to dig in and fortify defenses. >> i'm wondering, u.n. warning as many as 200,000 people could be displaced. the offensive. to go back to my earlier question, human taesh groups in particular had enough time to sort of establish refugee camps and sort of simultaneously the iraqi government has been encouraging people to stay in their homes rather than flee. and you raise the specter that is concerning everyone of suicide bombings and guerrilla warfare in the streets of mosul. can you talk about why or if the
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u.s. believes that advice -- >> obviously we've been coordinating very closely with the iraquis as they have tried to organize this campaign and do so with the strategic goal in mind of dislodging isil from the second largest city in iraq but also as they carry out this operation and try to save as many lives as possible. i think the first thing for us to acknowledge, is while isis has been in charge of mosul, they have engaged in a violent campaign to bring that city under control. they are killing civilians all the time. so the idea that we -- somehow the iraqi security forces should delay this operation because of their concern about the humanitarian situation in mosul, it doesn't make sense. so what we have tried to do, work closely with international community and united nations to plan in advance for potential
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that some significant or widespread humanitarian concerns could be prompted by this assault on mosul. i know that the u.n. put out a release earlier today or maybe over the weekend, sort of detailing some of the resources they mobilized in terms of tents and facilities where people who are fleeing violence could be housed temporarily until the operation has been completed. our expectation is that significant quantities of food and water have been mobilized and prestaged, may have to be used to treat those fleeing violence. there's a lot of planning undertaken to try to address the potential humanitarian situation that could be created. but look, the united states has contributed more than a billion dollars since 2014 to address the humanitarian situation inside of iraq. we've helped secure pledges
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around the world for more than 2 billion in humanitarian assistance and stabilization in the run up to the mosul operation. so there's a lot of investment that has already gone into this effort in advance of the operation. i think that we'll pay dividends as we continue to make progress against isil in mosul. hopefully we won't have to spend all those investments. hopefully the kind of humanitarian situation we're preparing for won't come to pass. but if it does, there are already significant resources mobilized and try to minimize the impact on innocent civilians there. >> do you -- strategy similar to liberating other iraqi cities from isil but humanitarian groups, including those, the u.s. fought alongside shia
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militiamen who by all accounts committed what could be war crimes as they were going through and sadly beat people, desecrating bodies. i'm wondering if the u.s. is doing anything to make sure this doesn't happen in mosul or to prevent those groups from getting access to u.s. arms. >> had is something the u.s. has been mindful of since the beginning, ensuring it's operated consistent with the needed to look out for basic universal human rights and to ensure these operations are not being used as a cover to carry out retribution against other religious groups is something we've been very focused on in context of other operations, not just mosul. with regard to mosul, making announcement about the planned operation, only iraqi security forces sbr mosul undertaking these operations to clear isil from the mosul city limits. and
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we have seen the iraqi central government military leaders of the iraqi security forces demonstrate and articulate a clear commitment to those principles. and we expect they will be upheld in the context of this operation as well. >> last one on a different subject, wikileaks, julian assange link had been severed by a state party. i wonder if we could chalk this up to proportional response that may or may not be announced for the u.s. in response to russian leak named a week or two ago. >> i've seen some reports of this, and i know there have been a lot of rumors swirling about potential this may have been linked to some classified u.s. operation. i'm not in a position to confirm whether that is true or not.
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i'm not in a condition to confirm or deny any sort of classified operation on the part of the united states of america. andrew. >> follow up on mosul. concerned about humanitarian operations but also political parts of this. in many ways mosul is a microcosm of problems in iraq at large involving sectarianism. essentially there's great concern about what happens the day after mosul is liberated. i was wondering if you could speak a little about the preparation. >> andrew, there has been an intense focus making sure once isil has been cleared from communities in iraq, that there is a strategy for stabilizing those areas cleared of isil. in some other communities, places like tikrit and ramadi, we know isil was intent on sabotaging infrastructure of these communities as they left them.
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and it's an indication of just how depraved isil's tactics are. but it's also an indication of the work we are likely to have in front of us with regard to a situation like mosul. but similar complexities presented in tikrit. more than 95% of the population of tikrit has returned to their homes and that community. and in ramadi about 200,000 people have returned over the course of this year, and that was only -- that's something we were able to do -- those people only able to return home after significant quantity of ieds were cleared from the streets. those of you who traveled with the president to saudi arabia this year will recall that the president's meeting with the other leaders of the gcc included a prominent discussion of the kind of financial commitment we would like to see from gcc cubs to stabilizing
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those areas of iraq where isil has been cleared. so the united states has played an important leading role in mobilizing resources that are needed to stabilize these communities, and we've had some success in rebuilding communities like ramadi and tikrit after isil has been cleared from them, but that's not to minimize the significant challenge we'll face in mosul. mosul is a large city, a larger population than ramadi or tikrit. we know the challenge will be significant, but we've done this -- i should say the iraquis have done this on a smaller scale with strong support of the international community. i think the international community recognize this is needs to be a priority. we can't be focused on military effort to clear isil. we need to be thinking ahead strategically about how to stabilize the city once it has been cleared. there are resources that have already been mobilized to ensure that's monaco we could do successfully. >> response to accusations while
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the military portion of this is well advanced, humanitarian and political are not quite so advanced and military being rushed because of timing that has to do with the u.s. political calendar and because needs a victory at home as well. >> with regard to the decision about twho about when to initiate, that's by the prime minister. the government is the one calling the shots. they should. it's their country. they are a sovereign nation. the support they are receiving from the united states and coalition partners is at their request. and obviously the united states has a very strong relationship with the iraqi central government. we're able to closely coordinate, particularly through military channels. and the iraqi security forces benefited significantly from the
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advice they received from the united states, particularly military leadership. but the united states is confident that the decisions that prime minister abadi is making are the decisions he's making for the right reasons. he's not going to be distracted by the american political calendar. he's going to be focused on the strategic considerations that are most likely to contribute to success on the ground in iraq. he's looking for the best interest of the iraqi people. he's interested in moving expeditiously, as quickly as possible, to clear isil from mosul, to stabilize that city, and to kick isil out of iraq. that's been a priority that he's been pursuing for quite some time. we've made steady progress over the last year, year and a half. this is the next step in that process. and again, i don't want to leave
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you with the impression i'm trying to down play the significance of this. this is going to be a difficult operation. this is not something that will yield success overnight. months of planning has gone into ensuring success of military operation but also in terms of thinking through the humanitarian and political challenges that are almost surely to follow, even after isil has been dislodged from the second largest city in iraq. >> i understand why you would want to paint this as abadi's decision alone but you're not suggesting that he did this without having an explicit commitment from the u.s. on intelligence assets and support. >> no. that was the reason i made that reference to close coordination between abadi government, the u.s. government, and the senior members of iraqi security forces and the united states military. there's close coordination here. ultimately the decision to move forward with this operation is
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one that was made and should be made by the prime minister of iraq. okay. kevin. >> thanks, josh. i just want to follow just a bit about coordination. there was some reports about the u.s.'s 101st airborne being on the ground taking part in some of the operations in mosul. while you can't speak specifically to who or what units may be where, are you prepared to tell the american people it is likely americans will die as a part of this operation in mosul? >> kevin, for which u.s. military personnel or which military units of the united states military are involved, i'd refer you to the department of defense. they will be able to give you some more detail about that. the role for u.s. military service members who are supporting iraqi security forces in this mission is the same role that they have played in other missions around iraq, which is that iraqi security forces will be in the lead.
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this is their fight. they are the ones who must fight for their country and regain the ground in their country that isil has overtaken. we've seen iraqi security forces benefit from the significant training they have received from the united states and other coalition partners including italy in clearing isil from other large cities or other large other cities in iraq. so there is a template for pursuing these kind of operations and completing them successfully. that all said, our men and women in uniform, who are serving in iraq are putting themselves in harm's way for our safety and security. we owe them a deep debt of gratitude. there's no one, including commander in chief, who would downplay the risk they are taking on our behalf. there also should be no misunderstanding that the role this they are playing there. they are not responsible for leading these operations.
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they are equipped for combat. they are equipped to defend themselves. but their goal is to provide assistance to military forces. >> does that include holding mosul after the primary battle is over? >> well, again, the role will continue to be the same. the responsibility for holding that community after isil has been dislodged from it will fall to the iraqi central government and iraqi security forces. i know one of the thing they are very interested in doing is try to rebuild local police force. that was critical to the success rebuilding communities like tikrit and ramadi and i anticipate they will be interested in doing the same thing again in mosul. so that will be the responsibility of the iraqi central government and that's the only way we can ensure their success. if the united states is in a position where we are chiefly responsible for their security, we have seen that's a strategy that does not yield the kind of long-term benefits we would like to see. if we're trying to stabilize
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iraq over the long-term, we need to give iraqi government the confidence and support they need to provide for their own security situations so the united states is not constantly put in the position of having to provide it for them. >> let me ask you about reports or at least complaints about possible election rigging and voter fraud. you've heard some of the folks in the trump campaign raise the issue prominently most recently. how concerned is the white house about the possibility of election rigging. i've read reports in colorado, you've seen this before, for sure. dead people voting and ballot box stuffing and people voting for family members and people who are not eligible to vote somehow casting ballots for years. how concerned are you about this? >> not at all. neither is mike pence, who is the second highest ranking official in the trump campaign. neither is paul ryan, if you believe his spokesperson who indicated he had confidence this election would be conducted
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fairly. when you take a look at the battleground states, the states where the presidential election is likely to be decided, we're talking about states like georgia and arizona and florida, north carolina, ohio, indiana, iowa. at least the states i've named, all of which are going to play an important role in this election, all have republican governors. presumably all those governors have confidence in the state's ability to manage elections fairly. we have seen these kinds of suggestion in the past. but any time there's been an effort to actually conduct a study and investigate suggestions of widespread voter fraud, there's never been evidence to substantiate it. so the president is very confident in the ability and honesty of election officials in both parties in states all across the country to ensure this upcoming national election is conducted freely and fairly.
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>> now that the vice president has signaled there will be retaliation for russian cyber attacks, can you tell us whether it's likely to be cyber attack in return or some sort of diplomatic retaliation. >> bill, we've indicated we're not going to take -- at least when i'm talking i'm not going to be in a position to take an option off the table for the commander in chief while he considers proportion ate response to efforts by russian to undermine or tamper with our political system. whatever response the government does settle on is something we're likely to announce in advance. it's also something in some cases we may not ever acknowledge. but what we are prepared to do is make clear this is an
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important issue for us and one the president and his team will consider very carefully. with regard to the vice president's comments, obviously he was saying something not only different than what you've heard me say on a number of occasions and the president on a number of occasions, the united states maintains significant capabilities in cyberspace. those capabilities far exceed the capabilities by other countries. >> you said there will ab response. has there been one already? >> again, as the president considers an appropriate response is not likely to be something that we'll announce in advance. with regard to -- it may be something we don't ever acknowledge. the one thing i will make clear, the range of responses that are available to the president aren't just limited to the cyber
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sphere. there are other responses including the use of financial sanctions. the president earlier this year signed an executive order designating authority to secretary of treasury allowing united states government to deploy economic sanctions against individuals or even countries that are involved in nefarious in cyberspace. authorizes to be considered as part of effective and proportional response. >> did the white house sign off on the justice department decision to prosecute general cartwright? and if so, why? >> those kinds of prosecutorial decisions are made by the prosecutor's office and without any input from the white house. >> the hacking issue, what do you make of these reports about these e-mails suggesting there was some sort of quid pro quo
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between state department and fbi offered in the -- during the clinton years there? >> not much, because both the state department and fbi have denied there's any such arrangement existing. >> seem to speak very clearly, plainly, that's what was happening, expected fbi and state department would say that it didn't happen. >> you're suggesting they would lie? look, man, if that's the place we're going to be in, i think maybe you should go ask somebody else. the point is both the state department and fbi indicated that the purported arrangement that is being flaunted around by congressional republicans is not true. and here is the other thing. the fbi did take a look into it. there were those that looked into the situation and they didn't choose to prosecute anybody. i understand congressman chaffetz likes to make a big deal out of these things.
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this is a leader of congress leading benghazi members of congress acknowledged was solely to drive down hillary clinton's poll numbers. if you consider who would be a bad messenger when it comes to prosecuting these criticisms, i might have in mind a congressman who has an official gmail address on it. that's what congressman chaffetz has done. doesn't put him in a good position to criticizes e-mail habits of others. >> you're saying the purported document is false somehow, was doctored? >> what i'm suggesting is, if there's a suggestion that somehow the fbi and state department were involved in a quid pro quo, the thing you would do is ask the state department and fbi if they were involved in quid pro quo, that's what other journalists have done and found both state department and fbi said on the record that was an inaccurate allegation. >> in terms of isis, does isis
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still have the ability to coordinate, not just inspire attacks despite mosul operation and despite where you think you are on the effort. >> united states remains vigilant about the threat posed by isil. we have degraded their ability on those attacks but we guard against them. that's why we continue to look for ways to apply pressure to senior isil leaders to prevent them from being able to orchestrate and organize threats to the united states and around the world. >> after mosul captured they will still have this ability? >> we know there's a significant chunk of leadership that remains in raqqah. being able to dislodge from mosul will have a positive impact from our standpoint in terms of degrading their ability to plan and organize and orchestrate plans overseas. it doesn't eliminate it. it's important for united states and the rest of the international community to remain vigilant about the threat.
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>> what's the administration thinking about raqqah and about the offensive there? >> well, we continue to support opposition on the ground engaged in shaping battlefield to prepare for commencement of that operation but not something that started yet. >> something to change the level of support or what the united states is doing to help the -- help its forces or allies, if you will, in syria. >> well, there's been important work done there in terms of helping those opposition forces reclaim a significant swath of territory in northern syria from isil fighters. it has put us in an important strategic position cutting off access to the border with turkey. but the operation against raqqah has not commenced at this point. >> what about the talks over the weekend produced nothing. so what's the next step?
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is there anything at all? >> again, i don't think that's how secretary kerry would describe what's happened here but you can check with him to get a better sense. >> what did happen? there was a meeting in switzerland, luzon, what happened in what positive -- >> secretary kerry continues to be engaged with our partners both in the region and around the world to try to exert diplomatic pressure in syria to try to reduce the violence there, to try to get the assad regime and russians to stop engaging in these kinds of tactics that actually target civilians. >> going to improve the situation in aleppo. >> there will be continued diplomatic -- major break enthusiasm. that was clear before the meeting and also after the
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meeting. what is happening behind the scenes is a continued sustained vigorous, diplomatic effort to engage the wide variety of cubs deeply concerned about the situation in syria to try to come up with a solution there that will reduce the violence, increase the flow of humanitarian assistance and kick-start the kind of political talks that are badly needed to address root cause of the problems in syria. okay. >> i want to get straight in regards to russia and potential for u.s. counter-cyber attack. you said what response the president does have, does that mean he's considering options at the moment. >> means the president and his team are continuing to evaluate exactly what russia has done and, yes, they are still considering the potential response. but again, i'm not really in a position to help you with verb tenses, though, in terms of you
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know whether or not any sort of -- any semblance of a response has already been initiated. >> the vice president's cryptic message to russia and their president in regards to these hacking attacks, was that something coordinated and encouraged by the white house? >> well, the vice president was obviously answering a question from an interviewer. but the vice president has obviously been deeply engaged in the questions national security team formulating responses the president believes is in the best interest of the american people. >> was that meant to send a message to vladimir putin? >> again, i think the vice president was answering a question. and he is obviously somebody who has a lot of influence on the policymaking process here at the white house. and he is somebody who obviously
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has decades of experience in terms of helping to shape and manage the u.s.-russia relationship. he's also somebody who spent a lot of time policy. and he understands the significance of these kinds of decisions, given that in many ways, the cyber realm is one where rules of the road have not been established. and establishing precedence specifically precedence and norms has long-term consequences. so he certainly understands the need for caution in prudence when considering potential responses. but he also is somebody who has his own deeply engrained sense of what's necessary to protect the american people and protect the united states of america. >> the italian state visit is tomorrow. there are some reports that italy may be the next nation to leave the eu, is that something
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would potentially be on the president'sen agenda. would he try to dissuade. >> a brexit-type response? >> i'm not aware that that's something that rates very highly on the agenda. when you consider all of the other high priorities that the two leaders need to discuss, that kind of, that kind of speculation i'm not sure will come up. >> a discussion about the eu is a low priority in tomorrow's visit? >> no, no, no, i think that obviously italy is an important partner of the united states. an important ally the united states, particularly when it comes to our relationship with europe and all of the efforts that we undertake to strengthen our collective security and strengthen the economic ties that bind the united states with europe. i think the prospect of italy leaving the eu is not one that is likely to come up frankly because i think i haven't actually seen that much coverage
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of that coming to pass. italy makes an important contribution to a stability in europe that make answer important contribution to the european economy. they obviously make important contributions to europe's security through nato. so, those, those i think are likely to be the topics of conversation between the president and the prime minister. >> and on saturday, donald trump suggested that presidential candidates should have to take a drug test. white house response? >> well so you're telling me that the candidate who snorted his way through the first few debates is accusing the other candidate of taking drugs. it's a curious development in the campaign. that's my response. michelle. >> are you saying just now that you think that the sniffling or sorting as you described it might have been related to -- >> not at all. >> okay. so what were you saying? what were you trying to get across when you say that? >> just trying to have a little
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fun. you guys are so serious today. >> you heard the gasps in the crowd. >> i was expecting more chuckles. it's probably my delivery. >> all right. so you were just saying -- >> thank you mark. >> okay, so you're saying that the portion of it is still continuing to evaluate what has happened with the cyber attack and to look at what the response could be, but you also said something about you're not in the position to say whether it might have been an issue. so can you just clarify that? is it possible then that whatever the u.s. response is going to be may have already started? >> i think what i will -- the best way that i can clarify the situation is just to make clear that our response is not something that we're going to be in a position to discuss publicly. >> right. >> so i can't give you a time frame about whether or not something has started or whether or not it's ended.
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the united states is evaluating what's happened. still an active investigation that is ongoing. the president and his national security team are still learning from that investigation. and there's no considering what sort of response is appropriate. once the president's made a decision about that. that's not likely to be something we'll announce in advance. and some -- with some aspects of the response, it may be something we never acknowledge, but the the range of responses that are open to the president extend beyond just the cyber realm.
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>> again, i think the point of both my attempts to answer an honest question and yours is ham strung by the fact that i'm not going to be in a position to discuss the response. >> when you say things like but the president is still considering what the best options would be. that sounds like there's been no response yet. >> there's only room for 60,000
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or so. but there could be 200,000 just in the initial days and we could see more than a million iraqis affected by this operation. so are you saying that those, when you say that the response that's been prepared to humanitarian concerns is well thought out and planned, are you saying that those estimates that we're seeing and the concerns we're seeing might be inflated? that you think that that won't be a problem to that extent? >> well, i think that our approach to each of these situations is to prepare for the worst. and that is why you have seen so many work going into preparing for a range of humanitarian contingencies. that's why you've seen the united nations taking the lead in trying to collect significant resources from around the world to prepare for those humanitarian contingencies. but, no one can predict precisely exactly what will transpire. we just want to ensure, and when
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i see we, the international community wants to ensure that we have thought through what those possible contingencies could be. and that's why you've seen the united nations work to mobilize temporary housing for a large number of people. there has been water and food and medical supplies that have been prestaged or staged strategically so that they can be quickly used to offer relief to individuals who are fleeing violence. and i know the united nations has actually indicated that they are interested in collecting additional resources because i believe there is more preparation that can be done to prepare for the wide range of contingencies. so, we're mindful of this potential need to care for the basic humanitarian needs of a large number of people flying violence from mosul. but what's also true is the
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people who are in mosul right now and have been stuck in mosul for the last two years are facing a rather dire humanitarian situation. we know that isisle, in attempt to exercise control over that city has killed innocent people. has tortured people. has used violence as a tool to try to pacify the population. that's why there's a sense of urgency but also to make sure that there are resources mobile ietzed to deal with any humanitarian contingencies that may arise. >> over the past couple of days, we've seen a number of women accusing donald trump of either assaulting them or acting inappropriate with them growing, what does the president respond to that? what's the administration's response to seeing some of these stories coming out kind of fast and furious? >> listen, i think for some insight into the administration's response, i'd refer you to the powerful speech
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that was delivered by the first lady within the last week. i think she spoke powerfully about -- about this situation. about the way that millions of americans, women, in both parties are responding to it. as she described it, it's something that goes to our coal values as americans, it goes to our basic sense of fairness and justice. and freedom. so, you know, she has obviously thought about and responded very powerfully with her own personal reaction to shh situation and the tone and tenor of the debate and the nature of the debate.
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[ inaudible question ] . >> i can confirm that u.s. strategic command detected what we assess was a failed north korean missile launch. over the weekend near the north western city. the missile is a ballistic miss and norad determined that it did not pose a threat to north america. as we said on a number of occasions, each time that north korea conducts a test like this, we strongly condemn this missile test because it violates the u.n. security council resolutions, that explicitly prohibit north korea's launches missile. the united states has worked
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with our partners and allies in the region to isolate north korea and to apply pressure to them. to try to persuade them not to engage in this kind of destabilizing behavior. and the united states is prepared, and is mobilized the appropriate military resources to defend our allies and ourselves. and that is why the united states has been in discussions with our south korean allies about deploying a thad battery and anti-ballistic missile battery to south korea to protect south korea from the ballistic missile threat imnatoing from north korea. there's other equipment and resources that have been mobilized in the asia pacific region including to japan, alaska, and guam. and to count they are threat and protect the american people and their ally us. all of that is the reflection that imnatos from north korea.
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and all of that reflects the president's determination to ensure that the safety and security of the american people is protected. >> other sanctions on these? >> i don't have a specific response to outline for you, but, you know, obviously the united states will continue to stay in close touch with our allies and those in the region to assure we continue to apply pressure to the north korean regime and protect our interest in that part of the world. >> north korean government officer has announced north korea preparing for the missile launch or mark for a nuclear test within the end of this year. so, how would you, you know, do this? >> well again, we've been deeply concerned about the willingness of the north korean regime to ignore or even flout their basic
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international obligations. and that hasn't just been a source of concern for the united states. it's also been a source of concern by our allies in south korea and japan. both china and russia have expressed concerns about this kind of destabilizing behavior from the north koreans. and, you know, it's an indication of just how isolated the north koreans are right now. okay. mark. >> the u.s. doesn't acknowledge that it responded to russian cyber nefarious action, how will russia know it's been retaliated against? >> well, again, i think this is -- the concerns that we have are concerns that we've made clear both publicly and privately. the president's alluded to previous conversations he's had with president putin about our concerns about their activities in cyber space. so, russia is certainly aware of
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our concerns about their behavior. >> so when there is response, you're saying russia will get it. they'll understand where it's coming from and that they're being retaliated against for their actions. >> again, i'll let the russians speak for themselves with regard to whatever it is that they conclude or understand about a particular situation. what i have tried stood speak as clearly as possible about our concerns about what the ic has concluded about russia's activities in cyber space. and i've tried to be as clear as possible within the significant constraints that i have here to make clear that the president believes it's important for the united states to use our resources, to protect our elections infrastructure and to consider an appropriate response. >> and one clarification, you said, you said the visit tomorrow was a state visit. i thought it's an official visit with the state dinner?
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>> it's not in my materials, but we can clarify to get to the bottom of it. go ahead j.c. >> i don't know all the plans that are in place for tomorrow, but we'll keep you posted. okay. i saw you had your hand up. >> thank you. the prime minister moodi said those remarks, at a big summit which was valid on the street, and the summit of china -- [ inaudible ] >> how do you see the commitment? >> well, i guess i would characterize it that russia has often made a strong case what they believe to be a strong case to the united states about our shared interest in confronting extremists. and not just in syria and iraq, but around the world.
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and there are things done in the past that could candidate that nair not committed as they claim to be. because they devote so much time to shoring up the assad regime. in a way that makes it harder to resolve the conflict that ends up fueling extremism. so, we've been so secret that we've been frustrated about russia's inability to live up to the commitments that they claim they're willing to make in the context of shared priorities. and the fact that they have not followed through on those commitments raises questions about whether or not they actually share those priorities. so, i can't speak to the specific statement that was signed at the brigs conference, but, you know, the united states does believe that there are countries around the world with
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whom we should coordinate to counterextremism. the forces of extremism only threaten the interest of countries around the world. and there should be an opportunity for the international community to coordinate our response and to counter those threats. >> again, i think china's an example of a country with whom we had been able to work very effectively in pursuit of some common interests, but there are some interests where we have not been able to -- where apparently our interests don't align. >> the united states has an
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aspiration to work more effectively in the community to counter extremist threats and there are countries like italy with whom the united states is able to work very effectively in a way that safeguards the safety and security for citizen in both countries. our relationship with russia and china is different than with a country like italy. okay. all right. goil, go ahead. >> by the u.s. and india registrations are concerned, any of the holidays in india that frighten against evil or evils i know that are going on. and millions of people around the globe are thinking, you know, president obama of course, but -- [ inaudible ]
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because they are keeping so many terrorists there and feeding them and wanted by the u.s. and india. my question is where do we go from here because they will call and online petition by the community that escaped sponsored terrorism to stop terrorism around the globe. >> well, i can't account for many of the things included in your question. what i can say in general is that the united states has been able to work effectively with pakistan to confront extremist
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threats that threaten the interests of both of our countries. at the same time, we've acknowledged on a number of occasions that there's more we would like to see pakistan do to confront that threat. in part because the pakistani people face a unique threat from those extremists. and there are many times when i stood at this podium being asked to respond to the attacks from extremists that were carried out inside of pakistan that resulted in the death or injury of many pakistani citizens. so, there is a built-in interest for pakistan to confront this extremist threat that they face. and there are a variety of ways in which the united states supports them in those efforts. but of course there is more that we believe that they can and should do. and we'll continue to have those conversations with them.
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>> as we have discussed a couple of times, the united states and india share deep cultural ties. they contribute greatly to the success and vibrancy of our country, our economy, and our democracy. and our country benefits from the large indian american population that lives here and makes tangible contributions to our country on a day lil basis. and so, you know, if -- if the issuance of that, stan, is viewed as by the indian community as an affirmation of
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the important role that they play in our country, then that certainly would please the president of the united states. >> great, thanks. okay. mac, i'll give you the last one. >> i wanted to ask you about a comment hillary clinton made in a speech to goldman sachs. this was a series of things that happened in the last couple of days. she was talking about covert activity. i think it was in the context of syria. and she said, we used to be much better at this than we are now. and now you know everybody can't help themselves, they go out and tell their friendly reporters and somebody else, look what we're doing and i want credit for it. i'm wondering where the president shares her concern that covert action is more difficult for the united states to take because there is a tendency in people to talk. >> yeah. >> well, it's an interesting question to ask the president's spokesperson, who i think over
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the course of many administrations have historically played the role of complaining about the unauthorized leak of sensitive information. i've on a number of occasions had the opportunity to fill that role in this administration as well. let me start by issuing my typical disclaimer, which is that i've been quite reluctant to comment directly on the stolen e-mails from a private citizen. and so, while i know much of the reporting indicates that there's plenty of reason to believe that this particular transcript is an accurate reflection of what she said. do think i want to initiate my response by noting the stolen nature of the materials. with regard to the president's thoughts on this question though which is where i think you're going, you all have heard the president speak on a number of occasions about how preserving
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secrecy and confidentiality does advance our national security interests. the president's view though is that we should be quite judicious about deciding to invoke that kind of secrecy. in fact, the president has undertaken a number of initiatives to make our national security apparatus and our national security operations more transparent. and even in the new york times over the weekend, mark, there was a careful look at this by your colleagues with regard to our operations in somalia. many of the details that were included in that story were
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reported because they were disclosed by the united states government that there were war powers, report notifications made to capitol hill about the deployment of u.s. military personnel. there were news releases generated by the department of defense. announcing certain counterterrorism strikes including those that were successful against shabaab leaders. there've also been public acknowledgments about investigations of strikes that may have resulted in some civilian casualties. the president believes that that level of transparency gives the united states of america the opportunity to indicate our commitment to upholding the kinds of values that we cherish. in fact in some cases the values that we're fighting for. so the president has long acknowledged the need for some secrecy. but he believes that so much of what we do to keep the country safe on his orders is something
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that is even more effective when we can be transparent about it. ing and there are cases it's not possible. and where it's not possible, the president believes it's important for those who have taken an oath to protect national security information to follow through on that commitment. but the president also, i think, part of his legacy will be the dogged commitment that he has pursued to make these kinds of operations and make many of these efforts more transparent than they have been in previous administrations. thanks everybody. we'll see you later. >> white house press secretary josh ernest wrapping up this nauz conference. if you missed this, watch all of it shortly on our website, c-span.org.
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>> c span brings you more debates from key u.s. senate races. tonight, three debates starting at 8:00 p.m. eastern on c-span. first from pennsylvania, incumbent republican pat toomey faces democrat katie mcginnty. then florida senator marco rubio seeking reelection, challenged by democratic congressman patrick murphy. and from ohio, senator rob portman debates former democratic governor ted strickland. that's at 10:00 eastern on c-span. tuesday, live coverage on c-span 2. a debate from indiana to succeed republican dan coates who's not seeking reelection. republican representative todd young faces former democratic senator evan buy. that's live at 7:00 eastern. after that, another debate to succeed a retiring member of the senate, louisiana republican david vitter. several candidates will take the stage, including republican state treasurer john kennedy,
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republican congressman charles and democrat caroline. that's live at 8:00 eastern on c-span 2. on thursday, the candidates and ohio senate race meet for another debate. senator rob portman and democrat ted strickland live at 7:00 p.m. eastern on c-span. from now until election day, follow key debates from house, senate, and governor's races on the c-span networks, c-span.org, and on the c-span radio app. c-span where history unfolds daily. >> and president obama getting ready to host the final state dinner of his presidency, the guest of honor, the italian prime minister. we have complete coverage of the event tomorrow at 6:30 p.m. eastern on c-span, we have a chance to speak with the italian ambassador to the united states about the dinner. >> ambassador, how did the state visit come about with the italian prime minister?
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>> it was an important event that counts a as sign of a special relationship between the united states and also have to say has a special relationship between president barack obama and the prime minister. >> how did italy get selected though for what could be the president's last state dinner? >> there were long standing tradition, relationship between italy and the united states. we are partners. we are allies. we have very strong community here in the states, but help say that our two leaders share the same view of international topics. they do consider that democracies have to stand together and both united states and italy had a special relationship and special responsibility. >> why do you think now? why now? it's been eight years, why now italy? >> italy, italy next year will be member of the united nations
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security council. next year in march, we'll be celebrating six years and it is important that italy's a prominent member of the u confirms the importance on european integration. so i think that also this european brofd framework will rank the discussions between president obama and the prime minister. >> describe our relationship, u.s./italian relationship. where are we working together? >> in many fields. we have military work in the standing side by side in many theaters. we share responsibility and our common endeavor to fight terrorism, we wanted to tackle the global issues ranking from climate change to migration. these are issues where the great tradition like italy and it has
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shared the same interest and shared the same approach. >> what's going on this week at the embassy as you prepare for the state dinner? >> well, as you can see here it's rather active and lively. there's a great sense of excitement. we are really excited by this event. we have many, many things to care about, but i think that myself and my staff, we are particularly excited and happy. >> and the prime minister, what kind of leader is he? what should the american people know about him? >> it's a young talented leader, very, very dynamic. it's the youngest prime minister ever in italy. and he brings the sense of enthusiasm. the sense of italian, italian personality and i'm sure that the americans will come to know and love a young guy and who will be here with his spouse. >> americans will see him with
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his wife. they will have an arrival at the white house. americans will see the pajts ri that goes into the type of visit like this. what's the coordination like between the prime minister's office, the embassy here, and our government? >> coordination runs very smoothly. we have the acts of corporation with our college of france or the advisement, the white house. the secret service, there are so many details to take care of. but as you said, this is a happy event. this is a celebration. so we are happy that we can share with our friends and colleagues that the moment. >> any special protocol for the italian prime minister? >> the protocol is particularly accomplishment when it comes to state visits. we will try to follow the different procedures with the jolly spirit and i think that what really matters is that we consider this as a celebration of a friendship of a long standing friendship, but also it
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is important for us to draw a common agenda for the future. >> and what is that future agenda looking like? what's the common ground, you talked about the military. where else? what will they talk about? >> if i may draw a line between the different topics, the many challenges, it's a fact that both president obama and the prime minister share the same approach. it means that we do consider that globalization requires on the part of leaders great care, we have to harvest the process, but we rest, convince that there are many opportunities ahead of us. >> does the prime minister have any concerns though that he'll talk to the president about when he has his meetings with him behind closed doors? >> yeah, the two leaders know each other. they work, they have many meetings and different, being the 20, so, they knew each other
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very well. i don't think that the prime minister will bring here is this. i will stay concerned but a deep understanding that in order to tackle this challenges, our countries, our democracies have to build bridges, have to stay connected because integration is the only way to harness this process. >> what do you think of the ainl people are hoping to get out of this visit for their country? for their leader to come here. and will they be watching? >> for sure. italians are excited. i'm sure that when president obama and first lady together with the prime minister and his spouse will be seen together at the white house. i think this will be a great image. the four of them will give the sign of a strong-boned and our
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italians will love it. >> mr. ambassador, thank you for your time. appreciate it. >> thank you. >> and our coverage of the state dinner for the italian prime minister begins tomorrow at 6:30 p.m. eastern on c-span. watch c-span's live coverage of the third debate between hillary clinton and donald trump on wednesday night. our live debate preview from the university of nevada las vegas starts at 7:30 p.m. eastern the briefing for the debate studio audience is that 8:30 p.m. eastern and the 90-minute debate is 9:00 p.m. eastern. stay with us for a viewer reaction including your calls, tweets, and facebook postings. and watch the debate live or on demand using your desk top, phone, or tablet at c-span.org. listen to live coverage. download from the app store or google play. >> and a hearing now on
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encryption and cyber security from the senate armed services committee last month. this runs an hour and 45 minutes. to waive the requirement for two more members in order to conduct the routine business for the 4,158 pending military nominations. which i'm -- none of which are
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controversial. is there any objection to that? they are two days short of the committee's requirement. the nominationings being committee for seven days. no objections been raised. each nomination waive the rule in order to permit the confirmation, nomination of these officers before the senate goes out for the october recess. is there a motion to favorably report these nominations to the senate? >> so moved. >> is there a second. >> i thank the committee. we wouldn't want to go out far long period of time with these pending nominations. none of which are in any way controversial. and i think that there was a cyber attack on admiral rogers
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automobile which accounts for him. i was joking. >> we'll begin with you mr. secretary. >> chairman mccain, ranking member reid. members of the committee. thank you for inviting us to discuss the importance of strong encryption. trends on it's use, and it's impact on the department of defense. with your permission. >> if you'll hold far moment, secretary, i forgot the opening statements. which is the reason why so many colleagues are staying here in order to hear that. >> we thought you were going to
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spare us. >> probably should given the calendar, but could i just -- i'll go ahead and we'll hold you, senator, secretary encryption has become ubiquitous across the counterterrorism fight. isil has leveraged messaging applications developed by some of our most innovative companies to create an ended encryption save haven where they can operate with near perfect secret ri and arm's length of law enforcement. intelligence community and the military. from syria to san bernardino to paris to brussels to perhaps even orlando, isil utilized encrypted which were limited to a select few of the world's premier military of intelligent services. as i've stated in the past, this is a complex and difficult problem with no easy solutions, must balance our national security needs and the rights of our citizens. we must also recognize the
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regime are eager to gain keys to encrypted software so they can further their own abuse i have policies situation suppressing dissent and violating basic human rights. and how it alters the way you do business. you have frequently spoke within this committee about so the-called dual hat. under which cyber command also serves as the director of the nsa. i will strongly recommend to anyone who ask that we remain in the dual hat relationship.
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this is the correct thing to do. it is a good solution given where we are. you were asked again in our hearing earlier this year and reaffirmed the need to keep the two organizations tightly aligned. that's why i'm troubled by recent reports that the obama administration may be trying to prematurity break the dual hat before obama, president obama leaves office. on friday it was reported that secretary of defense ash carter and james clapper have backed a plan to celebrate cyber command in the nsa. here we go again. oates plarge policy matter has apparently been decided with no consultation whatsoever between the white house or the department of defense with this committee. i urge secretary carter to provide this committee and the congress the details of this plan and his reason for supporting. i will hope you will explain what has changed since the last
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time the administration rejected this idea in 2013. and while i'm sure the phrase predecisional is written somewhere in our witnesses briefing papers, i would remind them that this committee does not take well to being stone walled while they're colleagues in the administration leak information to the press. even if this decision is not been made, our witnesses should still be able to provide substantive analysis on the consequences of separating the dual hat for our national security and for tax payers. let me be very clear. i do not believe rushing to separate the dual hat in the final months of an administration is appropriate given the very serious challenges we face in cyber space and the failure of this administration to develop an effective deterrence policy. therefore, if a decision is prematurely made to separate nsa and cyber command, i will object
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to the confirmation of any individual nominated by the president to replace the director of the national security agency, if that person is not also nominated to be the commander of cyber command. this committee and this chairman are tired of the way that congress in general and this committee is treated by this administration. these issues present larger concerns about whether the department is appropriately organized to manage the defensive and offensive requirements of the cyber commission. we know that the department faces challenges and recruiting and retaining top cyber talent. we know that the department's cumbersome acquisition system enters technological advancement and road as our superiority. and we know that the administration's failure to confront deficiencies in the cyber policy has undermined the department's ability to effectively defend, deter, and
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respond to our adversaries in cyber space. both russia and china have leveraged cyber to systematically pillage certain critical defense technologies, create uncertainty in our networks and demonstrate capability. make no mistake. they are the first movers in the cyber domain, and they have put us on the defensive. but the administration has consistently failed to provide a meaningful response. the latest media reporting that russia may try to undermine our electoral process underscores this point. russia is using describer to undermine american national interests and now it appears our democracy could be the next target. and the administration's response to a mere warning from the secretary of defense is that the best the united states can do? despite this committee's numerous request for the
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framework. the administration has failed to prevent any meaningful strategy, instead, it is evidently distracted itself with debates over the dual hat. instead of shaping the limits of acceptable behavior in cyber space, the administration instead has allowed russia and china to write the playbook, as a result, this administration has left the united states vulnerable. i look forward to hearing more about the cyber operations against isil and the challenges, opportunities, and constraints we're facing on the cyber front. senator reid. >> well thank you very much, mr. chairman. let me join in welcoming secretary and admiral back to the committee. thank you, gentlemen and men and women that you lead for their service and your service. this is a third committee hearing focussed on the encryption issue which underscores the importance of this issue and it's impact on national security. the rapid growth of applications and extremely secure physical access control to smart phones
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and computers has an adverse impact on law enforcement agencies at all level of government and impairs the ability of the intelligence community and the defense department's cyber community to account. at the same time, this helps to protect individuals, corporations, and the government against cyber crime, espionage, terrorism, and aggression. while fbi director comey has tireless less stressed the danger of law enforcement going dark, respected national security experts including general michael hayden, former director cia, and nsa. michael, the former secretary or secretary rather of homeland security have advised against compelling industries to ensure that the government always gives access to encrypted behavior. these say the cyber vulnerabilities are the greatest threat to the public and national security. and this debate underscores the complexity and difficulty in the issue that we all face and we all must deal with very quickly because it is growing as a chairman's testimony indicates it's a growing throat our
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national security and our law enforcement. major problem for law enforcement that the juncture is gaining access to data on devices that are physically in their control for foreign intelligence collection with physical access is really applicable the challenges overcome data and transit and to gain access to their devices when they are turned on and communicating. and the latter set of problems is not qualitatively new and i'll ask the question, were there others nanna the law enforcement issues? in addition to encryption and other important areas we're able to discuss today is the issue that the chairman brought up. that's the future of cyber command. i understand the administration is delivering on whether it is the proper time to elevate cyber command to a unified command and if and under what conditions the administration should terminate the so-called dual hat arrangement on which the cyber command serves as the director of the nsa.
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again, that is a very critical issue and one that we're very much involved and interested in. once again, thank you for your service and your appearance here today. >> madame secretary. >> chairman cain, ranking reid and thank you for inviting us to discuss the importance of strong encryption, trends on it's use, and it's impact on the department of defense. with your permission, i have a written statement that is a little longer than my opening statement hear and id ask it bl made part of the opening statement. i would like to underscore three points, first the department of
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defense strongly seeks robust encryption standards and technology vital to protecting our war fighting capabilities and ensuring that key data systems remain secure to our adversaries today and well into the future. the department support for the use of strong encryption goes well beyond it's obvious military value. for example, commercial encryption technology is not only essential to u.s. economic security and competitiveness, but the department depends upon our commercial partners and contractors to help protect national security systems. research and development data related to our weapons systems, classified in sensitive information and service members and department civilians personally identifiable information and health records. second, we are concerned about adversaries, particularly terrorist actors using technology innovation i

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