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>> good morning everyone andwelcome to or welcome back to cdc, it's greatto have you here, we're very much lookingforward to celebrating a 70th, seven decades of firsts at cdc. welcome to everyone who'shere in person as well as watching on live video. we have a lot to coverin a short time period and we're really delighted tohave past directors with us to celebrate, toreflect on the past,

and look forward to the future. there is so much to beproud of as we think of what cdc has accomplishedin the past and also so much to be excited about, aboutwhat more we can accomplish in the future. there is much to do tohelp americans live longer, healthier, more productivelives and we're delighted to kick off this conversationa very special public health grand rounds.

we're going to start with threevideos, we're going in order of service of pastcdc directors, so we we'll first behearing from three directors who couldn't join usby chance they're the three who go chronologicallyfirst bill foege, jim mason and bill roper, andwe'll hear about some of the great accomplishmentsand thoughts from each of their terms at cdc. bill foege served from 77 to 83,

of course this wasa momentous period in which smallpoxeradication was announced, the first aids caseswere reported in the mmwr, atsdr was established. we'll then hear fromjim mason and there, from '83 to '89 a period when the officeof smoking and health joined cdc and the polio eradicationinitiative was launched.. following that we'll hearfrom bill roper '90 to '93, the first youth risk behaviorsurvey, national strategy

for early detection and controlof breast and cervical cancer, other key initiatives. after that i'll come backto introduce david satcher who we'll hear more aboutand from in a minute, but we'll now go right tothree videos in succession. >> i actually startedat cdc 54 years ago when cdc was only 16 years old,i became the director 39 years ago and there were twoimmediate challenges, one was moralewas very low.

the nation had just gonethrough the swine flu problem, and with swine flu the formerdirector david sencer had concluded quite correctlythat this was a new virus, it was now spreadingin humans at fort dix, and we had no immunity. in the past, every time thosethree things came together there was a pandemic. he decided quite correctly tohave an immunization program against swine flu, but theepidemic never occurred

and some people hadadverse reactions. so while it was a brightpublic health decision, the political parties and thenews media made a big thing out of cdc havingmade a mistake. when joseph califano becamesecretary of what was then hew, he decided to fire davesencer because of that and morale at cdc was very low. a petition was written, sent tothe secretary which i signed, asking him to reconsiderwhich he did not.

so that was the bigchallenge - morale. second challenge waswhile cdc had started as an infectious disease agency,there were new things coming into public health; environmental health, occupational health, chronic diseases,and we had to look at what should the objectivesbe for this institution? we did three things, we sentletters to hundreds and hundreds of people asking "whatdo you think the priorities

of cdc should be?" dr. seth leibler then puttogether all of the answers into a coherent picture, andwe asked an outside group that became known asthe "red book" committee because of theirreport being red, what they thought weshould do and they looked at the suggestions, pasthistory and they came up with 12 priorityobjectives for cdc. third and last thing, we tookthe top management staff at cdc

on two retreats to berrycollege, and we worked out what cdc should be doingand how we should be organized. there were a numberof accomplishments that offset this poor morale. number one, smallpox waseradicated in the world and cdc was a majorpart of that. number two, the vaccine programand cdc became just first class. president carter andsecretary califano were totally supportive, made sure we hadthe resources, and we were able

to bring immunizationrates up to 90, 92, 95% and then we did somethingthat was just unbelievable, we asked whether we couldbreak measles transmission in the united states and we did. this led to internationalimplications because in 1984 jonas salkand robert mcnamara helped to lead an effortto ask the question, "how could we apply what waslearned in the united states to the world as a whole?"

and there was a task forceformed in march of 1984, called the task forcefor child survival. it included who, unicef,undp, the world bank, the rockefeller foundation and in six short yearsimmunization levels in the world were broughtfrom 20% up to 80%. so that on september 30, 1990 atthe world summit for children, jim grant was able to getup and say 80% of children in the world have receivedat least one vaccine.

he called it thebiggest peacetime effort that the world has ever seen. another great accomplishmentin 1978, the public healthservice started an effort to develop objectives inhealth for the year 1990. first meeting was heldat emory and at cdc and 220 objectiveswere set for 1990. by 1990, 50% of thoseobjectives have been met, but what was very importantit started a process

so every decade theseobjectives are updated and it doesn't matter whichpolitical party is in power. but this also hadinternational ramifications because rafe henderson, acdc employee, working at who in 1988, march of 1988presented the first objectives for global health in childrenand this eventually led to the millenniumdevelopment goals and now the sustainabledevelopment goals. there are other accomplishmentsthat should be mentioned two

for sure - reye's syndrome. two former eis officers, karenstarko and george johnson worked out the problem of whatwas causing reye's syndrome, and found that it wasbasically due to the use of aspirin in children who hadchickenpox or flu, and by advertising thiseven though the white house at that time did notwant this information out because the aspirinmanufacturers were putting pressure on them, just byputting this information

out reye's syndrome hasdecreased yeah, tremendously in this country andnow around the world. the other program ihave to mention is aids. this developed in the19- early 1980s and one of the unsung heroes was paulwiesner, who was head of stds at that time, he immediatelyput a half-dozen investigators on this problem totry to figure it out. then jim curran and harold jafferan the aids program for years and cdc did a very excellentjob at finally figuring

out what was happening with aidsand how it could be prevented. these were times of greatsatisfaction for me, we had some excellentsecretaries of hhs. three of them in particularjoseph califano, patricia harris and richard schweikerwere just as supportive of public healthas they could be. we had a fourth secretary,secretary heckler, who did not have a greatinterest in health, but those first threereally did help cdc.

we had two excellent assistantsecretaries for health, julius richmond duringthe carter years and ed brandt duringthe reagan years. the emergency responsethat cdc is so well known for has been absolutelyessential to the developmentof this institution. first of all, it's providedbetter health for people who are in the throes of an emergency. number two, it's providedtraining and education

for young people at cdc. but third it's also improvedwhat cdc has had to do in order to support that kindof an effort. so i think this is a tremendouspart of the cdc history. global health will continueto be an important part of cdc because we are the goldstandard for the world, and the ebola outbreak andnow the zika outbreak continue to show that the cdceffort is needed in order to provide for healthy world.

the last thing i shouldsay, i have regrets, one regret is i never could getinjury control funded while i was director of cdc. we succeeded in doingthat in later years but when we would set up abudget for injury control, the response was always "thisis a highway safety problem, this is a security problem, it's not a public healthproblem." we know it isand finally it was funded.

my other regret is how slowit was in tobacco control. tobacco control hascertainly improved and smoking rates have gonedown but it's been far too slow. and finally when i talk topeople who worked during that era at cdc, there is sucha great sense of satisfaction and they always talk aboutthe coalitions, and they talk about the humor thatexisted at cdc at that time. it was a wonderful job. thank you.

>> congratulationsare appropriate as cdc celebrates 70 yearsof distinguished achievement. i wish i could bethere with you. from my vantage point, thisamazing cdc shows no signs or symptoms of physicaldecline or dementia, in spite of the advancing age. it seems only yesterday whilei was serving as director, it was a younger organizationthen and we were struggling to upgrade and obtain essentiallaboratory and office space.

we were involved in the fightto get essential funding for aids research andcontrol activities. cdc had defined aidsrisk factors, and it was in the process of publishing science-basedprevention guidelines such as universalprecautions in mmwr. cdc had asked for authority to distribute an aidsinformation brochure to help reduce hiv transmission

and remove fear anddiscrimination. in 1987, this brochurewas mailed to a hundred and 4 million homesin the united states. we couldn't allowaids to distract us from other criticalendeavors like control of vaccine preventablediseases in inner cities where vaccine coverage lagged. the acquisition of the nationalcenter for health statistics to partner with cdcs celebrateddisease surveillance became

another step in establishingcdc's chronic disease prevention and injury controlresponsibilities. it required greatvision in 18, in 1946, to reinvent an obscureorganization called malaria control in war areas to becomethe communicable disease center. cdc's responsibilitiesand reputation grew through the ensuing yearsbecause of its staff. from the directorsoffice to housekeeping, they focused on excellence.

amazing outcomes wereproduced by dedicated employees with all sorts of academicdegrees in different backgrounds who worked at everylevel in cdc. enormous strength and innovationwere created by this diversity. visionary staff recognizethat the length and quality of human life shouldbe improved. they understood healthis a global affair, disease doesn't occurin one place without affecting thequality of life elsewhere.

my mentor alex langmuir was anexample of scientific excellence and visionary leadership. he earned academicrecognition before arriving at cdc. alex comprehendedthe threat of new and emerging infectious diseases and perceived the intentof future terrorists. where would cdc be todaywithout smallpox eradication and bill foege, don hopkins,d.a. henderson, david sencer and the many otherswho were serving

on a winning cdc who team? how well cdc faces thechallenges and opportunities of the future decadeswill unquestionably depend on those who worked there. can cdc continue toattract and retain the best and brightest scientists? will it thrive becauseof visionary leaders? the world needs visionaryscience-based leadership more today than ever before.

have a wonderful 70thanniversary celebration. i predict cdc will continueto be a light on the hill, a beacon directing the pursuitof public health excellence. my very best wishesfor the future. >> greetings everyone. i'm delighted to join withyou in this celebration of cdc's 70th anniversary. i wish i could be with youthere in person but nonetheless, we have a lot tocelebrate together.

during the time that i wasthere, with help from lots of people but especially marthakatz, we focused intently on what cdc's mission isand came to describe it as the nation's preventionagency. i see now that you'retalking about it as the nation's protectionagency, and that's the logicalfollow on. but it was during thatperiod that sen. tom harkin of iowa grew interestedin changing the name

of cdc formally to the centers for disease controland prevention. we happily embraced thatidea but asked him as well to make sure thelegislation specified that the initials wouldforever remain the cdc because of the brandequity that goes with that. speaking of prevention, itwas during my time there that with help from lots ofpeople especially steve thacker and steve teutsch, jeffkoplan and others

that we created the preventioneffectiveness initiative that brought the toolsof health economics and health services research tobear on the issues of prevention and how to advance the public'shealth through prevention. during my time as director,there was a case of what came to be known as healthcare workertransmission of hiv and aids. that caused a flurry ofattention appropriately so. and it taught medeeply the importance of cdc's meticulous commitmentto evidence-based generation

of public healthrecommendations. that commitment is somethingthat has stood cdc in good stead over these decades andwill long into the future. as we look forwardto what lies ahead, i just would further finallyremember for you that in 1993, there was an outbreakof hanta virus in the southwesternunited states, and the epidemic investigationand the infectious disease work and the public healthpreventive steps

that were taken highlightedthen the importance that persists even now forcdc to have a ready capability to put into actionwhenever called upon. we've learned that againlast year with ebola virus and this year againwith zika virus. so i think we need loudly tosay to the public at large and to the congress, it'simportant that cdc have that capability becausethe nation and the world depends on it.

i'm proud of the thingsthat you all have done that we've done together throughthe centers for disease control and prevention and it willdo long into the future. thank you very much. [ applause ] we're now honored to hearfrom dr. david satcher. dr. satcher served as cdcdirector from 1993 to 1998, he then went on serve as ussurgeon general for four years and assistant secretary ofhealth, dr. satcher was there,

was here, when thevaccines for children program was established, when pulsenet launched, whenthe fetal alcohol surveillance system was created and reallycan provide a wonderful both historical background and guide for where we should befocusing our attention in the future, dr. satcher. thank you very much dr. frieden for that very kind introduction.i'm delighted to be here

and to be able to share withyou this very special occasion. brings back a lot of memories because during my tenurehere we celebrated cdc's 50th anniversary and i'llsay a little bit about that. but i think these celebrationsare important because i think leadershipis important. over at our leadership institutewe have two major principles that i think thecdc exemplifies. one of course is that leadershipis a team sport as you've heard,

and secondly that leadershipis like a relay race and as you hear the stories about how programs havebeen taken to a certain point and then handed offto future directors. again, i think thecdc illustrates better than any place i canimagine that leadership is in fact a relay race. i want to start off by sayinga word about this hot idea of continuing momentum.

when i came onboard in 1993, as you've heard there was several important things to continue and i think the childhood vaccination program was certainly one ofthe most important. it was going well, except wewere having trouble reaching certain underserved communties. for example while the state of vermont had an immunizationrate of greater than 70% by the age of 2, detroit michiganhad a rate of 29%.

so we we targeted these citiesby developing partnerships with the mayors of these cities,we also develop partnership with the national council ofblack churches, with the council of la reza, withthe wic program. and i think these uhpartnerships made a great difference in our successat reaching children that we had had troublereaching before. you might say that my wholeexcitement about disparities in health was sort of bornduring that period of time

as we demonstrated thatwe could make a difference that we could make a dent. you have to say aword about hiv-aids and i'll just say two things- one i think it was during that early period thatit was really gratifying to see the tremendous reduction in children being infectedwith aids in utero. the fact that we wereable to educate parents, test pregnant women, treatthem and reduce the spread

of hiv from mother to child. one of the greatestsuccesses in fact in the response tothe aids epidemic. the other thing thatwe did here, you heard the name jim curranbefore and jim did a lot of things here with hiv-aids. claire broome, who is my deputyand i decided to see if we could pull all of thesedifferent aids programs together and so we, we pulledtogether a committee,

they worked for several monthsand came up with a proposal. helene gayle chaired thatcommittee, the proposal was that we bring theaids programs together in a new major institute atthe cdc, the national center forhiv, std and tb was born. around the mid 1990's and helenegayle was appointed to direct that institute and the restas they say is history. there were 36 studiesthat cdc had funded throughout the country toevaluate the whole issue

of needle and syringe exchange. there was a lot ofpolitical opposition to that, but the 36 studies showed that these exchanges coulddramatically reduce the spread of hiv aids and thatthey could do it without increasing drug use. in fact many of the people camein to treatment so we recommended that to washington,didn't go over too well. but, it's one of thethings about being

surgeon general and assistantsecretary for health. as assistance secretaryfor health i had to agree with the administration, assurgeon general i didn't. so i went around the country,encouraging cities and states to fund needle andsyringe exchange programs. that's just of course cdc hasstruggled with that in terms of the politics thatoften interfere with the successof public health. and i think bill foegementioned the national breast

and cervical cancer program. i think it's one of themost successful programs in the history of the cdc. when we started,there were 18 states that had these developed theseprograms, we were able to, to spread them to all 50 statesand i would imagine in terms of the lives saved all through out the country because of that program, it's innumerable. well, the second major thingthat we had to do and is a part

of the leadership transition andleadership as a relay race, was to bring in newinfrastructure strengthening programs andi'll just mention them. the emerging infectiousdisease obviously has been a real challenge. cdc has been a leader in terms of laboratory support throughoutthe world and since you are so familiar with ebola, i willmention that in the mid-1990s, in zaire, the congo oh there wasa major outbreak of ebola,

about 30% of the peoplewho died were physicians and nurses in this one hospital. cdc had a great team, they weresent to zaire and within less than a month of course hadcontrol of that outbreak. of course they were verygood but the difference with west africa of course wasthat in zaire, there was a river that prevented the easeof movement and unlike in west africa where peoplecould easily cross borders. you've heard about injuryand violence prevention,

and that is such an importantprogram that i have to say that i think it's one of thethe most important things that cdc has done it has not been easy and it's not easy today. we funded 8 centers ofexcellence for injury prevention and control, however,politically we again we ran into problems because one of, one of our grantees really did astudy showing that in fact homes with guns were not saferthan homes without guns. it was a very well done study,art kellerman and others,

and of course, withthat congress decided to take the money out ofthe budget and unfortunately to this day it hasn'tbeen returned but i think we're getting close. i'm an optimist. i'll mention a few thingsthat we tried to add to the infrastructure. i think the behavioral,the associate director for behavioral health, marjoriespeers was a very important

development, mrs. cartermentioned that last year at her symposium. i think mental health isimportant, i would be able to go on and release the firstsurgeon general's report on mental health butit started here at the cdc and our associatedirector for mental health. we also were able to buildon the work of bill roper and others, congress hadpassed legislation '92, allowing for the development ofthe cdc foundation, we were able

to appoint a board,outstanding board of directors for that foundation and to recruit an outstandingleader in charlie stokes. in the first ten yearsof that foundation, it raised over $100 million,because there are times now when it raises $100million a year, but it got off to a great start. it was a very important part of the infrastructure and still is. the department of health andhuman services had had a program

in prevention and a guide toclinical prevention and we felt that it was importantto go beyond that, so we started the guide tocommunity prevention and some of the leaders of that programare still here, but it turned out to be very importantand people all over the country havebenefited from that guide to community prevention. i mentioned the tuskegee studyand might, you may say well how does that relateto the infrastructure?

i think trust is avery important part of the public healthinfrastructure and i think what thetuskegee study had done and maybe continues to dois to interrupt that trust. there were people in the countrywho didn't trust public health because they knew aboutthe role of public health in studying these 400black men in tuskegee without treating them even afterpenicillin became available. the tuskegee study wastransferred to the cdc in 1959

and in 1972 it was discontinued. we felt that it was really important to revisit the tuskegee study. so an outstanding commission of100 persons were put together and they came out with thereport really revisiting what happened with tuskegee andwe presented that report to president clinton andsecretary shalala with then a recommendationfor a national apology which president clintonreleased on may 17, 1996.

it was important, itwas not just an apology, it said three things. one it said that anybody who received federal fundingwould have to demonstrate on an ongoing basis a knowledgeof the legal and ethical aspect of a research, doing researchin human population. that communities are, just like we have informed consent for individuals there had tobe community informed consent. and he recommended that there bea bioethics center at tuskegee

and that bioethics center is going strong under the leadership of reuben warren who i guess was director of the office of minority health, hereat the cdc at the time. well, let me close by sayingthat cdc is a great institution, there are always newand emerging challenges, the one that started ina big way while i was of course was theoverweight and obesity. the rapid rise in americans whoare overweight and obese and out of that of course came, veryinteresting program for those,

for that 50thanniversary our projects here at the director's challengewas to the get the cdc employees to become physically activeand to engage in good nutrition and i must say the dramaticincrease was impressive. they went from about 30% toabout 70% in that one year but the cdc populationwas quite engaged. led us to get thesurgeon general to do a surgeon general'sreport on physical activity and nutrition andlater on of course

as surgeon general, i releaseda surgeon general's call to action to prevent andreduce overweight and obesity. i'll say again istrongly believe that leadership is ateam sport and i believe that leadership is like arelay race and the challenge of passing the baton has beenmet quite well in the history of this organization,so congratulations on this 70th birthdayof the >> thank you very muchdr. satcher, and speaking

of passing the baton, we now move on to dr.jeff koplan 1998 to 2002. momentus years:world trade center attacks, anthrax attacks, the nationalcenter for birth defects and developmental disabilityestablished as part of cdc. so an expanding mission,an expanding mandate and an increasingly complicatedworld to navigate, jeff. >> thanks tom. well, cdc directors arepolitical appointees,

we've all been driven by respect for the institutionand its mission. thus we serve in acontinuum as david said, building on our predecessors andcontributing to our successors. similarly any individualsdirector's achievements inevitably involvefrom several colleagues to hundreds of colleagues. whether obvious or notit's always a team effort. we've got a, ahorizontal common mission

and a vertical handout mission. in 1998 in the fewweeks before and after i officiallybecame director here, the future prioritiesin many ways was shaped by three conversations. one a lunch conversationweeks before i started. i had lunch conversations withthe center directors, many of whom are lined up here today, but it was a differentcast then,

and i had lunch conversationwith jim hughes who i'm glad to see here about whatwere the important things in infectious diseases, andthe take away from that lunch which left me uneasy forever waswe needed to focus on bioterrorism, because it was notif it was going to occur, but when it was going to occur. a second conversation involveda phone meeting briefing with senior leadershipat who, and there seemed to be a slackening

of commitments topolio eradication. through further phone calls anda visit to geneva, we were able to get a reaffirmationof polio eradication as a vital global good and absolutely necessarypublic health priority. a third conversation took placein an antecedent auditorium to this, those of you mayremember auditorium the very appropriately and well namedauditoriums a and b and we met in a windowless roombeneath those auditoriums

to discuss the problem. should we continue ducttape and superglue repairs, or make a case for a completecoordinated multicampus building plan? it was a difficult decision tomake, we needed auditoria but these would requiremillions of dollars of investment to be torn...to be remodeled and at that discussion idistinctly remember suggesting that we knockdown the auditoria,that we didn't have funds put

up anything new so wewould have a field there and that we conduct whatevermeetings people wanted to have in that field with mega phones. protest was made thatit would be winter and people would be cold and theanswer was they can wear coats to the meetings. but we thought thatwould draw attention to what was an untenablecycle of repairing places that were well beyond repair.

the goal however wasnot to build buildings and the create a landscape, itwas to strengthen science at cdc as we entered the 21st century. we needed to recruit andretain the best scientists, whether they were laboratoryscientists, epidemiologists, social and behavioral, environmental, chronic infectious etc. to do the first-rate work that was needed and to do that first-rate work weneeded first-rate facilities.

the facilities we had atthe time were subpar to many of the better high schoolsin the atlanta area, and yet we were neverable to get traction on getting the fundsneeded to put that in place, and that this need forfacilities was true both in atlanta at its multiplecampuses, at the time we had over 12 separate campus spacesall scattered around the city but it was true of ourfacilities in hyattsville, morgantown, pittsburgh, fortcollins, etc. all needed help

and again the purpose was to get the best peopleable to do the best work. i think throughout cdc'shistory, when people are asked, why do you work hereand not at a university? i don't know if i could, like you could ask the reverse question of me now, and the answer hasalways been...mission! and without further explanation,we all know what that means. it's the particular callingwe have to be here and to do

that mission, anything thatinterferes with us doing that mission is a hindrance andundermines our efforts and so that was the spiritin which the buildings and facilities plan took place. we sought and achieved anaesthetically pleasing, energy efficient approach onmultiple sites in atlanta and our other locations. and rather than just a clusterof nondescript buildings, we sought a campus whose design

and quality would reflect thehigh quality of the workers and indeed inspire those workers to high quality workin their tasks. i drew up a crudeplan in that meeting in that subbasement room withthe sam tarr and george chandler and george still has it in thisflip chart page in his locker. however, at site he's atnow they're both still at cdc and that is the picture of arow of administrative buildings, a water feature in thecenter, a campus,

a trail around the whole campus so people could get some exercise, and new labs liningthe whole other side, it looks remarkably similarto what's outside now. in order to get that done,we assembled a great team with ginny harris leading agroup that addressed budget, architect and constructioncompany selection while martha katz worked withthe cdc foundation to put together the friendsof cdc, who played a key role in washington in gaining fundingand phil jacobs, bernie marcus

and oz nelson playeda key role in that. we couldn't havedone, you can't do it with state health departmentdirectors, you can't do it with public healthpeople, but business people who are contributors to the major partiescould play a key role in threatening legislators to do what they should havedone in the first place. a second achievement was

to initiate an acceleratedengagement by cdc in global health as exemplifiedby a rededicated commitment to polio eradication, theinitiation of the stop teams to which, to, today arestill active and effective by retaining a positive and mutually respectedcdc relationship with who and developing a globalhiv-aids presence. first for the globalaids program gap and then followed by pepfars.

and by working closelywith china to establish the china cdc,in a national surveillance and public health networkfor the world's largest, most populous country. third, we prepared forpandemics and bioterror but also for risk factors thatposed major contributions to the us burden of illness. we increased the stockpileof a new smallpox vaccine, we established laboratoryspecimens triage unit,

we strengthened activeserology and pathology units and provided stateswith training and agents such as anthrax that couldbe used for terrorist acts. we identified the obesityepidemic in an article in jama by cdc authorship receivedthe most press attention in jama history. we later linked thatincrease in obesity to a marked increase in diabetesand other chronic diseases. fourth, we sought tostrengthen capacities

of state health departmentsand fought for and gained a $1 billion increased appropriation from congress for state laboratoriesand health departments. fifth, we designated the10th greatest public health achievements of the 20thcentury, and used this to publicize the value of publichealth to the general population and to governmentdecision-makers. cdc is special, the mostimportant thing we tried to do was retain theunique aspects that make cdc

such a respectedand honored agency. we resisted the notion that cdcneeds to be more like the nih for dhhs or the dod, it didn'tthen and it doesn't now. it's a special place becausewe are driven by our mission, share core values,and are committed to addressing the needs ofthe poor, the underserved, and those at increase risk bothin the us and around the world. cdc has a unique culture,where leaders are surrounded by the best peopleand listen to them.

everyone regardless of rankis treated with respect. service is embraced as a callingand we strive to be humble about what we know anddon't know, and most of all if you work at cdc,you get to be part of a talented interestinggroup of people who genuinely like each other and enjoywhat they do every day. >> thanks so much jeff, we'resitting here now because of that relay race that'sallowed the establishment of these wonderful facilities

that match the world-classexcellence of our staff with world-classfacilities in the atlanta and around the country. dr. julie gerberding wasdirector from 2000 to 2008, again momentous years: sarsresponse, rubella eliminated in the us, hurricane katrinaand response and so we're very much looking forwardto hearing from julie. it's a incredible honor to be here and a little awesome to see this auditoriumso full of people

and i know there are peoplein rooms next door in and hopefully on the web, butwhat could be more fitting for bringing us together thanthe celebration of 70 years of absolute extraordinaryachievement in public health. we really do congratulateyou and hope that we do have at least 70 more years tocelebrate going forward. i've been listeningto my predecessors, and it is very humblingto think about the history that brought us to where we aretoday, but also the challenges

that are ahead of us, and wheni thought about what i would like to contribute, i thoughti would start with a reflection on the fact that during mytenure, i was really operating in the first 10 yearsof this millenium when we were dealingwith the flat world. that flat world of incredibledigital connectivity, financial connectivity andsocial connectivity as was described in a book bytom friedman, friedman, not frieden a few years ago.

and i think we've always beenrecognized globally as leaders in public health in incrediblyimportant organizations, but that's not always beenappreciated inside the united states or in our government,and some of the things that we've already talkedabout in terms of hiv and the other challengesthat we've experienced in this millennium havei think taught americans and america politicalleaders how important it is to have a globally capable

and competent publichealth agency in our midst. the first real exampleof that of course was the hiv-aids epidemicand the appreciation that this just wasn'tsome ordinary epidemic, that 40 million peopleat the early days of this millennium were likelyto be infected and living with hiv aids and 20million people were dying. that is a publichealth emergency, and it was a slowly burningemergency in the minds

of many people but when peoplefinally stood back and looked at it realized thatthis was a pandemic, and it needed global leadershipand a great deal more action than we'd been able tomuster up to that point. so the global aids programpepfar was announced in the presidents' daythe union address in 2003, and then the congressdid appropriate a budget of $15 billion over a fiveyear period of time which was at least commensuratewith the scale and scope

of the problem we weretrying to resolve. cdc was a main implementor but of course pepfar involvedmany partners many federal agencies and many, many,many thousands of people in the affected countries. but i think therewere some aspects of the pepfar implementationthat were uniquely valued and uniquely due to cdc. first and foremost wasthe fact that our work

in pepfar is based on science that we really exemplifiedthe importance of surveillance of really understanding thedeterminants of transmission, the scale and shape and scopeof the epidemic as it moved through communities, thevalue of interventions, the changes in virology,the epidemiology of the opportunisticinfections and so on and so on. that our pepfar implementationprograms were founded on that scientific framework

that really i think was thedistinguishing factor that built on the global aids programbut also kept us in the game as pepfar was administeredby the administration and the more consolidatedformat. the second thing ithink that was unique about cdc's contributionwas the fact that we built local capacity. we don't do pepfar through largeimplementing organizations, by and large, we work with localindividuals, training them,

helping build the people'scapacity who will stay and work in their communities andin their laboratories and in their clinics,so that when we leave the capacity remainsand we create an impact that exceeds theimmediate short-term value of the dollars thatwe contribute. the last thing i would say that i think is uniquelya cdc characteristic in this regard is something thatif you not have a chance to go

and visit a pepfar site youmight not fully appreciate, but it's how, highlyrespected the cdc teams are by the health ministries and thelocal government, that we're not in the embassieswhen we can avoid it. the cdc has been embeddedin the health ministries or in the clinical arena wherethey're working side-by-side with the local health officialsrolling up their sleeves on the front line and reallycontributing what is the best of cdc with incredibleinnovation, energy and passion

for what they're doing. these are some of themost recent results of the pepfar program that wereoutlined in this year's report to congress, i mean, i thinkthis is an extraordinary, extraordinary publichealth achievement that i truly believe wouldnot have been achieved to this magnitudewithout the efforts of an incredibly large dynamicand amazing workforce of cdc. now when i came intothe role we had,

well we we're stilldealing with the aftermath of the anthrax attacks, butit didn't take me very long to realize that, mother naturewas a much better terrorist than the people that we werefocusing on at the time. the very first experienceof course was sars, an epidemic that reallycharacterized how fast things can move around the worldin this very small world. literally overnight 11 travelersglobalized this new infectious disease, that was a verysobering reality and, and,

and one that i thinkcaused everyone to recognize the global natureof the threats that we face. that was followed innot very long time by the flu vaccineshortage when one of the two supplierswas not able to supply vaccinein a given year. that really illustratedthe vulnerability of our influenza vaccine system which is not a whole lotbetter today i know now

from my vantage pointin the industry and the, the need for global actionto secure a much more robust and accessible supply vaccine. next year we experienced the year of influenza on a seasonal basis but one that had anespecially challenging outcome for young children. the disproportionatemortality in children in at least some parts ofthe country, illustrating that even seasonal influenza canbe full of surprises and then

of course there wasavian influenza, a disease that was fortunatelynot very transmissible but had a very highmortality rate. and when you look atthese things in sequence, it doesn't take a greatimagination to appreciate that your mother natureis playing with us, something that moves fast, something that'shighly transmissible, something

that disproportionatelyaffects vulnerable populations, or something thatreally defies our ability to use our manufacturing andscience to mitigate against. finally, after all ofthese things happened, some people in washingtonwoke up again and realized that we really did need to takepandemic planning seriously. cdc published a great reviewof pandemic planning since 1976 and there was sort of awaxing and waning investment but no sustainedcongressional support,

no sustained administrationsupport for a true pandemicpreparedness platform, and finally that platform wascreated, the funding did follow, and once again cdc,while it was a whole of government effort, thecdc was the central dynamic that really created thescientific credibility and the platformfor preparedness. this is a great timealso to recognize that while we'recelebrating 70 years at cdc,

we wouldn't be celebrating ifit weren't for our partners in the state and localhealth departments and this is just one examplewhere they too, really stepped up to the plate and madeextraordinary contributions to what we needed to doto build local capacity. the flu summits that were held in every state wouldn'thave happened without of the leadership ofour state and local partners and as well the partnersin our healthcare system.

so that network,that connectivity or i guess the flat world ofpublic health really paid off. but in the center of the slideare just some pictures reminding me of the incredible importanceof the science in our labs, nancy cox who worked tirelesslyto characterize viruses and her teams of people willliterally going around the world to make sure that we understoodthe epidemiology and the virology of what was happening, and that we help prepare other countries to be able to do that.

our immunology branch with theinnovations and surveillance, all of the stockpilingin preparation for countermeasure deliveryand so on and so forth in a concerted way the pandemicpreparedness effort brought all of the parts of our agencytogether that really play a role in these kinds of infectiousdisease emergencies and i hope that that lesson which stilldoes not seem to result in, in continuous fundingwill ultimately be learned by our bill payers that wemust have sustained funding

for our infectious diseasepreparedness efforts because we are just always onetraveler away from an outbreak or one animal exposureaway and i'm sure, tom will talk a little bitabout zika in a minute. the last thing i wanted tosay was that we have done so many things inso many ways and, and yet there are some thingsat least for me personally, i regret i didn't put morefocus and attention on them, and two of them are illustratedin these photographs,

those are really the very linkedproblems the women and water. women because theyreally do hold up more than half the earth,and yet everywhere in the world there is stilltremendous gender disparities in health and in and allother humanitarian aspects, the women on the right at ahospital in kabul and the women, i guess this woman is thewoman who is retrieving water from the headwaters of the nileriver and there's a cow standing about 20 feet away fromher while she's doing this.

and then also really tellsme that it takes a cdc, it takes a cdc torecognize these kinds of cost-cutting challenges,it takes the national center of environmental health, but italso takes the national center of infectious disease, ofbirth defects, of injury, all of the differentcomponents of the cdc on a global basis haveplenty of work cut out for them going forward. i have no doubt thatwe will succeed

in making global contributionsin these areas as well and i, i look forward to beingthe, the loudest champion that i can be in any placethat i can be to advocate for what is necessary to helpthe cdc get the resources and the recognitionthat it deserves. david satcher got to say whathis leadership philosophy was and i take this advantage to saywhat my leadership philosophy is and that is it's an incredibleprivilege and i thank you for letting me be here today.

>> well it's a good thingthat we are in a literal and not a actual relayrace, because we're running about 25 minutes late, andi'm going to just show six or seven slides fromthe past seven years, seven and half years at cdcto give a sense of what some of the current actions have been and the current progressbuilding on the work before you heard from dr. gerberdingthe wonderful work done

in influenza are probably thebiggest risk that we face, if we can have thefirst slide please? it's so important to look backat what we've accomplished, but also look forward at what wecan accomplish in the future, it is as you've heard aremarkable privilege to serve as cdc director and somethingthat i think all of us treasure. i want to just very quickly note that we've had much progresskeeping the united states safer and stronger.

the lowest smokingrate in history, we've also seen healthcareassociated infections at least of some kindsfall substantially, we've also seen a steadydecrease in teen pregnancy also to the lowest rate inus history, something that we'vefocused on through partners. nutrition, physicalactivity, obesity, we certainly haven't succeededbut we've begun to see decreases in obesity in some populationsin some parts of the country,

younger children and somefood safety a progress for some pathogensand some products. we've also seen a dramatic dropin motor vehicle fatalities, although the past year showsnot such a positive trend, but we have seen abig decrease building on that injury work alwayschallenging, and in hiv fewer and fewer people are unaware oftheir infection that helps them. so that they can get care and that helps the society sothey're less likely to spread.

globally the relay race ofpolio eradication has continued and the world is closer thanever we've gone from more than 350,000 polio cases a yearto 74 last year and less than two dozen sofar this year. we also have seen thechallenge of dealing with ebola and i'll talk more about thatin a moment, but we were able to surge in with therest of the world to stop the world's firsttrue epidemic of ebola. we've also responded toemergencies as in haiti.

you don't often hear thewords "haiti" and "progress" in the same sentence, butactually we are on the verge of elimination of malaria,filariasis and maternal to child transmissionof hiv in haiti, so lots of progress there. we've also seen substantialprogress with global healthsecurity and this really, we think is the next big thing in global health as dr.foege says we need

to "tie the fears of the richto the needs of the poor". global health security doesthat by emphasizing that, unless every countryis able to find, stop, and prevent a health threatwhen and where it emerges, their country, theregion, the world and the united stateswill be at greater risk. we also have seen substantialprogress with pepfar and dr. gerberdingtalked about this, this is the largest bilateralglobal health program ever

and we've continued thatimportant relay race, the numbers you saw there, really transformationalthroughout many parts of the world andsomething you don't hear about is the widespreadtransmission of mers and that's because we were ableto work with partners to rapidly identifyit and stop the spread around the world and in the us. here at cdc we focused on beingstronger and more effective,

identifying areas where we canmake very specific progress. enhancing our scientificrigor including and especially our laboratorieswhich are truly the secret of our success at cdc. looking at future leadershipnot only through the eis program which celebrated its 60thanniversary recently, but also through the laboratoryleadership service analogous to the eis program,thought of a few years ago, but finally we've gotten overthe finish line to start it,

thanks so much for thestaff who have done that. i think in futureyears we'll look back at the lls is having asimilar transformational impact on laboratory science and safety that eis has hadon epidemiology. and our public health associateprogram, crucially important, literally rejuvenatingpublic health. we now have hundreds of newdynamic public health leaders with on the ground experience

on the front linesentering public health, and year after year they willinfuse a new sense of enthusiasm and accomplishmentinto our work. in communications we have honedthe mmwr as our main vehicle of communication, but alsomoved into social media where cdc now has the mostvisited health website in the world. we collaborate withhealthcare, understanding that the affordable care actbrings remarkable opportunities

but also real challenges,and the work of ensuring that we have qualityhealthcare delivered effectively to achieve public health gainsis crucially important for us. and emergency operations, the emergency operations centerhas been activated for more than 90% of the time ofthe past seven years, and that's a reflection ofthe world that we live in. ebola is importantto reflect on. it was, we believe, thelongest, most sustained,

most extensive responsein cdc history. we had more than4000 staff involved, more than 1300 peopledeployed to west africa. you see on the slide herewhat could have happened - exponential increase, what,what was projected to happen if we reached the tippingpoint of adequate care and adequate safe burial wewould then see a rapid decline. and in fact that'sexactly what we saw in both liberia andsierra leone.

at the bottom you see thatin that little noticed line at the very bottomof the top left, you see what would'vehappened with rapid control, in fact that range is exactlywhat actually did happen. so cdc's model bothguided what happened and predicted what did happen. nigeria could have been anabsolute disaster if cdc staff, along with cdc's trainedstaff in polio eradication, had not stopped ebola in lagos,there is every likelihood

that it would'vespread for months or years throughoutnigeria and africa, and we would still be dealingwith a global catastrophe. in march of 2014 ebolaspread in west africa. there was a limited response:tens of thousands of cases, at least 11,000 deathsfrom ebola, a larger number fromother causes. in march of 2016 anotheroutbreak - rapid response by host government, 13 cases,nine deaths, outbreak stopped.

that's the world thatwe need to work toward. we're now dealing with zikaan unprecedented threat, first time ever we've hada mosquito borne cause of birth defects. cdc staff are undertakingremarkable work, not only with programimplementation, but with innovations: newways to control mosquitoes, new ways to test for the virus;new uses of viruslike particles to create testing kits; andnew ways to control mosquitoes

with natural products that areeffective and low toxicity. all of these things willtake time but they remind me of a critical pointthat dr. foege makes. all of us in publichealth should be involved, not just in programimplementation, but in the rigorousevaluation of programs, and i think that's one ofthe great strengths of cdc that we've continuously beennot only willing but eager to ask the question - so what?

why are these programs importantand how can they be better? what are we doing to advancethe impact that we're having in communities and thescience that we have in our laboratories,on our computers, and with our partners. so thank you all very muchfor the work that you do in advancing public health. we're going to go over by about 20 minutes, so my apologies but ahh,bear with us,

and we're going to take questions from twitter. please send your questions to our twitter feed, and also from the audience. but i'm going totake the priviledge of asking two quick questions for your thoughts... we're facing real challenges with zika in puerto rico where it is spreading wildly but it's invisible. 80% of people don't have symptoms. no children with microcephaly have been born,

'cause that won't happen for a few more months, and the actions we are recommending are concerning... aerial spraying, try to knock down the number of mosquitos. this builds on the problem of lack of trust. the government like dr. satcher, he spoke of builds on the need for emergency response that dr. koplan and dr. gerberding spoke of. any advice on how we can advance public health progress in puerto rico with these enormous challenges?.

[laughter] dr. satcher? >> ...the only thing that iwould say is number one: you are facing a tremendous challenge, and i congratulate you for how you met it today. the answer is inpuerto rico though. it's not, it's not here. so i think if the issue of culture and values are reallycritical things in terms

of getting the cooperation of apopulation. they look, may look at micro-encephaly, not as welook at it when they compare with all of the other thingsthey're struggling with. so i think somehow we've gotto connect with the culture, that's easier said than done. so, that's why i said it. [ laughter ] >> jeff?? >> just buildingon david's point

when i was an eis officer myfirst two years at cdc, there was one behavioralscientist in all of cdc, his name was bill darrow,and today - hundreds. and it's an integral part of the complex public healthproblems we deal with, whether it's tobaccoor obesity or any of the infectious diseases. so to david's point early ongetting a community assessment: what drives people,what do they care about,

what would be an importantmessage -and i know there's an emergency situation, but maybethere's an emergency analog to epidemiologistsrushing to the fray. and it's to get a quickand dirty, if you, will a communityassessment as to what some of these answers are locally that will then make themeither more amenable to the interventions wepropose or the opposite -- and that causes us to takealternative approaches.

>> thank you, and in fact thatwas absolutely crucial in ebola where we had anthropologists and sociologistslooking at the situations. the second question i would ask is the, what i refer to as the question of "lane". when i got to cdcpeople told me "you know, that's not our lane.".and to me this is one of the great challenges ofcdc, because public health over the decadesexpands and contracts.

it expands as we add birthdefects or chronic disease or injury to our mission. it contracts as other parts ofgovernment spin off and create - whether it was 100 yearsago with the department of sanitation orenvironmental protection. but whether it'svis-ã -vis the state or local health departmentsor other parts of the federal governmentor hhs, how would you tryto define our lane?

i like to say publichealth doesn't have a lane. we have a superhighway. but this is clearlyan area where we can get into political challengeswhere there can be turf battles. but ultimately we tryto do whatever we can to protect people andto advance health. and how would youthink of that question of what's the appropriaterole or lane of cdc? >> i fear that the metaphoryou're using will promote

someone to say that's individualresponsibility to keep your car in the center of the lanewhether it's auto-drive or not. i think the lane forpublic health is... what kills, injures, and disables people, andhow we can both classify it, learn from it, and dosomething to stop it. and when we started chronicdisease activities at cdc in the late 70s, early 80sand then through the 80s, innumerable leaders inthis institution said

"we don't do that. we shouldn't havea cancer program. we shouldn't worry about heartdisease that's for nih to do". and others of us felt that was,'lief was, we would be a museum for our 70th anniversary rather than an active publichealth agency. >> i obviously agreewith what jeff said, the notion of a lane doesseem so anachronistic, and even a superhighway isa little slow these days.

so we're really a networkand we're hubs and spokes of incredible technical and, andtraditional knowledges that if, it's wherever there'sa problem we are likely to have something to contribute. that doesn't mean we alwayshave to be the leader, but i'm sure we can wadeinto almost any lane where there is a health issue that requires strongsurveillance, strong epidemiology,and strong assessment

of risk and risk mitigation. so, we're everywhere. >> thank you. dr. satcher... >> just briefly, jeff andi were talking earlier about the definitionof public health. i believe it was includedin the 1988 annual report that basically said public health is the collective efforts of the society tocreate the conditions in which people can be healthy.

now i've served onwho's commission on social determinants ofhealth, and we released that report as a big newthing, but when you look back at the definition of 1988it actually included all the conditions that can interferewith people being healthy, and i think that's our lane. >> great, i think we'regoing to go to twitter for our first questionand then will come to questions in the room.

>> much of america is stillplagued by unhealthy habits such as tobacco use, lackof physical activity, and poor diets thatlead to chronic diseases and a diminishedquality of life. what approaches will reducethe burden of chronic disease? >> way's to addresschronic disease... >> i think tobaccohas taught us so much, in that fifty-year reportfrom the surgeon general. so i think we've learned a lot, for example, we were

talking earlier, when california became the first state to pass legislation restrictingsmoking in public places, the response to that was notonly legal and how to stay out of jail, but cultural. it was no longer coolto smoke, it had to do with values and culture. i just think that that's one of the things wehave to keep in mind. we can learn a lot fromwhat we've experienced

with tobacco, it's amazing! >> just on the same note,in the early 70s if you were to describe a major decreasein smoking prevalence rates, the turning around of americanculture from a smoking culture to a non-smoking culture, people would have scoffed at that notion that this could happen. so when someone says to youthat we can't do something in public health, you can'tchange human behavior is what we hear often relatedto risk factors

for noncommunicable diseases and chronic diseases,that's garbage. we've done it innumerable times. when i grew up drivingwe didn't use seat belts, there were not airbagsrequired in every car. we've changed ourbehaviors in multiple ways to a positive health affectand tobacco is one of them. we'll have to do thesame in terms of diet, physical activity, interms of dealing with many

of the chronic diseases,and with obesity and hypertension etc. it can bedone, and the same thing needs to be done for gun control. >> i just add to thatthe concept of health in all policies, because inthe sense that's what happened with the tobacco successstory that we've created, a set of policies thatcome in many dimensions in many different locations,and took a long time, but ultimately they resulted inthe kind of sociologic change

that we're experiencing today. i think that theability to nudge people into better behavior,to create the right kind of behavioral economicincentives, whether that's through costs or rewards,there are lots of tools that can influencewhat people eat and how physicallyactive they are, and add into that our digitalera and all of the devices and nudging that we can achieve.

i just came fromhiking in the dolomites and i can tell youexactly how many steps and how many storiesi hiked every day. >> and i would just addthat there are real lessons to be learned from theinfectious disease world: surveillance, policy change, interaction withclinical providers, specific programsworking in different areas and documenting theevidence of impact there,

developing practice-basedevidence from for programs that work; all of theseare things that we've honed in our infectious disease workand they're all quite applicable to any health problem we face. first question in theroom, succinctly please. >> hi, i'm dr. camara jones. i'm the president of the american publichealth association and proudly a formercdc scientist.

at apha we are launchinga national campaign against racism, and especiallygiven the events of last week which brought to the fore againthe profound impacts of racism on the health and well-being ofthe nation, i would like each of your prospectiveson cdc's kind of legitimate leadership roleor not in naming, measuring, and addressing the impactsof racism on health, especially given the historyof cdc that we've laid out which is been one ofembracing more and more issues

as being within thelegitimate domain of public health intervention. >> yeah first, letme commend you camara for your leadershipin this area. i especially like the factthat you have put racism in a really clear perspective. it's not a situation where youpoint fingers at other people, but you say "this is a problemof society, we are all victims. now together we allhave to solve it."

i think that's why you'vemade such great progress, i know we have a lotmore progress to make. but i hope that we can all geton board with the fact that racism is aproblem of our society, we should acknowledgeit and we should work together, because we're all victims of it. >> and it's a crucialelement of public health, and it effects a widerange of health conditions and risk factorsacross the board.

so as we've all agreed thatsocial determinants are critically important,and racism is a, is one of these socialdeterminants. >> and also i would add that racism is a global issue. i think sometimes wethink of it as a us issue, but it's actuallyfunctional in just about any society i can thinkof, and we have to think about it broadly as a healthissue and a social issue. >> race is in manyways the original sin

of the united states, andwe have a great deal to do to continue to address thedisparities and inequalities in health outcomesin our society. and i think one of our rolesat cdc is to bear witness to those inequalitiesbut another is to identify very specific waysin which we can confront them. we'll go to our twitterfeed for the next question. if future cdc directors arewatching or listening right now, what sort of skills do you thinkthe next cdc director should

have to address someof the threats that could impact the waywe work, and the work we do? >> the question is what otherskills would a future director have to have? i'll say first, a thick skin. and accompany thatwith a sense of humor. >> well this is easyto say, but leadership, i think leadership skillsare probably most important, and cdc has a lot of very,very talented people,

very committed people, butwe still look to leadership to bring together the teamapproach, and to make sure that we're communicatingappropriately and things like that. >> and i don't haveanything to add, i think the thick skinreally hits home with me. but it, it is also reallyimportant i think to, to come to the role withhumility and to recognize that it is a team sport, butit's also a network of people

across far more thanjust the cdc or the public healthcommunity that have to be brought togetherto get anything done. so that ability to,to collaborate and to build a big tent ofpeople with different points of view and differentperspectives. >> just an added comment, thatprobably anyone who is out there thinking"that's what... i want to be the cdc director!"...probably not going to happen.

it's the person sittingout there that says "it's the lastthing i want to do, i'm really happy in whatever lab i'm working in or the project i'm working on,"you better worry about what... >> well, we've gone over. what i'd like to do is ask,starting with dr. satcher, for each of us to say a coupleof last words before we break for our receptionhere from judy monroe. but we have gone over in time,

so we don't have timefor more questions. but any last thoughtsdr. satcher? >> well, this actually comes from the satcher healthleadership institute at the morehouse schoolof medicine, and it's sort of a guiding principlewhich is much bigger than, of course, i am. but it says that in orderto achieve health equity, we need leaders whofirst care enough.

we also need leaderswho know enough, leaders who have thecourage to do enough, and leaders who will persevereuntil the job is done. and the cdc has beenblessed with a lot of leaders throughout theagency who fit that picture. >> that's a goodway to wrap it up. >> thank you. well, we've collectively agreed that we can't improveon that statement.

[ laughter and applause ] >> what truly makes cdcgreat, and cdc is great, is the people here at cdc. you combine the three criticalfactors that are needed - scientific rigor - and i like tosay that if you opened a textbook of medicine to any page randomly you'd probably find one of, if not the world'sexpert in that disease or condition here at cdc.

so a scientific expert alongwith operational excellence - the ability to get the job donewhether it's the public health advisor series orcontracting or grants or operational activities -that's crucially important. good ideas don't get anywhereunless you can implement them. but third and what you've heardabout, perhaps more frankly from others and i'm at libertyto say now, is the importance of politics and ofpolitical commitment to doing what worksto save lives.

and that key triad of science, operational in politics is whatallows cdc to protect americans and protect peoplearound the world. of course, to get to the rightpolitical decision means getting the right information to theright people in the right form at the right time so theright decision can be made, and that all can bedone with the science and the operationalaspects, within limits. but we also recognize thatit is a long-term battle,

that it's not something thatwe can change overnight, and a 70 year retrospectivehelps us remember how far we've come, recognize how farwe still have to go, but gives us the confidenceto know that we can take that baton, we can havethat relay race and continue to accelerate aswe improve health, reduce health disparitiesand protect lives - not only in this countrybut around the world. so thank you all so very much.

now i think were goingto hear from judy monroe. judy is the new presidentand ceo of the cdc foundation. she's done a tremendous amountin the first few months, great leadership, agreat help on ebola, so thanks for your support andshe's going to also tell us about our our receptionright outside. >> well thanks tom. just very briefly while ithink all of you would join me in saying incrediblestories, incredible 70 years,

and so much more yet todo, but in addition to all that you've heard this morning iwould also just remind everyone, i know for my own experience, that every single day thereare clinicians, individuals, public health officials,communities just across the worldthat are looking to your guidance using thoseguidelines and and looking to your expertise, and of coursecdc would not be the great organization that it iswithout the great leaders

as you've seen today. so, what a wonderful morningto be able to have the caliber of leaders such as drs. foege, mason, roper,satcher, koplan, gerberding and frieden with us today. a very, very special morning, but i want to reiteratesomething i heard from several of, of the directorsis that it's all of you. it takes a great team, so greatleaders have to be supported

by great teams, and i will saywhen i was at cdc and i continue to see this: the part, it's notjust your scientific expertise but it's that willingness to putyourself in harms way and, and, and personal sacrificethat makes cdc such a remarkable organization. so on behalf of the cdc foundation's board of directors and staff, we just want to reallycongratulate you on 70 years. we look forward to continuing tosupport you from the foundation

and with that thereis a reception. so thank you.