tv U.S. House of Representatives CSPAN August 16, 2010 6:14pm-8:00pm EDT
more than double the number of people who received treatment during the first five years of pepfar. we are raising our goal for care, to more than 12 million people, including 5 million orphans and vulnerable children. and we are raising our goal for prevention. through the global health initiative, we aim to prevent 12 million new hiv infections. to do that, we are embracing a more comprehensive approach and expanding on what we know works. we are moving beyond a-b-c -- abstinence, be faithful, and consistent and correct use of condoms -- to an a to z approach to prevention. because we need to use every tool we have -- the full combination of medical, behavioral, and structural intervention. that includes male circumcision, the prevention of mother-to-child transmission, improvements and the investments of making detection more available and affordable, education, and when needed, legal, policy, or regulatory
changes that will make it easier to protect populations. despite all the investments the united states has already made and that the world has already made, to stop this epidemic, we know we confront 2.7 million new infections every year. so if we are going to win this war, we need to get better results in prevention. and our strategy under the global health initiative will enable us to do so. so the immediate impact for pepfar is clear. its funding will increase, its impact will increase, and its prevention strategies will become more comprehensive. similarly, we are strengthening our support for the other health programs we fund around the world. we are increasing our support for the president's malaria initiative, with the goal of reducing the malaria burden by 50 percent for 450 million people.
against tuberculosis, we intend to save 1.3 million lives by increasing access to treatment. and we are scaling up our work in family planning and maternal and child health -- areas in which the united states can and must lead. every year, hundreds of thousands of women die from complications related to pregnancy or childbirth, nearly all of them in the developing world, and for every one woman who dies, 20 more suffer debilitating injuries or infections. and every year, millions of children in the developing world die from wholly preventable causes. saving the lives of women and children requires a range of
care, from improving nutrition to training birth attendants who can help women give birth safely. it also requires increased access to family planning. family planning represents one of the most cost-effective public health interventions available in the world today. it prevents both maternal and child deaths by helping women space their births and bear children during their healthiest years. and it reduces the deaths of women from unsafe abortions. the united states was once at the forefront of developing and delivering successful family planning programs. but in recent years, we have fallen behind. with the global health initiative, we are making up for lost time. all told, we will save millions of additional lives through our increased support to existing u.s. health programs around the world through this initiative. but what about all the systemic challenges that surround pepfar and usaid programs and other u.s.-funded health programs in
the field? the constellation of logistical, structural, legal, and political problems that decrease health and make life tenuous for the woman that i described a few minutes ago. as long as they persist, that will limit our or any donor's impact. women we save from aids will die in childbirth. children we save from polio will die from rotavirus. and on a broader level -- in terms of the scope and quality of medical and public health services available in communities and countries -- the future will not look much different than the present. we need to lay the groundwork now for more progress down the road by tackling some of those systemic problems, and working with our partner countries to uproot the most deep-seated obstacles that impede their own people's health. that is how we can make our investments yield the most significant returns and save the greatest numbers of lives, today and tomorrow. so let me explain a few key
ways in which we are pursuing this goal. first, we are working with countries to create and implement strategies for health that they take the lead in designing based on their distinct needs and existing strengths, and we are helping them build their capacity to manage, oversee, coordinate, and operate health programs over the long term. now, in practice, this will mean different things in different places. in some countries, our development experts are training community health workers to deliver basic care and answer basic health questions. in others, we are setting up supply chains and establishing drug protocols to ensure that medicine will reach patients efficiently. in still others, we are helping set up health information systems, so health workers can collect and analyze more data -- from the number of births and deaths to more complex
information, like the number of women who receive prenatal care at a clinic and return later to deliver their babies. countries need a sustainable system for capturing and understanding data, to continuously monitor and improve their own performance. second, we are focusing on the needs and contributions of women and girls, who are still frequently overlooked and underserved by health professionals who don't notice their suffering or hear their concerns. our commitment to promoting the health of women and girls is, of course, for their sake, but also for the sake of their families and communities. because when a woman's health suffers, her family suffers and then there is a ripple effect throughout a village as well.
but when women are healthy, the benefits are similarly broad. too often, the social, economic, and cultural factors that restrict their access to health services -- such as gender-based violence, child marriage, female genital mutilation, lack of education, lack of access to economic opportunity, and other forms of discrimination -- remain unacknowledged and unaddressed. we are linking our health programs to our broader development efforts to address those underlying political, economic, social, and gender problems. and we're working with governments, civil society groups, and individuals to make sure that the needs of women and girls are recognized as critical not only by us, but by the health ministers, the people at the grassroots who administer care every day, that they are taken into account in the budgets and the planning of finance ministries, prime ministers, and presidents. third, we are improving how we measure and evaluate our own impact. this includes shifting our
focus from "inputs" to "outcomes and impacts" -- that is, determining our success not simply by how many bed nets we distribute, but by how many people actually avoid malaria by using them correctly -- a fuller picture that demands that we invest in improving how we ourselves collect, analyze, and share data. fourth, we are investing in innovation, with a focus on developing tools that will help diagnose, prevent, and cure disease in the communities where we work, which are often remote and poor in resources. many of the tools and techniques we use to keep people healthy here in the united states are unsuited to the realities of life in other places. so we need to be innovative about how to reach people effectively. one example is by using cell phones. in several countries, we're working with public and private partners to help prevent
maternal and newborn deaths by sending timely and critical health messages to pregnant women and new mothers via cell phone. the cell phone has penetrated where health clinics have not. in another exciting example of the impact of innovation, we achieved a significant breakthrough just last month, when scientists in south africa successfully tested the first
microbicide gel to help prevent the transmission of hiv. this proof-of-concept trial was made possible with funding from pepfar through usaid and the south african department of science and technology, and it has the potential to be a major breakthrough in the prevention of aids, because it is an affordable tool that women can use without needing permission from their partners. too often, the men decide whether condoms will be used. but with such a gel, women will have the power to protect their own health. fifth, we are improving coordination and integration. and that begins with aligning all u.s. government programs within a country by finding opportunities to bundle services -- much like pepfar did in kenya, by linking hiv and aids programs with maternal and child health, tb, and family planning. coordination starts at the top, here in washington. the global health initiative brings together experts from across our government. and here today are the three extraordinary heads of agencies -- who also happen to be three exceptional doctors -- who are leading the day-to-day operations of the initiative. dr. raj shah, the administrator of the u.s. agency for international development. dr. eric goosby, the u.s. global aids coordinator at pepfar. and dr. tom frieden, the director of the centers for disease control.
their agencies, along with the national institutes of health and other agencies from the departments of health and human services, defense, the peace corps, among others, will work together under the guidance and direction of deputy secretary of state jack lew who is also here with us today. now, this is a unique leadership structure and it embeds our commitment to coordination at every level, from the white house down. sixth, we are working with existing partners and seeking out new ones. we want to align our efforts with that of other donor countries and multilateral organizations, many of which do outstanding work to improve global health. let me just mention one in particular.
the global fund to fight aids, tuberculosis, and malaria. this organization has had a transformative impact on the world, not only in the millions of lives it has saved, but by creating a new model for how global community can come together to contribute and to coordinate in the fight against epidemics. the united states was proud to be the fund's first donor and its largest donor. we remain the largest donor under president obama's request for 2011. but our most critical collaborations will be with our partner countries, and we are going to be calling on them to bring their full commitment to this effort. because after all, their contributions will determine whether we succeed with our goal of building integrated, coordinated, sustainable systems of care for more of the world's people. we need only look around the world today to see how critical country leadership is. in places where governments invest in their people's health, where civil society groups are empowered and engaged, where health is recognized as a priority in every sector and at
every level of society, health improves and people thrive. consider the progress in south africa with respect to hiv/aids. this country has one of the world's highest burdens of hiv. for too long, some of south africa's leaders had a view of the epidemic that denied the link between hiv and aids. but that has now changed. under president zuma, the south african government has come forward with a real, renewed commitment to battling the epidemic, with increased funding and strong goals for increasing testing and treatment. the united states has demonstrated our support with additional funding to help south africa build its capacity to meet those goals and address the epidemic over the long term. to galvanize country leadership, we are bringing to bear the full weight of american diplomacy. our diplomats are working
closely with their counterparts worldwide to embed a deep commitment to health -- not only in the office of the health minister, but the foreign minister, the defense minister, the finance minister, and especially at the top, in the offices of prime ministers and presidents. too often, we've seen health relegated to the sidelines and treated as a lesser priority in terms of how much money is allocated and how much attention is devoted. in fact, we've seen that the united states and other donors come in with money and countries actually take money away from health thinking that we're going to make up the difference. the united states is willing to invest our money, our time, and our expertise to improve health in countries. but we are now asking their governments to demonstrate a similar commitment, in terms of human resources, serious pledges to build capacity, and where feasible, financial support. we expect these countries to step up. and their people expect the same. now, this will not be easy. the changes we are working to achieve through the global health initiative are broad and
deep, and there are many obstacles standing in the way. but if we succeed, we will have transformed how health is delivered and received across the world. now, we have already come so far as a nation and as a global community in saving and improving lives. and we are grateful to all who brought us to this point, particularly the heroic health workers, and the visionary leaders, the determined scientists and researchers, and committed activists. thanks to them, we are able -- and i would argue, we are obligated -- to go even further. to save more lives, to take on more difficult tasks, to commit ourselves to the patient, persistent work of building the foundation for a healthier future. this is a challenge worthy of us, as a nation and as a people. and we are rising to meet it, as we have done many times in the past. together, we can give millions of people the chance at healthy lives, and create a healthier, more stable, more peaceful
world. coming to sais to talk about this is truly a privilege because this is a place that will be providing the leaders we need in the future to realize this vision, to ask the hard questions about just because this is the way we've always done it before and we've had some success, is this the way we should continue. to challenge the congress whose own structure often creates stovepipes that prevent our own government from working together. to do the difficult, but essential work of convincing countries' leaders that investing in their own people's health is not just a worthy goal, but critical to the future of security, peace, and prosperity they claim to be seeking. so we're aware of all the pitfalls and all the obstacles,
internal and external. but we cannot sit idly by. and we have to do all that we can in our power in this time to make a difference. and that's what i know you came to sais in order to find your own way forward in achieving. and we welcome your participation and we invite you to be part of helping to solve some of the world's greatest challenges now and in the future. thank you all very much. [applause] [applause]
>> thank you, secretary clinton for that comprehensive and compelling description. there is no one in this audience today or in the audience of the media then thinks they heard this speech for today. young leaders will be learning about this speech four years to come. we are privileged. secretary clinton has agreed to except questions. -- accept questions. >> i do not know what the arrangements are. do i call on people? >> whenever you like. -- whatever you like. when i call on you, give your name and affiliation and only
ask one question. we will let harley has -- as the first question >> speech. bring to global health issues. i think everyone really appreciates that. use the global health has everything to do with foreign policy and i completely agree. this affects global health and how you implement that when the u.s. is engaged in places where we have humanitarian and strategic interests window -- strategic interests. >> we have interests all across the world, not just in the places which are so well aware of right now.
i like to think about every day, considering with the headlines equally important, what are the headlines? one of the problems the u.s. will deal with in one year, five years, 10 years, 20 years if we do not begin thinking about them and acting on them now? this is such a clear example of that. as i pointed out in this speech, we have so many intersecting goals when it comes to being the leader in global health. of course, it has to do with foreign policy. it has to do with the health of our own people. it has to do with the values of america. it has to do with how we prevent -- how we present ourselves in the world. when it comes to how better to integrate and coordinate this, diplomacy is a key role. from the very beginning of my time a secretary of state, i talked about elevating diplomacy and development alongside defense and go -- alongside defense.
as i look at the world in which we live, they are not separate. we see, perhaps, the military taking the lead in some places, but the development experts are in there every single-doing what we can to improve health in the education. it is the as a necessary cooperative integration of power. we're trying to they get every program that we have across the government and more effectively deliver on that promise of integrated power. we will be releasing the first ever quadrennial diplomacy
review. the defense department has done one for many years. having watched the affected this for the defense department, congress, and the public to put together a statement of those commissions, and strategy really gives life to what we're putting forward toward this integrated approach. when we think about a country like nigeria, we have the cdc, pepfar, and usiad -- usaid all in nigeria. we had development experts on the ground doing extraordinary work. we responded to what became a series of rumors about how the polio vaccine was designed to sterilize children. the matter how hard our development experts, are
doctors, our nurses, or anyone from our agency worked that problem on did much of the effort that we were engaged in. we launched a diplomatic effort to goal of -- to go along with our efforts. when the deputy secretary was in northern nigeria recently he went to see the chief of the area, the mirror -- the emir. he vaccinated with the oral polio vaccine his own grandchild. that spoke more clearly than any argument we could make. we cannot do one without the other. we have to have a coordinated effort. what happens to often is that people work so hard. i have never seen harder working people in the people i have seen from usaid, pepfar, or the cdc. the work so hard to improve lives, change lives, change governments. very often in the countries in which they serve, they do not work together.
i have had members of congress tell me repeatedly who are interested in their development work that they go to the embassy in the country in latin america, europe, asia, and they want to meet people in development. all the different leaders and workers come together. that is the only time they are together. we need to end that.
we have the smartest, most able, dedicated people working in development working in the united states government. if they do not work together, they cannot possibly leverage what they're doing to get anywhere near the goals that we set. this is a passion of mine. i want this to be viewed as the best in the world across the board and wanted to become the premier development agency
across the world. we cannot afford in a time of limited financial resources to have everybody be doing their own thing, you know? if we are going to have a clinic, they need to do not on the h.i.v.-aids but family planning, polio, and other matters. if we are trying to have a team in a country working together, they do not all need of their own suv's. we need to get smart about how we spend our money. we do not have a limitless resources. i feel a particular obligation, as i have said numerous times in the past 18 or so months, at a time when american unemployment is recorded as slightly less than 10% and we know structural unemployment is worse and we are asking hard working, maybe unemployed americans to keep paying their taxes and some money will go to fund our development and clumsy efforts worldwide, i have to
look them in the eye and tell them they are getting their money's worth. we have to get smarter, more agile. i have seen these doctors in their own agencies working to bring that idea fourth. now we are going to try to do this across government. those of you who are checking in for your first year here is not easy. any ideas you have come a send them our way it is we are committed to making the changes for the long term. >> any students over here? the young woman with the brown hair. if you could wait for a microphone. please remember to give your name. >> i am a second year student here. thank you so much, secretary clinton, for coming here because this is an honor. i'm glad to speak on behalf of
my class. as a current in turn on usaid, i am not speaking behalf of the u.s. government, this is my personal -- [laughter] rwanda just underwent elections. a lot of the sub-saharan countries are going through their own elections. hardy you reconcile leadership especially in africa where a lot of our global health funding is going into the impact that has on whether or not the program goes forward and has the support, maybe future recommendations working with you -- future african leadership. >> great question. at the core of some much of the work that we do and the analysis that we undertake every day, that is why i mention south africa. leadership matters. it matters enormously. for years, the south african
leadership, unfortunately, was in denial or was refusing to accept the facts about hiv. the epidemic exploded in south africa which now has the highest percentage of hiv- infected people anywhere in the world. the president has changed that. we were in south africa last year and we saw firsthand what a difference it makes when a president starched to treat people, at 3 more people, produce more drugs, get a health minister that is dynamic and very committed. it was stunning and wonderful to see. leadership matters. we can go into countries and deal with emergencies. we can even set up parallel
systems which we have done because there is no other way to do it. we run our own health clinics. we run our own immunization programs. we improve the quality of life. if there's nobody in from the leadership, these are not sustainable. we have countries in africa, asia the are becoming quite well stay in one respect -- quite well see yet you see none of the money going into health. we have to tell countries that we cannot help them any more than they are willing to help themselves. maybe their health is just getting the right people appointed to the right jobs
because they do not have any more resources than not. sometimes it is allocating their own resources so that all the sudden care where the money goes. some of it is working with us on training programs. there is a myriad of ways that leaders and governments can show their commitment. i have been enough countries everywhere in the world to know that leadership is the alpha and the omega has to whether you have sustainable, effective health care in any country. i am hoping that through this partnership, this global health initiative, that we will see greater by and -- buy in. if they will come in and do
health that we will do roads. that is a good substitute. our argument has to be, this has to be a comprehensive approach. of course you need roads and that can bring people to the clinics. it cannot be one or the other. we want to do more work with other donor countries and other ngo's. what we're trying to do in doing this, we would like to see it globally. we're talking with donor countries that have programs in the countries regarding the global health initiative. we are trying to see how we can maximize the impact. ideally, i'd been led to see a map of the world all the up. the scandinavian country to take their resources and go to this country which the united
states can not do and no one else will do and we would the global fund to been supplementing in not supplanting the resources that go in. and is very difficult. we also started discussions with china on development that secretary geithner lead in beijing. the chinese are on a presence in africa, latin america, and déjà. but -- and asia. there are millions of chinese that are working and involved in the contract. and the businesses that are being developed there. often, the chinese will offer some kind of development aid in return for a mining contractor.
when we're trying to do is if they're wrong to do it then gets integrated. the chinese are building a road and we are building a hospital and we would like it if the road came to the hospital. those discussions are ongoing to go back to the first question about development in diplomacy. we are trying to look at this holistic play. we are buttressing and supporting leadership, trying to get health ira. it needs to be one of our biggest economic difference with his we cannot really accomplished this if we do not have the support and buy ins. >> i hope there are students in the back to have questions. if you could take a microphone. >> madam secretary, i am a
student here. my question is a relation between the house initiative and the mdg. while these are ambitious, even if they are achieved by 2014 we will still fall short. do you see these as no longer achievable? if you do, what outcomes will you be looking for from the summit next month in new york? >> i see them as achievable, but i see their achievements as taking longer than any of us would have hoped for when they were first adopted back in 2000. as a forward to the summit in the general assembly on september. i agree to participate because what we're doing is continuing on the path toward the
millennium develop and falls. we are taking stock and we have met with the u.s. officials to ask that everyone takes dogs. where have we made progress and why? worm with fallen short and why? what can we do you try to fill the gap and we can continue on the path toward achieving the goals set for us. i am sensing a much greater openness to this done enough just to care ala. -- it is not enough just to care a lot. he have to -- you have to ask -- to ask
yourself how much good in my really doing. is this in a well in advance to maximize progress. i think we can save pleasure and pride. child mortality is down. there are some positives that have been reached from the way -- on the way to the goal. we have met a long way to go. we hope to use the u.s. firms multilateral organizations and the donors to give it to have this very for a discussion. rod shaw has started this argument in usaid to solve global challenges. in the u.s. we are working on them.
we think technology can make a big difference that will help us better educate people. we see the glass half full. it has a long way to go before it gets to the top. we are committed to the process. >> last question, hopefully by a student. >> thank you. i am an incoming student here at sais. what metrics do you intend to use with regards to promoting women's health? >> we will be rolling out metrics, right guys? [laughter] let me answer that in a brief
non- statistician way. cdc is like the epicenter of evaluation and reporting. they can give the rest of us help on how best to do that. there are many different indicators. we are focusing on maternal mortaliity because it is measurable. we have a better idea what works and what it will take to have more women deliver. a safe birthing kit, a bar of soap, plastic, a razor, all the way to tertiary care for complicated pregnancies. we will be judging outcomes and how do we meet the needs along the way. it is built into the ownership concept. better access to family planning is directly related. if women are better able to space out their children and the births are more likely to be safe and successful, we also
would like to see increases in the legal age for marriage. we know young girls are more likely and that physical risk for pregnancy and delivery of new. this is another way that development in diplomacy work together. we are encouraging countries to pass stronger laws and enforce them. so you do not have girls between 10 years old than 16 years of trying to deliver babies. we're looking at the access to care which is the example that i gave because hiv and aids and now has an enormous a lot of work to be done to prevent the continuing sexual abuse of girls and women by men infected with hiv. some have the very unfortunate
-- girls and women. these are some of the examples on how we will in a broad matrix judge ourselves. we would really like to see with the mdg's agreed upon measurements. they are honored more in the breach than in the actual implementation. i think there is a lot we can do by pulling together what we already know and trying to, frankly, published it in a more digestible form. it is fascinating to me that in our last strategic dialogue with afghanistan, both when i was there last month in in the recent visit by president karzai and members of his
government, of their number one developmental request was to help fund the issue of maternal mortality. when you think about it, i run back to the first question about foreign policy, diplomacy, and development. there are varying degrees of attitudes within the afghan culture about interventions in health. there is general agreement about trying to keep women alive as they deliver babies. the united states working with other partners in a concerted effort on maternal mortality in afghanistan gives you an opportunity to connect with may or may not be particularly
supportive of anything else that we and others are doing. you have to look at how this goals we have in foreign policy. that is why i will end where i started. sometimes with humanitarian emergencies, like what we are seeing in pakistan, like what we saw in the haiti earthquake, you just acting and do what is right because it is the moral imperative to do so. the american people are very generous in responding to those disasters. once the disaster has receded and the human cost of death and destruction, and jury, devastation of infrastructure and farmland is left, then i think we had both a humanitarian and a strategic imperative. i think we are at our best when we are able to produce results where people see us as we see ourselves. the american people see us, and i certainly see our country as
an incredibly generous nation. we have gone time and time again to the aid of others with whom we do not have much of a connection and perhaps the real politic would not dictate that we should, but we have. if we are going to be investing time, money, blood in our efforts that we go into this with a very clear view of what we are trying to accomplish and we take into account the values and the cultures and traditions of others but we recognize there are certain issues that have to be addressed, leadership being absolutely have the top. i'm very optimistic about the global health initiative, about what it can mean in terms of results, and what it can represent as, frankly, a new model of how we better present ourselves to the world, how we are no rigid more cost- effective and efficient in
delivering services and real united states leads by our values and people can see what that means to them. thank you all very much ringbone -- very much. [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010] >> the "washington journal summer series continues this week with a look at the new financial regulations law. tomorrow, its impact on banks. a new topic every morning this
week at 9:15 eastern. >> i think what we are trying to do is take away profit. profit is what drives crime. intellectual property theft on the internet and homeland security role in stopping it. >> a discussion on the state of the u.s. army with general george casey. he talks about the army's ability to conduct two wars simultaneously as well as the fight against terrorism and the military's budget. he is interviewed at the aspen institute. this lasts about an hour. >> good afternoon, my name is meryl chertoff -- [laughter] >> -- and i'm a fan of walter isaacson's too. i'm the director of the justice ansociety program at the aspen
institute. the justice and society program is the oldest ofhe seminar and policy programs in the institute. the justice and society seminar for the summer is full, but for many of you are interested in 2011, we have already started to assemble people who will be attending. we hope to welcome some of the next year. it is my very distinct privilege today to welcome general george casey, who is the chief of staff of the u.s. army. general casey will be interviewed by david sanger, the
chief washington correspondent for "the new york times." david has reported from around the world. he covered the, five-year art of the bush presidency and now covers the obama administration. he is the author of the recently published "the new york times best seller, "de inheritance." i want to recognize that he has brought with him the secret weapon, and that is his wife, sheila. as we know, military spouses also served and sheila has her own very distinguished career in washington as well. [applause] >> thank you very much. general casey has already been
introduced, but just to give you his last 2 posts. he was in iraq for 32 months during what was the roughest years of the war. for the past three years, he has been chief of staff of the army. he is responsible for thinking for read about the future of the forces, as well as making sure that they are supplied with all that they need in goods and strategy. in the next hour, we hope to cover a range of issues that general casey can discuss in that regard. this is a great time to get him because he is nine months, he is off to the next stage of his life. let me start would be probably
most general and broadest question. we have seen the biggest changes in the u.s. army in the 10 years since 9/11. at almost any time in history sense the end of world war ii. i would like to ask you first to give us your sense of how the army is doing, how it has changed. when you are done with that, i will ask you about -- >> it is wonderful to be out here with you. you, but in two months we will have been at war for nine years. and the result of that is that the -- today's united states army is a hugely professional combat season four, it's really the bestn the world at what
it does. but it is also stretched and stressed by the demands of the last nine years. when you think about it we've been deploying at one year-out one year-back for almost five years. and if you'd asked me five years ago if we could have sustained that, i would have said, now, you're crazy. and so the force that we have is usually resilient and usually committed. but i wrestle with this season four's stretched-and-stressed force. and so when i came in, sheila and i traveled around the army and we talked to soldiers and families trying to get a sense of where we were. and i came up with the term that the army was "o of balance," that we were so weighed down by current demands that we couldn't do the things that we knew we needed to do to sustain the volunteer force for
the long haul and to prepare to do other things. and i said that because i was hearing at the time, the army was broken, e army was hollow, the army wasn't ready, and that's just not true. and so we put ourselves on a program, back in 2007, to get ourselves back in balance by the end of next year. and we have been moving forwa on those -- on four imperatives. we had to sustain or soldiers and families. we had to continue to prepare soldiers for success in the current conflict. we hato reset them effectively when they returned, and then we had to continue to ansform for an uncertain future. and i'll just say a few words about all those. "sustain" is probably the most
important. no this is a volunteer force. and when i first came in i called my predecessor, shy meyer. and shy meyer was the chief of stf in 1980 who went to congress after vietnam and said the army's hollow. that was seven years after the last combat battalion left vietnam, the army's hollow. fortunately, he had the foresight to tell the president that the day before. [laughter] >> so i -- >> always a good strategic move. >> right. so i said, shy what happened. how did the army get hollo and he said, george it's all about the people. and he said there's a thin red line out there, that try as you might, you'll stumble across it. and the mid-level officers and noncommissioned officers, the ones that take you a decade or so to grow, they'll leave. and that's what happened. i lived through that in the '70s. it took us a decade to rebuild our noncmissioned officer corps and our officer corps, after vietnam. and so we focused on preserving our -- those mid-level officers and noncommissioned officers and doing things to retain them and we've had good success. one of the things that we did though was to focus on families. and i'm an army brat. i've been a member of an army family for over 60 years. i won't go into how much over. [laughter] >> but when i was traveling around the country with my mom and dad, the message to us in
the backseat was make the best of it. ll, we're asking our - so much of our soldiers and families, asking them to continue to make the best of it doesn't work. and so we really have ratcheted up what we're doing for families, and i think to good effect. so sustaining soldiers and families is the core of what we need to do. the second element is to continue to prepare soldiers for success in what they're doing today, and we've made great strides in this. i ask the soldiers, every time i travel around, what do you need, what's not working, and i generally get pretty positive responses. occasionally, i run into a soldier who wants another gun or something, but by-and-large they're pretty happy with what they have. to give you an example of how we've improved in meeti the needs more rapidly, it took about three years while i was in iraq to get a full complement of up-armored humvees to the theater. when we made the decision to go to better armored wheeled vehicles, it took 18 months to get the full complement in the
field. and just recently, we've got a smaller version of those to put in afghanistan and that took nine months. and so we are getting better at that and the soldiers have the tools they need to do what they need to do. the third element is to reset them. reset the soldiers and the equipment when they come back, because they're turning around in a year or so and headed right back. so the equipment has got to come through an industrial process, get fixed, given back tohem and moved out, and it's -- that's gone very well. the other thing though is resetting the people. and we've recently completed a study that told us what we intuitively knew, that it takes two to three years to recover
from a one-year combat deployment. it just does. the human mind and body weren't made to deal with the stresses of combat repeatedly. and so one of our goals was to keep soldiers home for at least two years, and with, even with the plus-up in afghanistan and with the drawdown in iraq, we actually get to the point by the end of next year where we'll start having soldiers home for two years, and that's hugely important to the long-term health of the force. and the last thing i'll talk about is the transformation. and you mentioned this, david, but we have undergone, since september 11th, the largest organizational change of the army since world war ii. and we've done this while we've been sending 150,000 soldiers over and back to iraq and afghanistan every year. for example, we were in 2001, good army. but it was an army designed largely to fight tank battles on the plains of europe or in the deserts of the middle east. and when the -- september 11th happened, the first reaction was what's normal in large institutions, you take what you have and you try to adapt it to use it for something completely new. and so we tried that. and it really wasn't until 2004 when we said to ourselves, you
know, these tanks really ain't working in baghdad. and so we started really in earnest in 2004. and since then, we have converted all 300-plus brigades in the army to modular organizations, designs that can be organized rapidly to meet the situation that presents itself. we have rebalanced ourselves where we've taken about 160,000 soldiers away from skills that were very necessary in the cold war, and converted them to skills more necessary today. for example, we've stood down about 200 tank companies, artillery batteries and air defense batteries, and we've stood up a corresponding numbers of special forces, civil affairs, psychological operations. all that has been going on here. we also increased the size of the army by about 75,000. president bush put that on the table in 2007, and we've completed that gwth already. that's a big help for us. if that wasn't enough, because of the base realignment and closure act and the growth of
the army and bringing some soldiers back from korea, we are also restationing the whole army. and between now and the end of next year, we will resettle about 380,000 soldiers, civilians, and family members as a result this rebasing. and right now we have everybody on cell phones, and we'll publish the wiring diagram at the end when we get everybody settd at the end of next year. anthen lastly, the thing that is probably causing us the most internal change is we're putting the whole army on a rotational model much like the navy and the marine corps have been on for years. and we have to do that, because it's the only way we can meet these continued commitments at a tempo that's predictable and sustainable for the all- volunteer force. so that might be -- have been more than you bargained for, david, but that's just an update on where we are. >> a great start. so let's begin to add on the layers of complication. in the midst of all of this, the military's overall budget
has doubled in the ten years nine years since 9/11. defense secretary tes made the point the other day that the u.s. military budget is now bigger than the military budgets of all the countries in the rest of the world combined. you made the point that the army budget is bigger than -- >>ussia and china defense budgets combined. >> and so in this atmosphere it's clear that's unsustainable for all the other reasons that are going on with the budget. and secretary gates has tried sometimes successfully, sometimes unsuccessfully, to kill off some fairly large weapon systems to enable you to have some room for growth in the personnel. he's run into extraordinary blockades in congress. he said recently, only in the parallel universe that is
washington, d.c., would cutting back a little bit from a doubling of the defense budget be considered gutting defense. [laughter] >> these are true words. tell us first what you think you're going to need for the kind of growth that's going to be needed for the force in the next years that you've described. and secondly, how you do that in this consained budget environment. >> okay. first of all, i think secretary gates is exactly on the right track with this. we recognized this about two years ago. and for us in the army, we don't have lar ships or airplanes or satellite contracts that we ca cut. our money is in people. and so it becomes a question for us then, of what's the size of the army. and as you all know, people costverywhere are increasing. and so the more peop we have,
the less that we can afford to spend on other things. so two years ago we started focusing ohow we were organized to do our business. and it was very, very enlightening. the department of the army is a pretty good size -- i'll say - not-for-profit organization. [laughter] >> and in those not-for-profit organizations, you do not have the market incentive that causes you to be more efficient with your money. the other thing -- and this isn't necessarily confined to not- for-profits -- but we are organized, and the way we're organized, we've created a lot of silos. and every organization has silos, but it seems like our silos have walls that are three feet thick and things only g up and they never go sideways. and so what that creates is a lot of redundancy. and especially in a time of war
when you're moving as fast as you can to get things to the troops. and when that happens, you -- there's a lot of inefficiency. we're getting stuff -- anything you do fast is not as efficient as something done in a structured way. so we have been working at this. the other thing about the silos is we have a process where the requirements come up from below. so someone says i need this. but the person who is developing the requirement is not -- doesn't have any relation to the person who has to provide the money for the requirement. so it's open-ended. and so when they come up in these silos, it only -- they only go up. and so the budget can only go up unls you do something to get at the requirements process and eliminate the redundancy. >> general, every silo is in a congressional district. >> that's true. >> and that makes a difference.
>> that's true. >> are we at a point right now where the congress is fundamentally incapable of being able to restrain the size of the defense budget or help reorient it, simply because every weapon system, every silo has got its own constituency? how do we get out of the cycle that we're in? >> yeah, i understand what you're saying. i don't think we're lost. and i think we have to continue to work at this and demonstrate -- i mean congress, better than anyone, ows that we have to decrease the size of government spending. and so we're just going to have to continue to work this. and i know secretary gates -- >> they agree with it in general. it's just every time the secretary comes up with a --
>> it's all local, sure. >> -- weapon system, it's all local. >> yeah. >> let's turn to -- >> but anyway, to answer your first -- >> sure. >> -- the first part of your first question there was we believe that we can get at the $2 billion to $3 billion a year that we need to not have to cut our force structure through these efficiencies that we've been workingn for the last couple years. and we've had good success on
eliminating some reddancies. and we are going to meet secretary gates' targets that he's already given us for the program here -- knock on wood -- so far without having to reduce force structure, which is an important thing. because for me to go out now and say we're going to cut the force when we haven't even got them two years at home, i think tha would have a really negative effect on the troops. >> the qdr that came out a few months ago, the quadrennial defense review, was the first to sort of step away from the old concept that the united states need to be able to fight a war in one place, do a holding action someplace -- it was always the symbol, or that was always the korean peninsula -- elsewhere, and moved instead to the concept of a much more flexible military, especially the army, that could do unterinsurgencies in different places around the world and still have the capability around to fight a major war if one needed to do it. baseon all that you have seen both in your experience in iraq and since you've been back at the joint chiefs, is that a realistic way to structure the u.s. military? can we dthat many different things at one time and be prepared for that many contingencies at one time? >> yeah. i think we have to. and i think it was a very good and reasonable first step. but as i've looked at this now over time, from my perspective, the central organizing principle of the department of defense for the last six years has been convtional war, has been the
ability to do these two major regional contingencies. that isn't what we're doing today. and -- but yet the whole department of defense is lined up to produce the outputs for conventional war. and i have come to think, after we've looked at the environment -- and i'll say a few words about that in a second -- is that versatility, the need to be able to do a variety of dierent things has got to become the central organizing principle of the department. and that's the way we're going with the army. but as we look at the future, you know, we start from the point that we're at war, we're at war with a obal extremist network that attacked us on our soil and has tried twice since christmas to do it again. these guys aren't going to quit. they're not going to give up, and they're not going to go away easily. so we believe that this is a long-term ideological struggle. and then if we look at the trends in the global environment and that trends seem more likely to exacerbate that situation rather than ameliorate it. and that leads us to think that we're in for a decade or so of what i call persistent conflict -- protracted confrontation among states, non-states, and individual actors who are increasingly willing to use violence to accomplish their political and ideological objectives. i think that's what were looking at as a country. and i think that's troubling. and it's -- we -- the two things as we look at
that environment that come out, it's going to be more complex and it's going to be more uncertain. and so you have to have yourself organized to deal with a range of contingencies. and then you have to be agile enough to change directions, becausy're never going to get exactly what you want. in fact, what does yogi berra say? "predictions are hard, especially when you're talking about the future." [laughter] >> and then i say what i said with great humility, knowing that the best we can hope to do is get it about right. >> you mentioned this 10-years of persistent conflict. when president bush was running for president the first time in 2000, he talked about how we could not allow the united states military to become a nation-building force. it was not the role of the military to go do that.
he then took a trip to kosovo, saw that the only working institutions there were in fact the u.s. military -- this was prior to 9/11. post-9/11, gave a fairly lengthy speech at virginia military institute where general marshall had been trained, about the need for a marshall plan in afghanistan. and you have spent the past nine years trying to figure out whether he was right the first time in the campaign, or right the second time after he was elected about whether the military was set up to go do this. are we -- >> i think he was right. [laughter] >> are we in a persistent ten- year effort have the u.s. army at the centre of nation- building as well? >> you know, when we were talking about nation-building, we were talking about a military that was designed to do conventional war. that's what we were set up to do. and as i said before, we were like that for 60 years. but the types of conflict that we're fighting in iraq and afghanistan, and i think are likely to be fighting here for a decade or so, are focused on the people. and you've heard -- i'm sure you've heard this said a and you've heard -- i'm sure you've heard this said a thousand times -- we're not going to succeed in either place by military means alone. you're only going to succeed when the people perceive that there is a government that is representative of their interest, when there is an economy that can give them a
job to support their families, where there are educational systems that they can educate their children. all those things are essential to the long-term success of the military operation. and so i think as a military we got past that a while ago. in fact, in february 2008, we published the first change to our formal war-fighting doctrine since september 11. and we said army forces will simultaneously employ offense, defense, and stability operations to seize and retain the initiative and achieve decisive results. we raised stability operations which is -- could be your nation-building -- to the level of offence and defense. because in the types of operations we're going to be conducting in the 21st century, we think that's an essential element of our ability to accomplish our national objectives, not just our military objectives. >> when you were in iraq, you were there, as i said at the introduction, in some of the darkest days of the war.
you were also there when the awakening happened, and when you were able to encourage that awakening, which as we look back over the course of the conflict, was a very decisive turning point. we've all been waiting for the equivalent of the awakening in afghanistan, a very different society. while there have been some individual signs in some small places, you've not seen it on the scale that you saw it in iraq. why not? and does it have any prospect of occurring? >> every successful counterinsurgency has had a reconciliation process that -- as part of the solution. and so both in iraq and afghanistan, if they are to succeed, will have this reconciliation process. the process that we started in iraq began right after the elections in january 2005. it -- and it took that long of
constant effort of standing up an organization to figure out who the right people were to talk to, to bring then in, to figure out what incentives they needed, to get the iraqi government involved in a reconciliation process, because it ultimately will devolve to them. we can't reconcile with, you know, with the afghans, they have to do that themselves. i think one of the things that we learned from all that process is timing. and timing is everything in reconciliation. and successful reconciliations have come from a position of strength. and i think we -- go ahead. >> admiral mullen was sitting on this stage a week ago at the aspen security summit talking about the same subject. and we asked him whether that meant that ultimately you couldn't have complete reconciliation unless you had mullah omar and many of the
others -- afghan taliban, the pakistani taliban, all as part of this process, something the u.s. government has been cautious about. do we take your statement to believe to include some of the hardest line american enemies who would have to be part of the solution? >> that's something that -- there's always a matter of debate in this. but all of these -- and when you say -- it has to begin from a position of strength. the first thing that has to happen for a reconciliation to be successful is the insurgents need to have them recognize that they have no military options. and i don't think we're quite there yet in -- especially in afghanistan. but that has to happen. and what i'm suggesting to you is that you don't have to wait for that to happen to start setting the conditions for the reconciliation. >> right. >> and what happened was we started in 2005 to build the reconciliation that ultimately became the awakening.
and it really wasn't until 2006 when we got some forces in there and thumped them in anbar province and they -- that's when they recognized that they needed to side with us and then the government. >> but your point here is they have to be convinced they're going to lose. in afghanistan, i think we're all in agreement that the insurgents are not yet persuaded of that. and in fact, some of them have said, just to listen to their own propaganda, that since the american surge peaks in the summer of 2011 and the president has said that at that point they will begin a withdrawal at some pace -- pace is unclear -- that there is some incentive for the insurgents to hold out for another year, and hope that starting in 2011 that they could come back even if they are thumped over the next 12 months. how do you get around that psychologically? >> well, i mean it's hard. first of all, don't believe everything the enemy says. i mean they clearly are out to make themselves look stronger than they really are.
>> sure. >> and that's something i've learned very painfully here over the last several years. but you know, this timeline is a double-edged sword and there's not -- there's no right or wrong edge to it. it's really a question of balance. and people -- different people will perceive timelines or timetables differently. and i think the -- it doesn't surprise me that the taliban are saying okay, we're just going to wait them out. well, they're going to be doing a lot of fighting while they're waiting us out. then i think admiral mullen was probably pretty clear with you the other day that there is a timetable -- a date in july of 2011 to begin bringing out some of the surge forces, but the number and -- you know, is condition-based. so we'll continue to work that. >> but when you say it's a double-edged sword, what you mean is on the one hand it creates an incentive for the afghan government to step up by that time, on the other hand, it creates an incentive for the taliban to hold on.
and it's sort of a race for who can perform better between now and 2011. >> right. and -- but the other thing that it also does is it demonstrates to the afghan people that we're not occupiers, we're not going to stay there for the long haul. we're there to help them get back on their feet and then we're moving on. so -- but again, it's balance. >> now in iraq, you are going to be down 50,000 troops you believe by the end of august, just months from now. those people who advocated the surge would say that had it not been for the surge, we never would have gotten down to that 50,000. when you think back to the smaller size surge that was already under way when you were in the last months of your command in iraq, could that also have accomplished what we're doing today? could we have gotten down to these numbers even earlier, do you believe? or do you believe that in the end the surge in iraq really was
decisive? >> i don't know if we could have got down any earlier. it's hard to say. but i think the surge was as important as a statement of the commitment of u.s. interest and resolve as it was the additional troops. i mean they certainly helped. but it was the statement of united states' commitment that further spurred the awakening. and then when the sons of iraq were brought into the fold, that started at eliminating some of the insurgency and we -- and they could get on with the political process. so i think the surge was a decisive application of combat force at a critical time in a mission. and i think in the end it has -- it's ultimately been successful. >> before we open this up to questions, i just want to flip you around to the other side of the world for a moment. you mentioned in your opening that you had moved a lot of troops out of korea in part to help feed these two wars, iraq and afghanistan.
we had just in the past few months seen a north korean ship -- a north korean submarine sink a south korean ship killing 46 aboard. there are some signs of new instability in north korea, just given the succession crisis that is underway there, or succession politics. could we come to regret the day that in our focus on the middle east that we have actually pulled down by almost half the number of troops we based in -- on the korean peninsula? >> i don't necessarily think so, because what's happened during that period is a huge increase in the capability of the south korean security forces. i mean -- >> but not such a huge increase that they were willing to go through with the command -- >> -- transfer? >> -- operational command
transfer in 2012 that was just delayed till 2015. >> right. and -- but i think -- but i mean to your question, there has been a significant increase in the capability of those forces there. and so that -- our withdrawal of some of our forces has been mitigated by that improvement. and then as you just mentioned, the -- we just agreed to president lee's request to delay this transfer of operational control. right now, the commander in korea, as the combined forces command korea is an american. and he basically commands and controls korean forces in the event of an emergency. there had been a plan in place for that control to pass back to the koreans, i think by april of 2012 -- it's 2012, but i'm not sure of the month. at the request of president lee of korea, president obama just agreed to move that to 2015. and i think that's indication of the strength of the relationship and of our commitment to korea. >> and so what does the united
states need to do, in partnership with the south koreans, to demonstrate to the north now, politically, that the kind of behavior you've seen over the past year or two is something that the u.s. is prepared to respond to? you've seen, since president obama was inaugurated, a missile test, a nuclear test, and the sinking of a -- of the south korean ship. >> yeah, but -- i mean that's another very, very difficult policy issue. right now, there's things being worked in the united nations. i think that it's important for that process to continue. but i think we have to be very careful, we the united states, with our south korean allies, in doing something that may be misinterpreted and become inherently -- increase the instability rather than decrease it right now.
we just have to be very careful of that. >> and along those same lines, i would be remiss if i didn't ask you about iran. obviously, we've got a bigger military presence -- >> thought we were going to get by that. >> oh boy. [laughter] >> nice try. we've increased the american military presence to a small degree in the gulf. we've been -- the united states has been providing standard missiles and other -- any missile equipment to a number of the gulf neighbors. and yet there is this continuing debate played out here just a few days ago with the statements of the ambassador from the united arab emirates about whether or not an attack on the iranian facilities, nuclear facilities, would be more destabilizing than an iran that gets a nuclear weapons capability. as you debate this out among the chiefs, how do you weigh those two options? >> well -- i mean, you have put your finger on what is a hugely difficult policy issue for the country right now. and those types of discussions that you're talking about right now are going on within the government and i wouldn't want to prejudge them, the outcome of
those discussions. but -- i mean, that's the kind of challenges that you get in these days. there is no good solutions, and the solution may be worse than the cure. and so that's something that the administration is wrestling with. and i think you're going to see that play out over the next 12 to 24 months. but that's -- i think that's an indication of the types of challenges that are going to be facing us here over the next decade or so. >> and within the army are there preparations underway for what the reaction could be if -- >> not within the army. >> not within the army, but more broadly, within the military. >> we have contingency plans, we do, we have contingency plans for everything, but we don't talk about specific plans. >> well, let me open this up to all of you. there are people who will be walking around with microphones, if you'd raise your hand, tell us who you are and actually ask a question in the spirit of
aspen. we'll start with the gentleman right here in the black hat. >> thanks, general. i'm jason from chicago, thanks for coming. i want to ask the question and i need to set it up just a little bit, but i won't take long. both afghanistan and iraq are very resource rich and an integral part of the reconciliation process is business stability. we know that chinese corporations and russian corporations are going into these areas and trying to capitalize on the stability, limited stability that's been created so far. my question to you is, do you think that congressional policy towards u.s. corporate culture essentially handcuffs american ability, american business ability to participate in the reconciliation because we're not allowed to play on local terms?
>> i'm not aware of specific congressional policies that limit u.s. business involvement. >> hart-scott-rodino and sarbanes-oxley, things that don't allow us to, you know, to be blunt, bribery, for example, which is part -- which is the chinese are willing to, you know -- [laughter] >> -- corporate guests, things of that nature that we can't -- which is standard over there, did you not encounter them at all in iraq? i mean, the -- >> i have footlockers and footlockers of junk that i've exchanged and gifts and things that i've exchanged. i'm not stepping up for bribery at all -- >> right. and i wouldn't ask you to. >> what i saw in iraq was opportunities for u.s. businesses to come in and get engaged, and there was a great effort by a guy named paul brinkley who went out and brought in business leaders from
around the country and they met with iraqi businessmen and they basically said, if you build x of these, i'll buy them from you. and so they were actually causing the businesses to get setup and get organized. i think that - stuff like that is usually productive and the other thing i'd say is, i know the folks who are trying to make inroads into the iraqi oil community, and i would think that the u.s. companies would have as much access to them as anyone else. >> flip side of that, are we securing parts of afghanistan for the chinese who are not on the ground helping secure the place to go into those sources? >> yeah, i don't know. yeah, i understand it. i don't know. >> sir. >> john debs, palo alto. first, thank you for your service and for all the people that are serving. [applause] >> thank you.
>> my question is, 1% or 2% of the country is involved in afghanistan and iraq and the rest of us are told to party and have fun and go out and spend or whatever, you know what they say. and, to me, this is morally wrong. and so my question to you is how can we, the other 98%, whoever we are, help you more in what you have to? >> well, thank you for that. first of all, you are all already helping. and i can tell you one of the things that has allowed this force to hang together over the last nine years has been the outspoken support of the american people for our soldiers and their families. don't underestimate the impact of talking to a soldier in the airport. i mean, i was sitting in an airport coming from leave when i was in iraq and these two young soldiers come up in their uniforms, and they are -- they were clearly basic trainees, they were going back after
christmas break. and they sat down next to me, and i watched them, we chatted them up a little bit and they went to pay their check and they said it's taken care of. as an aside, i got up and introduced -- and went over and said hello to them. and one of the guys looks at me and says, "hey, are you general casey?" and i said, "well, yes, i am." he said, "i thought you were taller." [laughter] >> but anyway that -- don't underestimate the impact of that on the soldiers and their families. the other thing i'd tell you is, the support that employers give to guardsmen and reservists is absolutely essential. we have 70,000 to 80,000 guardsmen and reservists mobilized over the course of a year on a given day, that's a lot. but we wouldn't have been able to do what we've done without them. and it's -- employers are carrying a heavy burden. my son is a reservist, he's mobilized, he is back on leave from afghanistan. his company is paying the
difference between his army salary and what he was making when he left the company. i mean, there is a lot of companies out there that are doing that. that makes a huge difference. and then the third thing i'd say to you -- i'd say two more things, and the third thing would be, continuing with business, hire these young men and women that are getting out of the army. and there may be some concern out there that everybody who goes to combat gets posttraumatic stress. and that's absolutely untrue. and we have surveys that document. the -- everybody that goes to combat gets stressed, believe me. but what our studies show is that the vast majority of people who go to combat have a growth experience and they come out stronger, and that's what you see. askthen the last thing i'd you is, there are lot of private organizations out there that are raising money to support wounded soldiers, to support their families and to support the families of the fallen, and to the extent that you can
support those groups, that would be a very positive thing. -- don't underestimate what the impact the support of the american people has had on our ability to hold this force together. >> gentleman right back there. >> stewart brand, global business network. general casey, thank you for what you're doing and from the sound of how you're doing it. paradox a question of a that seems to have survived from vietnam. in vietnam we had vietnamese troops on our side and vietnamese troops, north vietcong that we were fighting, and during the course of that war, vietnamese troops on our side became kind of dependant and not very motivated. and all that time the vietcong was becoming more and more skilful as they were fighting a more and more skilful us and their motivation stayed strong. how is what we're doing with the taliban going to be different from that, because it seems like we're facing a similar situation where the afghan
troops that we're train up, they're coming up in somewhat of a dependant mode with us, but the taliban troops we're fighting are getting more and more skilful fighting us. how do we fix that? >> yeah. i mean, that is a central challenge when you're working with indigenous forces. but you will only succeed when those indigenous forces can maintain domestic order and deny their countries safe havens for terrorists. and so it's a question of balance, it's not one or the other. and -- i mean, we wrestle with this in iraq all the time. you know, we build these units, then we take them on operations and then you try to get them to do something but they wouldn't do it unless you were standing there with them. and it to the better part of three years to work them through that till they finally got the confidence that they could do it on their own. and the other thing i saw even at the highest levels of -- the higher levels.
you know, people won't necessarily take risk, and iraqi leaders weren't necessarily ready to take a lot of risk. and they came by, honestly, they came from a culture under saddam hussein for 35 years that if you made a mistake, the consequences were often worse than you could stand. and so, anyway, it's a matter of training our soldiers to find the right balance between spoon feeding them and putting them on their way. but it just takes time to go through that process and we have to do it. >> all right here. just wait a moment for the microphone. it's just coming down to you. >> thank you. thank you, general casey for your recognition of the need for recovery by returning veterans. i'm gail sheehy. in last fall i was following a revolutionary program that you
introduced or resiliency training to train soldiers in emotional resiliency on the -- based on the principles of positive psychology. and through drill instructors, not the softies we would think would be training people in emotional resilience, but they really like the program. so i wonder if you could tell us how it's working. >> the program that gail was describing is called comprehensive soldier fitness and it was one of the things that we realized that we had to give our soldiers and family members the skills on the front end so they wouldn't get the problem to begin with. now about two years ago we looked at all the programs that we were doing to help soldiers deal with the cumulative effects of then seven years at war. and we realized that all our programs were after the fact. we had good treatment programs but they were all after the fact. and so we went after this and spent, you know, the better part of 18 months with some of the best minds in the country, trying to figure out what we could do to build a program to give the soldiers skills to be more resilient.
the program revolves around an assessment tool and we started that in october. and to date, over 750,000 soldiers and family members have taken this tool. it takes you about 20 minutes and it gives us assessment of your strengths in the five key areas of fitness, physical, emotional, social, spiritual and family. and you just get a bar graph and the soldier can look at it and say, well, i got a long bar here and a long bar here, okay. i got a short bar here. it then allows them to connect to self-help modules online in the privacy of their own home and get some tips on how they can improve their strengths. the third point, and this is the drill sergeant's comment that was made here. we are training master resilience trainers, sergeants, and these sergeants are going to university of pennsylvania for 10-days and are getting
trained by the professors there on how to use these skills. we've trained about 1,300 of them already and they are out in the force. our goal is to get one of those for each battalion in the army by the end of this year. so this is a program that has a lot of promise. right now we're kind of in a period where we're bridging from people that have taken the test but there is not enough resilience trainers in the field to get the program actively going. but i suspect by the end of this year it will be something that will be engrained in the army culture. >> successful as the resilience in training has been, you're dealing with unusually high number of suicides these days, how come? >> well, it's a combination of things. i mean, there is no one answer. in fact, we have -- we commissioned about a year and a half ago now a study with the national institute of mental health, it's a 5-year study to help us look at the whole problem of suicide.
i -- suicide, as we look at this, the leading causes that we see are relationships, relationship problems, financial problems and then there is usually drug and alcohol mixed in with those other problems. and then the fourth element is that there just seems to be a lack of resilience and a lack of those kinds of skills in the population that's coming into the army. we have been working this very hard. we have a very active suicide prevention program. we've got the comprehensive soldier fitness program going. but, as you suggest, since 2004, the number of suicides over the course of the year has increased by about 20 a year. now, knock on wood, so far this year we are at the same number as we were last year. and if that continues, i'm hopeful that we're doing some things that can stem the tide. it's not all about deployments.
and when we look at the data, it's kind of interesting because a third of the soldiers who commit suicide have never deployed, and a third commit suicide while deployed and then another third have deployed but it happens after they're back. so i believe it's a contributing factor but it not the overriding factor. >> there was a hand back here for -- >> todd martin, dallas, in aspen. our share of global defense since world war ii has well exceeded our share of gdp. have you thought about how long it would take and how we would get to sharing the defense responsibility for, let's call it, non-troubled regions of the world with the people that are there so that our share of global defense approaches our share of gdp? >> i think that's the exact approach that the president spelled out in the national security strategy that we have
to go after more collective security and help others do more for security around the world. now, that said, if you look at what's happening in europe, it's going in the other direction, that the money that some of these countries are willing to put toward defense is going down and going down fairly sharply, so that's the tension that we have here. >> back here. >> i'm lauren cobb from boulder, and in there interest of full disclosure, i am a military subcontractor for u.s. southern command. part of the -- >> how did you get up here? >> part of the operations that our military does are not war fighting, they are things like peacekeeping, humanitarian
missions, disaster relief operations, peacekeeping for the un, peace enforcement under chapter seven of the united nations charter, there is nation-building, a large group of things which are not classical war fighting. as we move further into the 21st century, how do you see that developing, is it going to get more or would we deemphasize it? what's your vision? >> well, the doctrine that i described, that we put out in february of 2008 looks at our -- at having the ability to operate across the spectrum of conflict, from peacekeeping to conventional war. and so the versatile forces that we're building have to be able to plug in at any place on that spectrum and be successful. now, that's a tall order. but i believe we have to be involved in a range of activities, because involvement in a peacekeeping operation may
prevent a larger of broader conflict. and so it's entirely appropriate for us to be involved in those kinds of things. but again, i think we in the military are already moving away from the notion that until -- if we're not fighting the big one, we're not working, and we're well past that. and i believe that is the mindset that we have to have to be successful in 21st century conflicts. >> we are down to just time for two or three more questions if the questions are short and induce short answers. right back here. >> this is a good follow up to the last question, general casey. patricia ellis, women's foreign policy group. the military has taken the lead on nation3 building and i was wondering if you could talk a little bit about your relations with the civilian side, i.e. state department and aed -- aid and how you see the
relationship evolving, are they going to be taking on more of the tasks or how do you see the relationship? thank you. >> and maybe, along the way, while you're doing that, you can explain why it is that this long into the obama administration we still see relatively few, comparatively few state department and aid workers in afghanistan compared to, say, the surge in the military force. >> first my -- john negroponte was around here over the last couple of days, he was the ambassador in iraq when we went in together. within 2 days after i was nominated, we met in my office and we agreed, one team one mission, that the civil-military effort had to go forward as one and we worked very, very hard to make that happen. i believe that's the only way we're going to be successful. now there is all type of the cultural and sniping that goes
back and forth, but if the leaders don't commit to that upfront, then it doesn't happen. and civil-military cooperation is essential for the nation to succeed. and as i mentioned before, there is no military solutions here. the military and the civil side have to complement each other if we're going to be successful. so i worked very hard to build relationships, not only between myself and the ambassador but between my staff and the ambassador. and to john's credit, he accepted 300 guys and gals with guns into his embassy because we felt it was important to have my staff and his staff working together. and so that process, i think, has to continue. i don't think it's a secret that some of the other agencies of the government have been slower to adapt to the challenges that we're facing in places like iraq and afghanistan. and that -- candidly, that has been a point of friction among some of the soldiers because
they're out there working 24/7 and they see someone else that has 60 days of leave a year and they -- you know, they take off. now, that doesn't mean they're not committed because everybody out there is working their tails off. but i think we have to keep pressing the other agencies of the government to get more adaptable and to get more used to operating in the kinds of environments that we're operating in. >> all right, take one more right here. sir. >> thank you very much, you ought to re-up, you know. couple of -- [laughter] >> i went over 40 years service on 6th of june, i think that's plenty. [applause] >> that resilience training caught my attention because during world war ii outward bound was founded on the same principle, so it seems to work, prepare our soldiers for those tough times. >> we're actually working with
outward bound and they are running trips for wounded soldiers for exactly that purpose. >> right. and i'm glad to hear that. another lesson from world war ii ties to the last question on the marshall plan, it was led by the state department and civilians. well, you just answered that question, but i wonder at what point during our longest war ever, nine years, that the mere presence of the military becomes part of the problem, you become the target, you know, if maybe you were in different uniforms or something, i just wonder. >> i went over and spoke to a group of foreign service officers in the state department and they were trying to figure out how to better civil military relation. and i kind of went back and forth between this is what you think of us and this is what we think of you. but one of the -- we are our own worst enemy, the military is sometimes. i mean, our can-do attitude, we get in there and we just try to do, do, do and everybody else get out of the way, and it is not necessarily the best way
all the time. and so that's part of the tension that we have here. and the other thing that just drives the civil side crazy is there is so many of us, you know. i mean, we -- i'd have six colonels standing around a foreign week. this poor guy is going, come on, i'm only one. so there is -- i mean, we have -- and i think we have done a good job of changing and adapting over time. but we have our own culture too and it's not always helpful. >> well, i thank you very much, general casey, for your service, for your comments today. >> thank you, i appreciate it. thank you very much. [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010]
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