Press Gaggle by Press Secretary Josh Earnest and Deputy National Security Advisor for Strategic Communications Ben Rhodes

Aboard Air Force One
En Route Riyadh, Saudi Arabia

2:21 P.M. IST
 
MR. EARNEST:  So I came back for two reasons.  The first is I wanted to commit to your attention a statement that we put out overnight our time from my deputy, Eric Schultz, talking about the recent report from the CBO.  Their latest estimate indicates that we’re continuing to make significant progress in expanding access to health care and reducing our deficits.  And the deficit is still on track to come down at the fastest sustained pace since the end of World War II.  So that was a notable latest estimate from the non-partisan CBO.
 
The second thing, and Ben will do this, is to give you a little sense of what we’re going to do when we arrive in Saudi Arabia in terms of our schedule.  We’ll be there for four hours or so.  I’ll let Ben walk through that, then we’ll take a couple of questions.
 
So, Ben do you want to do this?
 
MR. RHODES:  Sure.  So when we get to Saudi Arabia, we expect we’ll have an arrival ceremony and then when we move to the palace, there will be a receiving line with King Salman and the U.S. delegation.  Then the Saudis will be hosting a meal for the U.S. delegation, and then that will be followed by a smaller bilateral meeting between President Obama and King Salman.  And, again, this is an opportunity to both pay respects to the legacy of King Abdullah, who was a close partner to the United States, and also to touch base on some of the issues where we’re working together with the Saudis -- to include the efforts against ISIL, the situation in the region, including Yemen, Iran nuclear negotiations and the broader U.S.-Saudi relationship.
 
You saw the list of the delegation that will be meeting us in Riyadh, so you have that list, but happy to answer any questions about the day’s events.
 
Q    Is that delegation -– do you know if they’re all traveling over together?  Separately?  And the current U.S. officials I assume will be –- will they be part of the bilateral meeting that Obama is having?
 
MR. RHODES:  So my understanding is the majority of them, if not all of them, are flying over together and joining up with Secretary Kerry in Ramstein.  So probably not, again, all of them, but I think most of them will be coming together with Secretary Kerry.
 
And then my expectation would be that they will be all included in the meal and receiving line, but then the bilateral meeting will be more of a working meeting between current U.S. officials and the Saudi King and his delegation.
 
Q    How did you choose the delegation, and can you tell us a little bit about how that all came together?
 
MR. RHODES:  Yes, so in any case we would have a delegation, whether or not the President was leading it.  So as soon as we received the news of King Abdullah’s death, we went to work to put together a delegation that represented people who had been invested in the Saudi relationship for a long time and had known King Abdullah well.  We wanted to make sure that we had bipartisan representation from members of Congress, given the deep congressional interest and relationship with Saudi Arabia, and we also wanted to make sure we had bipartisan representation across different administrations.  And, again, we were able to have a number of former administration officials, including Republican administration officials, join us and then people who worked closely on the Saudi relationship.  So I think if you look across it, it meets the threshold of being bipartisan, high-level, and individuals who have worked very closely with Saudi Arabia over many years.
 
Q    Can you bring us up to speed on any new developments in Yemen?  Obviously, that will be part of the discussion –- is there any evidence of Iranian support of the Houthis?  There’s been allegedly –- do you guys have any factual knowledge on that?  And then small clarification:  There was some confusion late yesterday about whether it was the embassy or the consulate in Yemen that’s closed to the public –- which is that?
 
MR. RHODES:  So on your second question, there was some confusion.  The embassy is open, the embassy is still functioning, people are still going to work at the embassy.  What happened is the embassy is not providing consular services.  So one function of the embassy is closed, given the security environment, but that should not be equated to the embassy itself closing down.  It’s still operating.
 
With respect to developments in Yemen, it’s still a very fluid situation.  I think the different actors inside of Yemen are seeking to determine a way forward that can hopefully deescalate the situation.  And what we’ve encouraged consistently is a political process where there can be dialogue rather than the use of violence in determining how the different factions in Yemen can come to a common view about how to move forward.
 
With respect to the Houthis and Iran, we have seen in the past -- over the course of several months and, indeed, the last several years -- that Iran has, at times, provided materiel support to the Houthis, so they have a relationship.  At the same time, however, I think it would be overstating it to suggest that Iran is directing the activities of the Houthis.  It’s more to the case that, again, they have a relationship that has included Iran providing support and we’ve spoken out about that in the past. 
 
I think in terms of what we want to see happen, I think all parties in Yemen have an interest in the restoration of stability and a process in which all the people of Yemen can agree upon a path forward that does not rely on the division of the country or the use of violence to achieve political ends.  That’s in the interest of all parties, and we would encourage all countries in the region to support that type of constructive process because what we don’t want is the type of sectarian violence that has plagued so many parts of the region.  This will clearly be an important agenda item going forward.  In the past, Saudi Arabia, leading the GCC countries, has played an enormously important role in supporting stability inside of Yemen and putting forward a framework for a political process that can maintain stability.
 
Q    The President doesn’t seem to have actually met with Salman all that many times.  Can you give us a sense of what his sense of Salman is directly and what the White House’s sense -– or is this really a getting-to-know-you meeting?
 
MR. RHODES:  So, yes, King Salman we’ve met a small number of times.  In the past, he has held a number of positions in the Saudi system, many of which were focused internal to Saudi Arabia although he also worked on some security portfolios.  I think what’s very clear to us is that King Salman has sent a signal of continuity -– I think that in how the royal families manage succession, what they’ve made clear is that they’re going to emphasize continuity in terms of Saudi interest and the Saudi relationship with the United States.  So we do believe that Saudi policy will remain quite similar to how it’s been under King Abdullah. 

At the same time, given the importance of some of the things we’re doing with Saudi Arabia, including the counter-ISIL campaign, it will be important for the President to establish that relationship with King Salman.  He had a close relationship with King Abdullah -– they could pick up the phone, they didn’t always agree, but they could be candid in their differences, but they also were able to do a lot of things together.  And I think he’ll want to develop the same time of relationship with King Salman, where we’re able to move forward on areas of common interest and able to be very candid and frank with one another about developments in the region.
 
Q    Do you believe he is in good mental and physical health?
 
MR. RHODES:  We certainly do believe he is ready to assume the duties of King of Saudi Arabia, and so we look forward to working with him on that basis.  And, again, we believe that he has made clear that he is ready to take the reins and sustain the U.S. relationship that is based on a series of overlapping interests.
 
They’ve also identified very capable people in Prince Muqrin and Prince Mohammad bin Nayef, who have been very close friends of the United States as well, in their continued plan of succession as we go forward.  So I think we have, among the Saudi leadership, led by King Salman, partners who we’ve worked with closely and who will want to stay invested in the efforts like the counter-ISIL campaign, like the pursuit of regional stability, that have been the hallmark of our cooperation.
 
Q    The President just spoke in Delhi about the importance of equality, women’s equality, religious freedom to a successful society –- is that the message he is going to take to the King in Riyadh?
 
MR. RHODES:  Yes, I think, look, what we would say to all of our partners around the world is that we fundamentally believe in a set of values to include equality for women and religious freedom and tolerance.  Obviously different countries are in very different places in terms of their embrace of those values.  I think what the President would say is that it’s not simply a matter of the United States telling other countries what they should do; it’s frankly a fact that societies are more successful when they respect those types of universal values.  And that’s the message he delivered in India.
 
And then, ultimately, stability in the long run is going to depend on a process of reform in different societies that move in the direction of those values.  Again, places don’t change overnight but I think with Saudi Arabia what we’ve said we’d support is a reform process that does provide for greater respect for those types of universal values.  King Abdullah took some initial steps in that direction, in terms of more political participation for some people within Saudi Arabia, more access to education for women.  But, clearly, much more work needs to be done to realize the types of values that the President was talking about in India, and that will be a consistent part of our dialogue with all countries around the world.
 
Q    Do you guys expect that you’ll be able to readout any of the meetings after they’re done, either when we’re still on the ground or on the flight?
 
MR. RHODES:  Yes, we should be able to do that.
 
Q    A quick question about oil.  You didn’t mention oil prices and oil production in your list of sort of issues that you want to discuss.  Is that going to be on the agenda at all -– oil production, energy production?
 
MR. RHODES:  Generally speaking, frankly, we have that dialogue with the Saudis in the channels in our government who work on energy policy.  It only becomes a leader-to-leader conversation usually when there’s a particular crisis point.  So energy and oil is certainly a part of our relationship and our ongoing dialogue with Saudi Arabia.  I wouldn’t expect it to be -– certainly not high on the agenda today.  And it’s more likely those are the types of issues that we’ll continue to manage at a working level.
 
MR. EARNEST:  Thanks, everybody.
 
Q    Did you guys say that the whole delegation will be at the dinner?
 
MR. EARNEST:  Yes.
 
END  
2:33 P.M. IST

Remarks by President Obama and Prime Minister Modi of the Republic of India in a Joint Radio Address

5:37 P.M. IST

PRIME MINISTER MODI: (Speaks Hindi.)  I request President Barack Obama to say a few words.

PRESIDENT OBAMA:  Namaste.  Thank you, Prime Minister Modi, for your kind words and for the incredible hospitality you’ve shown me and my wife, Michelle, on this visit.

And let me say to the people of India how honored I am to be the first American President to join you for Republic Day.  I’m told this is also the first-ever radio address by an Indian Prime Minister and an American President together, so we’re making a lot of history in a short time.

To the people of India listening all across this great nation, it’s wonderful to be able to speak to you directly.  We just came from discussions in which we affirmed that India and the United States are natural partners, because we have so much in common.  We’re two great democracies, two innovative economies, two diverse societies dedicated to empowering individuals.  We are linked together by millions of proud Indian Americans who still have family and carry on traditions from India. 

And I want to say to the Prime Minister how much I appreciate your strong personal commitment to strengthening the relationship between these two countries. 

People are very excited in the United States about the energy that Prime Minister Modi is bringing to efforts in this country to reduce extreme poverty and lift people up, to empower women, to provide access to electricity and clean energy, and invest in infrastructure and the education system.

And on all these issue, we want to be partners.  Because many of the efforts that I am promoting inside the United States to make sure that young people get the best education possible, to make sure that ordinary people are properly compensated for their labor and paid fair wages and have job security and health care -- these are the same kinds of issues that Prime Minister Modi, I know, cares so deeply about here.

And I think there’s a common theme in these issues.  It gives us a chance to reaffirm what Gandhiji reminded us should be a central aim of our lives, and that is we should endeavor to see God through service of humanity because God is in everyone.  So these shared values, these convictions are a large part of why I’m so committed to this relationship.  I believe that if the United States and India join together on the world stage around these values, then not only will our peoples be better off, but I think the world will be more prosperous and more peaceful and more secure for the future.

So, thank you so much, Mr. Prime Minister, for giving me this opportunity to be with you here today. 

PRIME MINISTER MODI:  Barack, the first question comes from a young doctor.

Q    (As interpreted.)  The whole world was about your affectionate love for your daughters.  What do you plan to tell your daughters about your experiences in India?  And do you plan to go shopping and buy things for them?

PRESIDENT OBAMA:  Well, first of all, they very much wanted to come.  They are fascinated by India.  Unfortunately, each time that I’ve taken a trip here they had school and they couldn’t leave school.  And in fact, Malia, my older daughter, had exams just recently. 

So they are fascinated by the culture and the history of India, in part because of my influence, I think.  They are deeply moved by India’s movement to independence and the role that Gandhi played in not only the nonviolent strategies here in India but how those ended up influencing the nonviolent Civil Rights Movement in the United States.

So when I go back, I’m going to tell them that India is as magnificent as they imagined.  And I am quite sure they’re going to insist that I bring them back the next time I visit.  It may not be during my presidency, but afterwards, they’ll definitely want to come and visit. 

And I will definitely do some shopping for them -- although I can’t go to the stores myself so I have to have my team do the shopping for me.  And I’ll get some advice from Michelle, because she probably has a better sense of what they would like.

PRIME MINISTER MODI:  (As interpreted.)  Barack said that he would bring his daughters, and I do believe you can bring them when you’re the President or even after, but definitely India looks forward to welcoming you and your daughters. 

[The next] question:  You have started the Educate the Girl Child mission.  Have you spoken to the President of the United States about this?  Have you asked him for help about this? 

PRIME MINISTER MODI:  I think this is a very good question you’ve asked.  The poor sex ratio in India is a cause of great concern.  We have a sex ratio of a thousand boys, and in comparison to that the number of girls is very low.  And even our way of looking at, or our perspective of viewing women and men, girls and boys, is something that needs to be rectified. 

I think when we look at President Obama and the way in which he has brought up his two daughters, I think this is an inspiration for us.  In our country, we have so many people, and we have so many families where there are no sons and they only have daughters, and they do bring up their daughters very proudly.  And I think that is an inspiration.  And I think this kind of inspiration can be a strength for us.

And since you’ve asked this question, I would like to say that Save the Girl Child, Educate the Girl Child is a social responsibility that we have.  It’s a responsibility that we have towards our culture, it’s a responsibility towards humanity. 

And I have another question which is also being addressed to Barack, and it’s been addressed to me, as well. 

Q    (As interpreted.)  Your wife has been working on diseases like obesity and diabetes.  She’s been doing a lot of work in this field.  These challenges are growing at a rapid pace in India, as well.  So after leaving office, do you and the First Lady plan to or intend to come to India -- for instance, as Bill Gates and Belinda Gates have taken up cleanliness as an issue in India -- so do you think that you would work on obesity and diabetes?

PRESIDENT OBAMA:  We very much look forward to partnering with organizations and the government and non-governmental organizations here in India around broader public health issues, including the issue of obesity. 

I’m very proud of the work that Michelle has done on this issue.  We’re seeing a worldwide epidemic of obesity, in many cases starting at a very young age.  Part of it has to do with the increase in processed foods not naturally prepared.  Part of it is the lack of activity for too many children.  And once they’re on this path, it can lead to a lifetime of health challenges. 

And so this is an issue that we’d like to work on internationally, including here in India.  And it is part of a broader set of issues around global health that we need to address.  The Prime Minister and I have discussed, for example, how we can do a better job in dealing with issues like pandemic, and making sure that we have good alert systems so that if a disease like Ebola, or a deadly flu virus, or Polio appears, that it’s detected quickly and then treated quickly so that it doesn’t spread. 

And the public health infrastructure around the world needs to be improved.  I think the Prime Minister is doing a great job in focusing on these issues here in India, and India has a lot to teach many other countries who may not be advancing as rapidly in improving this public health sector. 

But it has an impact on everything because if children are sick, they can't concentrate in school and they fall behind.  It has a huge economic impact on the countries involved.  And so we think that there’s a lot of progress to be made here, and I'm very excited about the possibilities of continuing this work even after I leave office.

PRIME MINISTER MODI:  (As interpreted.)  [Next questioner] has asked a question and it's quite an interesting question.  House’s asked me:  There’s an old photograph of you as a tourist in front of the White House.  So when you went back to America last September, what aspect really touched your heart?

Well, it's true that when I went to America for the first time I couldn't actually get into the White House, of course.  There was a big iron fence outside the White House.  And we had a photograph of ourselves clicked standing in front of that fence. And when I became Prime Minister, of course, that photograph has also become quite popular. 

But at that time, of course, I never thought that I would have the opportunity of actually going into the White House.  But one thing really did touch my heart and I can never forget it.  Barack gifted me a book, and I think he took a lot of trouble to actually find that book.  In 1894, that book became famous.  It had to do with Swami Vivekananda who is one of the people I really deeply regard.  There was a world religion conference in Chicago in 1894, and this was a compilation of the proceedings of that conference. 

And his gifting me that book was something that really deeply touched me.  And it wasn’t just that.  He had actually opened that book, read through that book, and actually put notes on the pages for me.  And very proudly, he said that, I am from Chicago, and that is a city to which Swami Vivekananda had gone. And as I said, that deeply touched me, and I do consider that is something that is my heritage.  I never did think that standing in front of the White House, having a photograph taken, and actually going into the White House and being gifted a book of somebody I deeply respect -- I mean, you can imagine how deeply that must have touched me.

Barack, there’s a question for you now. 

PRESIDENT OBAMA:  Well, the question is, did you both imagine you would reach the positions that you’ve reached today? And it's interesting, Mr. Prime Minister, you talking about the first time you visited the White House and being outside that iron fence.  The same is true for me.  When I first went to the White House I stood outside that same fence and looked in.  And I certainly did not imagine that I would ever be visiting there, much less living there.

I think both of us have been blessed with extraordinary opportunity, coming from relatively humble beginnings.  And when I think about what’s best in America and what’s best in India, the notion that a tea seller or somebody who is born to a single mother, like me, could end up leading our countries is an extraordinary example of the opportunities that exist within our countries.

Now, I think part of what motivates both you and I is the belief that there are millions of children out there who have the same potential but may not have the same education, may not be getting exposed to opportunities in the same way.  And so part of our job, part of government’s job, is that young people who have talent and who have drive and are willing to work for it are able to succeed. 

And that's why emphasizing school, higher education, making sure that children are healthy, and making sure those opportunities are available to children of all backgrounds, girls and boys, people of all religious faiths and all races in the United States is so important, because you never know who might be the next prime minister of India or who might be the next president of the United States.  They might not always look the part right off the bat, and they might just surprise you if you give them a chance. 

PRIME MINISTER MODI:  Thank you, Barack.

This was also addressed to me:  Did you ever think that you would reach the position you have today?  No, I never imagined that, because, as Barack said, I came from a very humble background.  But for a very long time, I remember that I told people that don't ever imagine you're going to become somebody, don't ever dream of becoming somebody.  If you have to dream something then dream of doing something.  Because when you do something you also get satisfaction and you're inspired to do more.  If you only want to become something and then you don't become what you wanted to become, you are disappointed.  And that is why I never, ever dreamt of becoming someone. 

And even today, I don't dream of becoming somebody, but certainly I do dream of doing things.  I do want to serve my country.  I want to serve the 1.25 billion people in my country. And I think that there can't be anything more ambitious than that.

There is also a question for Barack. It relates to (inaudible.)

PRESIDENT OBAMA:  Well, this is a very interesting question. His question is:  The youth of the new generation is a global citizen.  He’s not limited by time or boundaries.  In such a situation, what should be the approach by our leadership, governments, as well as societies at large?  And I think this is a very important question.

When I look at this generation that’s coming up, they’re exposed to the world in ways that you and I could hardly imagine. They have the world at their fingertips, literally.  They can, using their mobile phone, get information and images from all around the world.  And that’s extraordinarily powerful.  And what that means I think is, is that governments and leaders cannot simply try to govern or rule by a top-down strategy, but rather have to reach out to people in an inclusive way and an open way and a transparent way, and engage in a dialogue with citizens about the direction of their country.

And one of the great things about India and the United States is we’re both open societies, and we have confidence and faith that when citizens have information and there’s a vigorous debate, that over time, even though sometimes democracy is frustrating, the best decisions and the most stable societies emerge, and the most prosperous societies emerge, and new ideas are constantly being exchanged.  And technology today I think facilitates that not just within countries but across countries.

And so I have much greater faith in India and the United States, countries that are open-information societies, in being able to succeed and thrive in this new information age than closed societies that try to control the information that citizens receive.  Because ultimately, that’s no longer possible. Information will flow inevitably one way or the other.  And we want to make sure that we’re fostering a healthy debate and a good conversation between all peoples.

PRIME MINISTER MODI:  (As interpreted.)  That was addressed to Barack.  It is a question that is also addressed to me.  And I think that the answer that Barack has given is very good, is very inspirational.  What I would like to say is that people influenced by a communist viewpoint used to call for communism across the world.  They used to say, workers of the world unite, the workers of the world should become one.  That was a slogan that we’ve heard for decades.

I do believe that the youth today have strength.  They are able to reach out and looking at that strength, I think we should say that the youth unite the world.  We need to change our slogan.  The youth of today must bring the world together.  I do believe that youth today have the strength and they can do it.

The next question is from a chartered accountant from Bombay.  He’s asked me this question.  He’s asked me:  Which American leader has inspired you?

PRIME MINISTER MODI:  (As interpreted.)  When we were small, we used to look at Kennedy’s photographs in the newspapers, and we thought his personality was really impressive.  But the question is, who inspired me? 

I had a great interest for reading when I was young, and I did read Benjamin Franklin’s autobiography.  He lived to a ripe old age, and he never did become President of the United States.  But his life is really inspirational:  how one person can manage to change his life; how he can make those attempts intelligently; how he can deliberately seek to reduce the number of hours that he needs to sleep, how to reduce the amount of food -- the kind of hunger that he feels; and how to influence people who are angry with him, how to find solutions to that. 

There are very, very small issues that he has addressed in his biography.  And I always tell everyone that we need to read about Benjamin Franklin’s life.  He’s an inspiration to me, even today.  He was a multifaceted personality.  He was a political scientist.  He was a thinker.  He was a social worker.  And he came from a very humble background.  He wasn’t able to complete his schooling, but he has had a profound influence on American life and thought, even today.  And I really found his life to be truly inspirational, and I would like to motivate you to read about his life. 

And if you want to learn how to transform your life, you would be able to learn it from there.  There are small examples that he gives that can serve as an example to you.  And I do believe that you would find this an inspiration as well. 

There is a question from Monica to Barack.  Barack, this question is addressed to you.

PRESIDENT OBAMA:  The question is:  As leaders of two major economies, what inspires you and makes you smile after a bad day at work?  And that’s a very good question.

I say sometimes that the only problems that come to my desk are the ones that nobody else solves.  If they were easy questions, then somebody else would have solved them before they reached me.  So there are days when it’s tough and frustrating.  And that’s true in foreign affairs, that’s true in domestic affairs. 

But I tell you what inspires me -- and I don’t know, Mr. Prime Minister, if you share this view.  Almost every day I meet somebody who tells me, you made a difference in my life.  So they’ll say, the health care law that you passed saved my child who didn’t have health insurance, and they were able to get an examination from a physician, and they caught an early tumor and now he’s doing fine.  Or they’ll say, you helped me save my home during the economic crisis.  Or they’ll say, I couldn’t go to college, and the program you set has allowed me to go to the university.

And sometimes they’re thanking you for things that you did four or five years ago.  Sometimes they’re thanking you for things you don’t even remember or you’re not thinking about that day.  But it’s a reminder of what you said earlier, which is if you focus on getting things done as opposed to just occupying an office or maintaining power, then the satisfaction that you get is unmatched. 

And the good thing about service is that anybody can do it.  If you’re helping somebody else, the satisfaction that you can get from that I think exceeds anything else that you can do.  And that’s usually what makes me inspired to do more, and helps get through the challenges and difficulties that we all have -- because obviously we’re not the only people with bad days at work.  I think everybody knows what it’s like to have a bad day at work.  You just have to keep on working through it.  Eventually, you’ll make a difference.

PRIME MINISTER MODI:  (As interpreted.)  Barack has really spoken from the heart.  Because no matter what office we hold, we are all individuals, we are all human beings first.  And listening to this, I also feel like recounting an episode from my life.

For many years, I was working, I was single, and I was occupied with my work.  And a lot of people at that time used to give me food to eat.  And there was one family that used to invite me very often, but I never went to their house because I felt they were very poor, and I thought if I go to their house and have dinner, then it will be a burden on them.  But one day, because they were so affectionate and kept inviting me, I did bow to their wishes and visited them. 

They had a very small hut.  There was a very small place to sit there.  They gave me something to eat, which was a piece of bread and some milk.  And they had a small child who was looking at that milk, was just staring at it.  And it looked as if the child had never even seen milk.  So I quickly gave that glass of milk to the child, and immediately, within seconds, he just drank up that milk.  His own parents were quite angry with him because he had had my milk, but I experienced at that point that perhaps that child had never had any milk besides his mother’s milk.  And they had wanted to feed me well, and that’s why they had gone and got milk.

And it really touched me that somebody living in a poor hut, a poor family would go through that kind of trouble to feed me.  And you need to actually dedicate your life to serving these people, and that is something that inspires me.

As Barack has said, what common people feel is something that we’ve experienced.  And I’m very grateful that Barack has taken the time out today to join us, to speak to us.  I’m also very grateful to the people of this country, because I know that people in every town, in every city, in every street are listening to this program.  And we hope that this program, that the voice that we are spreading will be with you always.

And I do have an appeal.  I have a suggestion.  We are going to take out an e-book of this conversation between Barack and me today.  We want to bring out an e-book of this conversation.  And I would like to ask those listeners who have been listening in on this program today to participate.  The best hundred suggestions that we get will be included in this e-book that we plan to bring out.  So whether it’s on Twitter, Facebook or any other online medium, use hashtag #YesWeCan.  Write to us using this hashtag #YesWeCan.  The issue: Alleviate poverty, hashtag #YesWeCan.  Quality health care to all, hashtag #YesWeCan.  Jobs for all, hashtag #YesWeCan.  Global peace and progress, hashtag #YesWeCan.

I want that you join this movement, that you write in with this hashtag.  Give us your thoughts, give us your ideas.  We will select the best hundred ideas.  And the conversation that we’ve had today, Barack and me, we will be taking up these ideas, including them in that e-book.  And we hope that this will become everyone’s thoughts -- the heart-to-heart thoughts of everyone.
 
I’m, again, very grateful to Barack for being here.  And on the auspicious occasion of Republic Day on the 26th of January, I am very happy and I’m very proud that he’s with us today.  Thank you.

END
6:09 P.M. IST

FACT SHEET: President’s 2016 Budget Proposes Historic Investment to Combat Antibiotic-Resistant Bacteria to Protect Public Health

Antibiotic resistance is one of the most pressing public health issues facing the world today.  The Centers for Disease Control and Prevention (CDC) estimates that each year at least two million illnesses and 23,000 deaths are caused by antibiotic-resistant bacteria in the United States alone.  Antibiotic resistance limits our ability to quickly and reliably treat bacterial infections, and the rise of resistance could hamper our ability to perform a range of modern medical procedures from joint replacements to organ transplants, the safety of which depends on our ability to treat bacterial infections that can arise as post-surgical complications.

Antibiotic-resistant bacteria also pose economic threats.  The CDC reports that antibiotic-resistant infections account for at least $20 billion in excess direct health care costs and up to $35 billion in lost productivity due to hospitalizations and sick days each year.

Given the clear need for action on this issue, in September 2014 President Obama signed an Executive Order launching Federal efforts to combat the rise in antibiotic-resistant bacteria.  The Administration also issued its National Strategy on Combating Antibiotic-Resistant Bacteria, which outlines steps the U.S. government will take to improve prevention, detection, and control of resistant pathogens.  In addition, the President’s Council of Advisors on Science and Technology released a report with recommendations for addressing the antibiotic-resistance crisis.

The President’s FY 2016 Budget builds on these recent efforts by nearly doubling the amount of Federal funding for combating and preventing antibiotic resistance to more than $1.2 billion.  The funding will improve antibiotic stewardship; strengthen antibiotic resistance risk assessment, surveillance, and reporting capabilities; and drive research innovation in the human health and agricultural sectors.

This $1.2 billion investment increases funding for antibiotic resistance across the government in FY 2016.  For example, the Budget:

• Proposes an almost $1 billion investment in FY 2016 – nearly double the 2015 funding level –  for the Department of Health and Human Services (HHS), including:

• Nearly quadruples antibiotic research and surveillance funding at the Department of Agriculture (USDA) to $77 million.
• Increases funding at the Departments of Veterans Affairs (VA) and Defense (DoD) to $85 and $75 million, respectively, to address issues related to antibiotic resistance in healthcare settings. 

Improving Antibiotic Stewardship

Judicious use of antibiotics is essential to slow the emergence of antibiotic resistance in bacteria and extend the useful lifetime of effective antibiotics.  Preserving the usefulness of antibiotic resources without compromising human or animal health requires coordination, cooperation, and engagement of healthcare providers, healthcare leaders, pharmaceutical companies, veterinarians, the agricultural and pet industries, and patients.

The President’s FY 2016 Budget supports several key efforts to address issues related to antibiotic stewardship, including:

• Enhancing collaborative efforts to improve antibiotic prescribing and prevent the spread of resistant bacteria.  Antibiotic-resistant bacteria can spread when infected patients move between hospitals, long-term care facilities, or other healthcare settings.  The President’s FY 2016 Budget includes investments that will help healthcare facilities work together, in close partnership with state health departments, to implement effective interventions that slow the regional spread of antibiotic-resistant bacteria.
• Strengthening education programs for medical professionals, veterinary professionals, food-animal producers, and members of the public.  Some antibiotics are overprescribed in a variety of human and animal settings. Investments in this area will be used to develop education and outreach programs to clarify and strengthen responsible, appropriate use of antibiotics in humans and animals.  Investments will also support programs that enhance relationships and support necessary linkages across the human and animal health communities.
• Improving antibiotic stewardship in animal agriculture.  FDA will continue to support the phasing out of medically important antibiotics in food-producing animals, and accelerate the evaluation of new antibacterial drugs and diagnostics for antibiotic-resistant organisms.
• Improving the health and well-being of veterans.  VA will improve the implementation and effectiveness of the VA Antimicrobial Stewardship Program.  This program fosters the judicious use of antimicrobials through education, direct provider-to-provider stewardship, and surveillance, and supports and expands ongoing efforts to prevent emergence of multidrug-resistant organisms.  All of these actions are focused on improving the health and well-being of our veteran population.
• Investing in advanced diagnostics.  Optimal, informed deployment of antibiotics relies on diagnostic tests that can quickly and accurately detect disease-causing bacteria, identify the presence of antibiotic-resistant bacteria, and characterize resistance patterns.  Currently, most diagnostic tests take 24 to 72 hours from specimen collection to results, with some tests taking up to weeks.  The President’s FY 2016 Budget will accelerate the development of new advanced diagnostic tests – including rapid point-of-care diagnostic tests suitable for use during a healthcare visit – that could significantly reduce unnecessary antibiotic use.  The Budget will also expand the availability and use of advanced diagnostics to improve treatment, enhance infection control, and improve responses to outbreaks of antibiotic-resistant bacteria in hospitals and in the community.
• Advancing research to make antibiotic stewardship more effective.  The President’s FY 2016 Budget supports research to develop improved methods and approaches for embracing good antibiotic stewardship practices and combating antibiotic resistance in a variety of health care settings.  In particular, improvements in antibiotic stewardship practices are important in the acute-care hospital setting and in ambulatory and long-term care settings, where stewardship efforts are not as well developed.  Investments in this area include translation of relevant research findings into useful tools for healthcare providers to prevent and control emergence and spread of antibiotic resistance, and support for DoD efforts to develop antimicrobial stewardship policy to foster judicious use of antimicrobials. 

Strengthening Antibiotic Resistance Risk Assessment, Surveillance, and Reporting Capabilities

Resistance can arise in bacterial pathogens affecting humans, animals, and the environment.  The adoption of a “One-Health” approach that integrates human health, veterinary, and ecosystem surveillance will help strengthen detection and control of antibiotic resistance.  Improved surveillance will be achieved through enhancement, expansion, and linkage of existing systems that monitor human and animal pathogens, including the National Healthcare Safety Network (NHSN), the Emerging Infections Program (EIP), the National Antimicrobial Resistance Monitoring System (NARMS), the National Animal Health Monitoring System (NAHMS), and animal health laboratories.

To improve national and international capabilities for surveillance and reporting of antibiotic resistance, the President’s FY 2016 Budget proposes expansion of existing capabilities and establishment of new supporting networks and programs.  Efforts in this area include:

• Bolstering monitoring and reporting of antibiotic-resistant bacteria.  The number of CDC’s Emerging Infections Program (EIP) sites will be doubled from 10 to 20 across the United States.  The EIP focuses on improving national estimates related to healthcare and community antibiotic resistant infections and expanding antibiotic resistant bacteria surveillance.  Investments in this area also:

• Understanding new types of antibiotic resistance.  A Detect Network of Antibiotic Resistance Regional Laboratories will be established, serving as a national resource to characterize emerging resistance and rapidly identify outbreaks of antibiotic-resistant organisms.  Laboratories in the network will use state-of-the-art methods to characterize known resistance patterns in real time and more quickly identify clusters of resistant organisms.  In addition, a new Antibiotic Resistance Isolate Bank will provide a complete collection of current antibiotic-resistant bacteria, help keep pace with mutations, and provide information to guide FDA approval of new tests, antibiotics, and related products.
• Increasing surveillance for antibiotic-resistant zoonotic and animal pathogens.  Surveillance for antibiotic-resistant zoonotic and animal pathogens nationwide is essential to understanding what bacteria may ultimately generate outbreaks that impact human and animal health.  The President’s FY 2016 Budget will improve existing surveillance capabilities by enhancing the NAHMS and expanding capacity among existing animal health networks.
• Supporting the National Healthcare Safety Network, a web-based system to monitor antimicrobial resistance and antimicrobial use. 

Driving Research Innovation in the Human Health and Agricultural Sectors

Antibiotics for treating human disease that lose their effectiveness due to the emergence of resistance must be replaced with new drugs.  Alternatives to antibiotics are also needed in animal agriculture and veterinary medicine.  Advancing antibiotic development and increasing the number of candidates in the drug-development pipeline requires intensified efforts to boost basic scientific research, attract greater private investment, and facilitate clinical trials of new antibiotics.  The President’s FY 2016 Budget will:

• Invest in basic life sciences research.  Understanding environmental factors that facilitate development and spread of antibiotic resistance common to human and animal pathogens is essential for ensuring that newly-developed drugs and vaccines remain effective.  Basic research in this area will exploit powerful new technologies – including systems biology, rapid genome sequencing, metagenomics, and Big Data – to advance the study of antibiotic resistance.
• Intensify research and development of new therapeutics and vaccines.  Despite the urgent need for new antibacterial drugs, the pipeline of antibiotics in development is inadequate, and commercial interest in antibiotic development remains limited.  The Budget directly supports activities that will advance the discovery and development of new antibiotics, non-traditional therapeutics, and vaccines by investing in basic and applied research, providing researchers with scientific support services (e.g., specimens, sequence data, and regulatory guidance), and fostering public-private partnerships that reduce the risks, uncertainty, and obstacles faced by companies developing new antibiotics.  Investments in this area include:

• Develop alternatives to antibiotics in agriculture.  The President’s FY 2016 Budget nearly quadruples funding to $77 million for USDA efforts to combat antimicrobial resistance.  This funding supports USDA development of alternatives to antibiotics, including improved management and animal care practices and other tools.

The United States government has laid out an ambitious plan that aims to help dramatically curb the expansion of antibiotic-resistant bacterial infections.  Over the next five years, the Administration’s efforts to combat antibiotic resistance will enhance national capabilities for antibiotic stewardship, outbreak surveillance, and research in the human healthcare and agricultural sectors.  This effort holds the potential to:

• Reduce the incidence of carbapenem-resistant Enterobacteriaceae (CRE) infections by 60 percent.
• Reduce the incidence of Clostridium difficile infection (CDI) and methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections by 50 percent.
• Reduce the incidence of multidrug-resistant Pseudomonas infections acquired during hospitalization by 35 percent.
• Spur at least a 25 percent reduction in the rate of multi-drug resistant Salmonella infections and pediatric and geriatric antibiotic-resistant invasive pneumococcal disease. 

Together, the Administration’s proposed investments of more than $1.2 billion to combat and prevent antibiotic resistance that will lead to critical new developments that could fundamentally transform how public health prevents the transmission and emergence of antibiotic-resistant infections.

Presidential Nominations Sent to the Senate

NOMINATIONS SENT TO THE SENATE:

Sim Farar, of California, to be a Member of the United States Advisory Commission on Public Diplomacy for a term expiring July 1, 2015. (Reappointment)

Sim Farar, of California, to be a Member of the United States Advisory Commission on Public Diplomacy for a term expiring July 1, 2018. (Reappointment)

William Joseph Hybl, of Colorado, to be a Member of the United States Advisory Commission on Public Diplomacy for a term expiring July 1, 2015. (Reappointment)

William Joseph Hybl, of Colorado, to be a Member of the United States Advisory Commission on Public Diplomacy for a term expiring July 1, 2018. (Reappointment)

Dallas P. Tonsager, of South Dakota, to be a Member of the Farm Credit Administration Board, Farm Credit Administration, for a term expiring May 21, 2020, vice Jill Long Thompson, term expired.