Drug-Resistant H7N9 Retains Pathogenicity

In a study published Wednesday in Nature Communications, researchers discovered that certain strains of  H7N9 have mutated to become “highly resistant” to antivirals like Tamiflu while maintaining high levels of pathogenicity. This is not normal. Normally when  a virus acquires drug-resistance through mutation, this mutation attenuates it, decreasing viral virulence or replication ability.  The study authors write, “in stark contrast to oseltamivir-resistant seasonal influenza A(H3N2) viruses, H7N9 virus replication and pathogenicity in these models are not substantially altered by the acquisition of high-level oseltamivir resistance”. Moreover, drug resistance in highly pathogenic avian influenza (HPAI) viruses is usually limited to amantadine resistance; infact, many influenza A and B strains are already resistant to amantadine. This means that in many cases, the only  effective antivirals are neuraminidase (NA) inhibitors. Luckily, resistance to NA inhibitors is rare. Unluckily, some strains of H7N9 appear to have it.

Read the full paper here.

(image of H7N9: CDC/Cynthia S. Goldsmith and Thomas Rowe; false color added by author)

Image of the Week: Cholera

This week’s image is of Vibrio cholerae, the gram-negative bacteria which causes the disease cholera. Cholera affects up to five million people globally each year, and causes as many as 120,000 deaths. The disease is not contagious, but is spread through ingestion of contaminated food or water, the latter often due to poor sanitation. Haiti is currently experiencing an unrelenting cholera outbreak; between October of 2010 and October of 2013, there have been over 680,000 cases.

cholera(image: CDC)

Bubonic Plague in Madagascar

In the latest outbreak of bubonic plague in the country, 20 people died from the disease last week in north-western Madagascar. Bubonic plague, caused by the bacteria Yersinia pestis, is endemic to the island nation, and resulted in 60 fatalities last year alone. The island’s prisoners are especially vulnerable, due to pervasive unsanitary conditions enabling a large rat population in local prisons. However, last week’s outbreak occurred in the relatively remote village of Mandritsara. Health authorities are currently investigating the outbreak.

Plague is spread to humans through infected fleas, often from rats. Bubonic plague is something we’ve written about extensively here on the Pandora Report, usually in a historical context. It’s easy to forgot that for many nations, outbreak of the disease remains a very real fear today.

(image: wikimedia commons)

Hong Kong Quarantines 19 people after 2nd H7N9 case

Health authorities in Hong Kong have quarantined 19 people who were thought to have come in contact with an 80-year-old man diagnosed with H7N9 earlier this week. This is the second case of the influenza A virus in the area. The man has subsequently stabilized – however, at least one person with whom he came in contact has symptoms of a “mild” respiratory infection. H7N9 emerged for the first time in humans earlier this year. Case numbers rose to 137 by the end of October, with 45 fatalities, and the newer cases are thought to result from the cooler temperatures. 

(Image caption: “This negatively-stained transmission electron micrograph (TEM) captured some of the ultrastructural details exhibited by the new influenza A (H7N9) virus.” CDC/Cynthia S. Goldsmith and Thomas Rowe)

 

This Week in DC: Events

A few events scheduled for today may be postponed due to the weekend snow – be sure to check event websites before heading out!

Monday, December 9, 2013
PeaceGame
US Institute for Peace
All day Monday – Tuesday afternoon

Governments around the world regularly devote enormous resources to conducting “war games.” On December 9 and 10, the U.S. Institute of Peace (USIP) and The FP Group (FP) will conduct the inaugural PeaceGame, with a focus on “the best possible peace for Syria.” With one game in the U.S. and another in the Middle East, the semi-annual PeaceGames will bring together the leading minds in national security policy, international affairs, academia, business, and media to “game” out how we can achieve peace in Syria. USIP and FP intend for the game to redefine how leaders think about conflict resolution and the possibility of peace.

Tuesday, December 10
Strengthening National Laboratory Commercialization
Information Technology and Innovation Foundation
10:00 AM

Post-World War II era U.S. science, technology, and innovation policy has been defined by a linear approach to public investment in basic research. For many decades, this worked because the United States was one of the few countries with the technological capabilities to translate research into new products and services. But in today’s intensely competitive global economy where nations are fiercely competing for innovation advantage, this paradigm is no longer tenable. Robust public investments in basic research remain critical, but equally as important are investments and institutional reforms to commercialize new ideas from the laboratory into the marketplace. To advance the debate on potential policy reforms, the House Technology Transfer Caucus, Co-Chairs Rep. Gus Bilirakis (R-FL) and Rep. Ben Ray Luján (D-NM), the Information Technology & Innovation Foundation, and Innovation Associates are convening a series of Capitol Hill briefings featuring leading experts in innovation policy.

Hearing: The Iran Nuclear Deal: Does It Further U.S. National Security?
House Committee on Foreign Affairs
1:00PM

Chairman Royce on the hearing: “I continue to have serious concerns that the agreement the Obama Administration negotiated does not meet the standards necessary to protect the United States and our allies. The deal does not roll back Iran’s nuclear program, but instead allows Tehran to keep in place the key elements of its nuclear weapons-making capability. Under the agreement, the international community relieves the sanctions pressure on Iran while its centrifuges continue to enrich uranium. This hearing will be an opportunity for Committee Members of both parties to press Secretary Kerry to explain why the Obama Administration believes this sanctions-easing agreement is the right course.“

The Transition in Afghanistan
Senate Foreign Relations
2:30PM

Witnesses: Ambassador James Dobbins, Special Representative for Afghanistan and Pakistan, U.S. Department of State; Mr. Donald L. Sampler, Jr. Acting Assistant to the Administrator, Office of Afghanistan and Pakistan Affairs U.S. Agency for International Development (USAID)

Wednesday, December 11
Squaring the circle: General Mark Welsh III on American military strategy in a time of declining resources
American Enterprise Institute
8:00 AM

With sequestration likely to remain law throughout this year and beyond, the US Air Force finds itself in a “ready today” versus a “modern tomorrow” dilemma. How will the Air Force balance capability, capacity, and readiness in the coming years? What is the future of key modernization initiatives such as the F-35 Joint Strike Fighter, the KC-46 aerial refueling tanker, and the long-range strike bomber? Moreover, what lessons has the Air Force learned from past debates that will influence upcoming budget proposals? In the concluding session of its series with the Joint Chiefs of Staff, AEI’s Marilyn Ware Center for Security Studies will host General Mark Welsh III, Chief of Staff of the US Air Force, to address these questions and more.

World Health Organization: Global media launch of the World Malaria Report 2013
National Press Club
9:30 AM

Malaria is one of the world’s most serious diseases, causing over 200 million infections and more than 600,000 deaths each year, mainly in children under five in sub-Saharan Africa. An estimated 3.4 billion people are at risk of the disease in almost one hundred countries, and need access to life-saving prevention tools, such as mosquito nets, and effective treatment. One week after the replenishment conference for the Global Fund to Fight AIDS, Tuberculosis and Malaria, during which international donors pledged 12 billion USD for the Fund, the World Health Organization (WHO) will launch its latest comprehensive report on the global effort to control and eliminate malaria. An annual scorecard, the World Malaria Report 2013 includes an assessment of trends in the scale-up of mosquito control tools, preventive therapies, diagnostic testing and treatment. It also reviews the global funding situation, the double threat of drug and insecticide resistance, as well as progress towards global targets set for 2015. WHO’s Dr Robert Newman will be joined by leading experts to discuss key findings of the report. The event will be moderated by former CNN journalist Jeanne Meserve.

Thursday, December 12
Critical Mass: Nuclear Proliferation in the Middle East
Center for Strategic and Budgetary Assessments
10:00 AM

At the briefing, the report’s author Dr. Andrew Krepinevich will provide his assessment of key security issues that may emerge in the event Iran acquires a nuclear capability, to include: the dynamics of a bipolar regional nuclear competition between Israel and Iran; the prospects for (and potential consequences of) a Middle East proliferation “cascade” involving other states in the region; the potential for a “Nuclear Great Game;” and the overarching challenges associated with preserving crisis stability and avoiding regional nuclear conflict. Dr. Krepinevich will also address why Cold War deterrence models may not apply to the nuclear competition in the Middle East, and why missile defenses may prove both destabilizing and cost-ineffective in this environment.

Joint Subcommittee Hearing: The Resurgence of al-Qaeda in Iraq
House Committee on Foreign Affairs
1:00PM

Witnesses: Kenneth M. Pollack, Ph.D., Senior Fellow, Saban Center for Middle East Policy, The Brookings Institution; Ms. Jessica D. Lewis, Research Director, Institute for the Study of War; Michael Knights, Ph.D., Lafer Fellow, The Washington Institute for Near East Policy; Daniel L. Byman, Ph.D., Professor, Security Studies Program, Georgetown University.

Friday, December 13
New Nuclear Suppliers
CSIS
9:00AM

Nuclear power is shifting East, and so too may nuclear suppliers. Nuclear energy long has been dominated by the West and by advanced economies, but this is likely to change in the next thirty years. While Japan’s nuclear industry is still reeling from the Fukushima accident, China, India, and South Korea have ambitious plans for nuclear energy at home and abroad. All three countries face capacity, regulation and financing challenges and all three have relatively little experience in export control harmonization. CSIS, with partners in India, South Korea, and China, explored the contours of responsible nuclear supply with key technical, official, and industry experts. Please join us for a discussion of our findings, and the results of our workshops in Delhi, Seoul and Beijing, with a distinguished panel of experts.

(image courtesy of Dell)

The Pandora Report 12.6.13

Highlights this week include the second case of H7N9 in Hong Kong, WHO ramping up calls for increased surveillance for MERS, EEE in Vermont, why that one friend never gets sick, and the Philippines ramping up its biosecurity. Happy Friday!

Hong Kong sees second case of H7N9 bird flu in a week

Hong Kong has seen its second case of H7N9 in the last week. An 80-year old man with diabetes sought medical attention after experiencing minor heart failure, and within a couple days of hospitalization developed symptoms consistent with the flu virus strain. He has subsequently been isolated for further treatment – it remains unclear if he came into contact with poultry prior to his hospitalization. However, don’t freak out yet –  the two cases are consistent with expected resurgent flu numbers following the onset of winter. According to all literature and available case evidence,  the virus still cannot effectively transmit person-to-person.

South China Morning Post – “It was unclear whether the man had come into contact with birds and live poultry and which district in Shenzhen he lived in. The three family members coming with him to the city had been back in Shenzhen and the city had contacted the Shenzhen health authority for subsequent medical monitoring…Border checks have been stepped up after the first confirmed case, and three people, who stayed in the same ward as the helper but had had no symptoms, are being isolated at the Lady MacLehose Holiday Village in Sai Kung.”

WHO calls for action on Mers following death in Abu Dhabi

Earlier this week, a Jordanian woman infected with MERS died from the virus shortly after giving birth to her second child. Her eight-year old son and husband are both also infected, and are still under surveillance in Jordan. It is unclear if the newborn is also infected with the  virus. None of the family had any travel history, any prior contact with animals, or any contact with infected persons, further confounding public health officials trying to determine the virus’ vector. In response to the mother’s death, the WHO has strongly encouraged countries to ramp up their surveillance and monitoring efforts. To date, there have been 163 cases of the virus worldwide, with a case fatality rate of approximately 42% causing 70 deaths.

The National – “More must be done to stop the spread of the deadly Mers coronavirus, the World Health Organisation has warned. Countries must strengthen their surveillance, increase awareness and try to find out how people are infected, the WHO’s emergency committee said on Wednesday…But Mers-CoV is not yet considered an international public health emergency. ‘After discussion and deliberation on the information provided, the committee concluded that it saw no reason to change its previous advice to the director general,’ the WHO said. The 15-member committee, which includes the deputy health minister of Saudi Arabia, Ziad Memish, said the situation continued to be of concern, in view of new cases and of information about the presence of the virus in camels in Qatar last month. It called for more support for countries that are particularly vulnerable, such as Saudi Arabia – where most of the cases have been confirmed – and urged for more studies to investigate exactly how people become infected with Mers-CoV.”

Vt. testing deer samples to test for EEE virus

Biologists in Vermont have begun testing over 700 blood samples collected from local moose and deer in order to track the spread of Eastern Equine Encephalitis (EEE). The virus was first introduced to Vermont in 2011, following the importation of an emu flock. EEE is a zoonotic alphavirus virus which primarily affects horses. The virus’ natural reservoir is wading birds, and it is spread, like so many horrible diseases, by mosquitoes. Although in the US there are usually less than 15 human cases of EEE, the virus’ fatality rate can approach 60%. As an encephalitic virus, symptoms are typically nasty – first fever, splitting headaches, photophobia (aversion to light),  then irritability, coma, and death. Among those lucky enough to survive, the virus often causes permanent sequelae, including severe brain damage.

Seattle PI – “Biologists say that mapping where the virus is found will help broaden the state’s understanding of the spread of the virus — which killed two people in Vermont in 2012 and two horses this year. EEE antibodies detected in deer and moose have been found in every Vermont country. Biologists hope that by looking for antibodies in the deer and moose, they’ll be able to determine if infected animals are more commonly found near certain bodies of water or wetlands.”

A genetic defect protects mice from infection with Influenza viruses

Everyone has that one friend/relative/colleague who not only never gets sick, but also thinks the best time to discuss their fabulous immune system is when you’re knee deep in tissues and throat lozenges. It turns out there may be a genetic reason for their immunological smugness. According to a new study from researchers at the Helmholtz Centre for Infection Research (HZI) in Braunschweig, mice who possess a mutation in the gene which encodes for the Tmprss2 protease (a catalytic enzyme) are resistant to infection from the H1 influenza A viruses. While the virus still infects the mice, it is unable to produce mature, infectious virus particles, and the infection is quickly cleared from their symptoms. This opens up a potential new field for drug development, and by targeting the host system rather than the virus, concerns over drug-resistance fade.

Medical Express – “The virus uses haemagglutinin as a key to enter the host cell which is then captured to build new virus particles. To reach its final shape, the coating protein has to be cleaved by a molecular scissor. This is done by an enzyme of the infected host. Otherwise, the protein is not functional and the virus particles are not infectious. A variety of host enzymes, so-called proteases, that process the haemagglutinin have been identified using cell cultures. Scientists from the HZI have now been able to show how important those enzymes are for the progression of the infection. Mice with a mutation in the gene for the protease Tmprss2 do not become infected by flu viruses containing haemagglutinin type H1. They are resistant against H1N1, the pathogen responsible for seasonal influenza epidemics, the ‘swine flu’ and the ‘Spanish flu’, which caused an epidemic in 1918. ‘These mice do not lose weight and their lungs are almost not impacted,’ says Professor Klaus Schughart, head of the Department ‘Infection Genetics’ at the HZI.”

Philippine airports on alert for bird flu

The Philippines is on high alert for the H7N9 strain of avian influenza found in Hong Kong for the first time last week. Manilla has  banned the import of all Chinese poultry products, and  airports across the island nation already screen inbound travelers to prevent the virus’ spread. This is an interesting form of biosecurity, which is something we don’t often talk about on the PR, mostly because it’s not as much of a concern for us as our colleagues in say, Australia.In this instance, the human body itself is seen as the vector for pathogen movement, rather than a kiwi or tomato plant.

Xinhua – “The Philippine government has alerted airport authorities to ensure that the deadly bird flu H7N9 could not enter the country following the recent discovery of first case in Hong Kong, the Philippines’ Department of Health ( DOH) said Wednesday. To date there are 141 cases of bird flu and 47 deaths worldwide. Deaths were due to severe pneumonia with multi-organ failure. So far, two-thirds of bird flu H7N9 cases were males and two-thirds were more than 50 years old.”

(image via Hagerty Ryan, U.S. Fish and Wildlife Service)

H2N2 as a Potential Pandemic Threat

According to a new study published in the Journal of Virology, descendants of the H2N2 strain of avian influenza, last seen in humans in the 1950s, may still pose a significant threat to humans, particularly those under 50 years of age. According to the study, conducted by  St. Jude’s Children’s Research Hospital, the virus is still highly adapted to human respiratory cells. The last major outbreak occurred in 1957-58, and killed up to two million people globally. However, effective antivirals were absent at the time – should the virus, which has subsequently circulated in birds, re-emerge, it should be susceptible to modern antivirals. However, as the virus has not been seen in humans in over 50 years, anyone under the age of approximately 55 years would constitute a naive host, and as there are 230 million people in the US alone currently under the ages of 55, the size of this naive population is not insignificant. 

From Science Daily – “‘While these viruses genetically look very avian, this study shows they can behave like mammalian viruses and replicate in multiple mammalian models of flu,’ said the study’s first author, Jeremy Jones, Ph.D., a postdoctoral fellow in Webster’s laboratory. ‘That is troubling because some of the original H2N2 pandemic viruses looked avian when the pandemic began in 1957, but in a few short months, all of the isolated viruses had picked up the genetic signatures of adaptation to humans. Our results suggest the same could happen if the H2N2 viruses again crossed from birds into humans.’ Work is underway at St. Jude to identify other changes that are critical to the ability of avian flu viruses to infect and replicate in mammalian cells, Jones said.”

Read more here

(image via wikimedia commons)

Image of the Week: Evolution of Zombies

This week’s image is this very cool infographic depicting the evolution of the zombie in film and video games.

the-evolution-of-the-zombie-infographic_529c57b52ed59_w1500via visual.y

 

H7N9 in Hong Kong

Hong Kong confirmed its first case of H7N9 yesterday, a 36-year old female who had previously travelled to mainland China and been in contact with poulty. The woman was admitted to Queen Mary’s Hospital last month, after falling ill. She remains in critical condition.

This is the second time the virus has popped up outside of mainland China, with a previous case in Taiwan early this year. Since February of this year, China has reported 137 cases of the avian flu, with 45 fatalities. However, it’s worth noting that while the virus does have pandemic potential, the majority of cases occurred last Spring, with less than ten cases total appearing over the summer and fall. Avian influenza viruses often behave similarly to seasonal flu viruses, with the majority of infections occurring in cooler months.

Prior to February, H7N9 had not infected humans. Labs in the US, UK, and Japan have all developed candidate vaccines.

(Image: James Jin/Flickr)

This Week in DC: Events 12.2.13 – 12.6.13

The highlights of the free and open-to-the-public international security, terrorism, and policy events this week.

Monday, December 2
How the Global Order and the Modern State Empower Organized Violence
George Mason University School of Public Policy
7:15PM

Terrorists, human traffickers, insurgents, drug dealers, cyber criminals, pirates and other forms of organized violence, all actively exploit the separation that western societies and the international community try to maintain between what is considered “crime” and “war.” This separation, which is designed to promote stability and preserve liberty, is reflected in the very architecture, organizational and political cultures, and legal parameters assigned to law enforcement, judicial systems, and the military across western societies and within international institutions. However, insurgents conduct kidnappings by day and launch military-style raids at night as part of a holistic strategy that crosses traditional law enforcement and military boundaries. Pirates operate with impunity knowing that they are unlikely to be overtly attacked by navies on the high seas nor tried in a proper court upon capture. And drug lords, from Latin America to Los Angeles, challenge – and in some cases have virtually defeated – local law enforcement using high-end military weapons and tactics.

Tuesday, December 3
Cyber Conflict on the Korean Peninsula
Korean Economic Institute
10:30AM – 12:00PM

As the most wired place in the world, South Korea’s vulnerability to cyber threats is an important issue, especially when there are tensions with its neighbor to the north. South Korean banks, government agencies, media outlets, and businesses were all victims of cyber attacks and it is believed that North Korea was behind them. Many speculate that North Korea has units dedicated to cyber warfare and espionage. As a legitimate threat and provocation, it is important to understand the dynamics around cyber conflict on the Korean peninsula. Join KEI on Tuesday, December 3 as Dr. Steven Kim, Associate Professor at the Asia-Pacific Center for Security Studies in Honolulu, Hawaii presents his report on the cyber warfare tactics and strategies used by North Korea and the defense mechanisms employed by South Korea to prevent and deter cyber attacks.

Webinar on Environmental Security and Public Health
Elliot School of International Affairs
1:15PM – 2:15PM

Join us on the web December 3 for the third installation of a five webinar series on international environmental security, co-produced by the Security & Sustainability Forum and the National Council on Science and the Environment and led by experts from the Elliott School of International Affairs and the Stimson Center. Each webinar panel will examine a hypothetical scenario that could be a game-changer for national security, international business interests, political science theory, and our global environment. The panel on December 3 will examine the issue of the major threats to public health due to climatic and environmental change through a hypothetical scenario in which a new mosquito-borne disease emerges out of Africa or Asia. Please register for this ONLINE WEBINAR with the Security and Sustainability Forum at: go.gwu.edu/publichealth

Wednesday, December 4
FBI Agents to discuss National Security Issues
National Press Club
10:00 AM

FBI agents will discuss how sequestration’s mandated budget cuts are affecting daily FBI operations and hampering criminal and national security investigations, as well as the risks associated with additional budget cuts and furloughs expected early next year, at a National Press Club Newsmakers news conference on Wednesday, December 4. Leaders of the FBI Agents Association (FBIAA) will also update the group’s recent report Voices from the Field: FBI Agent Accounts of the Real Consequences of Budget Cuts. The report contains field reports from FBI Special Agents illustrating the impact of budget cuts on their work. Speaking at the Newsmaker news conference will be FBIAA President Reynaldo Tariche and several active duty FBI agents from around the country. This NPC Newsmaker news conference is scheduled to take place on Wednesday, December 4 at 10 a.m. in the Club’s Zenger Room, on the 13th floor of the National Press Building at 529 14th St. NW, Washington DC, 20045.

Subcommittee Hearing: Transition at a Crossroads: Tunisia Three Years After the Revolution
U.S. House Committee on Foreign Affairs
2:00PM

Chairman Ros-Lehtinen on the hearing: “Three years since the Arab Spring began, Tunisia is at a crucial crossroads in its democratic transition. The country has been enmeshed in a political stalemate, and growing internal and external security challenges further complicate the tenuous political process. A democratic Tunisia would not only be a model for other countries in this volatile region, but a failure to make this transition would have grave consequences for the security interests of the U.S. and other nations in the region. This hearing will examine the status of the transition and what the U.S. and other organizations are doing to promote democracy and civil society at this critical juncture in Tunisia’s history.”

Thursday, December 5
The Future of America’s Strategic Nuclear Deterrent
Center for Strategic & Budgetary Assessments
10:00AM

Although nuclear weapons have played a critical role in American defense strategy for more than 60 years, there is a growing debate over the number and type of nuclear forces that the United States actually needs to maintain its security and protect its allies. Over the past several years, calls for Washington to substantially reduce the size of its nuclear arsenal have become more prevalent, while the combination of declining budgets and looming recapitalization costs have made nuclear weapons a popular target for potential funding cuts. Please join us as CSBA releases its latest report, The Future of America’s Strategic Nuclear Arsenal, by Senior Fellow Evan Montgomery. At the briefing, Dr. Montgomery will address a number of issues: Can the United States implement deep reductions in strategic nuclear weapons and still deter rivals, dissuade competitors, and discourage proliferation? Should it retain the strategic triad of bombers, land-based intercontinental ballistic missiles, and nuclear-powered ballistic missile submarines? Finally, must it replace its aging nuclear forces?

Strengthening the NIST Cyber Framework Against Advanced Threats
CSIS
12:00 – 2:00 PM

The CSIS Technology and Public Policy Program invites you to attend Strengthening the NIST Cyber Framework Against Advanced Threats NIST’s Cybersecurity Framework has tremendous value for risk management and defines best practices to block known threats. This discussion will share intelligence about campaigns by sophisticated cyber threat actors that have targeted critical infrastructure companies and discuss how well the Framework stacks up against advanced and new, unknown threats. Lunch will be served.

The Effects of Funding on Scientific Productivity: The Case of Academic Chemistry, 1990-2009
GMU Technology, Science, and Innovation Policy Research Seminars
12:00 – 1:30PM

This month’s seminar will feature Joshua Rosenbloom, of the National Science Foundation. This monthly seminar series, sponsored by George Mason University’s Center for Science and Technology Policy (School of Public Policy), explores new ideas and work-in-progress with the Washington-area research community. It’s open and free to all interested researchers with a special invitation extended to graduate students. The seminars are held at the George Mason University’s School of Public Policy (Founders Hall) on the Arlington campus, a short walk from the Orange Line’s Virginia Square/GMU Metro stop. CSTP will provide coffee and cookies — participants are welcome to bring a brown bag lunch.

Can the U.S. and China Build a New Model of Major Power Relations?
Wilson Center
3:30 – 5:00PM

On December 4 and 5, the Kissinger Institute and the China Institute for International Studies will hold a groundbreaking dialog on U.S.-China relations. In an effort to build relationships between, and gain the insights of, promising young leaders from both countries, the Kissinger Institute and the China Institute for International Studies are bringing together 16 fully bilingual experts from a variety of fields for an unconstrained and uninterpreted dialog on major issues in Sino-U.S. relations. The U.S.-China Young Leaders Dialogue is developing a platform for new voices and constituencies in U.S.-China relations, with an eye toward finding new approaches to joint challenges. At this public session of the off-the-record Dialogue, four conference participants will offer their views on prospects for a new model of major power relations.

(image courtesy of Dell)