Press Briefing by Press Secretary Jay Carney, Secretary of Health and Human Services Kathleen Sebelius, and FDA Commissioner Margaret Hamburg
James S. Brady Press Briefing Room
1:46 P.M. EDT
MR. CARNEY: Good afternoon, ladies and gentlemen. Thanks for being here.
I have with me today two special guests. On my left, the Secretary of the Department of Health and Human Services, Kathleen Sebelius; on my right, the Commissioner of Food and Drugs, Margaret Hamburg. She is the top official at the Food and Drug Administration. They are going to talk to you this afternoon at the top of the briefing about a new ruling on labels for cigarettes and tobacco products.
What I'd like to do, as we've done in the past, is have them -- they'll each make a few remarks at the top, take questions from you so that -- and we can -- all the questions you have for them we can do at the top. I'll excuse them after 10 minutes or so, 15 minutes or so. Then we can start again and I'll take your questions on other matters.
With that, Secretary of Health and Human Services.
SECRETARY SEBELIUS: Well, thank you, Jay, and good afternoon, everybody. Today we're here to announce a major new step we're taking to reduce the death and disease caused by tobacco use, new graphic warning labels that will go on all cigarette packs and on advertisements for tobacco products.
Tobacco use is the foremost preventable cause of death in America and costs the U.S. economy about $200 billion annually in medical costs and lost productivity. Every day approximately 4,000 American kids between the ages of 12 and 18 try their first cigarette. A thousand of those children become daily smokers.
For years, we watched in this country as tobacco rates fell. In 1965, over 42 percent of Americans smoked. By 2004, it had fallen to just under 21 percent. And that's good news.
But despite the well-known risks, youth and adult smoking rates that had been dropping for decades stalled. So when President Obama took office, we decided that these numbers weren't changing and our actions had to change. And we're committed to taking steps that will help prevent children from smoking.
So over the last two years we've gone to work making it harder for tobacco companies to market to kids. We've restricted companies from using terms like "light" and "mild" on products and in marketing. We're supporting local programs to help people quit smoking and to stop children and adults from starting. And as part of last year's health care law, we gave Americans better access to counseling to help them quit smoking before they get sick.
So today we're announcing a measure that will forever change the look and message of cigarette packs and ads. The new graphic warning labels will be the toughest and most effective tobacco health warnings in this country's history, and they tell the truth. They'll replace the old warning phrase with pictures showing negative health consequences of smoking that are proven to be effective.
Now, Dr. Hamburg will go into more detail, but with these warnings, every person who picks up a pack of cigarettes is going to know exactly what risk they're taking.
Over the last two years, we've made giant strides in our fight against tobacco, and our efforts are paying off. So I'm here today with a renewed sense of hope and momentum that we can make tobacco death and disease a part of our past and not a continuous part of our future.
So I'd like now to turn over the podium to our talented and dedicated FDA Commissioner Dr. Peggy Hamburg.
DR. HAMBURG: Thank you very much, Madam Secretary. First, let me say how proud I am of the part that FDA has played in this comprehensive ambitious initiative championed by Secretary Sebelius and President Obama.
We share a vision for a healthier nation free of the dangerous consequences of tobacco. The sad truth is that tobacco is the leading cause of premature preventable death in the United States, as Secretary Sebelius said, and an enormous source of avoidable disease and disability.
The public health consequences are enormous, with an estimated 443,000 Americans dying each year, most of whom began smoking before the age of 18.
Combating this national tragedy must be at the forefront of our public health goals, and that is why Congress and the President were committed when they enacted the Family Smoking Prevention and Tobacco Control Act.
Since then, FDA has worked hard to implement that vision. We've taken important steps such as banning the sale of fruit- and candy-flavored cigarettes, which are especially appealing to children and youth, and for the first time requiring tobacco companies to tell us exactly what ingredients are actually in their products.
Last November, the FDA unveiled the 36 images that would be considered for inclusion on every cigarette pack in the country for graphic health warning labels, and today, we're publishing the nine selected.
These graphic warning labels represent the first major change to cigarette labels in 25 years. The final nine images were selected based on a number of important criteria: We took into account public comment from approximately 1,700 stakeholders, including experts and industry; some of whom submitted scientific research studies. We also conducted a national study of our own to gauge people's response to graphic cigarette health warnings -- actually, the largest study ever conducted involving some 18,000 participants.
We examined how effective the proposed warnings were at communicating the health risks, as well as the warning in terms of its ability to encourage smokers to quit, and if they discouraged non-smokers, particularly kids, from ever wanting to smoke.
Consider this: A pack-a-day smoker will see these labels more than 7,000 times a year. And kids who are under the impression that smoking is cool or glamorous will be confronted by a very different reality when they're tempted to pick up a cigarette pack 15 months from now.
These powerful images, coupled with a valuable cessation resource, 1-800-QUIT-NOW, which will be on every label, will go a long way toward a time where we can and will make tobacco-related death and disease a part of America's past, not its future, in the words of Secretary Sebelius.
Thank you so much very much.
MR. CARNEY: So I'll go ahead and call on people who have questions.
Q: Secretary Sebelius, as it relates to these pictures that are very graphic that we've seen --
SECRETARY SEBELIUS: They are.
Q: Do you think that the public will become desensitized at some point, and you will have to step up the photos, because after a while you keep seeing the same thing? They're not feeling the initial thrust that was felt again.
SECRETARY SEBELIUS: Well, actually, the law contemplates a sort of users getting used to them, if you will, and gives FDA not only the authority but the direction to change them on an ongoing basis. So immediately after the launch of the first set of nine, we'll begin the studies to make sure that we are keeping people sensitized and we have the authority then to move to a new set of labels. So we see this as a continuous. You're absolutely right. I think any time you have a frozen image, what may seem quite shocking at the beginning, people get used to fairly quickly.
Q: So a follow-up -- will they be more graphic in nature, or will they be along the same line?
SECRETARY SEBELIUS: Well, I think the plan is -- and I'm looking to Peggy -- if I give out incorrect information, she'll help me with this. But I think we will continue to test to see if they're making a difference.
One of the things that was done with this 18,000-person survey was really look at different quadrants of population. Which are the ads that really hit kids? What appeals to or distresses pregnant women? What do men respond to differently? So we're trying to be very market sensitive, and I think that surveying will go on on a regular basis.
MR. CARNEY: Dan Lothian.
Q: I'm just wondering what the reaction was from the tobacco industry to this campaign, this effort?
DR. HAMBURG: Well, we did engage the industry as we were developing the selections for these nine graphic health-warning labels. They were part of our public comment period, and of course we've had meetings with them.
This will be a dramatic change in what a cigarette package looks like, no doubt about it. These warning labels are very graphic. They're large. Actually, the law even specifies that they take up 50 percent of the cigarette package, front and back, with color pictures, a printed health-warning statement, and also the 1-800-QUIT-NOW line.
So it will change the consumer response to a package of cigarettes. But, frankly, that's what we want. That's what we're striving for. And that's what will make a difference for health.
Q: And Secretary, just back to what I believe you said earlier, that at one point the cigarette use was going down, that it stalled. Why did it stall? Did you look at what happened there?
SECRETARY SEBELIUS: Well, I think we didn't have the law that's now in place that President Obama encouraged to be passed and then signed, which was the Tobacco Regulation Law. So we've been able to really ramp up efforts since then.
And I think we hadn't made any progress on changes of labels. As Dr. Hamburg said, it had been 25 years since we had changed labels. A lot of the aggressive work that was done early on had become commonplace. So we really weren't doing much at all to focus on what is now killing about 443,000 Americans every year prematurely, the number one cause of preventable death.
And certainly for kids, although some states have gotten aggressive, I think at the federal level there really just wasn't a national focus on this. And I think what the President made clear -- and we are certainly very much engaged in -- is this is now a new national -- renewed national focus on smoking cessation and one that we think can pay off in dividends, in lives and in health care costs. And we know it can, because it's been successful in other parts of the world.
MR. CARNEY: Peter.
Q: Dr. Hamburg, which of these images -- specific nine images -- do you think will target teenagers, especially teenage girls who seem to be so attracted to smoking, picking up the habit?
DR. HAMBURG: Well, I think that some of the powerful images certainly are a reminder of the health risks. Some of the images, like the one of the mouth with the sort of rotting, dirty teeth and the ulcerating lesion on the lip are also reminders that smoking causes disfigurement. And I think that those are very powerful messages for potential teen smokers.
And we do hope that each time they pick up that cigarette package, they will deepen their understanding that there are really serious consequences of that smoking.
Q: Is there anything in this campaign that would try to deter them from picking up the package to begin with?
DR. HAMBURG: Well, of course these images will also be part of print advertisements for cigarettes. But I think it's -- when we think about having a real, ongoing, sustained impact on public health and really bringing those smoking levels down, this is a very, very important activity. But it has to be part of a broader, comprehensive set of public health activities.
And Secretary Sebelius has been of course spearheading a national tobacco control strategy that looks at how different components of government, working with partners at the state and local level and with partners in other sectors, can work together to make a difference for public health.
SECRETARY SEBELIUS: Let me just -- on the teenage thing, I think there are a couple of things also. Somebody said when they first saw the warnings, "These are really gross." And they are. We want kids to understand smoking is gross, not cool, and there's really nothing pretty about having mouth cancer or making your baby sick if you smoke. So some of these are very driven to dispelling the notion that somehow this is cool and makes you cool.
The other thing is, though, that we've done a very ramped-up effort already on the second-tier advertising. So it was not okay for cigarette companies to directly advertise to kids, but they were using lots of techniques about logos at concerts, appealing to younger generation with cool mottos, developing products clearly for a teen audience, not for an adult audience. And those are now also being banned. So we're not just looking at the packs, but all sorts of strategies to try and keep cigarettes away from our children.
Q: Madam Secretary, I have a question for you on a different topic. As I'm sure you know, the absence of nationwide data about the LGBT community's health needs and disparities has been a problem. Organizations want government assistance to address problems. The government assists on data to back up these requests, but the government won't collect data so the LGBT community remains stymied. It's public knowledge that groups have been advocating with HHS to address the data collection issue -- specific things like including LGBT questions on the National Health Interview Survey and the Behavioral Risk Factor Surveillance System. You and the President have been advocates for evidence-based decision-making. What's the holdup here?
SECRETARY SEBELIUS: Well, actually, it's a great question, and we fully intend to collect LGBT data. The problem is that it's never been collected, and what our folks came back to us with is we have to figure out -- and we're working with providers and advocates right now to actually market-test the questions -- how to ask questions in a way that they elicit accurate responses, because collecting data that doesn't give an accurate picture is not very helpful in the first place. And there has been so little attempt, either directly to consumers or to parents or to anybody else, to ask questions about LGBT health issues that we don't even know how to ask them.
So it is definitely a commitment. We will be adding data questions to the National Health Surveys. And right now we are looking at developing a slew of questions, market-testing them, coming back and making sure we have the right way to solicit the information that we need.
Q: Secretary, on the cigarettes, if any other product in any other category killed 443,000 people a year, I can't imagine it being allowed to remain on the market. Do you see a day when cigarette smoking would ever be illegal?
SECRETARY SEBELIUS: You know, I think that's up to the lawmakers to decide. This is clearly, as you know, if you looked at the history of passing the Tobacco Control Act, it was a tortuous path. It took a number of years, a number of fits and starts. There are people in our office who have been working on this for 20 years. So to say that this step was not a major hurdle to go over underplays I think the efforts of the past. And I think we will continue to collect the data and look at the information. I think the more people understand the health risks, hopefully we will be in a situation where not smoking will be the by far not only preferable norm, but there will be a lot of consumer pressure, which there already is.
I mean, people are now insisting that they don't want to live in housing projects where there are smokers. They don't want to be in open spaces -- knowing a lot more about secondhand smoke, that it isn't just the smoker, it's people affected. So I think there's a growing awareness that this is very dangerous, and that tobacco is unique.
Q: But the Surgeon General -- a former Surgeon General wanted -- foresaw a smokeless United States, and that's never going to happen, is it?
SECRETARY SEBELIUS: I really can't tell you. I think we're making some great strides. I think the lawmakers have to take a look at the data and take a look at what they're willing to do. I think the -- if you had ever told me that more than half the states in the country would have passed smoke-free laws, and that the majority of cities have passed them; that we would be taking these kinds of steps against advertising and rebranding our cigarette packs, I would have said that's probably not going to happen anytime soon. But I think people are becoming very aware of the unique power of nicotine, the addictive quality, and also the fact that, as you say, that $200 billion a year in health costs that we clearly could spend better elsewhere, and the loss of 443,000 lives a year, that's a huge toll to take on a country.
MR. CARNEY: Yes, sir. And then we'll do one more, Chip.
Q: Thank you, Jay. Madam Secretary and Dr. Hamburg, I wanted to segue over to the proposed warnings and retooling of the recipes in cereals and desserts that have come out, that have been written primarily by Dr. Hamburg's office, as well as the Federal Trade Commission and the Center for Disease Controls. Many in the food industry say this is a case of change the recipe or else. And do you see it that way? And will these eventually be enforced? These are the restrictions, of course, on cereal and other things.
SECRETARY SEBELIUS: Well, I'll let Peggy also comment on this, because Dr. Hamburg's office has a particular set of these issues. There is a lot of effort underway in the area of nutrition and certainly aimed at the obesity epidemic that is affecting one out of every three children and adults in this country.
So whether it's the "Let's Move" initiative, which is doing a lot of work voluntarily to get companies to begin to look at both sodium and sugar content and trans-fat; or conversations going on in the industry itself to look at reformatting their products; or Walmart who is now saying that as a major purchaser, they only want suppliers who meet certain standards; or the CDC, which is at looking at sodium; and the FDA, which is convening conversations around nutrition qualities; the reformatting of the new food plate that was announced by the Department of Agriculture and getting rid of the pyramid and looking at what healthy eating is. I think this is some space that is going to continue to have a robust conversation, because, again, it has a lot to do with underlying health costs and overall health of our nation.
Peggy can talk a little bit about the FDA's involvement in this area.
Q: And these are just suggestions now?
DR. HAMBURG: Yes.
Q: They're not enforced at all?
DR. HAMBURG: And what you're referring to is a request actually from Congress, several years ago I think, to the FTC, to look at issues of food advertising to children, knowing that of course how we eat, what we eat, does really matter for health. The FTC put together a working group that included the FDA and other components of government to look at some of the issues, and voluntary recommendations to industry have been put forward for further discussion. And it's an important discussion to have, because we need to work with industry to be able to provide consumers -- parents and children, all of us -- with the best possible information about nutrition and health so that we can all make good choices in terms of promoting and protecting health.
Q: So you're not saying, as the grocery manufacturers do, this is a case of make these changes or else?
DR. HAMBURG: These are voluntary recommendations. And we work closely in many domains with the Grocery Manufacturers of America and other industry representatives, because how food is formulated -- whether it's sodium, sugar, fat -- really does matter for issues like obesity and heart disease and diabetes and other things. The food industry recognizes that there are ways that they can improve and make more attractive the food products that they're developing. We certainly have a vested interest in that as a public health agency, and we want to work with them on that.
MR. CARNEY: Last one. Chip.
Q: Following up on that question, really there are some horrendously unhealthy foods out there. And people who oppose this kind of regulation say the next step is to put pictures, graphic images of clogged arteries and fat-encrusted hearts on really bad food. Is that the direction you would go in a perfect world?
SECRETARY SEBELIUS: Well, again, I think tobacco is unique. It is a product that is the number one cause of preventable death. We know that there are strategies that can be very effective, because they've been in place. We also know that we've been stalled in this country. So I think this effort about tobacco regulation, efforts around tobacco cessation, has been decades-old and is something that is a unique situation.
Having said that, I do think that there are going to be ongoing discussions -- as you look at the underlying health care costs, where we spend 75 cents of every health care dollar treating chronic disease -- what are the areas, if you want to lower health costs and have a healthier country, that you can focus on? Certainly, tobacco and obesity become two of the major underlying causes. So the work around obesity and healthier, more nutritious eating, more exercise will continue to be I think an ongoing focus.
Q: No graphic images on our food in the future?
SECRETARY SEBELIUS: Just lots of celery stalks and broccoli.
MR. CARNEY: Thank you, Secretary Sebelius, Commissioner Hamburg. I appreciate it. Thank you all.
Okay, so let's start anew. I just wanted -- obviously you all got the announcement that we sent out, that the President will be addressing the nation -- the nation, rather, from the White House tomorrow evening at 8:00 p.m., to discuss his decision about the -- implementing the plan for drawing down U.S. forces from Afghanistan. And with that, first question.
Q: Is that going to be from the Oval Office?
MR. CARNEY: We will announce, when we're ready, which location within the White House. But it will be in the White House.
Q: Has the President decided on what it is that he will be announcing?
MR. CARNEY: He has made his decision, yes.
Q: And what is his decision? (Laughter.)
MR. CARNEY: Okay, I'll tell you. No. I'll leave it to the President to make his announcement. I will make the point, however, that the President -- this is obviously something -- an issue he knows backwards and forwards, and something he's been engaged in intensely for a long time. And this has been a process, as I've pointed out, on a number of occasions in the past that wasn't just started anew in the last few weeks.
He's been chairing regular monthly meetings of his national security team, including our senior military and civilian leaders in Afghanistan since he initiated his policy in December of 2009. He has, obviously, in the last few weeks as I've talked about from here, had discussions with members of his national security team about various recommendations to take under consideration as he makes the decision on the pace and slope of the drawdown that will begin next month.
I'd also like to say that there's been a lot of speculation. And I think it's testament to the fact that every story has a different answer on what he's going to announce, that the stories you're reading are speculation and that the President's decision will be known when he announces it. In fact, a lot of the stories came out before he had even finalized his decision.
Q: Will his speech cover the disposition of all of the 30,000 surge troops? Will we know what's happening to them?
MR. CARNEY: I will leave the announcement to the President, which he'll make tomorrow evening, 8:00 p.m., from the White House, in an address to the nation, which we hope a lot of Americans will tune in to watch. The parameters of the decision involve the beginning of the drawdown of U.S. forces. As you know, we ramped up in a surge the number of forces in Afghanistan. And we are at that peak point.
And the President identified in December of 2009 -- made the commitment that forces would begin to draw down in July of 2011. He is keeping that commitment. And that's what he will announce tomorrow evening.
The other point I would make is that in Lisbon, at the NATO conference last year, that NATO identified 2014 as the year when final transfer of lead security authority to the Afghan national security forces would take place. So this is within a framework of the gradual transition of security lead to the Afghans. It's begun already in some places, but it will progress over the next several years. And obviously, as that happens, troops will be drawing down. But the decision that he'll announce tomorrow will focus in the first case on the beginning of that drawdown.
Q: Is there a risk of taking people out too soon? I mean, you've got Senator McCain saying pull out only 3,000.
MR. CARNEY: Well, first of all, as you know, there are 100,000 U.S. forces in Afghanistan. Second of all, the President, as I said, is extremely knowledgeable about the situation in Afghanistan, about the success that our policy has had, that our strategy has met in Afghanistan since the beginning of its implementation in late 2009.
I would note, again, that the President's objectives that he set out in that announcement were quite clear. Primary priority, primary objective -- disrupt, dismantle, and defeat al Qaeda; second, stabilize Afghanistan, so that it can -- will no longer become a haven for terrorists like al Qaeda who have, as their goal, doing harm to the United States.
Those objectives are being met. We've had a significant amount of success in meeting those objectives. And the President has, as I said, been very engaged in the process and evaluating that. We are not there yet, obviously. But it's important to remember what the objectives were from the beginning and what they were not. And the President will, I think, make that clear again tomorrow evening.
Q: And how much does the bin Laden death have to do with his decision?
MR. CARNEY: Look, the successful mission against Osama bin Laden highlights the broader success that we have had in going after members of al Qaeda in the Afghanistan/Pakistan region. And it really is to the credit of our men and women in uniform, as well as to our intelligence officials, that we've been able to do that. That is part of the overall strategy that the President put into place.
It is a high-profile and highly significant success, but it is one that is representative of a broader success that the mission has achieved.
Q: Just to kind of bounce off of that, the cost of the war -- I mean, some of the critics have said that that was another reason for not keeping large numbers in Afghanistan. Was that -- how much weight was given to the cost in this decision-making process?
MR. CARNEY: The process was all about the mission that was laid out in December of 2009, the surge in forces that followed from that decision and that mission, and the evaluation of the success that we've had since that mission began.
Having said that, we are always mindful of the fact that, as powerful and wealthy as this country is, we do not have infinite and unlimited resources, and we have to make decisions about what -- how to spend our precious dollars and, more importantly, how and when to use military force and put our -- put Americans in harm's way. That's a decision that obviously the President takes incredibly seriously.
Obviously he felt very strongly, as he said during the campaign, that we needed to refocus our attention on what had become the forgotten war in Afghanistan; that we needed to end the war responsibly in Iraq. He is keeping that obligation and keeping that commitment. As you know, he's withdrawn more than 100,000 troops from Iraq and we are on track to fulfill our obligation under a status of forces agreement with the Iraqi government to withdraw all of our forces from Iraq by the end of the year.
Secondarily, we needed to refocus our mission on Afghanistan, on particularly al Qaeda -- the threat that brought us to Afghanistan in the first place. And he has done that. That has been the focus of the process that has led to the decision that he made.
Q: Earlier you said that there are a lot of numbers out there and some are missing the mark. But is the President willing to go against some of the advice from his military leaders who wanted a slower withdrawal, smaller number rather than larger?
MR. CARNEY: I would say simply, Dan, that the President is Commander-in-Chief. And as was true when he oversaw the incredibly sweeping review of our policy in Afghanistan in which he insisted that every assumption be examined -- every assumption underlying every policy option be examined and examined again and tested, he is in charge of this process and he makes the decisions. And this decision will be the Commander-in-Chief's.
Q: You mentioned the terrorist threat. You don't mention the Taliban's capability. Is there a pivot here --
MR. CARNEY: You know, I knew there was a -- let me just make clear that among the goals -- and I get this right nine times out of 10 -- but the objectives that the President laid out in December of '09 were, one, disrupt, dismantle, ultimately defeat al Qaeda; two, reverse the momentum that the Taliban had leading up to that; and then to stabilize Afghanistan in order to give the Afghan government the breathing room it needs to build up the Afghan national security forces and the prevent Afghanistan from again becoming a haven for al Qaeda and terrorists who have the United States as their goal.
Now, it is important to note that defeating the Taliban is not the objective here. Reversing the momentum of the Taliban is an objective, and we have had significant success in achieving that objective. The fact of the matter is that any solution, any end to the violence or hostilities in Afghanistan in whatever time period will require some sort of reconciliation between Afghans, and that includes the Afghan Taliban.
We've talked about this -- we talked about this as recently as yesterday -- that we support the initiative led by the Karzai government to explore reconciliation possibilities.
Q: But if you look at the Taliban -- if you look at the total number of security incidents and you compare them season by season, which is the way the military says is the right way to do it, you compare October 2010 to March 2011, to the same period '09 to '10 -- incidents up. You compare last year, May to September to the previous year, incidents are up. So I'm curious --
MR. CARNEY: But you know the primary reason for that -- or a primary reason -- and I don't want to pretend like I'm a military analyst, but we have more boots on the ground. We have more soldiers engaging, because we surged troops by 30,000-plus.
Q: No question. And the military will --
MR. CARNEY: So that's obviously -- we've been taking the fight to the Taliban, as well as going after members of al Qaeda. And that has been why we've had the success we've had and the progress we've made.
Q: No question. And the military will say that, it's because of increased activity. But I'm just curious, what indicators, hard indicators was the President looking at to indicate that the Taliban has lost the momentum if these numbers speak --
MR. CARNEY: Again, I think the engagements reflect the fact that we have been more aggressive in engaging the Taliban and in securing territory, and in the success we've had in the south in particular. The progress that we've made in achieving the goal of breaking the Taliban's momentum has, I think, been articulated by members of the military, including the commanding general there.
So obviously we are keenly aware of the fact that this progress is not a done deal, that the mission is not fully achieved. And that's why the mission continues. And that's why the President supported the process outlined by NATO in Lisbon, that the full transfer of security lead would not occur until 2014, that this was a gradual process as the Afghan national security forces become more sophisticated, become more capable and more numerous, that that transfer could continue to take place.
Q: Just because you mentioned reconciliation, you're aware of recent stumbles. Have U.S. officials or their intermediaries heard anything from reputable Taliban leaders, ones that they believe speak for the Taliban, that they're interested in reconciliation?
MR. CARNEY: Well, I don't have -- I'm not able to speak with specificity about meetings. I think it's important to point out that the -- that this is an Afghan-led process, because this is not reconciliation between U.S. forces or U.S. personnel and the Taliban. It's a reconciliation between Afghans, between the Afghan government representative of the people and the Afghan Taliban. And that process is being led by the Karzai government -- not pretending that it's an easy process, but it is an important one that we do support.
Q: Thanks, Jay. Can you tell us the specific circumstances of his decision, who he was with, exactly when, after a meeting with whom, who has he told --
MR. CARNEY: Well, I'm not going to get into like a tick-tock of all the process. But I think I talked about the fact that he's met with members of his national security team principals, as well as others in his national security team a number of times. And those meetings continued up through today.
And he's been -- again, this is not something that he was starting from scratch on. So he has been working through his decision over the course of the last several weeks and finalized that decision today.
Q: And he made that decision during a meeting with some members of his team?
MR. CARNEY: Well, I wasn't inside his brain when the decision -- when he sort of said, this is the moment when I've decided. But he did meet with national security team members today and informed them of his decision.
Q: You don't have that kind of access? (Laughter.)
Q: Has he told you?
MR. CARNEY: I'm aware of the decision, correct.
Q: So it's pretty widely disseminated in the administration at this point?
MR. CARNEY: It is not widely disseminated. The meetings have been quite small.
Q: Okay. Will the Pentagon be pleased with the decision?
MR. CARNEY: Look, I think that this is a decision made in consultation with his national security team. And beyond that, I think we'll wait and see what the President announces tomorrow at 8:00 p.m.
Q: Well, Jay, just for clarification --
Q: I mean, let me just --
Q: -- the meeting with Secretary Gates, was that to inform him?
MR. CARNEY: No. That is his weekly meeting with Secretary Gates, which is -- as I've tried to explain on a number of occasions here, is separate from this process. It doesn't mean they don't talk about Afghanistan and Pakistan, because that's always an issue to be discussed and could be discussed at his weekly meeting, but that is separate from this process.
Q: Thank you.
MR. CARNEY: Yes.
Q: Are all of the President's senior military advisors, national security advisors, at least comfortable with the decision? I don't mean agree with --
MR. CARNEY: I think this is a variety of the question that Chip just asked. And I think that this is a process where the President consulted with all the senior members of his national security team and made a decision. And obviously, the Commander-in-Chief makes this decision.
It's also important to recognize that this is the implementation of a decision that he made after a thorough review of our Afghan policy back in the fall of 2009. He identified then that in July of 2011, we would begin the drawdown from our high mark of 100,000 U.S. forces in Afghanistan in July of 2011. And he is keeping his commitment.
Q: Members of Congress have not been shy about offering their advice. Have they contacted the President? Has he gotten a lot of calls?
MR. CARNEY: We have made a particular effort to regularly consult with Congress on issues related to Afghanistan and Pakistan generally. Over the past few weeks, principals from the White House national security staff, the Defense Department, the State Department and others contacted key senators and representatives from both parties -- leadership, committee chairs, and ranking members as well as rank-and-file members -- to solicit their advice specifically on the July decision and on the way forward in Afghanistan.
There were more than two dozen such conversations. Some were brief; others were lengthy. And they delved into many aspects of U.S. policy in both Afghanistan and Pakistan.
Q: Did it have an impact on the President's decision?
MR. CARNEY: Oh, I think he greatly appreciates and values the insights that members of Congress provide on this issue as he does on other issues. I think those conversations are ongoing and very helpful.
Q: And what is the President going to talk with his outgoing Defense Secretary about today? Is this the last time they'll have this meeting?
MR. CARNEY: I'm not sure, actually. I think the Secretary's -- Defense Secretary's last day is June 30th.
Q: Which means what, one more?
MR. CARNEY: Might have a weekly next week. I don't know if this is the last one or not. We don't read out those meetings.
Q: I thought you might -- you might make an exception.
MR. CARNEY: Well, it also hasn't happened yet today. But the President obviously appreciates Bob Gates' service immensely. And as he said when he made the announcement about his new national security appointments, the fact is he convinced Secretary Gates to stay even longer than Secretary Gates originally indicated he would be able to do that. And the President greatly appreciates his service.
Q: This morning, Secretary Gates said that the public sentiment was going to have to be a factor in the President's decision. So how much consideration did the President give to the viewpoints of the American people on this war?
MR. CARNEY: Well, I think we're all aware of what the public generally thinks. But I think the public is interested in the right policy and a policy that is succeeding and achieving its very clearly specified goals, and that is, as I said, disrupt, dismantle, ultimately defeat al Qaeda; reverse the momentum of the Taliban; stabilize Afghanistan enough to give it the space to train up its forces so that it can ultimately take over security of its country.
As the President has said, and said during the campaign as well as as President, we are in Afghanistan because al Qaeda attacked the United States and took nearly 3,000 lives, innocent lives, on September 11, 2001. In some ways you could say we lost our focus a little bit in the previous years before this President came into office. There was always a reason to be in Afghanistan and there was an objective to accomplish there, and we are moving steadily, with great focus, to achieve our goals.
And that's why the President wants to speak to the nation tomorrow, and he's not doing it during the day and he wants to do it at night so he can reach the American people and explain this decision, make clear that he is keeping the commitment that he made in December of 2009 to begin this drawdown, and explain again why this is important.
Q: To borrow a late-night TV phrase, is he going to adopt a "set it and forget it" approach to this drawdown, telling the American people about the schedule between now and the end of next year, or is he going to pay attention to a possible surge in the unpopularity of this war among the American people, based on what he says tomorrow?
MR. CARNEY: I think this goes back to the answer to Dan Lothian's question, which is this is about the implementation of a strategy. And this President made the decision that this was a strategy that was right for national security interests of this country. It is a strategy that we believe has led to our successes in taking the fight to al Qaeda, including in the successful mission against Osama bin Laden. It has led to our successes in stopping the momentum of the Taliban, and to our successes in training up Afghan security forces and preparing them to take the security lead.
So this is the focus. It's the mission, and where we are in that process of achieving our objectives and keeping the commitment that he made to begin the drawdown in 2011 -- July of 2011.
Q: Will we hear from flexibility, though, in -- that he will leave himself some wiggle room for changes down the road?
MR. CARNEY: Well, I think I will leave the decision -- I mean, I will leave the announcement to the President and all the details around it and the parameters that encompass his decision.
Q: Can I just follow up?
MR. CARNEY: Mark.
Q: Jay, briefly. You said that he's going to talk about numbers for July, which is obviously the starting point.
MR. CARNEY: He'll talk more broadly about the mission, about our goals, about the Lisbon 2014 date. But, I mean, I'm not going to be drawn into providing more details about numbers and time frames, because I think that this is the President's decision to announce.
Q: Of course, I understand it's his to announce, but is he going to be using numbers for anything for the rest of the year? Is he going to be using numbers for beyond this year?
MR. CARNEY: I think that falls into a discussion of the details that I don't want to get into from here.
Q: Jay, you just addressed the question -- the concern about whether the President possibly withdrawing too many troops for some people's taste. But today, Carl Levin was saying anything less than 15,000 is not significant. Could you just kind of speak to that, generally?
MR. CARNEY: Well, I think that the President will make the decision that he believes is the right decision as Commander-in-Chief. And obviously, he has thought quite a bit about the objectives in Afghanistan, the decision he made to send additional U.S. forces, to put more men and women in harm's way to achieve these objectives, and where we are in the process of meeting those objectives and how that affects our ability to draw down. There was never a question, because he made the commitment that we would begin the drawdown in July of 2011, and there was never a question as -- since the commitment was made by NATO in Lisbon that we would complete the transition to full Afghan security lead in 2014.
As we've said also previous to this, that the decision about the pace and slope of the drawdown would be based on conditions on the ground. And the President is keenly knowledgeable about the situation in Afghanistan regarding our forces and our civilian mission.
Q: Jay, how much of a factor were the comments and the behavior of Hamid Karzai, especially lately when -- in terms of suggesting the troops, American troops were occupiers and that the aid that Americans provide is contributing to corruption, and that reserving the right to deal with the foreign troops in a manner like Afghans have throughout history -- how much of a factor was that?
MR. CARNEY: Well, I addressed this some yesterday; I was asked about those comments. And I would simply say that we are very proud of the contributions the United States has made in Afghanistan, both its civilian and military personnel. We have for a number of years now, obviously, heard the concerns that President Karzai has expressed about civilian casualties and other issues, and we have engaged with him on those because we share the desire to reduce civilian casualties, as an example of one issue that has been sometimes a focus of contention.
But the reason we are in Afghanistan is to meet our objectives. We believe strongly that those objectives also are shared by the Afghan people and by the Afghan government. Al Qaeda is no friend of the Afghan people or the Afghan government. The need to reverse the momentum of the Taliban is a need, I believe, that is supportive of and shared by the Afghan people and the Afghan government. And obviously stabilizing Afghanistan and allowing them to build up their security forces is also a goal that we share.
We obviously have disagreements and we discuss those with members of the Afghan government, with President Karzai. But our objectives are clear -- no, this is not -- obviously, as you know, this is not the first time I had a question like that even since I've been here. And we're very clear-eyed about what we're doing and what we're trying to achieve in Afghanistan, and this decision has been focused on that.
Q: Yes, yesterday when we asked you about the Walmart decision you didn't really have anything. I'm wondering if you guys have digested that and if the President said anything, or what your views on that are today.
MR. CARNEY: Well, the President is aware of it, obviously. I have not had a discussion with him about it. I appreciate the question and I would just make a couple of points. One, as I said yesterday, the United States was not a party, it was not involved in the Supreme Court's Walmart decision. But what the decision underscores in our mind is the importance of moving forward with legislation that will address the problem of pay disparities between men and women comprehensively, rather than case by case.
As I said yesterday, ending pay discrimination is a key priority for the President, and that is why signing the Lilly Ledbetter Fair Pay Act was one of his first acts. It is also why he continues to call for new legislation. In particular, the President has called for Congress to enact the Paycheck Fairness Act, which, as you may remember, the House passed over two years ago but the Senate did not, coming only two votes short of cloture.
So that legislation has been reintroduced, and we call on Congress -- we urge the House and the Senate to take action because we think it's very important.
Q: So the decision adds urgency to the President's legislative agenda?
MR. CARNEY: I would say that it reminds all of us to, yes, pursue a legislative --
Q: -- the urgency?
MR. CARNEY: Well, it was, yes. I think it adds urgency to the need to -- I mean, it reminds us that we need to do this, that we need to do this in a comprehensive way and not in a case-by-case way.
Q: Can I follow up on that really quickly? The case, while, yes, had this undertone of gender discrimination, was actually primarily about the ability of workers to bring big class action suits like this to big companies. Does he have any comment on that aspect of the case?
MR. CARNEY: I don't have a comment on that aspect of it, and I again would note that we were not party to the case. But on the issue of disparity in pay, the President feels very strongly, and that's why he has supported measures in the past and action by Congress in the past and why he calls on them to act again.
Q: What about Rohrabacher?
MR. CARNEY: April.
Q: What about Rohrabacher?
Q: Jay -- I'm sorry. Jay, going back on the issue of the withdrawal --
MR. CARNEY: You okay?
Q: I am now, thank you for asking. Going back on the issue of the withdrawal, will the President's initial number satisfy those who are war-weary in this nation?
MR. CARNEY: The President will keep the commitment he made in December of 2009 to begin the drawdown of U.S. forces from Afghanistan next month. There are a lot of factors that go into this decision, factors that he has considered deeply and seriously. And I will not prejudge from here how his decision will be viewed by different segments of society.
But you can believe that it will be a decision made on the merits on what he views as the successes that we've had in the implementation of his strategy, the distance we still need to go in implementing that strategy between now and transferring full security lead over to the Afghans. And it will be a very thoughtful and reasonable decision based on a thorough assessment of the situation and conditions on the ground.
Q: And did he talk to any congressional leaders after those in the administration talked to them and passed on information to him? Did he pick up the phone himself and talk to anyone?
MR. CARNEY: Well, you know, it's entirely possible that he had individual conversations writ large the White House and other senior administration officials from -- the Defense Department and State Department have had these conversations with members of Congress, I'm sure. I just don't have a readout to give you. I'm sure the President had conversations with members as well.
Q: Just wanted to have the chance to ask my question. So this is my question -- another subject, regarding Morocco. So the King had this speech last Friday in which -- sweeping a lot of reforms. And a lot of reports that assess this speech as a model for the democracy in Islamic and Arab world. So how the White House evaluate these reforms?
MR. CARNEY: Well, I have to confess that I don't have a specific reaction to that speech or those proposed reforms. As we have said, we believe very strongly that the path forward in the region is to embrace political dialogue and embrace political reform, engage with civilians in a peaceful manner in order to bring about the kind of change that civilians all over the region are demanding.
Again, I can't give a specific response to that speech, but I think that broadly that is the way we view the need for reform in the Middle East and North Africa.
Q: Can we stay in the region? Can I stay in the region, please?
MR. CARNEY: Sure.
Q: On Syria -- thank you. In Syria, it has been more than 24 hours that the President Assad gave his speech. First of all, U.S. administration is satisfied with the Assad regime so far?
MR. CARNEY: Well, I would say that President Assad's speech contained little, if anything, that he and his government is not -- have not said before. And as I said yesterday, words are what matter -- or words are not what matter, rather -- actions. (Laughter.) Getting a little tired. Are we in hour two? Words matter, too. I know, you guys -- but words -- it's not words that matter, it's actions that matter.
And what the Syrian government needs to do is to cease the violence against its own people, and to engage in dialogue in a peaceful way with the Syrian people who are demanding change and are demanding a transition. And we believe that President Assad needs to either lead that transition or get out of the way.
Q: What about Rohrabacher? What about Rohrabacher?
Q: Thank you, Jay. Is the President --
Q: Could you just answer that one question?
MR. CARNEY: I don't even know what that question means, Lester.
Q: Does the President --
Q: Congressman Dana Rohrabacher led a congressional delegation of six to Iraq. They were expelled by that nation after he asked their Prime Minister if the U.S. could from Iraqi oil revenues be paid back the money it has given to Iraq. That's the question.
MR. CARNEY: I'm not aware of that, Lester, so I don't have a reaction.
Q: You're not aware of that?
MR. CARNEY: Ann.
Q: Does the President welcome the McCain-Kerry resolution that would authorize --
MR. CARNEY: We do welcome the resolution. And as I've said in the past, we support that and would welcome passage of it by the Senate, and if it were taken up in the House, by the House as well.
Thanks very much, guys.
END 2:40 P.M. EDT
Barack Obama, Press Briefing by Press Secretary Jay Carney, Secretary of Health and Human Services Kathleen Sebelius, and FDA Commissioner Margaret Hamburg Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/290706