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The CommonHealth is the podcast of the CSIS Bipartisan Alliance for Global Health Security. On The CommonHealth, hosts J. Stephen Morrison, Katherine Bliss, and Andrew Schwartz delve deeply into the puzzle that connects pandemic preparedness and response, HIV/AIDS, routine immunization, and primary care, areas of huge import to human and national security. The CommonHealth replaces under a single podcast the Coronavirus Crisis Update, Pandemic Planet and AIDS Existential Moment.
278 Episodes
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Dan Diamond, the national health reporter at the Washington Post, reflects on the shock of both United Health executive Brian Thompson’s tragic murder and the subsequent tsunami of anger and glee on social media. We’ve entered “a staggering moment” that does not feel real, but nonetheless reveals the remarkable depth of discontent with the American health system, in particular insurers. “Everything feels grey to me.” This moment is grounded in the collapse of trust, including trust in the media. United Health, America’s fourth largest firm, and the most powerful firm in the health sector, inevitably attracts—and will continue to attract—tough scrutiny and enduring questions over why the U.S. health system is so dysfunctional. This week Robert F. Kennedy, Jr. ventures to the Senate, where many Senate members simply do not know what to make of him. He has issued so many different statements on so many topics at different times to different audiences. While RFK Jr.’s vaccine positions will get the greatest play and are likely to remain a red line for Democrats, his pivot to chronic disease prevention and healthy food has rallied many to his side. Perhaps DOGE will be a vehicle for introducing progressive and budget reform ideas into the Republican Party in a new way. Will there be progress in changing the seasonal clock in America, a lighter, perennial topic? Probably not. There “is not a real path forward.”
Sheryl Gay Stolberg, the NYT health correspondent, feels her decades of health and political reporting prepare her well for understanding this remarkable moment in American history. Anger and alienation against the health sector and science are surging, drawing both on historical roots and current dynamics. Robert F. Kennedy, Jr. nominated to be HHS Secretary, taps into a profound mistrust that he has indeed stoked, aided by the platform Covid gave him to mobilize “vaccine resisters.” RFK Jr’s nomination has several advantages, including his pivot to prevention, the root causes of chronic diseases, processed foods, and declining life expectancy. He has moved past the extremes (heroin addiction, sexual patterns, conspiracies) to claim redemption and resilience. He appeals to populist dissatisfaction with “regulatory capture” by big pharma and big food.
Opposition can be loud. Mike Bloomberg has declared RFK Jr. “beyond dangerous, “medical malpractice on a mass scale.” Scott Gottlieb, AEI, has issued similarly scathing statements. Opposition can be muted. While there is “terror” among industry, public health, academic centers, opponents are cautious, out of fear of retaliation.
Jay Bhattacharya, Stanford, nominated to lead NIH, and others critics of the Biden administration feel they were marginalized during Covid and treated unfairly. “I think it is important that we engage with people on their ideas.”
How do we explain the peril that global health faces? Covid and the post-Covid backlash. The Biden years’ “status quo” approach. Less support in Europe. Excessive debt in Africa. The generational shift in Congress and aging of the flagship programs: “Time has passed.” “We never really dealt with PEPFAR’s treatment mortgage.” Dealing with the conservative critique of US global health funding Is essential to revitalize bipartisanship. 2025 could be rocky, should resources shrink. “We need to be creative, and realistic.” What should we make of the emerging Trump leadership team, most significantly, Senator Rubio, Elise Stefanik, RFK Jr., and Jay Bhattacharya?
In the sixth episode of the CommonHealth Live! series, Katherine E. Bliss will sit down with Dr. Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean. Dr. Balkhy will speak to her evolving vision for the region, encompassing EMRO’s multiple complex humanitarian operations—in Gaza, Yemen, Afghanistan, Libya, and beyond. She will also reflect on the growing challenge of antimicrobial resistance and what may come out of the UN High-Level Meeting on Antimicrobial Resistance (AMR) to be held on the margins of the UN General Assembly on September 26.
This event is made possible through the generous support of the Bill & Melinda Gates Foundation.
In the seventh episode of the CommonHealth Live! series, Katherine E. Bliss will sit down with Dr. John Balbus, Director of the Office of Climate Change and Health Equity at the U.S. Department of Health and Human Services. Dr. Balbus will speak about the foundation of his office in 2021, the work it has engaged in so far, lessons learned, and his vision for the future.
This event is made possible by the generous support of the Wellcome Trust and GSK
Javier Guzman, Center for Global Development debriefs on the High Level Meeting on Anti-Microbial Resistance held in New York City on September 26. Successes took several forms: significant new data, analyses, and projections; a political declaration committed to the creation of a scientific panel; elevation of equity of access and accountability; a target to reduce deaths by 10% by 2030; and agreement to convene again in 5 years. The panel has to be seen as a joint enterprise between the north and south. Emerging economies are getting more engaged. There are serious reservations among many countries that are heavily dependent on animal production. We do not have much visibility into what is happening in China. Data remains elusive. The $100m target of national governments commitment is “a drop in the ocean.” There is an urgent need for creative, large-scale financing and plans to bring to scale access to AMR technology. Countries themselves have to take control and commit.
Dr. Michael Osterholm unpacks the history of H5N1, as we struggle with the question of whether the current H5N1 outbreak may pose a grave threat of a human-to-human pandemic. "It’s possible that H5N1 may never get over the bar for human disease and we don’t know why.” He also speaks to what we are likely to face in the months ahead from the mpox clade 1b outbreak, centered in Africa.
Nidhi Bouri, DAA at USAID Bureau for Global Health, joined us to speak to the U.S. response to the dangerous mpox outbreak (clade 1b) centered in the Democratic Republic of Congo, boosted by President Biden’s commitment at UNGA to $500m in support, including 1 million vaccine doses. Much better data is urgently needed on the needs for diagnostics and vaccines. Tensions remain high among Africa CDC, WHO, and other key institutions with proven response capability, most notably Gavi, UNICEF and the Global Fund. Much is not known about modes of transmission, and the durability and efficacy of the Jynneos vaccine for clade 1b. As the virus inevitably lands in the United States, communications will be critical. Some important progress was seen in the High Level Meeting on anti-microbial resistance. The Marburg outbreak in Rwanda is of acute concern for multiple reasons: no vaccine, little testing, little knowledge of the pattern of spread. It is crunch time, as multiple replenishments converge. “Let’s be clear, there is not enough money.”
Dr. Jerome Adams authored his 2023 memoire, Crisis and Chaos: Lessons from the Front Lines of the War Against COVID-19. In it, he reflects on his upbringing in southern Maryland and the acute “hurting” among many citizens, rural and poor, dissatisfied with the status quo. Profoundly impactful to his tenure as Indiana State Health Commissioner was managing the opioid, Hepatitis C, and HIV outbreaks in Scott County, IN. As U.S. Surgeon General, he carried forward his enduring commitment to the overdose reversal drug, naloxone. During Covid, politics and toxic partisanship severely hampered the US response. “We keep playing whack-a-mole.” Upgraded communications were urgently needed. The attacks from within the Trump White House upon Dr. Fauci were paralleled by attacks on public health officials at state and local levels. Give a listen to learn more.
Dr. Anthony Fauci sat down with J. Stephen Morrison, CSIS, on August 13, for a conversation on his remarkable 54 year career of service as a doctor and scientist. Listen to hear about his early upbringing in Bensonhurst, Brooklyn; his Jesuit training; his expansive leadership at NIH on HIV/AIDS in the darkest days; the creation of a position of influence in science and public health unprecedented in American history, tied to the trust and confidence of six presidents; and, of course, his confrontation with President Trump during Covid and Trump’s campaign to discredit and damage him.
Dr. Megan Ranney, the dynamic, charismatic Dean of the Yale School of Public Health, joined us to illuminate the strategy she has pioneered to curb firearm injuries and deaths in America. It is a true epidemic that begs a serious public health approach. It requires coming to terms with suicide and homicide in America—both sensitive, disturbing phenomena. It requires a concentrated focus on data gaps, research investments, effective interventions, and scaling the response. Together these actions hold the promise of reducing deaths and injuries by 50 percent. Many commonsense actions are steadily achieving major gains, including safe storage of weapons, better engineering of weapons, fostering a community of dedicated researchers, and introducing economic incentives that favor safety. In combination, these are demonstrably raising hope, even in the face of enduring stigma and skepticism, political divisions, gaps in knowledge, and misinformation and disinformation. Come listen for the full story.
Please note this episode contains subject matter relating to gun violence and the topic of suicide. Listener discretion is advised.
With the International AIDS Society’s 25th global conference taking place next week in Munich, Mark Lagon, Chief Policy Officer at Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria and Bennett Freeman, Associate Fellow with Chatham House, joined Katherine to discuss a new Friends report regarding the role of the private sector and civil society organizations in advocating for global health programs, including HIV services. Lagon and Freeman argue that in a period during which restrictions on civic space seem to be increasing in many countries around the world, there is a business case to be made for the private sector in defending civil society organizations’ efforts to promote respect for human rights, monitor for equitable access to services, and encourage transparency and accountability within global health programs and beyond.
Leonard Rubenstein is Professor at Johns Hopkins Bloomberg School of Public Health, non-resident Fellow at CSIS, and Chair of the Safeguarding Health in Conflict Coalition. He joins us to unpack the Coalition’s 11th annual report on 2023. Four big wars—Ukraine, Myanmar, Gaza, Sudan—are driving up attacks upon civilians, and deaths, to exceptionally high levels. At the same time, attacks on the health sector reached over 2,500 recorded incidents in 2023, a 20% increase over 2022. Attacks on hospitals are often part of a deliberate, targeted military strategy. In other instances, they are a result merely of “contempt and indifference” as combatants wage war indiscriminately. What can be done, if policy is typically “hand-wringing” and “total impunity”? There could be breakthroughs through investigations and prosecutions in Ukraine and the International Criminal Court’s actions in the Israeli-Gaza war. Over time, we do see progress at the UN High Commissioner on Human Rights and the World Health Organization.
Dr. Raj Panjabi, former NSC Senior Director for Global Health Security and Biodefense, shares his personal story, his deep ties to Liberia, the genesis of Last Mile Health, the profound lessons that emerged from Ebola in Liberia. In his time (2021-2023) heading the President’s Malaria Initiative and serving at the NSC, what accomplishments is he most proud of? Alternatively, what were the toughest revelations? As the ground shifts politically in America, what strategy might sustain and renew global health as a priority? Give a listen.
This episode is the lively conversation J. Stephen Morrison had the pleasure to hold with Dr. Angela Apeagyei and Dr. Chris Murray, IHME at CSIS on May 14. It begins with the compelling findings of the 15th IHME annual report Financing Global Health 2023. Global health is beset by high interest rates, the rising claim on resources for climate, costly geopolitical ‘forever’ wars, and an era of populism and multiple elections. What are the elements of a proactive, updated strategy to sustain support for global health? Give a listen!
France’s dynamic Ambassador for Global Health, Anne-Claire Amprou, visited CSIS for an extended conversation on the topline historical challenges that her office addresses: elevating climate’s health impacts, the pandemic treaty negotiations and reform of the IHR, anti-microbial resistance (AMR) in the year of the UN General Assembly High Level Meeting in September, navigating multiple ambitious global health replenishments amid scarcity, investing in workforce training, the WHO academy in Lyons, strengthening the French-US relationship, and France’s special engagement on the humanitarian crisis in Gaza. Give a listen!
The inimitable Jennifer Kates, KFF, joins us to make sense of the multiple, convergent, competitive replenishments of the most significant instruments in global health – the Global Fund, Gavi, the Pandemic Fund, WHO at historic moment of intense geopolitical tensions and big, costly wars, the ascent of climate, fiscal scarcity, many elections in the populist era, and post-pandemic fatigue. The US elections are stirring high anxiety across the globe. Attention is focused on the Project 2025 blueprint for a Trump victory. Where is the hope and optimism? Give a listen.
In the fifth episode of the CommonHealth Live! series, J. Stephen Morrison speaks with Dr. Sandro Galea, Dean and Robert A. Knox Professor, Boston University School of Public Health on the public health workforce pipeline. How to position public health schools and departments within universities to be more powerful, better funded, with better access to senior leadership? What are the concrete changes in the curricula of public health programs and the recruitment of faculty and students that are going to be most essential to meet the demands of the post-Covid era and correct the drift into illiberalism? How to make the case more effectively that public health is a national security measure?
In our ongoing series on climate and health, we had the great fortune to enlist a friend and colleague, Noam Unger, Director of the CSIS Sustainable Development and Resilience Initiative, to discuss PREPARE, the President’s Emergency Plan for Adaptation and Resilience. Why did it take so long for adaptation to rise in significance? PREPARE is “a presidential initiative that is not coming with a big bag of money along with it,” which means its principal focus is coordination around food, water, health, infrastructure, data forecasting, and financing and insurance. What might that achieve? Is it meaningful to compare its prospects with those of PEPFAR? How to build a geostrategic rationale, a program framework, and a mixed constituency for PREPARE incrementally over time? Give a listen to the answers to these questions and more.
Since the start of 2024, several countries in South America have experienced a rapid increase in cases of dengue, a viral disease transmitted by the aedes aegypti mosquito. According to the Pan American Health Organization (PAHO), this year alone at least 18 countries in the Americas have reported cases, with more than 400 deaths. In Peru, at the end of February, the government declared an emergency in 20 districts, setting up makeshift clinics and sending additional financial and human resources to affected areas. Dr. Andrés (Willy) Lescano, who leads the Emerging Infections and Climate Change Research Unit at Cayetano Heredia University in Lima, Peru and was one of the co-authors of the Lancet Countdown on Health and Climate Change 2022 report on South America, explains why it has been so challenging to control aedes aegypti mosquitoes in the region, the extent to which urbanization, global warming, and the el Niño phenomenon are driving the current outbreaks, and steps that can be taken to better prepare the health sector for future crises associated with a changing climate.
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