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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.
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In a special crossover episode with CSIS's The Truth of the Matter, Andrew Schwartz and Steve discuss the recent measles outbreak and risks associate with it.
The United States is experiencing the worst measles outbreak in 30 years and the highest rate of contraction in the past six years after nearly eradicating the disease. Cases have surged in communities with low immunization coverage, raising concerns about further transmission. Hospitals are reporting an increase in severe cases, particularly among young children and immunocompromised individuals. Experts urge immediate action, emphasizing that vaccination remains the most effective defense against the highly contagious virus.
Dr. Elizabeth (Beth) Cameron, Professor, Brown University, and former senior official in global health security and biodefense at the White House and USAID, kindly shares her thoughts on the radical changes unfolding inside the U.S. government surrounding biothreats. Two internal factions within the Trump administration vie with one another. “It’s a bleak picture” in the accumulating damage to the federal workforce, programs, and the protective shield inside and outside our borders. Elon Musk alleges USAID is producing bioweapons, a patent lie. “It’s preposterous” and “dangerous.” More responsibilities will now fall to governors. What to make of the Trump administration’s recent $1B announcement on H5N1 to assist the poultry industry, and its decision to revisit the $590m contract with Moderna for a mRNA human vaccine for H5N1? We don’t know much on what is going to happen in Congress and DOD. And when emergency crises will strike next. Where to find hope? Our civil servants.
Dr. Vanessa Kerry, founder of Seed Global Health, Associate Professor, Harvard School of Medicine, and since June 2023 the WHO Director-General’s Special Envoy on Climate Change and Health, joined The CommonHealth to unpack her recent article ‘Health is a Cornerstone of Global Security,’ published February 14 in Foreign Policy. In it, she argues the need to rethink health as the first line of defense, with a heavy emphasis on economics, equity, and migration. We need to broaden the definition of the health security agenda; introduce health metrics into any discussion of economic growth; see health as an investment with high returns—a growing sector of national economies, in job creation, markets, and a larger tax base; and focus on finance e.g. special drawing rights, social bonds, and swaps. At the same time we need to engage internationally through strong moral leadership and humane policies, and upgrade our communications in an apolitical, non-partisan way that people see, understand, and feel. It is imperative to create opportunity in America that starts with protecting people’s health and well-being, and to create a new pathway, built on humility, to pull us out of the current confusing moment of crisis surrounding foreign aid.
In the eighth episode of the CommonHealth Live! series, J. Stephen Morrison sits down with Loyce Pace, Assistant Secretary for Global Affairs at the U.S. Department of Health and Human Services. Assistant Secretary Pace discusses the newly released HHS Global Strategy and its implications for U.S. climate and health policy.
Dr. Elizabeth (Betsy) Bradley, President of Vassar College, shares her thoughts on the fusillade of Executive Orders signed by President Trump directed at educational institutions, including the apparent special animus toward elite private institutions. In this moment of heightened scrutiny across multiple fronts, the first step is to circle back to core values and the return on investment, to communicate strategy better beyond campus to the broader community, including elected officials of all persuasions, and to spotlight jobs and financial and other vital contributions. The threat of a dramatic increase in taxes on endowments, as part of a Congressional reconciliation measure this spring, “would definitely deal a blow.” Anti-foreigner rhetoric is having a “chilling effect” on recruitment and retention of international students. “Ambidextrous leadership” is essential: be proactive, have the data you need, don’t overreact, and be ready to act quickly when needed.
Apoorva Mandavilli, the award-winning New York Times science and global health reporter, is on the front lines of several fast-breaking stories. “We should be worried” about the President’s Emergency Plan for AIDS Relief (PEPFAR). It was “already on the chopping block” before the hugely disruptive Trump pause on national grants and contracts. Secretary Rubio did issue a waiver, but there has been no follow-up clarification. PEPFAR remains in peril. Many bad things happen rapidly when a sensitive, complex program of this scale is disrupted. “The virus comes roaring back.” Though Robert F. Kennedy Jr.’s confirmation hearing to be HHS Secretary appears inconclusive, Apoorva was “not expecting the level of fireworks.” RFK Jr. was “damned by his own history” of false statements on vaccines, which “haunted him.” U.S. withdrawal from WHO is bad news for Americans in several concrete ways that will harm U.S. national interests. She has brought to our attention that scientists believe we have entered a new, far more dangerous phase in the evolution of the H5N1 threat, while the U.S. response remains woeful.
The renowned expert on vaccine confidence, Dr. Heidi Larson, London School of Hygiene and Tropical Medicine, explains why there has been a precipitous escalation in the past four years, especially among 18-24 year-olds, of vaccine skepticism and resistance. During Covid-19, “everybody got vaccinated,” everyone was exposed to the “digital swarm,” the “wildfire” on social media of mis- and dis-information regarding vaccines. Antivaccine groups amalgamated and rose in power. Public health officials were hesitant to compete on social media. Young parents were unhappy with public health sources of information and looked elsewhere. RFK Jr., his Children’s Health Defense, and the affiliated Informed Consent Action Network (ICAN), have had “massive, massive influence” as amplifiers of doubt and fear of vaccines. What to do? There is an urgent need to engage young leaders, increase public health communications budgets and change their practices and outlook, mobilize local communities, and create new communications partnerships. It requires a “huge effort.”
Since the start of her tenure in July 2023, Dr. Mandy Cohen, Director of the U.S. Centers for Disease Control and Prevention (CDC), has pursued several reforms intended to make CDC a stronger, nimbler agency better able to protect Americans from domestic and global public health threats and rebuild trust. She is joined in conversation with former Senator Richard Burr, Co-Chair of the CSIS Bipartisan Alliance for Global Health Security and Principal Policy Advisor and Chair, Health Policy Strategic Consulting Practice, DLA Piper, and J. Stephen Morrison, CSIS Senior Vice President and Director, Global Health Policy Center. They discuss the agency’s achievements, what has worked and not worked, the core challenges that persist, and how to best position the agency to sustain progress in 2025.
In the tenth episode of the CommonHealth Live! series, Katherine E. Bliss will sit down with Stacy Aguilera-Peterson, Deputy Director for Research, U.S. Global Climate Change Research Program, White House Office of Science and Technology Policy, and Josh Glasser, Assistant Director for Combatting Antimicrobial Resistance & Integrated Health Innovation (One Health), White House Office of Science and Technology Policy.
The discussion will focus on how the Biden administration has sought to define the relationship between climate change and health, the extent to which climate-related impacts on health can be seen as threats to national security, and opportunities for stakeholders in research, program implementation, service delivery, and the private sector to collaborate with U.S. government agencies and international partners on addressing global challenges at the intersection of climate change and health.
This event is made possible by the generous support of the Wellcome Trust and GSK.
In the ninth episode of the CommonHealth Live! series, J. Stephen Morrison will sit down with Rahul Gupta, Director of the White House Office of National Drug Control Policy.
Dr. Gupta will discuss the surprising 15 percent decline in overdose deaths in 2024, 70 percent of which are caused by fentanyl overdose, and what factors are driving this change. He will discuss measures taken nationally on treatment access and internationally on interdiction and related measures to reduce the flow of fentanyl. What more needs to be done to sustain progress and save more American lives?
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.
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