Take As Directed

"This is a marathon." Congresswoman Barbara Lee (D-CA), a renowned leader in Congress on racial justice and global health, discusses her proposed Commission on Truth, Racial Healing and Transformation, the George Floyd Justice in Policing Act, the awakening across America, this historic moment for elected Black women leaders, and this week’s virtual ‘AIDS 2020’ International AIDS Conference. Congresswoman Barbara Lee (D-CA) has served in Congress since 1998.

In this episode, Steve and Andrew invite Frances Stead Sellers, senior writer on the American desk at the Washington Post. Frances, through her eyes as an English immigrant to America -- and a renowned, veteran journalist -- has thought hard about what makes America what it is, in these days of a pandemic, economic pain and racial injustice. Her recent experiences in reporting have taught her about the deep divides in American society, the awakening within the business community, including at the Washington Post, people’s fear to come to the hospital, innovations in communications and delivery of medical services, and how journalism has evolved to capture these moments. 

In this episode, Steve and Andrew speak with Senator Patty Murray (D-WA) on the most pressing health issues before America. What is driving the astonishing resurgence of Covid-19 in the south and west, and what is now required? Why are we as a nation still hung up politically over masks and failing to reach the true level of testing we need? What should guide the U.S. in the race for a vaccine? In the current environment, is it possible to avoid a collision between science and politics?  Senator Patty Murray (D-WA) has served in the Senate since 193. She is ranking member of the Senate Health, Education, Labor and Pensions (HELP) Commission, a senior member of Senate Committees on Appropriations, Budget, and Veteran Affairs, as well as a member of the CSIS Commission on Strengthening America's Health Security.

In this episode, the hosts are joined by Julie Gerberding, a senior executive at Merck, a longstanding friend, and generous contributor to CSIS’s work. Congress was highly active the week of June 22 examining across several committees the hard lessons of the past months of the coronavirus pandemic in America and what needs to happen right now -- as the outbreak explodes in the west and south -- and looking into the future. Julie testified at two full Senate hearings. What were the key messages she sought to hammer home to policymakers? What is the status of debate in Congress over where we need to move next?  Executive Vice President & Chief Patient Officer at Merck and Co., and co-Chair of the CSIS Commission on Strengthening America’s Health Security. She was formerly the Director of the Centers for Disease Control and Prevention (CDC) (2002 – 2009).

In this episode, the hosts engage with Sheryl Gay Stolberg, renowned Washington Correspondent at The New York Times. Since early this year she has been charged with unpacking -- in the midst of the pandemic -- the complex intersection of health, policy, politics and culture. She’s dived into the controversy around hydroxychloroquine, a saga that starkly revealed the collision between science and politics. Have Americans reached a point of exhaustion and resignation, in the face of continued high infections and deaths, and unrelenting economic pain? How to make sense of how these twin crises now mix with protests against racism, social injustice and police brutality? Are Americans at a moment of awakening? 

In this episode, Renee DiResta, a prominent expert who studies malign narratives across social networks and what can be done to rebut them, walks Steve and Andrew through her thinking on several provocative questions: Why does the coronavirus pandemic invite pseudoscience, government conspiracy theories and misinformation campaigns? What to make of the recent release of the "Plandemic" video in which the discredited scientist Judy Miskovits makes outlandish, unsubstantiated claims of a secrete plot by global elites – Bill Gates and Tony Fauci – to use the pandemic to grab power, attracting 8 million viewers in short order? Why are CDC and WHO “behemoths” incapable of adapting to new realities? Where are other trusted authoritative sources? As the push accelerates for a vaccine for the planet, can we expect expansive personal attacks upon those developing the solutions? Renee DiResta is the technical research manager at the Stanford Internet Observatory and a regular contributor to Wired magazine. 

In this episode, Steve speaks with Dr. Jean William (Bill) Pape, a renowned public health professor and practitioner appointed in late April by Haitian President Moïse to co-chair the country’s Covid-19 response commission. Having combatted HIV/AIDS, cholera, hurricanes, and an earthquake, Bill deems the coronavirus pandemic as the toughest challenge he has seen, a “perfect storm.” Haiti’s extreme challenges are undeniable – deep political divisions, stigma, economic decline, sudden return of Haitians from the Dominican Republic, gangs and insecurity. What is the urgent way forward? And how is it to be executed?  Dr. Jean William Pape is Director of GHESKIO, based in Port au Prince, and Professor of Medicine at Weill Cornell Medical College. 

In this episode, we speak with Professor Salim Abdool Karim (Slim), a preeminent HIV scientist based in Durban who chairs the scientific Covid-19 advisory group launched by President Cyril Ramaphosa to guide the national response. Looking back to March, Slim bluntly surveys South Africa’s successes and achievements, the acute vulnerabilities of those living with HIV and TB, tough controversies, major constraints, and mistakes that required correction. Early aggressive action by the President slowed the spread of the virus and bought precious time, though excessive reliance on the police and military backfired. An army of 60,000 health workers are the lead element in proactive outreach to communities. Testing has expanded, but lack of access internationally to reagents holds the country back. Modeling has illuminated alarming possibilities, while triggering calls for more transparency. Cape Town remains a dangerous epicenter; others likely lie ahead. The future is a continued, difficult fight to control hot sp

In this episode, on the day when the number who have died from Covid-19 in America reached 100,000, we speak with special guests Eustace and Carol Theodore, both longtime friends of Steve. After vacationing in England in the first half of March, as the virus was swiftly and invisibly spreading throughout the UK, they returned to Vermont, just prior to President Trump imposing flight bans on Europe, the UK and Ireland. They describe Eustace’s accumulating symptoms, and the uncertain, extended process by which they finally came to discover he had indeed been infected with Covid-19 while abroad. In an extreme condition, Eustace is intubated and placed on a ventilator. How and why did he survive? How has recovery advanced? And what are the larger meanings of their profound, shared experiences?  Eustace Theodore has had a long career in education, as a sociologist and residential at Yale College, Executive Director of the Association of Yale Alumni, and President of the Council for Advancement and Support of Educa

In this episode, we are joined by a very special guest: Julien, a wonderfully insightful 13-year-old seventh-grader from Berkeley, California. We talk about his experience of over two months of shelter-in-place: how disruptive has this been to friendships, school, sports? What has he done to get greater control over his life? Are we going to get out from under this pandemic? And what’s a young person’s advice for the adults around him?

In this episode, U.S. Senator Chris Van Hollen of Maryland joins us to talk about what Congress can do to respond to Covid-19 right now, including ensuring access and affordability for new treatments and a vaccine, and building stimulus packages for every level of government. Senator Van Hollen shares his thoughts on how expanding national service could help to ramp up testing and contact tracing and alleviate unemployment. The Senator also unpacks why American global leadership is crucial and how China is taking advantage of this moment to gain strategic advantage.

In this crossover episode with CSIS's The Truth of the Matter podcast, Tulane University professor and historian John Barry, author of the New York Times bestseller The Great Influenza, joins the podcast from his home in New Orleans’ French Quarter to discuss the lessons gleaned from the 1918 Spanish Flu pandemic that speak to today’s coronavirus pandemic sweeping America and the world.

In this episode, we are joined by Director of the Africa CDC Dr. John Nkengasong and U.S. Ambassador to the African Union Jessica Lapenn. Africa CDC is advancing a continental plan to address the dire, burgeoning threat Covid-19 poses to Africa, where testing has been woeful, where the continent stands at the back of the line in access to test kits, protective gear, oxygen, and financing; and where lockdowns can trigger an economic shock, food crises and instability. WHO remains a vital, indispensable partner. South Africa President and AU Chairman Cyril Ramaphosa has led the charge. PEPFAR, the Global Fund, Gavi the Vaccine Alliance have created health infrastructure now adapting to the Covid-19 threat. Jack Ma, Alibaba Foundation, the Gates Foundation and others have moved with remarkable speed to support Africa CDC. 

In this episode, we bring in Alisha Kramer, a star who cut her teeth right after college working with the CSIS Global Health Policy Center. Now a freshly-minted resident doctor, practicing obstetrics and gynecology in Atlanta hospitals, she assists young pregnant women in navigating the new realities of Covid-19. She shares with us reflections on the risks and fears of health providers, the racial and class divisions she sees every day, the dangers of prematurely lifting the shelter-in-place policies, and the acts of generosity from the community that bring her to tears.

In this episode, the conversation takes off from a recent piece published by Steve and Anna Carroll, Global Health Policy Center’s Associate Fellow, that examines President Trump’s decision to suspend U.S. assistance to the World Health Organization. What drives that decision? And with what consequences, at this historic moment in the pandemic? Is there any possibility of a diplomatic solution that might preserve U.S. support of the WHO?

In this episode, the hosts are joined by Scott Dowell, coronavirus response leader at the Bill & Melinda Gates Foundation. They discuss how successful the global response has been in saving so many lives, as well as get Dr. Dowell's thoughts on which response strategy is best when considering herd immunity, lockdowns, intense digital contact tracing, isolation and quarantine. While we wait for a vaccine, how do we exit this phase? Scott tells us how most transmission actually occurs in the household, and that we should focus on protecting the family of patients, and the most vulnerable, to get control of this pandemic.  Dr. Scott Dowell is Deputy Director for Surveillance and Epidemiology and coronavirus response leader at the Bill & Melinda Gates Foundation. 

This week marks World Immunization Week, an annual celebration of vaccines that raise awareness and increase rates of immunization against vaccine-preventable diseases around the world. To mark World Immunization Week, Take as Directed launches a conversation recorded earlier in the year to place immunization within the debate around Universal Health Coverage (UHC). In a world faced by not only a pandemic threat but also continuing infectious disease challenges, immunization and universal health coverage is more important than ever.  In this episode, Senior Fellow Katherine Bliss talks to two immunization experts: Angela Shen, retired Captain from the U.S. Public Health Service with over 22 years of service at the U.S. Department of Health and Human Services; and Lora Shimp, Technical Director for Immunizations at John Snow Inc. They discuss what the difference is between universal health care and coverage, and how including immunizations under a larger package of preventative services means more people benef

In this episode, Steve and Andrew are joined by Congressman Ami Bera (D-CA07) to talk about his work on the CSIS Commission on Strengthening America’s Health Security and his impressions of Covid-19, as both a doctor and an elected representative.  They discuss how difficult it’s been to get Congress to spend resources on preparedness, and the work Rep. Bera is doing to build a crisis workforce. His main concerns: when the vaccine is found, how can we ensure the vaccines are distributed equitably to all countries, and who should get it first? Where would the supplies and workforce come from? Congressman Ami Bera has represented California’s 7th Congressional District in the U.S. House of Representatives since 2013. Before joining Congress, Rep. Bera had a twenty-year medical career as a physician, hospital administrator, professor, and as Sacramento County’s Chief Medical Officer. He is also a Member of the CSIS Commission on Strengthening America’s Health Security. Find his recent letter proposing a Covid-19

Former Senator Kelly Ayotte, co-chair of the CSIS Commission on Strengthening America’s Health Security, joins Steve and Andrew in explaining how the Commission’s November 2019 core recommendations remain compelling and essential in the midst of the pandemic, if we are to, once and for all, break the cycle of crisis and complacency. She offers her thoughts on the shocks we did not anticipate, such as our weak supply chains, which will now need to be strengthened for the future. Senator Ayotte also discusses China’s highly problematic role in the pandemic, and how the U.S. can reconfigure its dependence, along with a similar rethinking needed to strengthen and reform the World Health Organization. 

In this episode, Peter Sands, executive director of The Global Fund to Fight AIDS, Tuberculosis and Malaria, joins Steve and Andrew in exploring the chasm separating the world of finance and economists from that of public health, the extraordinary threats the pandemic poses to historical gains in development and global health, and the rapidly evolving role of the Global Fund in racing to support partner countries in their response to the coronavirus.