Take As Directed

With the ongoing Ebola outbreak in the Democratic Republic of the Congo rapidly escalating to dangerous levels, the global health community must consider how much progress has been made to prevent and efficiently respond to outbreaks since the 2014-2016 Ebola outbreak in West Africa. In this episode of Take as Directed, we are joined by Gabrielle Fitzgerald, founder and CEO of Panorama, a Seattle based action tank dedicated to solving global problems. Gabrielle discusses the main points of a British Medical Journal piece she recently co-authored, Global epidemics: How well can we cope?, which addresses the gaps that remain in the global capacity to respond to outbreaks from various standpoints such as financing, research and development, and knowledge sharing.  Hosted by J. Stephen Morrison.

Tuberculosis (TB) is a long-standing, urgent threat to global public health, yet it has never been discussed at the highest level of the world stage. That changes this week, as heads of state gather in New York for the UN General Assembly, where they will convene the first-ever UNGA high-level meeting on tuberculosis. After three years of dialogue in advance of this historic event, the meeting will aim to accelerate efforts in ending TB, and it should result in a Political Declaration on TB endorsed by heads of state. On this episode of Take as Directedwe are joined by Dr. Eric Goosby, the current UN Special Envoy on Tuberculosis, to share his hopes and expectations for the meeting, and its potential as an important step towards realizing the WHO global end TB strategy.  Hosted by J. Stephen Morrison.

The Ebola outbreak in the Democratic of the Congo poses unprecedented challenges to emergency responders as the first ever case in an active warzone. The response has had remarkable mobilization and promising achievements thus far, with successful vaccination campaigns, and a constant readjustment of strategies and resource allocation to best contain the virus. However, six weeks into the response, the outbreak sits on the edge of some of the most insecure and inaccessible areas of the country, where the virus could potentially wreak terrifying levels of devastation. In this episode of Take as Directed we are joined by Peter Salama, Deputy Director General of the World Health Organization and Director of the Emergency Programs, to provide an inside look at how the response team is navigating the complex dynamics of a highly dangerous outbreak.   Hosted by J. Stephen Morrison.

Tuberculosis (TB) is the number one infectious disease killer. Yet, pediatric TB is often overlooked as an urgent public health threat, especially in lower- and middle-income countries. In this episode of Take as Directed, we hear from Dr. Farhana Amanullah, a seasoned clinician and expert in pediatric tuberculosis who runs the largest, private-sector TB program for children in Pakistan at the Indus Hospital Karachi. Dr. Amanullah describes the challenges in diagnosing and treating TB in children and adolescents and shares her expectations for the UN High Level Meeting on Ending TB, which is to take place later this month.    Hosted by Sara Allinder.

Since committing to support polio eradication on its 100 anniversary, Rotary International has contributed $1.8 billion to the cause, along with thousands of volunteers, advocacy work, and political leadership. Serving as Rotary’s PolioPlus Committee Chair, Mike McGovern leverages the organization’s unique position as an expansive service network to complement the technical expertise of its partners in the Global Polio Eradication Initiative. McGovern joins us in this episode of Take as Directed to discuss lessons learned from Rotary’s long engagement with the initiative, strategies to sustain eventual eradication while strengthening global health capacity, and next steps for Rotary’s involvement in international public health. Hosted by Nellie Bristol.

Last month, top policymakers, scientists, and activists gathered in Amsterdam for the 22nd International AIDS Conference to examine the current state of global HIV/AIDS response, and how that response should be shaped by the global health community in the years to come. In this episode of Take as Directed, we are joined by Owen Ryan, Executive Director of the International AIDS Society (IAS), which organizes the International AIDS Conference every two years. Owen discusses the main science and policy takeaways from this year’s conference and addresses the concerns raised by activists about holding the conference in the United States in 2020, which is set to take place in San Francisco and Oakland.

In this episode, a former Vice Chairman of the Joint Chiefs of Staff joins us to discuss the story of his son Jonathan, who died from a fentanyl overdose last year. Admiral James "Sandy" Winnefeld is a retired four-star Navy admiral, and has become a vocal advocate for opioid death prevention. He heads Stop the Addiction Fatality Epidemic, or S.A.F.E. Project U.S., a national nonprofit organization dedicated to ending the opioid epidemic in the United States. Admiral Winnefeld describes how difficult it was to find treatment for Jonathan and recounts the challenges of recognizing signs of recovery--and signs of relapse.

Professor Quarraisha Abdool Karim is one of the world’s leading AIDS researchers and has made pioneering contributions to understanding the HIV epidemic in young people, especially among young women. She joined us for a two-part series to explain her latest research into epidemic hot spots in KwaZulu-Natal in South Africa, focusing on both the structural and biological risk factors that facilitate the spread of HIV in young women. In Part 2, she describes her recent findings about biological factors that can simultaneously increase a woman’s risk of HIV acquisition and decrease the efficacy of HIV prevention tools. Hosted by Janet Fleischman. Produced by Alex Bush. Edited by Ribka Gemilangsari.

Professor Quarraisha Abdool Karim is one of the world’s leading AIDS researchers and has made pioneering contributions to understanding the HIV epidemic in young people, especially among young women. She joined us for a two-part series to explain her latest research into epidemic hot spots in KwaZulu-Natal in South Africa, focusing on both the structural and biological risk factors that facilitate the spread of HIV in young women. In Part 1, she discusses the social and economic factors that contribute to the dramatic differences in HIV rates in women and men at different ages. Hosted by Janet Fleischman. Produced by Alex Bush. Edited by Ribka Gemilangsari.

In this episode, Elhadj As Sy, Secretary General of the International Federation of Red Cross and Red Crescent Societies (IFRC), joins us to discuss the different roles that IFRC plays across the vast array of populations they serve, their current work on the Ebola outbreak in the Democratic Republic of Congo, and the lessons they learned from the previous outbreak. Mr. Sy has also been named co-chair of the Global Preparedness Monitoring Board, and he describes to us the current state of the planning for this new independent monitoring body launched by the WHO and the World Bank on May 24th at the 71st World Health Assembly.   Hosted by Steve Morrison. Produced by Alex Bush. Edited by Ribka Gemilangsari.    

In 2016, the World Health Organization announced that a single full dose of yellow fever vaccine would provide lifelong protection from the virus. However, due to global shortages and complicated production requirements, there has not been sufficient supply to meet the demands of recent outbreaks. Angola and the Democratic Republic of Congo in 2016 and now Brazil in 2018 have turned to using fractional doses, or about 1/5 of a full dose, as a stopgap measure—these diluted doses are only known to offer one year of protection against the virus. In this episode of Take as Directed, Daniel Lucey, a senior scholar with the O’Neill Institute for National and Global Health Law at Georgetown University, joins us to discuss the threat of yellow fever, our lack of preparedness, and the potential for a significant outbreak in Asia.   Hosted by Steve Morrison. Produced by Alex Bush. Edited by Ribka Gemilangsari.

Dr. Christos Stylianides serves as the European Commissioner for Humanitarian Aid and Crisis Management and is the European Union Ebola Coordinator. Christos joins us for this episode to discuss how the current Ebola response has differed from the response in 2014 and the leading role that Europe is playing in that response. He also discusses his current work to expand resources for education services for children and adolescents living through crises and emergency situations.   Hosted by Steve Morrison. Produced by Alex Bush. Edited by Ribka Gemilangsari. 

Providing services equitably requires global health practitioners to have detailed data on the populations they are trying to reach. This episode of Take as Directed, hosted by Senior Fellow Nellie Bristol, highlights new initiatives to collect and analyze sub-national data to give a clearer picture of children being missed. Nellie is joined by guests Laurie Werner, Global Director for the Better Immunization Data (BID) Initiative at PATH, and Jon Mosser, a Fellow in pediatric infectious diseases at Seattle Children’s Hospital and the University of Washington and Clinical Fellow with the Institute for Health Metrics and Evaluation. They discuss new initiatives to map vaccine coverage, technical challenges to collecting data in resource poor settings, and the importance of spending development dollars on data collection and analysis.   Hosted by Nellie Bristol. Produced by Alex Bush. Edited by Ribka Gemilangsari.

The world of global health security has been amassed in headlines over the past few weeks—from the Ebola outbreak in the Democratic Republic of Congo, to the elimination of the Global Health Security Directorate within the White House National Security Council staff. For this episode of Take as Directed, we feature three leading health security experts with substantial frontline experience who discuss the current state of preparedness around the world, gaps and priorities looking ahead, and how to maintain pandemic preparedness as a high-level political priority at times of peace. Beth Cameron, Vice President of Global Biological Policy and Programs at the Nuclear Threat Initiative, serves as our guest host for this discussion, alongside featured guests Amadou Sall, CEO of Pasteur Institute in Dakar, Senegal, and Andrew Kitua, Africa Regional Director of the USAID Preparedness and Response project.

Amidst a time of potentially historic talks between the U.S. and North Korea, we take an inside look at the health challenges that North Korea faces and the opportunities for progress that can be made through key diplomatic steps. For this discussion, we turn to Dr. Kee B. Park, Paul Farmer Global Surgery Scholar at Harvard Medical School and Director of North Korea Programs for the Korean American Medical Association. Dr. Park has just returned from another trip to North Korea and joins us to discuss his latest visit, the potential impacts of economic sanctions on humanitarian engagement, and the operating environment that influenced the Global Fund's decision to close its TB and malaria programs. We conclude by hearing about some exciting new initiatives Dr. Park is pursuing to strengthen U.S.-North Korea collaboration in the health sector and his optimism looking forward. Dr. Park is also one of many co-authors on our recent commentary “The Gathering Health Storm Inside North Korea.” Hosted by Steve Morris

Christopher Murray, director of the Institute for Health Metrics and Evaluation (IHME), is a pioneer in the world of global burden of disease measurement. In April, IHME released their annual report on global health financing and two accompanying articles in The Lancet. Chris joins us for today’s episode to discuss the future of financing the global HIV/AIDS pandemic and the efforts to move towards universal health coverage around the world.   Hosted by Steve Morrison. Produced by Alex Bush. Edited by Ribka Gemilangsari.

Despite substantial progress made in expanding access to HIV/AIDS treatment and prevention options, a vaccine for HIV—even an imperfect one—is likely needed to put a durable end to the epidemic. In this episode of Take as Directed, Dr. Mark Feinberg, President and CEO of the International AIDS Vaccine Initiative (IAVI) discusses the landscape of HIV vaccine development and why he thinks a vaccine remains a necessary pursuit. Dr. Feinberg also discusses the facilitating role that IAVI plays in the HIV vaccine development process. Hosted by Sara Allinder. Produced by Alex Bush. Edited by Ribka Gemilangsari.