Take As Directed

Donald G. McNeil, the prize-winning science and health reporter—45 years with the New York Times—unpacks his newly published memoir, The Wisdom of Plagues. It covers his remarkable personal and professional story, his reflections on the travails facing PEPFAR, the stark lessons of Covid, his "radical" prescriptions for the future, and his reflections three years after abruptly departing the NYT. 

In the third episode of the CommonHealth Live! series, World Health Organization (WHO) Senior Advisor Dr. Scott Dowell joins J. Stephen Morrison for a discussion about the Global Health Emergency Corps (GHEC) concept, development thus far, and plans for 2024. What will it take to bring GHEC to life? What might the U.S. role be?

Dr. Sandro Galea, Dean of the BU School of Public Health, discusses his incisive, provocative new book, ‘Within Reason.’ Its central proposition: public health slipped into illiberalism during Covid-19, a “closing of the mind.” Over the course of the book, Dr. Galea unpacks that striking phenomenon: how and why it happened, what it means, and what needs now to happen to correct course? The loss of trust is the most poignant but not the only price. Give a listen!

Joseph Majkut, Director of the CSIS Energy Security and Climate Change Program, unpacks the big picture of COP28 (Dubai, Nov. 30-Dec 13, 2023), both the formal negotiations and the “trade show.” Is the commitment to “transition away” from fossil fuels a truly pivotal moment? What’s the significance of the launch of the "Loss and Damage Fund" especially with regard to tensions between the North and the South? What to make of the day dedicated to health and climate? How to assess UAE leadership? Ultimately, Dubai is not likely to stand shoulder-to-shoulder with Paris and Kyoto. It’s more of a “punctuation mark.” Give a listen!

In the second episode of the CommonHealth Live! series, J. Stephen Morrison speaks with International Rescue Committee (IRC) President and CEO David Miliband about the recently released IRC 2024 Emergency Watchlist. The onset of 2024 has brought with it record levels of humanitarian crises. How and why are global humanitarian crises evolving? How do we address these unprecedented global challenges? What can be done to reduce the impact on affected communities? This event is made possible by the generous support of the Bill & Melinda Gates Foundation. 

Dr. Yanzhong Huang, Council on Foreign Relations and Seton Hall University, argues in the CFR report Negotiating Global Health Security (co-authored with Georgetown Professor Rebecca Katz) that the US-China clash over Covid-19 origins in Wuhan has had a catastrophic impact on US-China relations. A "détente" is now needed. But how is that to be achieved, given the multiple ongoing geopolitical crises? Given what is happening in Congress vis-a-is China? And given that political will at the highest levels is the most significant missing element? “Avoidance” post-Covid has taken root there. Give a listen to hear the answers. 

On the occasion of National Influenza Vaccination Week, former Senate Majority Leader Thomas Daschle, chair of the Coalition to Stop Flu, joins us to discuss the Coalition’s mission and composition, its recent compelling report, ‘The 2022-2023 Influenza Season: Outcomes and Policy Recommendations,’ and the comprehensive legislation it has had a hand in crafting and advancing, The Influenza Act (S. 3219, H.R. 5846 – 118th Congress 2023-2024). Senator Daschle is alarmed by the decline in vaccination levels – a national security threat – combined with the spread of mis and disinformation and the urgent imperative to forge new communications capabilities to rebuild trust and confidence. Trusted messengers, new public-private partnerships, determined and collaborative leadership, additional resources, and hard work: these are essential elements for turning things around. Health equity must also be elevated as a top priority, with a special focus on the elderly, pregnant women, children, and racial and ethnic minor

In this episode recorded in advance of World AIDS Day 2023, Katherine speaks with Ambassador John Nkengasong, U.S. Global AIDS Coordinator and Senior Bureau Official with the Bureau of Global Health Security and Diplomacy at the U.S. Department of State. They discuss the current challenges around PEPFAR reauthorization; opportunities for enhanced U.S. diplomatic engagement to strengthen domestic and donor funding for global HIV programs; the critical role youth organizations can play in promoting equitable access to HIV prevention, diagnostics, and treatment; and why it is important to involve communities of people living with or at risk of HIV in policy development and program implementation. Check out the video here!

In this episode, Heidi Larson, Professor of Anthropology, Risk and Decision Science at the London School of Hygiene and Tropical Medicine, speaks with Katherine about the goals of the Global Listening Project, which is focused on “driving real understanding and positive action to better prepare society for times of crisis.” She shares information on the Project’s recent survey results regarding how people in more than 70 countries experienced the Covid-19 pandemic; how people perceive, trust, and adopt new technologies, such as digital apps or mRNA vaccines; and why people in some countries in sub-Saharan Africa seem to be more optimistic than people in other parts of the world about the potential of their health systems to respond to future outbreaks and health crises.

In this episode Merck’s Jenelle Krishnamoorthy, a member of the CSIS Bipartisan Alliance for Global Health Security, joins Katherine to discuss the growing challenge of antimicrobial resistance (AMR); the importance of incentivizing research and development of new amicrobials, even as there is pressure to use them in a limited way; plans for a United Nations High-Level Meeting on AMR in 2024; and opportunities to improve funding, governance, and international collaboration to meet the global threat of AMR in the years to come.

Dr. Dylan George, Director of the CDC Center for Forecasting and Outbreak Analytics (CFA), walks us through the CFA’s status, almost two years after its launch. Though still a startup, CFA has modeled multiple outbreaks, including Omicron, Mpox, and now the respiratory virus season (Covid, RSV, flu). Its clients? The White House and executive agencies, and increasingly, state, local and territorial officials. Its products? October 24, it issued its Respiratory Season Outlook. On November 8, CFA launches its $262 million/five year investment in a National Network for Outbreak Response and Disease Modelling, encompassing thirteen key university and private sector expert data partners across the country. Critical to CFA’s success will be building new communications capabilities to cut through noise and distrust and build trust and confidence.

Dr. Suerie Moon, Co-Director of the Global Health Center and Professor of Practice, International Relations and Political Science, walks us through the status of the pandemic accord negotiations (underway for two years), the recently released new draft, what lies ahead in the next round of deliberations, and how that diplomatic process relates to parallel negotiations underway over reform of the International Health Regulations (IHR). The draft treaty speaks to four core issue sets: One Health; access and benefits sharing (ABR); countermeasures (including intellectual property, R&D, technology transfer); and financing (including “common but differentiated responsibilities”). Today, there is “lots of space to bridge.” While the negotiations are not likely to cross the finish line in May 2024, that does not necessarily signal failure. “More time is needed.” A breakthrough in a few areas by May 2024 could sustain progress. The U.S. negotiating role remains “incredibly important.” Remarkably, in these polarized a

Len Rubenstein shares his trenchant, mixed reflections from a September visit to Ukraine, specifically the multiple burdens that the war imposes on Ukrainian society. Ukrainian morale and resolve remain strong, though gaps persist in medical rehabilitation services, including prostheses for soldiers who have lost limbs. 500 Ukrainian military medics and reportedly 20,000 Ukrainian civilians are currently held in Russian prisons, in violation of international law. Almost everyone points to the high level of mental health disorders. The war itself has changed: Russia has created the world’s largest mine fields.

Dr. Eric Goosby walks us through the Lancet Commission report on tuberculosis—which he chaired—that was issued immediately prior to the September 22 UN High Level Meeting on TB. The environment for progress remains very tough—shortfalls in political will, prioritization, finances, and investment by industry. But there are recent, promising gains in diagnostics and therapies. And a promising vaccine, M72, is now in advanced trials. That could be a breakthrough in the future. GSK, in partnership with Gates Foundation and Wellcome Trust, are investing $550m in fields trials across Africa and Southeast Asia. What was the significance of the High-Level Meeting? It generated a detailed agenda to which national governments should be held to account. Eric closes with personal reflections on the passing of Senator Dianne Feinstein.

Kate Dodson, UN Foundation and Nellie Bristol, CSIS Senior Associate, survey the outcomes of the UN General Assembly during the third week of September, with a special focus on SDGs and the health High Level Meetings (HLMs on pandemic preparedness and response, TB, Universal Health Coverage). Big cross-cutting themes emerged–gaps in finance, equity, health workforce, access, R&D, and intellectual property. Results were decidedly mixed: “process got in the way of ambition.” Overload carries a price, as do acute geopolitical tensions. Senior U.S. officials “showed up” at every point. President Biden spoke early about the SDGs–before Ukraine. What happened in New York may help nudge the negotiators in Geneva working on the pandemic accord. The results in New York may argue for greater precision in the 2024 High Level Meeting on Anti-Microbial Resistance (AMR). One resounding signal–members of the African Union were exceptional in their engagement. 

In this episode of The CommonHealth, we share the audio of a September 11 conversation among several different CSIS scholars on the question of whether the climate shocks of this summer were simply a continuation of underlying trends – an exclamation point – or a thunderclap signaling the arrival of a new moment. Hear from economist Stephanie Segal, climate scientist Joseph Majkut, water and food security expert Caitlin Welsh, and CommonHealth’s co-host, J. Stephen Morrison. 

Dr. Scott Dowell, the Bill & Melinda Gates Foundation, unpacks the foundation’s $2 billion in investments during the three-year acute phase of the pandemic. Some of the most impactful were in surveillance and modeling. The Seattle Flu Study, which predated the pandemic, was fortuitous in what it taught us. Bill Gates’ 2022 book, How to Prevent a Pandemic, introduced the concept of ‘the GERM team’ which has now evolved into the Global Health Emergency Corps, led by the World Health Organization. What are the GHEC’s component elements, and how will it be launched? The foundation continues to engage intensely with the Chinese: what is to be gained? What lessons have emerged from China’s experience? Current foundation R&D priorities include scaled diagnostics, early start of broad spectrum anti-virals, and vaccines in 100 days. On surveillance, priorities are sequencing and wastewater testing. End of the day, “I am optimistic.”

Dr. Celine Gounder walks us through what to expect as the fall respiratory virus season unfolds—the ‘tripledemic’ of Covid, flu, and RSV (respiratory syncytial virus). Promising new vaccines are becoming available amid confusion, disinformation, and burnout of the health workforce. Competent communications remain essential, though “most people do not believe the lies or the truth.” The elderly and the immunocompromised stand to gain the most from these vaccine opportunities. In the post-Covid moment, ‘hyperlocal’ leaders and the business sector matter enormously in shaping the response. 

In this episode of The CommonHealth, Andrew Schwartz engages Michaela Simoneau and co-host J. Stephen Morrison on their newly published analysis of the post-Covid moment, “The Worst is Over—Now What?” How do we define this moment we have entered, and what are the factors that lead inexorably towards pessimism? Inversely, what is the argument for a positive, sober realism? Optimism rests on pursuing five pathways for progress: rebuild trust, sustain bipartisan legislative achievements, operationalize new security doctrines, accelerate new technologies, and elevate U.S. health diplomacy.  

According to the recent report from the WHO/UNICEF Joint Monitoring Program for Water Supply, Sanitation and Hygiene, coverage of safely managed water and sanitation supplies has improved globally since 2000, but the world is not on track to meet the Sustainable Development Goal targets related to universal coverage. Placing a special emphasis on gender, the JMP report notes that inadequate access to water and sanitation, as well as hygiene services, affects men and women in significant, but different, ways. In this episode, Sera Young, Associate Professor of Anthropology and Global Health at Northwestern University and senior associate with the CSIS Food and Water Security Program, discusses the relationship between gender and water, sanitation and hygiene (WASH) and explains why it’s important to gather data, not just about men’s and women’s access to water and sanitation infrastructure but also about how individuals’ experience of water insecurity affects their physical and mental health. Armed with data a