Take as Directed

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!