Take as Directed

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 minorities. Much more work is needed to improve testing capacity and develop new antivirals for flu. 

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 and difficult geopolitical times, these dual talks have not yet been torn apart. The focus remains on health, with a newfound belief in equity as a guiding norm.

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.