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Over the past year, outbreaks of measles, a highly transmissible virus, have affected thousands of unvaccinated people across Canada, Mexico and the United States. With more than 5,000 cases and sustained transmission during 2025, Canada lost its measles elimination status in October. And the United States and Mexico could lose elimination certification later this year. To what extent are current outbreaks driven by changing immunization practices or attitudes towards vaccination? How might losing measles elimination status impact health security in North America and beyond? What will it take to stop the current outbreaks and re-ignite progress towards global measles elimination?
Listen to this broadcast from the CSIS Bipartisan Alliance for Global Health Security with Natasha Crowcroft, Vice President, Infectious Diseases and Vaccination Programs, Public Health Agency of Canada; William Moss, Professor and Executive Director of the International Vaccine Access Center (IVAC) at the Johns Hopkins University Bloomberg School of Public Health; and Daniel Salas, Executive Manager, Comprehensive Immunization Special Program, Pan American Health Organization (PAHO), regarding measles outbreaks and elimination in the North American context and the implications of sustained measles transmission for regional and global health security. Katherine E. Bliss, CSIS Senior Fellow and Director, Immunizations and Health Systems Resilience with the Global Health Policy Center, will moderate.
Jane Halton, chair of CEPI, the Coalition for Epidemic Preparedness Innovations, walks us through CEPI's evolution since its founding in early 2017, and the launch on February 14, at the Munich Security Conference, of CEPI 3.0, fitted to the current era of heightened threat of dangerous bioevents, scarcer resources, and a pivot to security partners, including NATO.
John-Arne Røttingen, CEO of Wellcome Trust, is a Norwegian leader whose expertise has a remarkable span, encompassing medicine, science, research, clinical trials, negotiations, diplomacy, philanthropy, financing of global health, and governance of international institutions. He shares with us his assessment of what prior factors, during and post-Covid, set the stage for the shocks of 2025; the implications borne by 2025’s sudden crises, and the essential, urgent changes in outlook and strategy unfolding in 2026. Give a listen to this timely and incisive conversation.
Keith Humphreys, a leading expert on addiction psychiatry, based at Stanford University, unpacks his January article in Science examining the steep reduction in overdoses deaths—between May 2023 and the end of 2024—in the United States and Canada. It likely stemmed from a supply shock, linked to steps taken by China to disrupt the supply of fentanyl and precursor chemicals. Underneath, US-China diplomacy was essential. This story was lost during the 2024 US presidential election cycle. Subsequently, President Trump’s overt threats to China, including the imposition of a 20% tariff tied to fentanyl, changed the negotiating context. Some progress followed on October 30 when Presidents XI and Trump met on the margins of the APEC summit in South Korea.
Amb. (ret) Karl Hofmann is CEO of the recently launched Health X Partners (HXP), a parent company under which Population Services International (PSI) and the Elizabeth Glazer Pediatric AID Foundation (EGPAF) now operate. He explains his personal story—from a successful diplomatic path centered in Africa to a pivot and second career as President and CEO of PSI starting in 2007. And he explains the logic by which PSI and EGPAF agreed in 2024 to form HXP to achieve greater efficiencies and prepare prudently for the end of the 25-year era, begun around 2000, that has generated an “amazing chapter of human progress” in health but which, it had become increasingly obvious, would not last indefinitely. As the unforeseen tsunami of Trump 2.0 hit in early 2025, it was both fortuitous and doubly-risky for HXP, as it stood itself up. The new leadership at FSI and EGPAF suddenly had to come to terms with 50% reductions in staff, budgets, and programs, while consolidating and integrating audit, HR, and IT teams. Change had been expected, but it “turned out there was a lot more change” than anticipated. How to view 2026? Profound uncertainty. Yet there is also one clear message to NGO implementers: focus even more on cost effectiveness; and get much closer to needs on the ground, networked and connected to leverage scale and innovation.
Dr. Chris Murray, IHME, co-chairs the Lancet Commission on 21st Century Global Threats to Health, which will launch its report in February at the Munich Security Conference. It is the “Commission of Commissions,” a novel, highly ambitious three-year effort to forecast what are to be the biggest, most costly problems by taking a broadened non-traditional view. It focuses on 16 factors plus hypertension, each forecast to exact over one billion life years over the next 75 years. These include the familiar big three – pandemics, climate, and conflicts – but includes other factors that rank surprisingly high: education, inequality and low economic growth, obesity, tobacco, and AMR. A wildcard such as malicious use of AI has to be taken into account. “We excluded meteors” and mirror life, the latter too early to include. The Commission calls for a rolling, annualized review, and for higher investment by governments in both promising innovative technological solutions and building better threat-ready health systems.
In the second episode of the Prevention Intention mini-series, Katherine speaks with Wafaa El-Sadr, University Professor in Epidemiology at Columbia University and the director of ICAP.
They discuss El-Sadr’s formative experience treating AIDS patients in New York City in the early 1980s, as the global HIV epidemic began to emerge; her decision to found ICAP in order to bring HIV treatments to patients worldwide; and ICAP’s contributions to HIV prevention research. They also cover the evolution of PEPFAR, the challenges and opportunities associated with current efforts to reform U.S. global health assistance, and El-Sadr’s emphasis on ensuring people and their communities are at the heart of all health research and service delivery endeavors.
In the first episode of the Prevention Intention mini-series, a series featuring conversations with leading female HIV clinical researchers, Katherine speaks with Linda-Gail Bekker, a medical doctor and director of the Desmond Tutu HIV Centre at the University of Cape Town.
They discuss Bekker's decision to focus her work on HIV as well as her involvement in the PURPOSE 1 clinical trials, which demonstrated the efficacy of long-acting pre-exposure prophylaxis (PrEP) among adolescent girls and young women in South Africa and Uganda. They also cover why it’s important to approach research as a highly collaborative endeavor that both contributes to scientific understanding and improves people’s lives.
Erika Elvander served her country as a federal career health diplomat for 27 years, including as the U.S. Health Attache in Beijing from the spring 2021 until the end of 2024. Her Asia passion ignited while a student in Hong Kong and traveler to Beijing in the late 1980s. And carried forward for the following decades. As Health Attache in Beijing during COVID, she witnessed China “digging in,” pursuing its 18 months of the fierce controls imposed under “static management.” "Achievements with China are incremental.” She was able to maintain dialogues with Chinese health officials, despite the fraught US-China relationship. Today, the COVID origins quagmire does persist and impede the U.S.-China relationship, six years after the advent of Covid. But “there has to be a path forward,” built on many opportunities in health.
Marian Wentworth, President & CEO, Management Sciences for Health (MSH), at age 13 started working in a local factory. Attended the famous Latin School in Chicago. Studied math at Harvard. Then joined Merck as it was "growing ferociously fast." Stayed 27 years, grew and led the vaccine business to $6 billion. Was the "quant jock." Spearheaded the launch of Gardasil, the HPV vaccine. Then pivoted to MSH. It was important "not having a pharmaceutical company on my business card." Now as she reflects on the stunning year of 2025, a series of radical pivots for MSH, is there space for MSH in the America First Global Health Strategy? Yes. Excited by the Accra Reset? Yes. Where does this leave MSH? "I believe this time is a crucible."
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