The CommonHealth

Dr. Debra Houry joined the podcast, following her resignation from CDC on August 25, upon the firing of CDC Director Susan Monarez, and shortly after her September 17 testimony before the Senate HELP Committee. What does she make of President Trump’s September 22 press conference on Tylenol, its alleged connection to autism, and the potential use of leucovorin? While serving as CDC’s senior most leader, how did she navigate the period from President Trump’s inauguration on January 20 until the arrival of Susan Monarez as the new CDC Director on July 31? How was the armed attack upon CDC on August 8 experienced? What are the downstream impacts? How did she plan and carry out her resignation in league with other CDC leaders? What did the September 17 Senate HELP Committee meeting accomplish? What is the state now of CDC? “I have grave concerns about what is coming out of that agency.” How to stabilize CDC? It needs permanent scientific leadership, a stable budget, more truth and oversight of advisory committees, better trust in CDC staff, and more voice by CDC staff and scientists in partnership with communities. 

The renowned global health leader, Peter Piot, LSHTM, opens this conversation with reflections on what drove the historic global health successes, including “a brilliant coalition” and U.S. bipartisan leadership grounded in statecraft and strategic thinking. That “twenty-five years of historical anomaly” has however now ended. In Europe, that shift has resulted from populism combined with intense migratory pressures, the costs of battling the threat of Russia, and the high costs of providing a social safety net for a rising elderly population. Global Health 2.0 will be built on health sovereignty in Africa, Latin America and Asia. The shock scarcities of the Covid pandemic had already awakened the need for greater self-reliance; the sudden and abrupt decline in donor funding for global health is the latest shock. We will see “sunset clauses” and “mergers and acquisitions” across many familiar international institutions. AI promises innovations in R&D and delivery, aided by philanthropies. Centers of excellence are now in place “everywhere.”  It is “no longer a one-way street.”

Listen to the recent CSIS Bipartisan Alliance for Health Security book launch of The Big One: How We Must Prepare for Future Deadly Pandemics. As bad as Covid-19 was, the next pandemic could be worse. While the world learns to live with Covid-19 and continues to recover from its worst effects, how do we prepare for the next pandemic lurking around the corner?   The event includes a panel moderated by CSIS Senior Vice President and Director J. Stephen Morrison, featuring co-authors Michael T. Osterholm, Director, Center for Infectious Disease Research and Policy (CIDRAP), University of Minnesota, and Mark Olshaker, Emmy Award-winning documentary filmmaker and New York Times #1 bestselling author.

Dr. Celine Gounder, Editor-at-Large, KFF Health News, explains how the U.S. vaccine enterprise could be damaged so swiftly by the Trump administration, with so little apparent resistance: it was a "shock and awe" blitz, while hesitation and fear dominated. "Silence was paralysis." It is too early to estimate the true scope of damage. The middle tier of professionals in government and scientific research has certainly paid a high price. While Secretary Kennedy's firing of CDC Director Monarez was a thunderclap, it remains to be seen if or when President Trump changes his view of the Secretary's performance. What lies ahead? Regional alliances of states setting policy on vaccines will be "the laboratories of public health." The Supreme Court may be called upon to revisit the balance between individual liberty versus public health. If pediatric hospitals are overrun with children suffering from dangerous vaccine-preventable illnesses, public outcry could escalate.  

In the fifteenth episode of the Common Health Live!, Katherine E. Bliss talks with Dr. Jarbas Barbosa, Director of the Pan American Health Organization (PAHO), about challenges related to health security in the Americas, the importance of regional cooperation in building resilient health systems and strengthening preparedness for future health emergencies, and opportunities for advancing efforts to improve the health of the region’s population through the upcoming UN High-Level Meeting on the Prevention and Control of Noncommunicable Diseases and the Promotion of Mental Health and the 10th Summit of the Americas, scheduled to take place in the Dominican Republic in December.  

Dr. Andriy Klepikov, the founder and executive director of the Alliance for Public Health (Ukraine), reflects on the Alliance's remarkable evolution over the past 25 years into a major Ukrainian—and regional—non-governmental force in HIV, TB, and harm reduction programs. Foundational to its early success was the exemplary partnership with the Global Fund and PEPFAR. Ukraine, in the midst of war, cannot at present soon transition to self-reliance. In the past three and a half years of war following the Russian invasion, the Alliance has become a provider of mass emergency humanitarian relief to the most vulnerable in Ukraine. It now serves five times the numbers it served before the war. Recovery will draw on telemedicine and mobile clinics, and prioritize mental health, war veterans who are blinded, have lost limbs, and struggle with long-term trauma. The United States remains indispensable to Ukraine's future—for peace and social justice.  

Dr. Heidi Larson, the acclaimed expert on vaccine confidence at the London School of Hygiene and Tropical Medicine – and CSIS Senior Associate – speaks to how the external world is reacting to the changes in the United States in vaccine policy, the scientific R&D biomedical enterprise, and public health. “What has shocked people is the abruptness of these measures with little consideration of the implications.” An abrupt drop in trust has followed. The United States has for decades been seen as the most stable and trusted collaborator, based in scientific evidence. People are now turning inward and to other countries. For those scientists whose U.S. grants have been disrupted, “You can’t turn your lab off for six months.” We are seeing the outmigration of US-based scientists to Europe and elsewhere. The multilevel siege of American universities is fundamentally a matter of values. It has raised the question of whether it will be possible to sustain transatlantic scientific partnerships. How to break out of a liberal bubble? Finding a common space is most critical. Sometimes you just have to keep your head down and keep moving forward …. keep our center.

In this episode of The CommonHealth Live!, Dr. Christopher J.L. Murray, Director of the Institute for Health Metrics and Evaluation (IHME) and Stephanie Psaki, CSIS Global Health Policy Center Senior Adviser, will discuss IHME’s new report on Financing Global Health, also released in a paper in The Lancet, and its implications for the way forward in a constrained financial environment. Who and which countries are those most affected by the sharp drop in development assistance for health between 2024 and 2025? How will recipient governments and other global stakeholders respond to fill the gaps? This event is made possible by the generous support of The Gates Foundation.

Dr. Ken Staley, Palantir, has served in health security positions in the George W. Bush and first Trump administrations, with time in-between in private sector biopharma. Palantir was founded after the 9/11 Commission to bring together data streams to enhance security and protect liberties. As director of the President’s Malaria Initiative in the Trump first term, Ken oversaw an effort to use data faster and in a more integrated way, to understand outbreaks, supply chains, and health impacts. He participated in the Lancet Commission as it looked forward on how to make malaria eradication a strategic end-goal. As Covid-19 coordinator at USAID during the 2020 Covid-19 outbreak, Ken shifted communications to the cloud to permit continuity of operations. Technology innovations in malaria control – vaccines and bacteria to disrupt mosquitoes – hold considerable promise. “We have a lot of cool stuff on the horizon.” In regard to WHO, the pandemic treaty, and reforms of the International Health Regulations (IHR), “missions are sacred, organizations are not.” On foreign aid, “the context has changed.”  

Dr. Ifedayo Adetifa is a pediatrician and tuberculosis expert who led the Nigerian Centre for Disease Control during the Covid-19 pandemic. A year ago, he became the CEO of FIND, the global alliance for diagnostics, a product development partnership based in Geneva. A major innovation gap was FIND’s initial focus – and remains a pressing priority. And over time, the access gap has become much more conspicuous and urgent. A 2021 Lancet Commission and recent update have proven highly valuable. The sudden decline in U.S. financing is having impact, directly and indirectly, upon FIND, but its diversification of funders has provided a cushion. FIND engages directly with over 100 US-based businesses. AI provides an opportunity for closing gaps in diagnosis, when combined with digital tools. However, there is a serious risk of low-income countries being left behind in the AI transformation. And a risk that diagnostics fall off the priority list.