The CommonHealth

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.

Michael Osterholm, on July 21, spoke with us on the Vaccine Integrity Project that he is spearheading in response to vaccine-related actions taken by the second Trump administration. “We are in totally unprecedented times.” He explores the VIP’s genesis and mission, its steering committee and partner medical associations, and the VIP’s forthcoming scientific brief on vaccines for RSV, flu and Covid, scheduled for release in early August. “Someone has to stand up and deal with the dis- and mis-information.” While the VIP is not a shadow of the Advisory Committee on Immunization Practices (ACIP), many actors who are witnessing the ACIP’s decline—insurers, medical societies, states and others—are now seeking reliable, alternative scientific data. If VIP comes under attack, will it be possible to mobilize strong bipartisan support? “This is not a fight between Mike Osterholm and Secretary Kennedy. It is about supporting the science. … All we are trying to do is save the vaccines that we know are so important.” It will be critical to manage carefully the risk that we are heading into a confusing, balkanization of the vaccine enterprise—and to restore the integrity of the ACIP.   

Beth Cameron, Senior Advisor and Professor of the Practice at the Brown University Pandemic Center and a Senior Adviser and non-resident fellow at CSIS, hosts this inspiring July 14 conversation with Richard Hatchett, the CEO of CEPI, the Coalition for Epidemic Preparedness Innovations. Richard first came to Washington DC in the aftermath of 9/11 to create the U.S. Medical Reserve Corps. There was no looking back. He served in several administrations as a leading expert in bio preparedness and left government to lead CEPI at its creation in 2017, its mission to support the accelerated development of vaccines and other countermeasures against future biothreats. With the Covid-19 pandemic, health security has become an enduring global concern, with now a fierce focus on access to new technology, and regional manufacturing capabilities. “You have to design your programs with your access goal in mind from the very beginning,”  Preparedness is “not a static achievement.” It is “a dynamic state of readiness” that evolves through practice – “train, train, train.”  CEPI’s signature big idea is the 100 Day Mission, in which vaccine designs and delivery platforms are ready to spring into action when new biothreats appear.  Cuts in finances and programs by the Trump administration and others will compromise disease surveillance, detection and containment measures, increasing the risks to Americans and beyond.  Cuts are also forcing reflection, the setting of priorities, and finding ways to finance and achieve better and more efficient outcomes. The remarkable speed in which a vaccine was introduced during the Marburg outbreak in Rwanda in September 2024 rested not on luck. It built on CEPI’s pre-existing partnerships with the Rwanda government and several other institutions, including WHO and key US agencies.  CEPI has invested since 2017 in over $1 billion in the US biotech sector, and has just concluded an agreement to work with DOD.