The CommonHealth

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.  

Joe Grogan, former senior official of the George W. Bush administration and the first Trump administration, operates an active consultancy, hosts a podcast, writes commentaries for USC Schaeffer Center, and is an active member of the CSIS Bipartisan Alliance for Global Health Security. Drug shortages remain a real problem, with the potential to scale and impose political costs. What to make of the Big Beautiful Bill? It might provoke a backlash. How to understand the rising vulnerability of the aging foundational programs—PEPFAR, Gavi, the Global Fund? And how to understand what happened during Covid-19? It was a “toxic brew.” We need to be “radically transparent.” 

Fabrizio Carboni, head of the ICRC delegation to the US and Canada, speaks to his vast experience in the wars of the past two decades, including the profound impact of 9/11 (2001) in integrating humanitarian action into battlefield strategies—including the targeting of humanitarian operations. Today, almost 25 years later, we are witnessing unrestrained violence, limitless war, and flagrant disregard for International Humanitarian Law. The emotional, psychological dimensions are poorly understood. Political leadership is essential whenever soldiers are asked to respect IHL. The most dangerous moment is when states argue that they are fighting a "survival war" that they believe is exceptional. Does the Trump administration honor IHL or seek a "realist" American First alternative? It is too early to reach a conclusion: "There is no rupture." It is also too early to know how deep cuts in US foreign assistance will impact ICRC and the broader global response to humanitarian crises. ICRC does remain a "soft target," increasingly exposed. It is striking how a single actor—the United States—can be so "steep" in changing its course. It shifts the ground towards deeper burden-sharing and inspires a debate on what the new architecture will be, with far less money. ICRC has just recently repatriated the remains of 6,000 persons killed in the Russian war against Ukraine. In Gaza there is no way for ICRC to avoid getting hit from all directions. 2,200 Gazans were recently shot or hit with shrapnel while approaching the Gaza Humanitarian Foundation food distributions. "Those numbers are unacceptable." 

In the thirteenth episode of The CommonHealth Live!, Katherine E. Bliss and J. Stephen Morrison discuss the outcomes of the June 25 Health and Prosperity through Immunization Global Summit, co-hosted in Brussels by Gavi, the Vaccine Alliance, the European Union and the Gates Foundation. During the Summit, Gavi aimed to secure pledges of $11.9 billion to save at least 8 million lives and protect at least 500 million children from vaccine preventable diseases between 2026 and 2030. While several countries maintained longstanding commitments to the Alliance, and new donors, including current and former implementing countries, stepped up to contribute, Gavi still faces a funding shortfall. U.S. Secretary of Health and Human Services Robert F. Kennedy, Jr.’s video statement expressing concern over Gavi’s approach to vaccine safety before stating that the United States would not renew its support raises questions about how the Alliance can close the funding gap to meet the ambitious goals set forth in the next phase of work.  The conversation highlights takeaways from the pledging session outcomes from the CDC’s Advisory Committee on Immunization Practices (ACIP) meeting the same day, and what recent events mean for the future of U.S. approaches to global immunization programs.