The CommonHealth

Dr. Elizabeth (Betsy) Bradley, President of Vassar College, shares her thoughts on the fusillade of Executive Orders signed by President Trump directed at educational institutions, including the apparent special animus toward elite private institutions. In this moment of heightened scrutiny across multiple fronts, the first step is to circle back to core values and the return on investment, to communicate strategy better beyond campus to the broader community, including elected officials of all persuasions, and to spotlight jobs and financial and other vital contributions. The threat of a dramatic increase in taxes on endowments, as part of a Congressional reconciliation measure this spring, “would definitely deal a blow.” Anti-foreigner rhetoric is having a “chilling effect” on recruitment and retention of international students. “Ambidextrous leadership” is essential: be proactive, have the data you need, don’t overreact, and be ready to act quickly when needed. 

Apoorva Mandavilli, the award-winning New York Times science and global health reporter, is on the front lines of several fast-breaking stories. “We should be worried” about the President’s Emergency Plan for AIDS Relief (PEPFAR). It was “already on the chopping block” before the hugely disruptive Trump pause on national grants and contracts. Secretary Rubio did issue a waiver, but there has been no follow-up clarification. PEPFAR remains in peril. Many bad things happen rapidly when a sensitive, complex program of this scale is disrupted. “The virus comes roaring back.” Though Robert F. Kennedy Jr.’s confirmation hearing to be HHS Secretary appears inconclusive, Apoorva was “not expecting the level of fireworks.” RFK Jr. was “damned by his own history” of false statements on vaccines, which “haunted him.” U.S. withdrawal from WHO is bad news for Americans in several concrete ways that will harm U.S. national interests. She has brought to our attention that scientists believe we have entered a new, far more dangerous phase in the evolution of the H5N1 threat, while the U.S. response remains woeful. 

The renowned expert on vaccine confidence, Dr. Heidi Larson, London School of Hygiene and Tropical Medicine, explains why there has been a precipitous escalation in the past four years, especially among 18-24 year-olds, of vaccine skepticism and resistance. During Covid-19, “everybody got vaccinated,” everyone was exposed to the “digital swarm,” the “wildfire” on social media of mis- and dis-information regarding vaccines. Antivaccine groups amalgamated and rose in power. Public health officials were hesitant to compete on social media. Young parents were unhappy with public health sources of information and looked elsewhere. RFK Jr., his Children’s Health Defense, and the affiliated Informed Consent Action Network (ICAN), have had “massive, massive influence” as amplifiers of doubt and fear of vaccines. What to do? There is an urgent need to engage young leaders, increase public health communications budgets and change their practices and outlook, mobilize local communities, and create new communications partnerships. It requires a “huge effort.” 

Since the start of her tenure in July 2023, Dr. Mandy Cohen, Director of the U.S. Centers for Disease Control and Prevention (CDC), has pursued several reforms intended to make CDC a stronger, nimbler agency better able to protect Americans from domestic and global public health threats and rebuild trust. She is joined in conversation with former Senator Richard Burr, Co-Chair of the CSIS Bipartisan Alliance for Global Health Security and Principal Policy Advisor and Chair, Health Policy Strategic Consulting Practice, DLA Piper, and J. Stephen Morrison, CSIS Senior Vice President and Director, Global Health Policy Center. They discuss the agency’s achievements, what has worked and not worked, the core challenges that persist, and how to best position the agency to sustain progress in 2025.

In the tenth episode of the CommonHealth Live! series, Katherine E. Bliss will sit down with Stacy Aguilera-Peterson, Deputy Director for Research, U.S. Global Climate Change Research Program, White House Office of Science and Technology Policy, and Josh Glasser, Assistant Director for Combatting Antimicrobial Resistance & Integrated Health Innovation (One Health), White House Office of Science and Technology Policy. The discussion will focus on how the Biden administration has sought to define the relationship between climate change and health, the extent to which climate-related impacts on health can be seen as threats to national security, and opportunities for stakeholders in research, program implementation, service delivery, and the private sector to collaborate with U.S. government agencies and international partners on addressing global challenges at the intersection of climate change and health. This event is made possible by the generous support of the Wellcome Trust and GSK.​​​

In the ninth episode of the CommonHealth Live! series, J. Stephen Morrison will sit down with Rahul Gupta, Director of the White House Office of National Drug Control Policy. Dr. Gupta will discuss the surprising 15 percent decline in overdose deaths in 2024, 70 percent of which are caused by fentanyl overdose, and what factors are driving this change. He will discuss measures taken nationally on treatment access and internationally on interdiction and related measures to reduce the flow of fentanyl. What more needs to be done to sustain progress and save more American lives? 

Dan Diamond, the national health reporter at the Washington Post, reflects on the shock of both United Health executive Brian Thompson’s tragic murder and the subsequent tsunami of anger and glee on social media. We’ve entered “a staggering moment” that does not feel real, but nonetheless reveals the remarkable depth of discontent with the American health system, in particular insurers. “Everything feels grey to me.” This moment is grounded in the collapse of trust, including trust in the media. United Health, America’s fourth largest firm, and the most powerful firm in the health sector, inevitably attracts—and will continue to attract—tough scrutiny and enduring questions over why the U.S. health system is so dysfunctional. This week Robert F. Kennedy, Jr. ventures to the Senate, where many Senate members simply do not know what to make of him. He has issued so many different statements on so many topics at different times to different audiences. While RFK Jr.’s vaccine positions will get the greatest play and are likely to remain a red line for Democrats, his pivot to chronic disease prevention and healthy food has rallied many to his side. Perhaps DOGE will be a vehicle for introducing progressive and budget reform ideas into the Republican Party in a new way. Will there be progress in changing the seasonal clock in America, a lighter, perennial topic? Probably not. There “is not a real path forward.”

Sheryl Gay Stolberg, the NYT health correspondent, feels her decades of health and political reporting prepare her well for understanding this remarkable moment in American history. Anger and alienation against the health sector and science are surging, drawing both on historical roots and current dynamics. Robert F. Kennedy, Jr. nominated to be HHS Secretary, taps into a profound mistrust that he has indeed stoked, aided by the platform Covid gave him to mobilize “vaccine resisters.” RFK Jr’s nomination has several advantages, including his pivot to prevention, the root causes of chronic diseases, processed foods, and declining life expectancy. He has moved past the extremes (heroin addiction, sexual patterns, conspiracies) to claim redemption and resilience. He appeals to populist dissatisfaction with “regulatory capture” by big pharma and big food. Opposition can be loud. Mike Bloomberg has declared RFK Jr. “beyond dangerous, “medical malpractice on a mass scale.” Scott Gottlieb, AEI, has issued similarly scathing statements. Opposition can be muted. While there is “terror” among industry, public health, academic centers, opponents are cautious, out of fear of retaliation.Jay Bhattacharya, Stanford, nominated to lead NIH, and others critics of the Biden administration feel they were marginalized during Covid and treated unfairly. “I think it is important that we engage with people on their ideas.” 

How do we explain the peril that global health faces? Covid and the post-Covid backlash. The Biden years’ “status quo” approach. Less support in Europe. Excessive debt in Africa. The generational shift in Congress and aging of the flagship programs: “Time has passed.” “We never really dealt with PEPFAR’s treatment mortgage.” Dealing with the conservative critique of US global health funding Is essential to revitalize bipartisanship. 2025 could be rocky, should resources shrink. “We need to be creative, and realistic.” What should we make of the emerging Trump leadership team, most significantly, Senator Rubio, Elise Stefanik, RFK Jr., and Jay Bhattacharya?

In the seventh episode of the CommonHealth Live! series, Katherine E. Bliss will sit down with Dr. John Balbus, Director of the Office of Climate Change and Health Equity at the U.S. Department of Health and Human Services. Dr. Balbus will speak about the foundation of his office in 2021, the work it has engaged in so far, lessons learned, and his vision for the future. This event is made possible by the generous support of the Wellcome Trust and GSK​​​