The CommonHealth

Dr. Ashish Jha, the White House Covid Response Coordinator, speaks to the “great unwinding” of the $4.6 trillion pandemic wartime transformation of America into a temporary social democracy. As we rush to the exits, are we emerging stronger? We do see huge turnover of public health leadership across the country, a real loss. We also see that cities and states, the front lines, have “learned a ton” about Test to Treat, mass vaccination. Will we transition out of this “collective trauma” of anger and “amnesia?” How will this pandemic transform public health itself? The White House is to stand up a new office to lead pandemic preparedness, at a time when U.S. scientific and public health leadership is depleted. What can we realistically expect? As he prepares to exit, what has Dr. Jha learned in the past year?

Joe Grogan, former Assistant to the President and Director, White House Domestic Policy Council in the Trump Administration, shares his insights on several outstanding policy challenges. How has the Inflation Reduction Act (IRA) reshaped innovators’ investment patterns in new drugs, and what adjustments might improve outcomes? It will be difficult to keep the proposed Next Gen $5 billion for Covid vaccines and therapies at the top of the agenda on the Hill, in the absence of strong figures like Senators Burr and Kennedy. While the NIH budget needs to be re-prioritized, CDC needs “massive cultural change.” Progress on anti-microbial resistance and steering the Pandemic All-Hazards Preparedness Act to a successful re-authorization each rest ultimately on leadership.

“Not all U.S. states struggled equally.” Thomas Bollyky, CFR, led an ambitious, nuanced effort to break down Covid outcomes across 50 states and Washington DC, published in the Lancet in April. There is a striking four-fold difference between the best and worst performing U.S. states. Some of the best states, led by Republican and Democrat governors alike, rivalled the best performers in Europe. High-performing states provide a formula for success which may be helpful in the future. Pre-pandemic differences were decisive—poverty, education, and race. Partisanship and politics skewed results. “Trust plays an outsized role.” The current hardening of opinion today in America remains a cause for worry.

As World Immunization Week gets underway, Professor Heidi Larson, anthropologist, founder of the Vaccine Confidence Project, and co-founder of The Global Listening Project, discusses the importance of closing the gaps in routine immunization coverage that have widened during the Covid-19 pandemic; describes why trust in health care providers has declined as beliefs about health and scientific expertise have become more polarized; and explains that in order to reach people with information that can help them respond effectively to crises, whether pandemics, climate change, or other emergency situations, it's important to really listen to people's concerns and articulate practical solutions that directly respond to people's needs. 

Sachiko Imoto, SVP, Japan International Cooperation Agency (JICA), is the lead on JICA’s human development work. In our conversation, she illuminates several key dimensions of Japan’s policy. What health gains will the Japanese Presidency of the G7 in 2023 generate? Both the U.S. and Japanese governments are committed to supporting the Pandemic Fund, Universal Health Coverage/primary care, surveillance, and equity and access to new countermeasures. What are the areas where Japanese-U.S. cooperation in health security could most profitably deepen? What concrete benefits could result from this alignment? How does the U.S. decision to launch a regional CDC office in Tokyo fit within the evolving geopolitical environment in Asia? How to address the intersection of health and climate change, Misinformation, conspiracy, decline of trust, and, of course, China? Give it a listen!

Dan Jørgensen, Denmark’s Minister for International Development and Global Climate Change Policy, reflects on a busy week of spring meetings at the World Bank, the importance of considering gender equality in supporting climate adaptation programs, the growing challenge of antimicrobial resistance in the context of climate change, and the role the private sector can play in helping to advance climate mitigation and adaptation projects.

We sit down again with Victor Cha, Professor at Georgetown University and Senior Vice President at CSIS, for an update on what we know, suspect, and do not know about a North Korea still in extreme isolation from the rest of the world; the status of its Covid outbreak and response; the heightened risk of famine; and the burgeoning exchange of North Korean weapons and ammunition in return for Russian food and energy. A narrow reopening with China is underway, while the continued high pace of missile launches is unnerving much of the world and is crowding out humanitarian considerations. The international presence inside North Korea remains miniscule. How might this isolation be cracked? Give a listen. 

Professor Jennifer Nuzzo, Brown University SPH Pandemic Center, reflects on the recent March 28 hearing that the House Select Subcommittee on the Coronavirus Pandemic staged on school closures. The subject remains “a political football.” But “we now better understand the potential harms. We have not all suffered the same harms.” Progress possible? Not clear, given how toxic the politics has become. Need to “take down the heat.” “We need a national plan for schools’ recovery.”

Dr. Raquel Bono, a recently retired, highly accomplished 3-star Admiral as 2020 opened, unexpectedly found herself advising Washington State Governor Inslee at the very advent of the pandemic. What did she experience and learn over the next six and a half months? Subsequently she became the chief medical officer for Viking Cruises, as it reopened its operations. What did that reveal, in particular about its interactions with CDC? Her views on Congress rescinding the mandate for Covid vaccines among US servicemen and women?

Sheryl Gay Stolberg, the iconic health policy/politics reporter at the New York Times, helps us inaugurate The CommonHealth podcast, companion to the newly launched CSIS Bipartisan Alliance for Global Health Security. Her recent prodigious output delves deeply into the evolving – and thoroughly confusing – story of the swirling debate over Covid origin in China. The Biden administration will soon declassify what intelligence it has on the Wuhan Institute of Virology: what might that mean? Will it cast light on the Institute’s cooperation with the Chinese military? Is a legitimate civil debate possible in America? Will we ever get the evidence to reach serious conclusions? Yikes! Give it a listen.