The CommonHealth

Dr. Jeffrey Gold, President of the University of Nebraska system, testified recently before the House Committee on Veteran Affairs Health Subcommittee on plans to replace a 1950 VA hospital with a hospital on the university grounds, with projected savings of half a billion dollars. Since the Trump administration began two months ago, it has been “a day-by-day, week-by-week course adjustment,” featuring ongoing court deliberations, cuts to programs, and the rollout of tariffs, amid great uncertainty. Anxiety has risen due to the unusual speed of change, which has permitted little time to prepare. In the meantime, the decline in the price of corn and soy jeopardizes the economy. The university system and hospitals account for 8.5-9% of the state’s GDP, the highest level per capita in the country. They also depend on $700 million of extramurally funded research. For the past nine years, Dr. Gold has led the highly successful weekly cable broadcast, ‘Rural Health Matters’ on Monday nights on RFD TV. Its mandate is to create awareness among farmers and ranchers, reaching over 15 million households, of the most impactful health matters. 

Politico’s global health correspondent Carmen Paun offers her insights into the White House decision on March 13 to withdraw the nomination of David Weldon to be the next Director of CDC. CDC, while vulnerable, has not seemed to be a priority target of the Trump White House, though it is “not totally out of the woods” and is proceeding cautiously in Texas in response to the measles outbreak. There may be factors shaping the Trump White House decisionmaking that we do not yet see or understand. Carmen shares her reflections on how it is possible that USAID could be so swiftly annihilated. The foreign aid constituency is weak. “We are witnessing a whole new world.” “The initial reaction was paralysis and fear.” “We still do not know what will be left of USAID.” “New things arise from shocks and crises.” Carmen closes with the implications of the U.S. withdrawing from WHO. 

In a special crossover episode with CSIS's The Truth of the Matter, Andrew Schwartz and Steve discuss the recent measles outbreak and risks associated with it. The United States is experiencing the worst measles outbreak in 30 years and the highest rate of contraction in the past six years after nearly eradicating the disease. Cases have surged in communities with low immunization coverage, raising concerns about further transmission. Hospitals are reporting an increase in severe cases, particularly among young children and immunocompromised individuals. Experts urge immediate action, emphasizing that vaccination remains the most effective defense against the highly contagious virus. 

Dr. Elizabeth (Beth) Cameron, Professor, Brown University, and former senior official in global health security and biodefense at the White House and USAID, kindly shares her thoughts on the radical changes unfolding inside the U.S. government surrounding biothreats. Two internal factions within the Trump administration vie with one another. “It’s a bleak picture” in the accumulating damage to the federal workforce, programs, and the protective shield inside and outside our borders. Elon Musk alleges USAID is producing bioweapons, a patent lie. “It’s preposterous” and “dangerous.” More responsibilities will now fall to governors. What to make of the Trump administration’s recent $1B announcement on H5N1 to assist the poultry industry, and its decision to revisit the $590m contract with Moderna for a mRNA human vaccine for H5N1? We don’t know much on what is going to happen in Congress and DOD. And when emergency crises will strike next. Where to find hope? Our civil servants. 

Dr. Vanessa Kerry, founder of Seed Global Health, Associate Professor, Harvard School of Medicine, and since June 2023 the WHO Director-General’s Special Envoy on Climate Change and Health, joined The CommonHealth to unpack her recent article ‘Health is a Cornerstone of Global Security,’ published February 14 in Foreign Policy. In it, she argues the need to rethink health as the first line of defense, with a heavy emphasis on economics, equity, and migration. We need to broaden the definition of the health security agenda; introduce health metrics into any discussion of economic growth; see health as an investment with high returns—a growing sector of national economies, in job creation, markets, and a larger tax base; and focus on finance e.g. special drawing rights, social bonds, and swaps. At the same time we need to engage internationally through strong moral leadership and humane policies, and upgrade our communications in an apolitical, non-partisan way that people see, understand, and feel. It is imperative to create opportunity in America that starts with protecting people’s health and well-being, and to create a new pathway, built on humility, to pull us out of the current confusing moment of crisis surrounding foreign aid. 

In the eighth episode of the CommonHealth Live! series, J. Stephen Morrison sits down with Loyce Pace, Assistant Secretary for Global Affairs at the U.S. Department of Health and Human Services. Assistant Secretary Pace discusses the newly released HHS Global Strategy and its implications for U.S. climate and health policy. 

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.