Dr. Celine Gounder walks us through what to expect as the fall respiratory virus season unfolds—the ‘tripledemic’ of Covid, flu, and RSV (respiratory syncytial virus). Promising new vaccines are becoming available amid confusion, disinformation, and burnout of the health workforce. Competent communications remain essential, though “most people do not believe the lies or the truth.” The elderly and the immunocompromised stand to gain the most from these vaccine opportunities. In the post-Covid moment, ‘hyperlocal’ leaders and the business sector matter enormously in shaping the response. 

In this episode of The CommonHealth, Andrew Schwartz engages Michaela Simoneau and co-host J. Stephen Morrison on their newly published analysis of the post-Covid moment, “The Worst is Over—Now What?” How do we define this moment we have entered, and what are the factors that lead inexorably towards pessimism? Inversely, what is the argument for a positive, sober realism? Optimism rests on pursuing five pathways for progress: rebuild trust, sustain bipartisan legislative achievements, operationalize new security doctrines, accelerate new technologies, and elevate U.S. health diplomacy. 

According to the recent report from the WHO/UNICEF Joint Monitoring Program for Water Supply, Sanitation and Hygiene, coverage of safely managed water and sanitation supplies has improved globally since 2000, but the world is not on track to meet the Sustainable Development Goal targets related to universal coverage. Placing a special emphasis on gender, the JMP report notes that inadequate access to water and sanitation, as well as hygiene services, affects men and women in significant, but different, ways. In this episode, Sera Young, Associate Professor of Anthropology and Global Health at Northwestern University and senior associate with the CSIS Food and Water Security Program, discusses the relationship between gender and water, sanitation and hygiene (WASH) and explains why it’s important to gather data, not just about men’s and women’s access to water and sanitation infrastructure but also about how individuals’ experience of water insecurity affects their physical and mental health. Armed with data about access and impacts, communities can raise awareness, demand policy change, and oversee improvements in the WASH sector.

In this episode, Anuradha Gupta, President of Global Immunizations at the Sabin Vaccine Institute, discusses key findings from the new World Health Organization-UNICEF Estimates of National Immunization Coverage (WUENIC). The latest report shows that countries are beginning to recover from decreases in coverage observed during the pandemic, although there is considerable regional and sub-national variation, and some low-income countries continue to show stalled progress. Gupta emphasizes the importance of examining community experiences to understand where greater effort needs to be made and stresses the need to build coalitions of civil society, patient advocacy groups, the private sector and governments to promote equitable access to, and uptake of, vaccines.

Gary Edson, Covid Collaborative, reflects on the President’s Emergency Plan for AIDS Relief (PEPFAR), now at its 20th anniversary. It originated with a Republican president, George W. Bush, who transformed development assistance. Bipartisanship was vital, and PEPFAR fulfilled moral and geostrategic goals. Now, PEPFAR reauthorization is in peril in the post-Dobbs era. What needs to happen to rescue things? In the toxic, polarized post-Covid era, how do we step over that noise and bring about a new conversation about topline goals to protect Americans on a bipartisan basis? Give a listen!

Sheryl Gay Stolberg, NYT national correspondent on health and politics, unpacks the post-Dobbs era: does it imperil or boost the right to contraception? Or both? Does it put the President’s Emergency Plan for AIDS Relief (PEPFAR) under new scrutiny? Calls to “take a fresh look” at PEPFAR may signal trouble. “Abortion politics is laying over all of our conversations” in this “super-partisan era.” In the post-Covid era, the reporting environment has loosened. Why is it that filling the US leadership gap in science and health is moving along so slowly? What should we make of RFK Jr’s arrival on the scene, a figure in the larger campaign to vilify Dr. Anthony Fauci? What can we expect in the coming battles over Medicare drug pricing following the Inflation Reduction Act? 

Dr. Mitch Wolfe, former CDC Chief Medical Officer, explains the genesis of CDC’s vision for six regional offices as a “long-term permanent overseas presence” that would expand coverage, deploy senior staff to develop regional strategies, and provide specialized technical expertise. Geopolitical security calculations predominate as CDC gets more involved in politics and policies. Proximity builds networks and knowledge. To succeed, the CDC regional offices will need strong leadership, an aggressive mandate with backing from Washington and Atlanta, and serious sustained funding. Mitch also opines on Rochelle Walensky’s legacy leading CDC and living in London these past months amid the UK’s acute economic and political travails. 

Helen Branswell, STAT, unpacks for us important complicated topics that can, frankly, be confusing. She explains why this is a big moment for Respiratory Syncytial Virus (RSV). She illuminates why GAVI is moving ahead with a hexavalent (6-in-1) vaccine that incorporates polio vaccines, and what that signals for the future of global polio control. In her recent profile of Mandy Cohen, the incoming CDC Director, Helen reflects on the changed understanding of what is required to lead CDC effectively. In the post-Covid period, how has health reporting changed?

Dan Diamond, Washington Post, reflects on big emerging themes. The administration’s scientific, biomedical, and public health leadership has emptied. What should we make of Mandy Cohen’s appointment to be the next Director of CDC? With the turnover, who will be the “quarterback” of government during the next crisis? Congressional panels are raising “uncomfortable” questions about Covid's origins. It is an “open question” what happens with the reauthorization of PEPFAR and the Pandemic All-Hazards Preparedness Act (PAHPA). The shift of opinion against NIH and CDC will leave “the brands damaged.” Presidential campaigns—Governor DeSantis’ attacks against “Faucism” and RFK Jr’s anti-vaxxer efforts— offer “nothing good for public health.” Attacks upon science and public health have far more energy than the defenders. “Easier to play offense than defense.”

Twenty years after President George W. Bush signed the U.S. Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003, establishing PEPFAR, David Kramer, the Executive Director of the George W. Bush Institute in Dallas, Texas, discusses the process of establishing the multi-billion dollar program at the Department of State; how ensuring equitable access to health care services for vulnerable and marginalized populations is important for national security; how investing in HIV services and partnering with countries to strengthen health care improves the relationships of the United States with countries overseas; and why it’s important that Congress reauthorize PEPFAR later this year.