The CommonHealth

Kate Dodson, UN Foundation and Nellie Bristol, CSIS Senior Associate, survey the outcomes of the UN General Assembly during the third week of September, with a special focus on SDGs and the health High Level Meetings (HLMs on pandemic preparedness and response, TB, Universal Health Coverage). Big cross-cutting themes emerged–gaps in finance, equity, health workforce, access, R&D, and intellectual property. Results were decidedly mixed: “process got in the way of ambition.” Overload carries a price, as do acute geopolitical tensions. Senior U.S. officials “showed up” at every point. President Biden spoke early about the SDGs–before Ukraine. What happened in New York may help nudge the negotiators in Geneva working on the pandemic accord. The results in New York may argue for greater precision in the 2024 High Level Meeting on Anti-Microbial Resistance (AMR). One resounding signal–members of the African Union were exceptional in their engagement. 

In this episode of The CommonHealth, we share the audio of a September 11 conversation among several different CSIS scholars on the question of whether the climate shocks of this summer were simply a continuation of underlying trends – an exclamation point – or a thunderclap signaling the arrival of a new moment. Hear from economist Stephanie Segal, climate scientist Joseph Majkut, water and food security expert Caitlin Welsh, and CommonHealth’s co-host, J. Stephen Morrison. 

Dr. Scott Dowell, the Bill & Melinda Gates Foundation, unpacks the foundation’s $2 billion in investments during the three-year acute phase of the pandemic. Some of the most impactful were in surveillance and modeling. The Seattle Flu Study, which predated the pandemic, was fortuitous in what it taught us. Bill Gates’ 2022 book, How to Prevent a Pandemic, introduced the concept of ‘the GERM team’ which has now evolved into the Global Health Emergency Corps, led by the World Health Organization. What are the GHEC’s component elements, and how will it be launched? The foundation continues to engage intensely with the Chinese: what is to be gained? What lessons have emerged from China’s experience? Current foundation R&D priorities include scaled diagnostics, early start of broad spectrum anti-virals, and vaccines in 100 days. On surveillance, priorities are sequencing and wastewater testing. End of the day, “I am optimistic.”

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.