The Threshold

Foreign Policy
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Global health is facing a tipping point. Scientific advancements have changed how we respond to epidemics like HIV/AIDS, tuberculosis, and malaria – and the pipeline of breakthrough innovations has never been stronger. But funding is down and priorities are shifting. Will the science come to scale so these diseases can finally be ended? Or will they surge instead? On The Threshold, reporters from around the world cover this unfolding crisis from all sides—talking to scientists, politicians, civil society leaders, pharmaceutical executives, and others. The Threshold is a seven-part Foreign Policy podcast hosted by acclaimed broadcast journalist Henry Bonsu and made possible through funding in part from the Gates Foundation.

  1. Gates CEO Mark Suzman Is ‘Very Concerned’ About a Health Funding Deadline

    EPISODE 1

    Gates CEO Mark Suzman Is ‘Very Concerned’ About a Health Funding Deadline

    Welcome to the first episode of The Threshold, a Foreign Policy podcast about the fight to end infectious diseases around the world and the innovations that could get us there. Host Henry Bonsu speaks with Gates CEO Mark Suzman and WACI Health Executive Director Rosemary Mburu about why they’re both optimistic and concerned about the future of disease elimination. And there is a big deadline on their minds that directly impacts the state of global health—which is in a tough place.   More than two million people die every year from the world’s biggest infectious diseases: HIV/AIDS, malaria, and tuberculosis. TB alone claimed more than 1.25 million lives in 2023, overtaking COVID as the world’s deadliest infectious disease.  On the surface, the fight to end these epidemics is harder now than it’s ever been. Aid for global health dropped more than 20 percent this year, driven in large part by cuts to USAID and British government programs. But for the first time in decades, science is much closer to ending these diseases. Recent advances—including an HIV prevention shot, TB vaccine candidates, and innovative tools to end malaria—could significantly reduce their prevalence.  Over the next seven episodes, we’ll explore how new scientific breakthroughs are making a huge difference in the fight against epidemics like HIV/AIDS, tuberculosis, and malaria. But also, we’ll tackle how we can approach global health funding at this geopolitically fraught moment.  At a live panel discussion recorded at Foreign Policy’s Health Forum, Suzman and Mburu explain why they believe we could eliminate HIV, TB, and malaria within our lifetimes. Plus, they discuss why they think the Global Fund’s replenishment round in November is critical. The Threshold is made possible in part through funding from the Gates Foundation. (Photo credit: Jonathan Heisler) Guests and organizations: Gates CEO Mark Suzman WACI Health Executive Director Rosemary Mburu

    31 min
  2. From Aid to Growth

    EPISODE 2

    From Aid to Growth

    On today’s show, we are tackling what is possibly the biggest challenge facing global health right now: funding. Host Henry Bonsu speaks with Indonesia Minister of Health Budi Gunadi Sadikin about how he approaches multilateral organizations for financing, as well as his vision for Indonesia. Sadikin was also a longtime banker before going into government.  Then, Bonsu talks with Dr. Ngozi Erondu, the technical director of GLIDE, the Global Institute for Disease Elimination. Erondu participated in the first-ever Africa Health Sovereignty Summit this year in Accra, with African government officials and global health partners. They strategized about how to redefine Africa’s role in its own health future—including shifting from external donors towards self-reliance. Erondu explains why she is optimistic about this initiative.  The Threshold is made possible in part through funding from the Gates Foundation. Guests and organizations: Budi Gunadi Sadikin, Indonesia Minister of Health Dr. Ngozi Erondu, Technical Director of GLIDE, the Global Institute for Disease Elimination.

    38 min
  3. The Promise of PrEP for HIV

    EPISODE 3

    The Promise of PrEP for HIV

    What could end HIV and AIDS as a public health threat? While there is still no vaccine or cure, long-acting tools like Lenacapavir, the recently approved twice-yearly HIV prevention shot, could significantly reduce new infections. Many health experts believe this may get us toward the end of HIV as an epidemic.  On today’s show, reporter Leah Kahunde Ndung’u examines what the Lenacapavir rollout will mean for Uganda, which was one of two Lenacapavir trial countries in Africa. She speaks with the Uganda trial’s principal investigator Dr. Flavia Matovu Kiweewa and HEPS Uganda Executive Director Kenneth Mwehonge, among others.  Then, host Henry Bonsu interviews Dr. Wafaa El-Sadr, founder and director of ICAP at Columbia University, Executive Vice President overseeing Columbia Global, and MacArthur genius fellow. Prof. El-Sadr has overseen HIV treatment programs in more than 40 countries. She shares her innovative approach to service delivery.  The Threshold is made possible in part through funding from the Gates Foundation. Guests and organizations: Dr. Wafaa El-Sadr, Founder and Director of ⁠ICAP⁠ at Columbia University, Executive Vice President of Columbia Global Kenneth Mwehonge, Executive Director of ⁠⁠HEPS Uganda⁠⁠ Dr. Flavia Matovu Kiweewa, Director of Research for the Makerere University and Johns Hopkins Research Collaboration (MU-JHU)

    33 min
  4. Turning the Page on Tuberculosis

    EPISODE 4

    Turning the Page on Tuberculosis

    Tuberculosis claimed more than 1.25 million lives in 2023, overtaking COVID as the world’s deadliest infectious disease. For the last century, there has been a vaccine protecting children from TB. Now, there is hope for a new solution: a potential vaccine for adolescents and adults.  On this episode, reporter Elna Schütz visits an M72 TB vaccine trial site in Worcester, South Africa, one of the world’s TB epicenters. First, Elna speaks with participants about their experiences in the M72 trial and with TB more generally. She also interviews South Africa Tuberculosis Vaccine Initiative (SATVI) Director Mark Hatherill and Angelique Luabeya Kany-Kany, SATVI’s chief research officer. SATVI runs part of the M72 trial in Worcester.  Then, journalist Chhavi Sachdev interviews Soumya Swaminathan, principal advisor on tuberculosis for the health ministry of India and former WHO chief scientist, about what is needed to end TB as an epidemic. Dr. Swaminathan is also the head of the MS Swaminathan Research Foundation, a nonprofit advancing sustainable rural development and climate resilience.  The Threshold is made possible in part through funding from the Gates Foundation. Guests and organizations: Dr. Soumya Swaminathan, former WHO chief scientist and current principal advisor on TB for the health ministry of India. Prof. Mark Hatherill, University of Cape Town and Director of SATVI, the South Africa Tuberculosis Vaccine Initiative. Prof. Angelique Luabeya Kany-Kany, University of Cape Town and Chief Research Officer of SATVI, the South Africa Tuberculosis Vaccine Initiative.

    28 min
  5. Out-of-the-box Innovations Against Malaria

    EPISODE 5

    Out-of-the-box Innovations Against Malaria

    Malaria kills nearly six hundred thousand people every year, with 95 percent of deaths occurring in Africa. Most of them are children under five. While progress on curbing malaria has flattened in recent years, new scientific breakthroughs may bring the world closer than ever not only to controlling malaria outbreaks, but potentially also eradicating the disease.  In this episode, we focus on the best mosquito control strategies to eliminate malaria. Host Henry Bonsu interviews Dr. Fredros Okumu, professor at the University of Glasgow in Scotland and a scientist at Ifakara Health Institute in Tanzania. His research evaluates many of the latest tools to combat malaria, including next generation insecticide bed nets, indoor residual sprays (IRS), and spatial repellants, also known as spatial emanators.  Then, reporter Paul Adepoju talks to scientists from the UK- and Tanzania-based Transmission Zero project. They have developed genetically modified mosquitoes that could dramatically reduce the transmission of malaria. Paul Adepoju speaks with Dr. Dickson Wilson Lwetoijera, a leading entomologist also at the Ifakara Health Institute in Tanzania, as well as Dr. Nikolai Windbichler from Imperial College London, who leads the molecular genetics side of the Transmission Zero project. The Threshold is made possible in part through funding from the Gates Foundation. Guests and organizations: Dr. Fredros Okumu, professor at the University of Glasgow in Scotland and a scientist at Ifakara Health Institute in Tanzania Dr. Dickson Wilson Lwetoijera, entomologist at the Ifakara Health Institute in Tanzania Dr. Nikolai Windbichler, associate professor at Imperial College London

    37 min
  6. ‘The Threshold’ Live

    EPISODE 8 BONUS

    ‘The Threshold’ Live

    We hosted a live virtual podcast taping of The Threshold on World Neglected Tropical Disease Day. Host Henry Bonsu spoke with Sabena Solomon, GSK vice president and head of global health access, and Sam Macintosh, the END Fund’s vice president of global strategic partnerships, about pharmaceutical companies’ unique role in the fight to end NTDs. Since 2000, dozens of countries have eliminated at least one NTD. This is in part thanks to pharmaceutical industry partners, who have donated over 30 billion tablets and vials toward ending NTDs. During this special event, which was made possible through funding from the Gates Foundation, we explored what is needed in this current moment to keep the momentum towards ending neglected tropical diseases.  We also enjoyed hearing questions from you, our listeners! If you have other thoughts or ideas for future episodes, email us at podcasts@foreignpolicy.com  Guests and organizations:  Sabena Solomon, GSK vice president and head of global health access Sam Macintosh, END Fund vice president of global strategic partnerships

    58 min
See All Season 1 (9)

About

Global health is facing a tipping point. Scientific advancements have changed how we respond to epidemics like HIV/AIDS, tuberculosis, and malaria – and the pipeline of breakthrough innovations has never been stronger. But funding is down and priorities are shifting. Will the science come to scale so these diseases can finally be ended? Or will they surge instead? On The Threshold, reporters from around the world cover this unfolding crisis from all sides—talking to scientists, politicians, civil society leaders, pharmaceutical executives, and others. The Threshold is a seven-part Foreign Policy podcast hosted by acclaimed broadcast journalist Henry Bonsu and made possible through funding in part from the Gates Foundation.

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