Take as Directed is a series of the CSIS Global Health Policy Center. It highlights important news, events, issues, and perspectives in global health policy, particularly in infectious disease, health security, and maternal, newborn, and child health. This series brings you commentary and perspectives from some of the leading voices in global health.
Rep. Tom Cole (R-OK) -- Health Security in America
Rep. Tom Cole (R-OK), the senior House appropriator and a respected national leader on health security at home and abroad, has served on the CSIS Commission on Strengthening America’s Health Security since 2018. In this wide-ranging conversation, he reflects on the 100th anniversary of the Tulsa massacre of the Black Greenwood community; the “successful but mixed bag” of the rollout of vaccines in America; the impressive management by the Native American community of the vaccine challenges; and the continued need for bipartisan support of US health security leadership abroad. China’s behavior on the origin of the virus looks suspicious, like a “coverup.” Attacks on Dr. Tony Fauci are a “dangerous phenomenon.” Dr. Fauci was wrestling in his emails with an evolving crisis. To attack him is like going after American nuclear scientists in the 1950s. Support for CEPI is “money well spent,” the “most modest of insurance.”
Rep. Tom Cole (R-OK) is in his tenth term representing the 4th District of Oklahoma.
Krishna Udayakumar explains how he systematically assembled data to make sense of the fast-moving global marketplace in vaccines, amid the pandemic, building on prior trust with private and public entities, and positioning the Duke Global Health Innovation Center as the go-to source. Starting in late 2020, that meant painting the picture of worsening inequities that reflected the overwhelming power advantages of wealthy states and powerhouse vaccine developers, rhetorical commitments to solidarity notwithstanding. We are now rapidly approaching a pivot point, as supply escalates later this year: estimated western production of 7 billion doses in 2021, 14 billion in 2022. The big worry looking ahead? Lack of delivery capacity and financing in low and lower-middle-income countries, which may, as a result, become “mired” in 20-40% coverage. The G7 summit was a “mixed bag, ” leaving us “nowhere near the end of the story.” The big question 12-18 months out: will it be a western consortium that vaccinates most of the low and lower-middle-income countries? Or will it be the world’s vaccine “workhorse,” China? Or some combination?
Philip Zelikow, former executive director of the 9/11 Commission, has launched an ambitious fast-moving planning effort to scope what a commission on the pandemic in America would examine, how it would be organized, what value it would deliver, how it would navigate our treacherous political terrain, why it needs to move fast to nail down what happened. Listen in to learn more.
Philip Zelikow is an American attorney, diplomat, academic, and author. He is a professor of history at the University of Virginia.
The Next Phase of Covid-19
This week the CSIS Schieffer Series hosted a high-energy exchange on “The Next Phase Of Covid-19.” Steve and Andrew were joined by Jeremy Konyndyk, executive director of USAID’s Covid-19 Task Force, who delivered a stirring keynote address outlining USAID’s vision for addressing the burgeoning pandemic crisis while simultaneously investing in long-term health security preparedness in acutely vulnerable low-income countries. A roundtable followed on the historic legacy of US presidential leadership amid global health crises -- and the lessons for the escalating urgent demands unfolding in South Asia, Latin America, and elsewhere. Steve, Andrew, and Jeremy were joined by Julie Gerberding, co-chair of the CSIS Commission on Strengthening America’s Health Security and executive vice president and chief patient officer of Merck; and Gary Edson, president of the COVID Collaborative and former White House official under President George W. Bush who played a pivotal role in launching PEPFAR and the Millennium Challenge Corporation (MCC).
Dan Diamond “Heady Times”
Dan Diamond has covered health, politics, and the White House for the Washington Post since January 19. What is going on in the international side of the US response to the pandemic? It is “piecemeal,” unclear who is making decisions, lacks a strategy, the approach is “much vaguer” than the domestic response. The US has announced a number of important steps which are “staccato moments.” President Biden came into office with the country “on fire.” His team is still settling, and there is no single person in charge of the international response. The issues are a complex “thicket” full of geopolitical risks. Nonetheless, it feels as if a moment is arriving where the administration is going to pivot to the international arena. Internally, senior officials are “raring to go.” Domestically, Dan has observed closely the four focus groups of vaccine-hesitant people launched by Republican pollster Frank Luntz, one session was a “transformative experience,” another a “total dud.” Perhaps the Community Corps will be able to bring to scale hyperlocal engagement with those who remain hesitant. Perhaps they simply need more information and more time. It’s “heady times,” practicing this form of journalism in Washington. Hypercompetitive, everybody wants a piece of the story.
Dan Diamond is the National Health Reporter at the Washington Post
Dr. Monica Gandhi
Dr. Monica Gandhi has thought deeply about the complex transition we have entered, with many vaccinated, and many not. We need to behave differently in private versus public settings. Being polite and compassionate remain essential. Resistance to vaccines comes from different populations, each requiring a different approach: racial and ethnic minorities; youth; those who ask what will be the rewards for getting vaccinated; and the recalcitrant. There has to be far more “positive motivation,” a form of “proactive, vaccine optimism” based on a concrete blueprint for how our lives will improve through vaccines. CDC guidance during this transition, on travel and outdoor masks, has been confusing but will improve as more people are vaccinated. School closures in the United States have been excessive. “It is political.” We are “not looking at data cleanly.” Global vaccine inequity is the world’s biggest moral challenge: we need to do “whatever it takes” to expand manufacturing and access. The population living with HIV whom she serves in San Francisco suffers from extreme loneliness, “untold mental health effects.” Her advice: “Please go see a friend.”
Dr. Monica Gandhi is Professor of Medicine at the University of California San Francisco, Director of UCSF AIDS Research, and Medical Director of the HIV Clinic at San Francisco General Hospital (“Ward 86.”)
This is a highly informative podcast from the CSIS podcast.
Far left perspective is of no value given how wrong they have been on Covid19.
Coronavirus Crisis Update is the most informative and listenable podcast out there.