Take as Directed

Hayley Severance, Deputy Vice President, Global Biological Policy and Programs, Nuclear Threat Initiative (NTI), walks us through the newly launched Africa Health Security Index (AHSI): its origin and purpose; its key African and other partners; what it reveals about significant progress in Africa since 2021 (surveillance, countermeasures) and what it reveals about glaring problems (biosafety/biosecurity, finance). The challenge now is to get the AHSI in front of senior African decision makers, and to engage with the Trump administration, among others, at this moment when the Bundibugyo Ebola outbreak is raging.

Aurélia Nguyen, Dep. CEO of CEPI (Coalition of Epidemic Preparedness Innovations) shares her unusual personal and career story, including working with Andrew Witty at GSK, and with Seth Berkley at GAVI during Ebola in West Africa 2014-2015 and later during the COVID-19 pandemic when she managed the COVAX facility. "It was incredibly difficult." CEPI's 3.0 strategy focuses on viral families; technologies and platforms; and networks to rapidly conduct clinical trials and begin manufacturing. CEPI swung rapidly into action with the advent of the Bundibugyo Ebola outbreak in Ituri, DRC. It struck a promising $50 million partnership with the Department of State in support of its work to accelerate development of four vaccine candidates. Clinical trials are beginning and will advance in the fall in the hot zone in eastern DRC. Mistrust and insecurity require intensive community engagement. Even with US and EU support, CEPI still strives to fill an estimated $130 million gap over the next 6-9 months. Her biggest worry? Cases have doubled in just 23 days. We are not yet able to gauge the true scale of the outbreak. 

Samaritan’s Purse (SP) has a well-established hospital and deep community ties in DRC's Ituri province. Vice President Ken Isaacs describes how SP pivoted during the unfolding Ebola outbreak, launching Ebola treatment centers. Humanitarian assistance reaches close to 200,000. Health workers have been very vulnerable to infection. "We have lost three." Expansion of international staff requires coping with the possibility of a 21-day isolation period before returning home. "What they need are Ebola fighters." Addressing malaria is essential. There is not yet a clear path to take care of international staff that get sick. If the U.S. facility in Kenya served a wide array of international Ebola fighters, that would be well received.

Jamie Bay Nishi, the dynamic CEO of the American Society of Tropical Medicine and Hygiene (ASTMH), is absorbed with the question: how do we navigate all the changes in government policy and programs and hold the global health community together? That includes philanthropies, universities, and companies. OMB’s proposed “Regulation for Federal Financial Assistance,” a 400-page document, would expand political oversight and weaken the authority of scientific advisory groups, changes that would alter the scientific research enterprise and create uncertainties. A 45-day period for comment is too little time to understand what is in the document and the ramifications if its proposed actions were enacted. It could further stigmatize collaboration with China. The June 3 White House Executive Order to reclassify the federal workforce will weaken career protections of GS-15 workers, leaving them open to firing at-will. CDC’s overseas country offices are to transition to a fee-for-service model, as part of the America First Global Health Strategy. This will not be sufficient to guarantee a sustainable work force, which requires a reliable surge capacity in CDC headquarters at Atlanta and stable expert in-country staff. It is incumbent upon Congress to change the funding scheme for CDC overseas experts and its surge capability.

Professor Rebecca Katz, Georgetown University, explains the Health Security Operations Center, the remarkable initiative she has spearheaded with others to enhance protection against dangerous outbreaks during the FIFA World Cup June 11-July 19 in the US, Mexico and Canada. She speaks to its genesis, mission, and coalition partners. Give it a listen!

On May 20, Professor Paul Spiegel presents in Geneva the report of the Lancet Commission on health, conflict and forced displacement, conducted in partnership with the Johns Hopkins Center for Humanitarian Health (CHH.) The U.S. rollout will take place June 2 at the JHU Washington Center, 555 PA Ave NW. Paul speaks in this podcast to the genesis and mandate of the Commission, and the innovative and comprehensive way it went about its work over the past two plus years. Most importantly, he presents in detail its compelling recommendations and how they are to be advanced: (i) Invert the Power: put communities in charge: (ii) End Impunity: attacks on civilians, health workers and hospitals must have consequences; (iii) Fix the Money: humanitarian financing must follow need – not politics: and (iv) Uphold Health for All: war does not suspend the right to health – it makes it more urgent. Give it a listen!

Priya Basu, head of the Pandemic Fund (est. 2022, based at the World Bank), reflects on the Fund's origin and evolution. "It exists to solve problems no one else was solving." Its $1.4 B invested over three years in pandemic preparedness and response has attracted seven times that much from partner governments and multilateral development banks. Finances remain fragile and voluntary. The hope is to grow threefold. The Fund, a Biden signature achievement, enjoys continued support from the Trump administration.

Gavi CEO Sania Nishtar sat down with Katherine E. Bliss, Director and Senior Fellow, Immunizations and Health Systems Resilience, to discuss the Alliance’s ambitious plan of work for the next five years; the ways in which Gavi is reforming to improve efficiencies, promote country ownership and self-sufficiency, overcome resource constraints and meet the geopolitical challenges of the current moment; and how Gavi and other multilateral organizations, including the Global Fund, the World Bank, and CEPI, can better partner with donors, co-financing governments, and the private sector to increase access to lifesaving services, prevent deadly outbreaks, and improve health outcomes for vulnerable populations in low- and lower-middle income countries.

In September 2025, the U.S. Department of State, Gilead Sciences, and the Global Fund to Fight AIDS, Tuberculosis and Malaria announced a novel partnership to procure and deliver lenacapavir—a groundbreaking twice-yearly injectable pre-exposure prophylaxis (PrEP) for HIV prevention—to up to two million people over next three years.  On Tuesday, April 14, the leadership of these three entities convened to discuss the partnership now that doses have begun to arrive in country and have been delivered. Katherine E. Bliss, Director of Immunizations and Health Systems Resilience and Senior Fellow with the CSIS Global Health Policy Center moderated the conversation with Jeremy P. Lewin, Senior Official for the Office of the Under Secretary for Foreign Assistance, Humanitarian Affairs, and Religious Freedom at the U.S. Department of State; Daniel O’Day, Chairman and CEO of Gilead Sciences; and Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria.  Together they examined how this deal fits into a renewed U.S. strategy for foreign assistance focused on big bets and advancing American innovations around the world, what challenges lie on the horizon as implementation unfolds, and what additional innovations may accelerate scaling this effort.

Dr. Eli Cahan explains how he evolved into both a neonatologist and an accomplished, intrepid journalist, inspired by the likes of Atul Gawande and shaped by experiences during the Covid-19 pandemic. It is a balancing act, rushing between fixed medical facilities and airplanes. “We get to bear witness.”  His stories have covered anti-microbial resistance (AMR) among war fighters. An upcoming piece will cover the weakening of prevention and control over polio and the possibility of the reemergence of polio in America. With each, a focus is shaping opinion in Congress. Polio has become a major biosecurity issue and does indeed command attention in Congress and within the administration. The Pitt is fearless in exposing the problems people experience with American health care. At the same time, most health communications are frayed–what to do?

Dr. Benjamin Park is Director of the CDC Division of Global Health Protection that protects Americans against dangerous outbreaks by strengthening partner countries’ capabilities to detect and respond. A personal and early professional epiphany was Benjamin’s role in leading the investigation in 2012 of a fungal meningitis outbreak that struck across America, killing dozens and gravely sickening almost 800. Subsequently—accelerating during Ebola and Covid-19—CDC’s Field Epidemiology Training Program (FETP) has been a powerful instrument in building capabilities of partner countries, through experts based for extended periods in CDC country offices. That has generated many dramatic stories—the core of the CDC outbreaks campaign—of success in ensuring that bad things do not happen. These are stories that many Americans do not know but deserve to know.

During this year’s Vaccination Week in the Americas, which runs from April 25 to May 2, countries across the hemisphere will celebrate the lives saved through immunization programs, carry out special campaigns to increase immunization coverage among vulnerable populations, and conduct educational activities to encourage vaccine uptake, combat misinformation and sustain political will for preventing transmission of costly and deadly infectious diseases, such as measles, pertussis, and diphtheria.  Please join the CSIS Bipartisan Alliance for Global Health Security for a broadcast conversation with Katherine E. Bliss, Senior Fellow and Director, Immunizations and Health Systems Resilience, with the CSIS Global Health Policy Center, Daniel Salas-Peraza, Executive Manager, Comprehensive Immunization Special Program, Pan American Health Organization (PAHO), Mario Melgar, a pediatric infectious disease physician and Chair of the Global National Immunization Technical Advisory Group (NITAG) Network, and Santiago Cornejo, Executive Manager, Regional Revolving Funds, PAHO, regarding the state of immunization programs in the Americas, what works in terms of closing gaps and expanding access to new vaccines, and the important roles played by schools, civil society organizations, and community groups in building and sustaining momentum for immunization programs.