Global Health Policy Center Monthly Newsletter: May 2018

Dear colleague,
 
Welcome to the May 2018 newsletter from the Global Health Policy Center (GHPC) at the Center for Strategic and International Studies (CSIS)! We invite you to catch up on our latest content.
 

Publications:

  • The Gathering Health Storm Inside North Korea: The health decay in North Korea is genuinely exceptional: in the dangers it poses, its unusual root causes, the astonishing contrast between North and South Korea, and the limited number and limited impact of key external organizations. After weeks of consultations with experts, I and my fellow co-authors published a brief commentary that examines the grim health realities North Koreans face, the immediate and longer term global health security threats that those grim realities pose, and the potential diplomatic steps that the U.S. and others can take. The one clear conclusion that emerges from North Korea’s clouded, confusing, and highly dangerous situation is that careful high-level advance planning should accelerate right away to address North Korea’s health insecurity through a coordinated international approach. I am thankful to the following co-authors that contributed to this piece and the preparation around it: Victor Cha, Senior Adviser and Korea Chair, CSIS; Rebecca Hersman, Director of the Project on Nuclear Issues and Senior Adviser in the International Security Program, CSIS; Kee B. Park, Paul Farmer Global Surgery Scholar, Harvard Medical School; Mark Dybul, Faculty Director, Center for Global Health and Quality at Georgetown University Medical School; Peggy Hamburg, Foreign Secretary, National Academy of Medicine; Ambassador Jimmy Kolker, Former Assistant Secretary for Global Affairs, U.S. Department of Health and Human Services; Nancy Lindborg, President and Chief Operating Officer, U.S. Institute of Peace; and Christine Wormuth, Director, Adrienne Arsht Center for Resilience, Atlantic Council.
  • Working Together to Protect All with Vaccines: In recognition of World Immunization Week (April 24-30), Katherine Bliss, GHPC Senior Associate, published a brief commentary that showcases the need for intensified engagement in vaccine delivery around the world. For example, Measles is resurgent in Europe, thanks to a combination of vaccine hesitancy, under-performing health systems, and problems reaching the most marginalized populations. In Brazil, where an ongoing outbreak of yellow fever could spill over into urban areas and threaten regional health security, the government is working to immunize the most vulnerable citizens, but the global stockpile of vaccine is currently insufficient. The spread of extensively drug-resistant typhoid in Pakistan has officials scrambling to distribute a new vaccine only recently pre-qualified by the WHO. Katherine recommends that U.S. policymakers work to enhance bilateral and multilateral action in support of global immunization initiatives, including through the upcoming G7 Summit, the G20 Leaders' Summit, and the December mid-term review of Gavi, the Vaccine Alliance.
 

CSIS Commission on Strengthening America's Health Security:

On April 17 in a private session on Capitol Hill, CSIS launched a new major initiative: a two-year Commission on Strengthening America’s Health Security, organized as a joint enterprise of the CSIS Global Health Policy Center and the CSIS International Security Program. The Commission is co-chaired by Kelly Ayotte and Julie Gerberding, and its 18 Commissioners are comprised of high-level opinion leaders who bridge security and health, drawn from Congress, past administrations, industry, foundations, NGOs, and universities. Congressional members serving as Commissioners are Sen. Patty Murray (D-WA), Sen. Todd Young (R-IN), Rep. Anna Eshoo (D-CA), and Rep. Tom Cole (R-OK). An expert advisory group of 7 subject matter experts also joined launch deliberations on April 17 and will help guide the Commission’s work.
 
The Commission will focus on five issue areas over the course of the following two years:
  1. Preventing and Responding to High Risk Disease Outbreaks: What epidemic disease threats are likely to emerge and spread in the years ahead? How to ensure continuity and forward progress?  What will be required in terms of funding, institutional changes, integration of domestic and international capacities, civilian and military?
  2. Winning the Fight Against Drug Resistance: How to ensure that new policymakers appreciate and address the threat posed by multiple forms of anti-microbial resistance, including: multidrug-resistant and extensively drug-resistant tuberculosis, artemisinin resistant malaria, and HIV drug resistance?
  3. Managing the Risks of Evolving Biotechnology: How are U.S. policy approaches to better address the rising concern that changes in science (e.g. gene editing and synthetic biology) are creating new vulnerabilities? How can the United States better promote strong security culture and practices without stifling research or innovation that serves the public good?
  4. Developing Effective Countermeasures: How can the United States develop and implement a viable resourcing strategy to incentivize innovation and development of next generation countermeasures? What steps can be taken to better strengthen public private partnership on countermeasures and resolve complex issues such as intellectual property rights?
  5. Protecting Health Security in the Face of Global Disorder: How is the U.S. to best address the grave, rising public health risks associated with excessive violence, lack of access, mass migration, destruction of health infrastructure in several chronic wars, and the erosion of international norms associated with health and humanitarian assistance?
We were greatly encouraged on April 17 by the strong turnout, the evident energy the Commissioners brought to the table, the extended investment of time by our Congressional Members, the positive response to the discussion paper we circulated beforehand, and the interest and excitement triggered by the compelling health security scenarios that enhanced our discussion. The commitment and influence of our four Congressional Members offers a special opportunity to shape discourse and build understanding of the health security agenda in Congress.
 
The Commissioners left us with the message to define a niche that is truly new and fresh.There is excitement over using the disordered world as a novel prism for illuminating many specific health security challenges. And all of the Commissioners exhibited a strong appetite for innovation in how we engage among ourselves and with others and how we present material: we will expect to rely a great deal on compelling real-time cases – e.g. North Korea – as well as simulations, films, podcasts, and new multi-media tools. Keep an eye out, as we will continue to roll out updates and content around this exciting new endeavor.

Events:

  • Global HIV/AIDS Financing Amidst Uncertainty: On April 18, the CSIS Global Health Policy Center and the Kaiser Family Foundation co-hosted a discussion on the current state of financing for the global HIV/AIDS pandemic. The event also served as the launch of the Institute for Health Metrics and Evaluation (IHME)’s Financing Global Health 2017 report and updated IHME interactive data visualization resources. Sara M. Allinder, GHPC Deputy Director and Senior Fellow, offered opening remarks. Christopher Murray, Director of IHME, presented the findings from IHME’s report in a keynote address. Following the keynote, I moderated a panel discussion that featured Jennifer Kates, Vice President and Director of Global Health and HIV Policy, Kaiser Family Foundation; Mark Dybul, Professor and Faculty Co-Director, Center for Global Health and Quality, Georgetown University Medical School; and Christopher Murray. Dr. Murray’s keynote presented the stark reality that the financial foundation for global HIV control is steadily eroding. Our panel discussion then focused around what needs to be done to ensure sustained, sufficient financial resources for HIV/AIDS.
  • An Advance Film Screening and Discussion: U.S. Leadership in Global Health and Health Security: On April 24, the CSIS Global Health Policy Center and Friends of the Global Fight Against AIDS, Tuberculosis and Malaria co-hosted a screening of the Foreign Policy Association’s Great Decisions Episode, “Global Health: Preventing Pandemic.” Chris Collins, President of Friends of the Global Fight, offered opening remarks and introduced the documentary. The film made a compelling case for how global health investments, in addition to saving millions of lives and stopping deadly infectious diseases, strengthens economies and protects the health security in the U.S. and around the world. Following the documentary, I moderated a panel highlighting the importance of U.S. leadership in global health investments and the challenges we face in a constantly changing global landscape. Panelists included: Ambassador Deborah Birx, U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy; Helene Gayle, President and CEO, The Chicago Community Trust; Amanda Glassman, Senior Fellow and COO, Center for Global Development; and Chris Collins.
  • New Barbarianism Screening at Swedish Embassy: On April 13, the Embassy of Sweden and the Embassy of the Netherlands co-hosted a screening of The New Barbarianism at the House of Sweden. After the film screening, I moderated a distinguished panel discussion which included General John Allen, President of the Brookings Institution; Alexandra Boivin, Head of U.S. and Canada Regional Delegation for ICRC; and Sarah Margon, Washington Director of Human Rights Watch. The discussion centered on the need for greater accountability for the perpetrators of the horrific attacks on health care facilities in Syria and Yemen, as well as the unique role of the U.S. government in increasing awareness of these atrocities.

Podcasts:

  • Vaccine Innovations to Improve Delivery: In recognition of World Immunization Week, Nellie Bristol, GHPC Senior Fellow, highlights an important but sometimes overshadowed aspect of vaccine coverage improvement—innovations designed to make vaccine delivery easier, especially in low-resource settings. This episode features Darin Zehrung, Global Program Leader for Devices and Tools at PATH, and Mark Papania, Measles Elimination Team Lead in the Global Immunization Division at the U.S. Centers for Disease Control and Prevention (CDC). Both men are involved in developing technologies, such as microarray patches, that offer alternatives to needle and syringe delivery methods. The patches and other new technologies make vaccines easier to administer and less burdensome on fragile cold chain systems in developing countries.
  • Pursuing a Vaccine for HIV: Despite substantial progress made in expanding access to HIV/AIDS treatment and prevention options, a vaccine for HIV—even an imperfect one—is likely needed to put a durable end to the pandemic. In this episode of Take as Directed, Sara hosts Dr. Mark Feinberg, President and CEO of the International AIDS Vaccine Initiative (IAVI), to discuss the landscape of HIV vaccine development and why Dr. Feinberg thinks a vaccine remains a necessary pursuit.
  • Christopher Murray and IHME Offer Financing Outlook for HIV and UHC: Christopher Murray, director of the Institute for Health Metrics and Evaluation (IHME), is a pioneer in the world of global burden of disease measurement. In April, IHME released their annual report on global health financing and two accompanying articles in The Lancet. In this episode, I host Chris to discuss the future of financing for the global HIV/AIDS pandemic and the efforts to move towards universal health coverage around the world.
  • The podcast series is available here and on iTunes. Please subscribe using the podcast app. 


Travel:

  • Uganda: In late April, Sara and Reid Hamel, Senior Fellow with the CSIS Global Food Security Project, traveled to Uganda to examine recent advances in nutrition-specific and nutrition-sensitive programming with the goal of educating the Trump Administration and Members of Congress about their importance. Nearly 70 percent of Ugandans live on less than $2.50 per day, and that has remained constant for the past 40 years.  Chronic malnutrition is persistent despite the country’s potential to be the breadbasket of eastern Africa. In Uganda, Sara and Reid met with U.S. government representatives and implementing partners, Ugandan government representatives, multilateral organization representatives, civil society, and other stakeholders in the capital Kampala and in field visits in the western region of the country. During their field visits, they saw how the HarvestPlus project supports the production, replication, and market growth of orange-fleshed sweet potatoes (high in Vitamin A) and teaches Ugandans how to turn them into flour for use in baking. They also observed a mothers health group in a remote village where women and adolescent girls learned about nutritious foods and how to cook them.  Lack of knowledge about healthy foods and how to prepare them was cited as a key challenge to addressing malnutrition in Uganda. A trip report will be published by early Fall.


Upcoming Events:

  • May 17: Pandemic Preparedness: Policy and Practice in the 21st Century: On May 17, from 3:00pm to 5:00pm ET, the CSIS Global Health Policy Center will host a symposium addressing how U.S. and international policies aim to reduce the risk of a 21st century equivalent of the Influenza pandemic of 1918. This event will examine how these policies translate into practice in high-risk countries through collaboration between human and animal health professionals and institutions. These discussions will take place on the eve of the opening of the Smithsonian’s National Museum of Natural History’s new exhibition, “Outbreak: Epidemics in a Connected World”. The event is part of the newly launched CSIS Commission on Strengthening America’s Health Security. The symposium will be immediately followed by a one-hour reception from 5:00pm to 6:00pm. You can register to attend the event or find the live webcast here.
  • June 21: The CSIS Global Health Policy Center will host a public event from 2:00pm to 5:00pm ET on June 21 to highlight lessons learned from the 5-year Saving Mothers, Giving Life (SMGL) initiative. The event will focus on the outcomes of SMGL programming and implications for similar partnerships moving forward. Expert panels will include representatives from the SMGL Leadership Council and high-level officials from key partner country governments—including Nigeria, Uganda, and Zambia. The formal invitation will be disseminated shortly.
Stay up to date on all of our events by visiting the Global Health Policy Center program page.

As always, I welcome your questions and comments.

Sincerely,
J. Stephen Morrison
Senior Vice President and Director, Global Health Policy Center
Center for Strategic and International Studies