The CommonHealth

Since January 2025, the United States has confirmed more than 3,000 cases of measles across multiple states - with South Carolina reporting nearly 1000 cases in just the first two months of 2026. The economic costs of these outbreaks pose a burden to local and state health agencies through hospitalizations, surveillance, and contact tracing, among other measures. Cases of pertussis are similarly high, with nearly 30,000 cases in 2025. Immunization coverage has stalled, and data indicate a rising trend of non-medical exemptions in states throughout the country. What is driving the resurgence of some vaccine-preventable diseases in the United States? Are we heading into a future of endemic measles, pertussis, and other disease outbreaks? How do the domestic outbreaks connect to global issues around immunization coverage and health security?  Listen to the recent CSIS Bipartisan Alliance for Global Health Security broadcast conversation with Katherine E. Bliss, Senior Fellow and Director, Immunizations and Health Systems Resilience, with the CSIS Global Health Policy Center and J. Stephen Morrison, Senior Vice President and Director, CSIS Global Health Policy Center, regarding the current outbreaks, the threats posed by sustained disease transmission, and opportunities for regional and international collaboration to prevent and respond to health security challenges.

Gilead Sciences, the Trump administration, and the Global Fund have joined in partnership to bring lenacapavir, the new twice-yearly injectable prevention tool against HIV/AIDS, to two million persons at-risk in ten African countries in three years. Emily Gibbons, Gilead Sciences, explains the back story—the determined work of the previous two and a half years to plan an effective launch that would have speed, support from communities, access to affordable volumes of the medicine, and implementation to deliver. She also speaks to the challenges ahead to see lenacapavir reach a meaningful scale to drive HIV infections down, especially among the most vulnerable populations.

This episode of The CommonHealth features a discussion of the recently published book, Deployed: A Physician on the Front Lines of Global Health, by Kevin M. De Cock.  In Deployed, De Cock details an insider’s perspective confronting infectious disease crises from the AIDS pandemic to Ebola to Covid-19. He explores the intersections between medicine, global public health, and epidemiology throughout decades of public health evolution across continents and crises. De Cock draws from his experiences in diverse settings to offer practical guidance to a new generation of health leaders. 

Andi L. Fristedt, former senior official at CDC, FDA and the Senate HELP Committee, heads up a newly established Washington, D.C. office of the Parkinson’s Foundation. The Foundation acts in close allegiance with Michael J. Fox and his foundation; advocates; scientific and policy leaders such as Professors Okun and Dorsey; and new voices such as Harvard Professor Sue Goldie. It supports research on the genetic underpinnings of Parkinson’s Disease: 13% of Americans have genetic variants that place them at considerable risk. The foundation focuses on therapies and improving the quality of care; education of the public; and strengthening prevention against environmental toxins. The Washington office’s mandate is to “connect the dots” between science with those in Congress and the administration able to be champions and shape policy. There is progress: “We just know a lot more. And how to tell our story.”  A paramount concern is the pesticide paraquat, which continues to be used widely in the United States, while outlawed in dozens of countries. Over 40 years of scientific research has made very clear the danger paraquat poses, especially to children. The EPA is currently revisiting paraquat, while many states spring into action.

Keith Poulsen, professor at the University of Wisconsin and director of the Wisconsin Veterinary Diagnostic Laboratory, provides an update on the status of highly pathogenic avian influenza (H5N1), as pertains to dairy cattle, poultry, wildlife—and humans. Are we making progress in biosecurity in the dairy industry? Dairy may be decades behind, but keep in mind: “Cows are like walking tanks.” Keeping boots and clothes clean is essential to contain viral spread. Vaccines are often not a viable solution, given trade, economics and political realities. What forces are most impacting the affordability of eggs, beef, and other items? Impacting access to rural workforces, especially migrants? What have been the implications of major recent disruptions at USDA, CDC and FDA?

Over the past year, outbreaks of measles, a highly transmissible virus, have affected thousands of unvaccinated people across Canada, Mexico and the United States. With more than 5,000 cases and sustained transmission during 2025, Canada lost its measles elimination status in October. And the United States and Mexico could lose elimination certification later this year. To what extent are current outbreaks driven by changing immunization practices or attitudes towards vaccination? How might losing measles elimination status impact health security in North America and beyond? What will it take to stop the current outbreaks and re-ignite progress towards global measles elimination? Listen to this broadcast from the CSIS Bipartisan Alliance for Global Health Security with Natasha Crowcroft, Vice President, Infectious Diseases and Vaccination Programs, Public Health Agency of Canada; William Moss, Professor and Executive Director of the International Vaccine Access Center (IVAC) at the Johns Hopkins University Bloomberg School of Public Health; and Daniel Salas, Executive Manager, Comprehensive Immunization Special Program, Pan American Health Organization (PAHO), regarding measles outbreaks and elimination in the North American context and the implications of sustained measles transmission for regional and global health security. Katherine E. Bliss, CSIS Senior Fellow and Director, Immunizations and Health Systems Resilience with the Global Health Policy Center, will moderate.

Jane Halton, chair of CEPI, the Coalition for Epidemic Preparedness Innovations, walks us through CEPI's evolution since its founding in early 2017, and the launch on February 14, at the Munich Security Conference, of CEPI 3.0, fitted to the current era of heightened threat of dangerous bioevents, scarcer resources, and a pivot to security partners, including NATO.

John-Arne Røttingen, CEO of Wellcome Trust, is a Norwegian leader whose expertise has a remarkable span, encompassing medicine, science, research, clinical trials, negotiations, diplomacy, philanthropy, financing of global health, and governance of international institutions. He shares with us his assessment of what prior factors, during and post-Covid, set the stage for the shocks of 2025; the implications borne by 2025’s sudden crises, and the essential, urgent changes in outlook and strategy unfolding in 2026. Give a listen to this timely and incisive conversation. 

Keith Humphreys, a leading expert on addiction psychiatry, based at Stanford University, unpacks his January article in Science examining the steep reduction in overdoses deaths—between May 2023 and the end of 2024—in the United States and Canada. It likely stemmed from a supply shock, linked to steps taken by China to disrupt the supply of fentanyl and precursor chemicals. Underneath, US-China diplomacy was essential. This story was lost during the 2024 US presidential election cycle. Subsequently, President Trump’s overt threats to China, including the imposition of a 20% tariff tied to fentanyl, changed the negotiating context. Some progress followed on October 30 when Presidents XI and Trump met on the margins of the APEC summit in South Korea.

Amb. (ret) Karl Hofmann is CEO of the recently launched Health X Partners (HXP), a parent company under which Population Services International (PSI) and the Elizabeth Glazer Pediatric AID Foundation (EGPAF) now operate. He explains his personal story—from a successful diplomatic path centered in Africa to a pivot and second career as President and CEO of PSI starting in 2007. And he explains the logic by which PSI and EGPAF agreed in 2024 to form HXP to achieve greater efficiencies and prepare prudently for the end of the 25-year era, begun around 2000, that has generated an “amazing chapter of human progress” in health but which, it had become increasingly obvious, would not last indefinitely. As the unforeseen tsunami of Trump 2.0 hit in early 2025, it was both fortuitous and doubly-risky for HXP, as it stood itself up. The new leadership at FSI and EGPAF suddenly had to come to terms with 50% reductions in staff, budgets, and programs, while consolidating and integrating audit, HR, and IT teams. Change had been expected, but it “turned out there was a lot more change” than anticipated. How to view 2026? Profound uncertainty. Yet there is also one clear message to NGO implementers: focus even more on cost effectiveness; and get much closer to needs on the ground, networked and connected to leverage scale and innovation.