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4 episodes with president's emergency plan
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3 episodes with president's emergency plan
2 episodes with president's emergency plan
3 episodes with president's emergency plan
Dr. Anthony S. Fauci is Distinguished University Professor in the Georgetown University School of Medicine's Department of Medicine, in the Division of Infectious Diseases ( https://medicine.georgetown.edu/divisions/infectiousdiseases/ ), an academic division that provides clinical care, conducts research and trains future physicians in infectious diseases. He also holds an additional appointment in the university's McCourt School of Public Policy. Dr. Fauci served as U.S. National Institute of Allergy and Infectious Diseases (NIAID) Director from 1984 to 2022. He oversaw an extensive research portfolio of basic and applied research to prevent, diagnose, and treat established infectious diseases such as HIV/AIDS, respiratory infections, diarrheal diseases, tuberculosis, and malaria as well as emerging diseases such as Ebola, Zika and COVID-19. He also led the NIAID research effort on transplantation and immune-related illnesses, including autoimmune disorders, asthma, and allergies ( https://www.niaid.nih.gov/about/anthony-s-fauci-md-bio ) . Dr. Fauci advised seven Presidents on HIV/AIDS and many other domestic and global health issues. He was one of the principal architects of the President's Emergency Plan for AIDS Relief (PEPFAR), a program that has saved more than 20 million lives throughout the developing world. Dr. Fauci was a key advisor to seven Presidents and their administrations on global HIV/AIDS issues, and on initiatives to bolster medical and public health preparedness against emerging infectious disease threats such as pandemic influenza and COVID-19. As an HIV/AIDS researcher he was involved in the scientific effort since AIDS was recognized in 1981, conducting pivotal studies that underpin the current understanding of the disease and efforts to develop therapies and tools of prevention. Dr. Fauci was the longtime chief of the Laboratory of Immunoregulation. He made many contributions to basic and clinical research on the pathogenesis and treatment of immune-mediated and infectious diseases. He helped pioneer the field of human immunoregulation by making important basic scientific observations that underpin the current understanding of the regulation of the human immune response. In addition, Dr. Fauci is widely recognized for delineating the precise ways that immunosuppressive agents modulate the human immune response. He developed effective therapies for formerly fatal inflammatory and immune-mediated diseases such as polyarteritis nodosa, granulomatosis with polyangiitis (formerly Wegener's granulomatosis), and lymphomatoid granulomatosis. Dr. Fauci made seminal contributions to the understanding of how HIV destroys the body's defenses leading to its susceptibility to deadly infections. Further, he was instrumental in developing treatments that enable people with HIV to live long and active lives. In a 2022 analysis of Google Scholar citations, Dr. Fauci ranked as the 44th most-cited living researcher. According to the Web of Science, Dr. Fauci ranked 9th out of 3.3 million authors in the field of immunology by total citation count between 1980 and April 2022. During the same period, he ranked 22th out of 3.3 million authors in the field of research & experimental medicine, and 715th out of 1.4 million authors in the field of general & internal medicine. Dr. Fauci has delivered major lectures all over the world and is the recipient of numerous prestigious awards, including the Presidential Medal of Freedom (the highest honor given to a civilian by the President of the United States), the National Medal of Science, the George M. Kober Medal of the Association of American Physicians, the Mary Woodard Lasker Award for Public Service, the Albany Medical Center Prize in Medicine and Biomedical Research, the Robert Koch Gold Medal, the Prince Mahidol Award, and the Canada Gairdner Global Health Award. Support the show
Today, panelists, Ashley Frost and James Maloney, Deputy Directors, Office of HIV/AIDS USAID, discussed USAID's localization initiative, locally-led development, and the importance of diversified local partners. They discuss USAID's Global Health work, how USAID supported PEPFAR and the successes it has enjoyed, including statistics of lives saved and changed. James Maloney and Ashley Frost share the new PEPFAR five-year strategy, the USAID Approach to HIV and Optimized Programming (AHOP). AHOP is a framework for USAID to employ assets through efficient, measured, and simplified programmatic approaches to ensure resilient and country-led approaches to the HIV response. The AHOP defines five critical pathways through which USAID will assist countries in sustaining epidemic control and accelerating progress in those that have not yet achieved the 95-95-95 goals. Each pathway outlines planned results and time-bound milestones. If this resonates with you, share successes with Congress to fund the five-year reauthorization of PEPFAR. IN THIS EPISODE: [00:32] Mike Shanley outlines key talking points regarding the accomplishments that PEPFAR has achieved over the last 20 years, delivering unprecedented impact in the global fight against HIV AIDS. [02:57] Ashley Frost and James Maloney describe their roles at USAID as Deputy Directors. [04:40] Discussion where funding originates, the investments they make at the primary healthcare level, and successes they have accomplished through PEPFAR, stating that USAID is the largest donor and they are advancing work in the HIV vaccine space. [11:00] James shares statistics of the impact made in the world attributed to PEPFAR and reflects on the history of growth and prevention. [14:50] Discussion of localization, local entities and partners and relationships within country-led staff and senior diplomats in their countries. [20:06] Looking forward to goals and objectives, James discusses the AHOP framework in response to HIV. [25:24] Ashley comments on the importance of keeping an open dialogue between all partners within the HIV AIDS space, and James outlines the importance of seeing the 5-year reauthorization of PEPFAR. KEY TAKEAWAYS: Oftentimes, hospitals and building new infrastructure is what gets a “ribbon cutting”, but in terms of buying the best health outcome with USAID's investments from U.S. taxpayers, the first area of importance is investments made at a primary care level, which will most impact healthcare outcomes, saving lives and supporting healthy lives. The second thing that drives a lot of USAID's investments across individual disease or health areas is health security. Much of PEPFAR's success lies in engaging with local partners. With regard to localization, the Office of HIV AIDS and the Global Health Bureau have been the front runners in the agency and have been able to guide our agency in these spaces. Right now, about 58 percent of our resources are implemented through local entities, and those sets of partners have been diversified. Small business engagement in the U.S. is essential and has much to offer to the work we can accomplish together. More significant international partners have specific skill sets that are necessary for USAID. As we think about localization, everyone needs to think outside the box and remember that one size does not fit all. By the end of 2025, the vision is to help countries reach what the USAID calls the global commitment of 95-95-95 goals. That means that 95 percent of those who have HIV know their status. 95 percent of those individuals are on treatment, and 95 percent of those individuals would be virally suppressed. The AHOP defines five critical pathways through which USAID will assist countries in attaining these goals. RESOURCES: Aid Market Podcast Aid Market Podcast YouTube Mike Shanley - LinkedIn James Maloney - LinkedIn USAID Approach to HIV and Optimized Programming BIOGRAPHIES: James Maloney has served as the Deputy Director for the Office of HIV/AIDS (OHA) within the Global Health Bureau at the United States Agency for International Development (USAID) since March 2020. OHA provides overall programmatic guidance for USAID's implementation of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and oversight of $4 billion in 53 countries. In March 2022, following Russia's invasion of Ukraine, James was asked to support the National Security Council Global Health Development Directorate and serve as the Coordinator for the Ukraine and Regional Health working group. In October 2022, James was designated as the Senior Operations Official for the Global Mpox Response Team and has led coordination of the United States' global response to mpox. Previously, James led the Supply Chain for Health Division at USAID overseeing over $700 million per year in HIV commodity procurement and supply chain management to advance HIV epidemic control and strengthen the capacity of countries to manage health supply chains. Prior to joining USAID Washington, James served as Senior Technical Advisor from 2015 to 2018 with USAID Haiti managing primary health care and supply chain programs to improve the availability, quality and utilization of health services in the areas of maternal and child health, HIV and TB, reproductive health, nutrition, and WASH. Prior to Haiti, James worked in South Africa from January 2010 with the Department of State and served as the Country Coordinator for PEPFAR and lead the U.S. Government's interagency response to HIV/AIDS in South Africa. Ashley Frost joined the Office of HIV/AIDS (OHA) as Deputy Director in August 2023. As a Foreign Service Officer, she most recently served as Health Office Director for USAID/Southern Africa. Over the last decade, she has served as Deputy Director for Operations, Care and Treatment Lead, and Strategic Information (SI) Lead, supporting USAID's PEPFAR programming in South Africa, Zambia, and Guatemala/Central America. Ashley holds a Ph.D. in Sociology and Demography from Penn State University, and her academic work includes quantitative and qualitative research in HIV, reproductive health, and gender. Before joining USAID in 2011, she worked with Congressional staff members, international researchers, policymakers, and program managers to improve evidence-based decisions for public health outcomes. She served as an education Peace Corps Volunteer in Benin, West Africa. Fun Facts: Ashley has three sons (ages 12, 9, and 9), and they do many sports as a family! They spend their free time jogging, biking, hiking, and attending many soccer games. Ashley and her husband, Jason, are section hiking the Appalachian trail each year and have walked through Georgia, North Carolina, and Tennessee together. Degrees: MA, PhD in Sociology and Demography, Languages: English, Spanish, French (comprehension)
NASA's JPL says Voyager 1 is having trouble with its flight data system. US Subcommittee on Space and Science hears from federal witnesses about mission authorization for all new commercial space activities. D-Orbit has signed two launch service contracts with South Korean space startup TelePIX, and more. Remember to leave us a 5-star rating and review in your favorite podcast app. Miss an episode? Sign-up for our weekly intelligence roundup, Signals and Space, and you'll never miss a beat. And be sure to follow T-Minus on LinkedIn and Instagram. T-Minus Guest Our guest today is African Space Policy Analyst, Ruvimbo Samanga. You can connect with Ruvimbo on LinkedIn. Selected Reading Engineers Working to Resolve Issue With Voyager 1 Computer – The Sun Spot Government Promotion of Safety and Innovation in the New Space Economy - U.S. Se… NASA's Space Station Laser Comm Terminal Achieves First Link Amazon to connect Kuiper satellites with laser links to boost space internet network Air New Zealand partners with Starlink for onboard wifi - Airport Technology D-Orbit and TelePIX Announce Contracts for the in-orbit testing of Tetraplex Tomorrow.io and TomorrowNow Supports the President's Emergency Plan for Adaptation and Resilience in Africa China's Space Program in 2023: Taking Stock – The Diplomat Blue Origin sure seems confident it will launch New Glenn in 2024- Ars Technica Pathfinder Launch Lessons Learned report- GOV.UK Massive 'lighthouses' on the moon could light the way for future lunar astronauts- Space T-Minus Crew Survey We want to hear from you! Please complete our 4 question survey. It'll help us get better and deliver you the most mission-critical space intel every day. Want to hear your company in the show? You too can reach the most influential leaders and operators in the industry. Here's our media kit. Contact us at space@n2k.com to request more info. Want to join us for an interview? Please send your pitch to space-editor@n2k.com and include your name, affiliation, and topic proposal. T-Minus is a production of N2K Networks, your source for strategic workforce intelligence. © 2023 N2K Networks, Inc. Learn more about your ad choices. Visit megaphone.fm/adchoices
Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: PEPFAR, one of the most life-saving global health programs, is at risk, published by salonium on December 10, 2023 on The Effective Altruism Forum. Summary: International funding and coordination to tackle HIV/AIDS and support health systems in lower- and middle-income countries, is at risk of not being renewed by US Congress, due to demands that it should be linked to new abortion-related restrictions in recipient countries. This program is estimated to have saved over 20 million lives since it was launched by the Bush Administration in 2003, and even now averts over a million HIV/AIDS deaths annually. Since it has also helped support health systems in LMICs, and tackle malaria and tuberculosis, its impact is likely greater than this. In my view this is the most important risk to global health we face today, and I think it isn't getting enough attention. If anyone is interested in research, writing or advocacy on this issue, please do so. If you are interested in jointly working on this, or if you already know of ongoing efforts, please comment below or get in touch. My email: saloni@ourworldindata.org Relevant background reading: The U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the largest commitment in history by any single country to address a disease, is estimated to have averted 25 million deaths from AIDS and enabled 5.5 million babies to be born free from HIV infection over the past 20 years.1 It has provided more than $100 billion in funding for HIV prevention, care, and treatment internationally, supporting 55 low- and middle-income countries that are collectively home to 78% of all people living with HIV. Together with the Global Fund to Fight AIDS, Tuberculosis, and Malaria, PEPFAR has transformed AIDS in low-income countries, especially those in Africa, from a death sentence to a readily treatable chronic disease by deploying programs that provide antiretroviral treatment even in the most remote villages. Right from the start, PEPFAR was more than just an AIDS program; it partnered with countries in Africa to support the development of health systems for essential community services, trained thousands of health care workers, fostered security and stability in affected countries, and engendered hope amid a devastating global AIDS crisis. Karim et al. (2023) Why is it at risk? Republican colleagues [...] accuse the Biden administration of using PEPFAR to fund abortion providers overseas and House Democrats who refuse to reinstate Trump administration rules that prohibited foreign aid going to groups that provide or counsel on abortions. Discussions about a compromise that would extend the program for more than one year but less than five, with language stressing the existing ban on federal money directly paying for abortions, have collapsed. Now, the best hope for re-upping the $7 billion annual program is a government spending process beset by delays and divisions and slated to drag into January and February with no guarantee of success. PEPFAR can hobble along without reauthorization unless there's a prolonged government shutdown. But its backers say that without a long-term U.S. commitment, groups fighting HIV and AIDS around the world will struggle to hire staff and launch long-term projects. Complicating any hope for compromise is the 2024 election. Congress passed two short-term funding patches that expire in January and February. That eliminated the possibility of the typical end-of-year omnibus bill that many on both sides of the PEPFAR fight saw as the best vehicle for its reauthorization and kicked the fight into an election year when compromise - particularly on a contentious issue like abortion - will be more challenging. Politico [7 Dec. 2023] The lawmakers stalling the reauthorization are seeking to impose on PEPFAR a prohibition...
Jasmin and Reese discuss congestion pricing for those driving into Manhattan, the President's Emergency Plan for AIDS Relief (PEPFAR) being in danger, the Russian Supreme Court bans LGBTQ+ "movement", and a court win for minimum wages for NYC delivery workers.
PEPFAR, or the President's Emergency Plan for AIDS Relief, was initiated by President Bush in 2003 is credited with saving 25 million lives over the past 20 years and remains the largest commitment to a single disease in history. But the global bipartisan program is now at the mercy of American politics. Dr. Chris Beyrer, director of the Duke Global Health Institute and a member of the scientific advisory board for PEPFAR, returns to the podcast to talk with Stephanie Desmon about why PEPFAR's reauthorization is in jeopardy and what the failure of reauthorization could mean for global health.
The federally funded President's Emergency Plan for AIDS Relief provides HIV prevention, treatment and education around the world. The program has seen broad bipartisan support on Capitol Hill for years, but now, a battle led by a small group of House Republicans is putting its future at risk. John Yang speaks with Jennifer Kates, director of global health and HIV policy at KFF, to learn more. PBS NewsHour is supported by - https://www.pbs.org/newshour/about/funders
The federally funded President's Emergency Plan for AIDS Relief provides HIV prevention, treatment and education around the world. The program has seen broad bipartisan support on Capitol Hill for years, but now, a battle led by a small group of House Republicans is putting its future at risk. John Yang speaks with Jennifer Kates, director of global health and HIV policy at KFF, to learn more. PBS NewsHour is supported by - https://www.pbs.org/newshour/about/funders
In this special episode, we're in conversation with Tom Hart, President of the ONE Campaign and former Director of The Episcopal Church's Office of Government Relations. We discuss the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the role of the faith community in the success of this program, and the urgent need for reauthorization. He will share his insights on the program and share his perspective on what steps must be taken to ensure that progress is not erased. About PEPFAR: In 2003, President George W. Bush launched PEPFAR, elevating the prevention and treatment of HIV/AIDS as a foreign policy priority. The faith community was instrumental in the development of this program, and we have continued to play a critical role in its success. PEPFAR has saved more than 25 million lives and fundamentally changed the course of the global HIV/AIDS pandemic. PEPFAR's authorization expired on September 30, and reauthorization is needed. Tom Hart is President of the ONE Campaign. Tom has been with ONE since 2003 and most recently served as acting CEO while Gayle Smith was on leave at the U.S. State Department. Tom has years of experience in driving the fight to end extreme poverty, a deep knowledge of and experience in making change happen, and an undying commitment to ONE's mission. Prior to serving as acting CEO, Tom was the North American executive director, where he oversaw ONE's advocacy in the United States and Canada, as well as ONE's global campaign against the COVID-19 pandemic. Tom has been part of the adoption of significant initiatives to support global health, increase electrification and private sector investment in Africa, and raise billions of dollars in poverty-fighting assistance. Previously, Tom was the senior director of government relations at ONE. Before joining ONE, Tom was the director of government relations for The Episcopal Church. The Office of Government Relations aims to represent the policy priorities of The Episcopal Church to the U.S. government in Washington, D.C., and to influence policy and legislation on critical issues, highlighting the voices and experiences of Episcopalians and Anglicans globally. The office facilitates the Episcopal Public Policy Network, a grassroots network of Episcopalians engaged in the ministry of public policy advocacy. Learn more at https://www.episcopalchurch.org/ministries/office-government-relations/. MENTIONED IN THIS PODCAST: Take action to support PEPFAR The One Campaign The Office of Government Relations Internship Program
Three news stories summarized & contextualized by analytic journalist Colin Wright.GM reaches tentative agreement with UAW, ending six-week strikeSummary: Less than a week after US automaker Ford signed a deal with the United Auto Workers union, General Motors has reportedly reached a tentative agreement with them, as well, potentially ending a period in which the industry was roiled by strikes and uncertainty.Context: This is still just a tentative deal, but it would seem that a 25% hourly pay increase plus cost-of-living allowances may be included in an updated four-year contract, similar to what was agreed with Ford; GM was the last holdout of the three major automakers in the country, and it's been estimated that the company has already lost about $800 million to the strikes, and could rack up another $200 million in losses per week if strike actions continue.—BloombergOne Sentence News is a reader-supported publication. To support my work, consider becoming a free or paid subscriber.UN peacekeepers leave Mali in a hurry and under fireSummary: UN peacekeepers, who were in the region to help local governments deal with militant extremist groups, were ordered in June to fully withdraw from Mali by the end of the year, triggering a frantic effort to destroy equipment that might otherwise fall into militant hands and to get everyone out safely.Context: That safety component was made more difficult by the enemies this group has made amongst local militant groups over the ten years or so they've been operating in the region, and by the sheer number of people—around 15,000 soldiers—that require extraction; nearly 6,000 peacekeepers have reportedly been safely withdrawn, so far, thought the extractions have been made more difficult and precarious by the withholding of flight and travel permits by local officials; the Malian government was overthrown by its military in 2021 and is one of several governments in West Africa currently run by military juntas.—Barron'sRepublicans delay more than $1 billion in HIV program fundingSummary: A government program called PEPFAR, short for the President's Emergency Plan for AIDS Relief, has been held up by Congressional Republicans due to unbacked allegations that some of the resources being divvied out by the program are funding abortions overseas.Context: Pretty much everyone involved with this program has assured lawmakers that the resources PEPFAR provides to healthcare entities is only used to make medicines, testing, and prevention services related to AIDS more widely available, and the program—which was created by then-President George W. Bush in 2003—has been credited with saving more than 25 million lives, costs not quite $7 billion a year, and has typically enjoyed bipartisan support, heralded as one of the most successful medical programs of its kind; PEPFAR can continue to operate without Congress' go-ahead, but details related to its operation—including how terms like “human rights” are used in the document that outlines the program—are being held up by Congressional Republicans, stymying efforts to keep things going.—The Washington PostIf current trends continue, by the 2040s, countries in Africa will account for two out of every five children born on Earth—a stark contrast to the aging populations (and ever-lessening fertility rates) seen in on-average wealthier countries around the world.—The New York Times~4,000Approximate number of electric vehicle chargers around the US (DOE estimates say nearly 4,000, other estimates have been closer to 4,700) that were offline as of early October.That's an outage rate of more than 6%, and it's the consequence of a shortage of technicians certified to work on these sorts of chargers.A lack of functional and reliable charging points is considered to be a significant barrier in consumer adoption of EVs in the US.—Automotive NewsTrust Click Get full access to One Sentence News at onesentencenews.substack.com/subscribe
Concern from some Republicans over abortion — and resurgent skepticism of foreign aid — could severely curb the effectiveness of the AIDS prevention program PEPFAR. Also known as the President's Emergency Plan for AIDS Relief, PEPFAR is credited with saving more than 25 million lives since it began in 2003.We want to hear from you about the show: npr.org/politicssurveyThis episode: White House reporter Deepa Shivaram, global health correspondent Nurith Aizenman, and senior political editor and correspondent Ron Elving.The podcast is produced by Casey Morell and Elena Moore. Our editor is Eric McDaniel. Our executive producer is Muthoni Muturi.Unlock access to this and other bonus content by supporting The NPR Politics Podcast+. Sign up via Apple Podcasts or at plus.npr.org. Connect:Email the show at nprpolitics@npr.orgJoin the NPR Politics Podcast Facebook Group.Subscribe to the NPR Politics Newsletter.
This week, Eric, Emily, and Dylan tackle the Catholic Church Synod on Synodality taking place starting this week at the Vatican. What is the Synod on Synodality all about? What issues facing the Church—the ordination of women, the blessing of same-sex couples, married priests, and more—are on the table? What power does the Synod actually have? And could this Synod have just been an email? Next, the President's Emergency Plan for AIDS Relief, or PEPFAR, is up for renewal, and there are some conservative lawmakers who don't want to renew it because of concerns over potential funding of abortion. Are those concerns valid? And if so, are they valid enough to scuttle what is largely agreed to be one of the most successfully public health programs in recent memory? And finally, California has raised the minimum wage for fast food workers to $20 an hour. What could go wrong? Quite a few things, actually. Say hello to your friendly new robot burger chef! Vatican Assembly Puts the Church's Most Sensitive Issues on the Table | New York Times A Public Health Setback | New York Times Poverty, Inc. PovertyCure How to Have a Great and Holy Council | Dylan Pahman, Religion & Liberty Online New California law raises minimum wage for fast food workers to $20 per hour, among nation's highest | Associated Press The social responsibility of Chick-fil-A is to make delicious sandwiches | Dylan Pahman, Religion & Liberty Online
Important provisions of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) could expire due to partisan divisions, threatening a widely successful initiative; libraries take part in U.S. Banned Books Week in the face of a rising censorship movement; Slovakia holds an early parliamentary election amid concerns that pro-Russia parties will gain power; and Chinese President Xi Jinping and Syrian President Bashar al-Assad announce a partnership. Mentioned on the Podcast Michelle Gavin, “PEPFAR at Twenty,” CFR.org “Let Freedom Read Day,” BannedBooksWeek.org Jonathan Masters and Will Merrow, “How Much Aid Has the U.S. Sent Ukraine? Here Are Six Charts,” CFR.org More Perfect, WNYC Studios The Coldest Cast in Laramie, Serial Productions The Rewatchables, The Ringer Peter Wehner, “The Republican Betrayal of PEPFAR,” The Atlantic For an episode transcript and show notes, visit us at: https://www.cfr.org/podcasts/pepfar-reauthorization-struggle-banned-books-week-slovakia-democracy-test-and-more
PEPFAR is an acronym that stands for the President's Emergency Plan for AIDS Relief. It is the largest foreign aid program targeted at a specific disease, and it is widely considered to be one of the most successful US foreign aid programs ever. George W Bush who started the program in 2003. It continued and expanded under President Obama and even thrived during the Trump years. But today its fate is uncertain. Funding for PEPFAR is provided by congress every five years, and typically this is a highly bi-partisan and wholly uncontroversial affair. It was due to be re-authorized this year -- but with the end of the fiscal year rapidly approaching, this legislation has not gone through. At issue is domestic politics around abortion. Anti-abortion groups in the United States have falsely accused PEPFAR under the biden administration of somehow indirectly or secretly supporting abortion. This idea has infected Republican politics -- several Republican members of congress who once supported PEPFAR are now preventing a vote on its re-authorization, threatening to undermine what one of these very members of congress once called "The most successful foreign aid program since the Marshall plan." On the line to discuss PEPFAR's history of success and its uncertain future is Gayle Smith, CEO of the One Campaign and former head of the US Agency for International Development.
This year marks the 20th anniversary of George W. Bush's transformative program to combat H.I.V. and AIDS in Africa, the Caribbean and elsewhere. The left's villain of yesteryear, who was (somewhat) rehabilitated in the Trump era, and rightly maligned for the disaster that was the invasion of Iraq, Bush also waged a noble war against an epidemic. This ongoing battle is now two decades old, and it has saved 25 million lives. But nothing is sacred in the MAGA tainted GOP. Even the life changing achievement of one of this era's most conservative presidents is apparently now on the chopping block and threatening to be defunded, woefully swept up in the maelstrom of the “own the libs,” anti-“woke” culture wars.Bush's initiative, which is called the President's Emergency Plan for AIDS Relief, or PEPFAR has funded antiretroviral medicines for people with AIDS and provided substantial resources to prevent the spread of the virus among newborn babies. It's been a heroic success by any reasonable metric. Except if you are a MAGA flame thrower.For those among today's far right saber rattlers, it is believed that the Biden administration has a secret plan to use PEPFAR to promote abortions overseas. Yes, a law which was originally midwifed by evangelical Christians and devout Catholics, and championed by the deeply pro-life George W. Bush is now a clandestine pro -abortion plot. But this is where we are folks. Have a listen to Adam's takedown of this deeply misguided but also life threatening fuckwaddery. Thanks for helping us save democracy one episode at a time!Join the Dirty Moderate Nation on Substack! Tell us what you think on Twitter! Or, if you are fed up with Elon's bullshit, hit us up on Threads! There are always shenanigans over on TikTok too…Are you registered to VOTE?
Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Did Economists Really Get Africa's AIDS Epidemic "Analytically Wrong"? (A Reply), published by TomDrake on August 30, 2023 on The Effective Altruism Forum. To demonstrate CGD's cherished principle of not taking organisation positions, here is a response from a couple of us in the health team to our colleague Justin Sandefur's recent(ish) blog on cost-effectiveness evidence and PEPFAR. Our concern was that readers might come away from Justin's blog thinking that cost-effectiveness evidence wasn't useful in the original PEPFAR decision and wouldn't be useful in similar decisions about major global health initiatives. We disagree and wanted to make the case for cost-effectiveness as well as addressing some of Justin's specific points along the way. A recent, thought-provoking blog by our colleague, Justin Sandefur, titled "How Economists got Africa's AIDS Epidemic Wrong", has sparked a debate about the historical role of cost-effectiveness analysis in assessing the investments of the President's Emergency Plan for AIDS Relief (PEPFAR) and, implicitly, the value of such analysis in making similar global health decisions. Justin tells the story of PEPFAR and concludes that economists that raised concerns over the cost-effectiveness of antiretroviral therapies got PEPFAR "analytically wrong", a conclusion that some readers may interpret as a reason to discard cost-effectiveness analysis for such decisions in the future. The original blog draws three lessons: Lesson #1. What persuaded the White House was evidence of feasibility and efficacy, not cost-effectiveness Lesson #2. The budget constraint wasn't fixed; PEPFAR unlocked new money Lesson #3. Prices also weren't fixed, and PEPFAR may have helped bring them down In this blog we argue that while Justin's observations hold some truth, they do not discredit the value of cost-effectiveness analysis in decision-making. Specifically, we contend that: Because there were many feasible and effective options at the time, this was not sufficient criteria for such a large decision. It should have considered the cost-effectiveness of other options, to explore the relative impact. PEPFAR may have unlocked some new money, but it wasn't all new money, and it will have had short- and long-term opportunity costs. Moreover we cannot be certain that PEPFAR was uniquely able to increase available funding. Thus the decision could have considered cost-effectiveness analysis to reveal likely trade-offs. Price reductions could have been analytically explored for PEPFAR and for alternative options as part of cost-effectiveness analysis during decision-making. The bigger lesson, we conclude, is that when the next PEPFAR-sized decision happens, our systems and their stakeholders must strive for higher standards, embracing analysis that models a range of good options and assesses them against key criteria. Cost-effectiveness analysis is a necessary component of this, but it is not sufficient, and additional analysis and scenarios should be considered through a deliberative process, before settling on a final decision. Below we offer reflections on each of Justin's three lessons, in order, then draw out the overall conclusions. Response 1: Feasibility and efficacy are not enough Justin uses an analogy of giving to a homeless person to invite the reader to agree that cost is not really the relevant issue when considering whether to do a good deed. True enough, if something can be considered not effective or not feasible then it's a non-starter and we don't need to trouble ourselves over cost or cost-effectiveness. But when there are multiple feasible and effective options with different levels of effectiveness and cost, understanding which does the most good for the money is absolutely worth knowing. Indeed we agree that there is a moral imperative to...
Gayle Smith, CEO of the ONE Campaign, served in many leadership roles in the federal government as a staunch advocate for evidence-based decision making. As Coordinator for Global COVID Response and Health Security at the U.S. Department of State in 2021, Smith led the U.S. effort to end the global pandemic, helping the Biden-Harris Administration map out a response, identify spikes, and target vulnerabilities through monitoring, testing, diagnostics, and other tools. As Administrator of the United States Agency for International Development (USAID) during the Obama Administration, Smith prioritized a culture of evaluation and learning, emphasizing the importance of focusing on outcomes rather than inputs and using data and evidence to make midcourse corrections on projects and programs. And, as a White House official who played a leading role in the U.S. response to Ebola, Smith saw firsthand the importance of leveraging data to track outbreaks, target treatments, invest resources, and move in real time to maximize impact. On this episode of Mathematica's On the Evidence podcast—one in our occasional Evidence in Government series—Mike Burns, Mathematica senior director of communications and public affairs, spoke with Smith about a range of topics including evaluation at USAID, the U.S. response to Ebola, the intersection of development finance and climate change, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), bilateral and global agencies, and the COVID-19 global health crisis, including its economic impact on women. A full transcript of this episode is available here: https://www.mathematica.org/blogs/gayle-smith-on-the-federal-role-in-global-response-to-health-and-climate-crises Read Smith's remarks from the 2016 Brookings Institution event on the state of evaluation at USAID: https://www.brookings.edu/wp-content/uploads/2016/03/20160330_usaid_evaluation_transcript.pdf Read the ONE Campaign's statement on the appointment of Ajay Banga as president of the World Bank: https://www.one.org/us/press/banga-world-bank/ Read ONE's statement on the 20th anniversary of the PEPFAR announcement: https://www.one.org/us/press/one-statement-on-20th-anniversary-of-pepfar-announcement/ Read Smith's POLITICO interview with Ambassador Linda Thomas-Greenfield: https://www.politico.com/news/magazine/2022/11/01/linda-thomas-greenfield-gayle-smith-interview-00014844
In 2003, President Bush created the President's Emergency Plan for AIDS Relief, or PEPFAR, and in the twenty years since, the program has been credited with saving over 25 million lives and stabilizing health systems around the world. On Sept. 30, 2023, the program will expire if Congress doesn't act, putting millions of people at risk of losing access to HIV/AIDS treatment.Lawfare Associate Editor of Communications Anna Hickey sat down with Emily Bass, a writer and activist who has spent more than twenty years writing about and working on HIV/AIDS. In 2021, she wrote “To End a Plague,” a book on America's war on AIDS in Africa. They discussed how PEPFAR has changed over the past two decades, why it is at risk of expiring this fall, and what the expiration would mean for the millions of people who depend on it.Support this show http://supporter.acast.com/lawfare. Hosted on Acast. See acast.com/privacy for more information.
Catherine Godfrey is the senior technical advisor for adult treatment at the U.S. President's Emergency Plan for AIDS Relief. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. C. Godfrey and J. Nkengasong. Prioritizing Mental Health in the HIV/AIDS Response in Africa. N Engl J Med 2023;389:581-583.
About 20 years ago, Congress pretty much agreed on one thing: PEPFAR.President George W. Bush introduced the President's Emergency Plan for AIDS Relief in his 2003 State of the Union address. Since then, it's been renewed with little fuss every five years. But abortion politics are changing that, Politicians are reacting to allegations that PEPFAR funds are being used to "promote abortion on demand." Congress needs to decide if it will renew the program by the end of September.We discuss PEPFAR and how the politics around the program became so fraught. Want to support 1A? Give to your local public radio station and subscribe to this podcast. Have questions? Find out how to connect with us by visiting our website.
The new documentary “The Deepest Breath” tells how Stephen Keenan died six years ago while trying to rescue fellow freediver Alessia Zecchini. Special Counsel Jack Smith today indicted Donald Trump for alleged conspiracy to overturn the 2020 presidential election and his role leading up to the Capitol insurrection. Congressional Republicans are threatening to torpedo the President's Emergency Plan for AIDS Relief (PEPFAR). It's one of President George W. Bush's greatest achievements. The U.S. Women's National Soccer Team is now in the final 16 of this year's World Cup. But the usually dominant squad is looking shakier than most people expected. Concertgoers have been increasingly throwing objects at performers while they're on stage. Why? Blame “main character syndrome.”
Gary Edson, Covid Collaborative, reflects on the President's Emergency Plan for AIDS Relief (PEPFAR), now at its 20th anniversary. It originated with a Republican president, George W. Bush, who transformed development assistance. Bipartisanship was vital, and PEPFAR fulfilled moral and geostrategic goals. Now, PEPFAR reauthorization is in peril in the post-Dobbs era. What needs to happen to rescue things? In the toxic, polarized post-Covid era, how do we step over that noise and bring about a new conversation about topline goals to protect Americans on a bipartisan basis? Give a listen!
Sheryl Gay Stolberg, NYT national correspondent on health and politics, unpacks the post-Dobbs era: does it imperil or boost the right to contraception? Or both? Does it put the President's Emergency Plan for AIDS Relief (PEPFAR) under new scrutiny? Calls to “take a fresh look” at PEPFAR may signal trouble. “Abortion politics is laying over all of our conversations” in this “super-partisan era.” In the post-Covid era, the reporting environment has loosened. Why is it that filling the US leadership gap in science and health is moving along so slowly? What should we make of RFK Jr's arrival on the scene, a figure in the larger campaign to vilify Dr. Anthony Fauci? What can we expect in the coming battles over Medicare drug pricing following the Inflation Reduction Act?
An abortion dispute in Congress threatens to jeopardize the reauthorization of PEPFAR, the President's Emergency Plan for AIDS Relief, credited with saving 25 million lives from the disease in the developing world. Host Megan Messerly talks with Carmen Paun about the debate over whether federal funds should support HIV/AIDS organizations that support abortion rights.
In this episode, Sujani sits down with Dr. Marissa Robinson, coordinator of the Ending the HIV Epidemic initiative at the US Department of Health. They discuss Marissa's education and career, her interest in HIV and the Black community's access to health, and harnessing charisma in your professional life. You'll LearnHow Marissa's personal experiences shaped her interest in the social determinants of health, specifically with HIV and the Black community's access to healthMarissa's experience at Spelman College, a historically Black college for women, and what factors she considered when making choices about educationTips on dealing with rejection, self doubt, and other barriers in your careerHow charisma is essential in leadership and public health and why it is especially important for women of colour to develop this skillToday's GuestDr. Marissa Robinson is a strategic-leader, visionary, and disruptor within the field of Infectious Disease. She focuses on HIV/AIDS research, educating the need to increase opportunities and diversity amongst the public health workforce. She currently leads as the Ending the HIV Epidemic in the U.S. (EHE) initiative Coordinator at the US Department of Health and Human Services (HHS) Office of the Assistant Secretary for Health within the Office of Infectious Disease and HIV/AIDS Policy.Dr. Robinson is a DMV native and is trained in infectious disease epidemiology. She has conducted extensive HIV/AIDS research for over a decade. She began her federal career when she joined the United States Peace Corps as a Community Health and Malaria Prevention volunteer in Togo, West Africa. After returning to the US, Dr. Robinson worked at the Health Resources and Services Administration (HRSA) in the HIV/AIDS Bureau (HAB) on global infectious disease surveillance supporting the President's Emergency Plan for AIDS Relief (PEPFAR) initiative. Following her time at HRSA, Dr. Robinson joined the Centers for Disease Control and Prevention (CDC) where she conducted and maintained data analytics for a Nursing and Midwifery initiative on behalf of PEPFAR for 13 African countries. After her time at CDC, Dr. Robinson joined the CDC Foundation on the Teens Linked to Care pilot program with the CDC's Division of Adolescent and School Health which focused on substance use and sexual risk among youth in rural populations.Dr. Robinson completed her Doctor of Public Health degree as a Goldseeker Scholar at Morgan State University's School of Community Health and Policy. Her dissertation was entitled “A Qualitative Exploration of Preexposure Prophylaxis Among Black Women Attending a Historically Black College and University in the Northeastern United States”. Dr. Robinson completed her doctoral fellowship training at Johns Hopkins School of Medicine Pre-Doctoral Clinical Research Training Program. Dr. Robinson received her Master of Public Health with a concentration in global health, infectious diseases, and a certificate in socio-contextual determinants of health from Emory University's Rollins School of Public Health and her Bachelor of Arts in psychology and public health from Spelman College.ResourcesFollow Marissa on LinkedIn or Twitter or send her an email Learn more about Spelman College Listen to The "It" FactorSupport the showJoin The Public Health Career Club: the #1 hangout spot and community dedicated to building and growing your dream public health career.
In the 2000s, cost-effectiveness analysis said it was a bad use of money to send antiretroviral drugs to low-income countries—drugs that ended up saving millions of lives.Twenty years ago, in the same State of the Union speech in which he made the case for invading Iraq, George W. Bush asked Congress for $15 billion over five years for an ambitious new plan to pay for antiretroviral drugs for two million AIDS patients in Africa and the Caribbean.The President's Emergency Plan for AIDS Relief, or PEPFAR, went on to become probably the most celebrated American foreign aid program since the Marshall Plan. An evaluation by the National Academy of Sciences estimates PEPFAR has saved millions of lives (PEPFAR itself claims 25 million). Impacts on total mortality rates across fourteen African countries were visible within just the first few years of the program (see figure 1). Separate research suggests the rollout of antiretrovirals, of which PEPFAR was a major component, explained about a third of Africa's economic growth resurgence in the 2000s.Source:https://forum.effectivealtruism.org/posts/qyhDz9djZAmxZ6Qzx/how-economists-got-africa-s-aids-epidemic-wrongNarrated for the Effective Altruism Forum by TYPE III AUDIO.---
Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: How economists got Africa's AIDS epidemic wrong, published by Justin Sandefur on June 10, 2023 on The Effective Altruism Forum. I'm reposting this from the CGDev site, as I thought it might be interesting to EA folks (thanks to Ryan Briggs for the suggestion). For the short version, here's a twitter thread. In the 2000s, cost-effectiveness analysis said it was a bad use of money to send antiretroviral drugs to low-income countries—drugs that ended up saving millions of lives. Twenty years ago, in the same State of the Union speech in which he made the case for invading Iraq, George W. Bush asked Congress for $15 billion over five years for an ambitious new plan to pay for antiretroviral drugs for two million AIDS patients in Africa and the Caribbean. The President's Emergency Plan for AIDS Relief, or PEPFAR, went on to become probably the most celebrated American foreign aid program since the Marshall Plan. An evaluation by the National Academy of Sciences estimates PEPFAR has saved millions of lives (PEPFAR itself claims 25 million). Impacts on total mortality rates across fourteen African countries were visible within just the first few years of the program (see figure 1). Separate research suggests the rollout of antiretrovirals, of which PEPFAR was a major component, explained about a third of Africa's economic growth resurgence in the 2000s. Figure 1. Adult mortality in PEPFAR focus and non-focus countries (from Bendavid et al 2012, JAMA) But at the time, some economists balked. The conventional wisdom within health economics was that sending AIDS drugs to Africa was a waste of money. The dominant conceptual apparatus economists use to evaluate social policies—comparative cost-effectiveness analysis, which focuses on a specific goal like saving lives, and ranks policies by lives saved per dollar—suggested America's foreign aid budget could've been better spent on condoms and awareness campaigns, or even malaria and diarrheal diseases. “Treating HIV doesn't pay” In a now infamous op-ed published in Forbes in 2005, before PEPFAR's impacts were well documented, Brown University economist Emily Oster declared that “treating HIV doesn't pay.” “It is humane to pay for AIDS drugs in Africa,” she wrote, “but it isn't economical. The same dollars spent on prevention would save more lives.” In fairness to Oster and others, the phrasing here is important. Her argument was not that African HIV patients' lives weren't worth the cost—that retroviral drug prices exceeded the “value of a statistical life”, as economists might phrase it—but rather that if we take the budget as fixed, and the prices as fixed, the money could do more good if spent on other health programs. Oster wasn't alone. While her delivery was perhaps deliberately provocative, her basic reasoning reflected a broad professional consensus, which viewed antiretrovirals through the lens of comparative cost-effectiveness analysis, and deemed them middling to poor value. A systematic review published in the Lancet in 2002, just as the Bush administration was privately plotting the PEPFAR announcement, found that in terms of saving “disability-adjusted life years” or DALYs, "a case of HIV/AIDS can be prevented for $11, and a DALY gained for $1” by improving the safety of blood transfusions and distributing condoms, whereas “antiretroviral therapy for adults, cost several thousand dollars per infection prevented, or several hundreds of dollars per DALY gained." Figure 2. Cost-effectiveness of interventions related to high-burden diseases in low- and middle-income countries (from Disease Control Priorities in Developing Countries, 2nd ed., 2006) In the 2006 edition of its authoritative volume on Disease Control Priorities in Developing Countries, the World Bank looked at 60 different health interventions to address “h...
In this interview, Cynthia Changyit Levin, a mom, author, and member of the ONE Campaign, discusses her upcoming trip to Capitol Hill to advocate for support for the President's Emergency Plan for AIDS Relief (PEPFAR). She highlights the importance of bipartisan efforts to fight against AIDS and shares the need to re-energize people's attention to this ongoing issue. Cynthia also expresses her concerns about funding and the potential consequences of neglecting the fight against HIV/AIDS. The interview sheds light on the impact of AIDS on marginalized communities and emphasizes the significance of grassroots activism.
This is Garrison Hardie with your CrossPolitic Daily News Brief for Wednesday, May 31st, 2023. https://www.christiantoday.com/article/archbishop.distressed.by.attacks.on.christians.in.india/140278.htm Archbishop 'distressed' by attacks on Christians in India The Archbishop of Canterbury has lamented violent attacks on indigenous tribal Christians in north-eastern India. Archbishop Justin Welby said he was "distressed" by the reports of violence coming out of Manipur state in recent weeks. Writing on Twitter, the Archbishop said he was praying that "justice and peace would prevail" in the region. The violence, carried out by Hindu nationalists, has killed dozens and displaced around 10,000 people, mostly Christians. Many churches and buildings belonging to Christians have also been destroyed. The Archbishop said he was praying "that regional authorities would protect all minority groups, including Christians and their places of worship, and that justice and peace would prevail". Open Doors last week shared reports from Christian partners on the ground fear that the violence will lead to a civil war. They have expressed disappointment at what they see as a lack of action by the Indian government and local authorities to quell the violence. According to Open Doors, at least 300 churches have been burned or demolished and 1,000 Christian homes have been destroyed in Manipur in the last few weeks. The NGO is providing support to Christians caught up in the violence but has warned that conditions are "grim", and many are still fearing for their lives. "If the situation continues civil war is inevitable," said an Open Doors partner who cannot be named for security reasons. "If there is a civil war the situation will only become more gruesome, more lives lost, properties destroyed and further open persecution of religious minorities." https://taskandpurpose.com/news/taliban-humvee-m240-iran-fight/ The Taliban is using leftover American gear to fight a border skirmish with Iran A gunfight broke out between Iranian border guards and Taliban fighters along the border between Iran and Afghanistan this weekend. Fighting killed three people in the biggest escalation between the two countries over water. And the Taliban brought out a big gun to help. Video posted to social media offered an up-close view of the skirmish, inside an unexpected place: an Humvee kitted out with an M240 machine gun. If that looks familiar it’s because those are some of the pieces of military equipment captured by the Taliban, now put into use for fighting other parties. Other accounts shared online reported heavy machine gun fire, as well as purported use of mortars and other explosives. Outside of the Humvee, Taliban fighters were spotted using AK-style rifles and RPGs to attack the Iranian position on the border. At least three people are confirmed to have died in Saturday’s gunfight, although accounts vary on how many belonged to each side. The Taliban claimed at least one of its fighters was killed, while an Iranian paper said all deaths were on Iran’s side, per al-Jazeera. The fighting took place in the Nimroz province of Afghanistan. As a result, the border crossing between Milak and Zaranj in Iran and Afghanistan, respectively, closed (it was not where the fighting took place). Both nations accused the other of starting the gunfight. The fighting between the two nations broke out amid political fights over water rights. Drought has been a serious issue in Afghanistan for the last three years. The Helmand River flows from Afghanistan into Iran and is dammed on the Afghan side. Earlier in May, Iranian President Ebrahim Raisi called on the Taliban not to restrict the flow of water. More than a year since the Taliban took control of Afghanistan, the group is using all kinds of seized American and NATO weapons. It’s not a new development. The Taliban regularly used captured American-provided equipment when fighting the U.S.-backed government. In the later years of the war, special Taliban units were spotted wearing American-style driving Humvees and even wielding weapons belonging to special operations units. During the fall of Kabul in 2021, Los Angeles Times reporter Nabih Bulos captured footage of Taliban fighters in the city dressed like special operations forces. When the U.S.-backed government fell and the Afghan security forces collapsed, the Taliban got its hand on a lot of leftover weapons and equipment. A 2022 report from the Pentagon’s lead inspector general for Operation Enduring Sentinel and Operation Freedom’s Sentinel found that approximately $7.12 billion in equipment was still in the country when the Taliban took over. That included everything from rifles to aircraft. https://www.newsmax.com/world/globaltalk/africa-uganda-gay-rights/2023/05/29/id/1121533/ Uganda Signs Anti-gay Law With Death Penalty for 'Aggravated Homosexuality' Uganda's president has signed into law tough new anti-gay legislation supported by many in this East African country but widely condemned by rights activists and others abroad. The version of the bill signed by President Yoweri Museveni does not criminalize those who identify as LGBTQ, a key concern for campaigners who condemned an earlier draft of the legislation as an egregious attack on human rights. But the new law still prescribes the death penalty for "aggravated homosexuality," which is defined as cases of sexual relations involving people infected with HIV as well as with minors and other categories of vulnerable people. A suspect convicted of "attempted aggravated homosexuality" can be imprisoned for up to 14 years, according to the legislation. Parliamentary Speaker Anita Among said in a statement the president had "answered the cries of our people" in signing the bill. "With a lot of humility, I thank my colleagues the Members of Parliament for withstanding all the pressure from bullies and doomsday conspiracy theorists in the interest of our country," the statement said. Museveni had returned the bill to the national assembly in April, asking for changes that would differentiate between identifying as LGBTQ and actually engaging in homosexual acts. That angered some lawmakers, including some who feared the president would proceed to veto the bill amid international pressure. Lawmakers passed an amended version of the bill earlier in May. Homosexuality was already illegal in Uganda under a colonial-era law criminalizing sexual activity "against the order of nature." The punishment for that offense is life imprisonment. The U.S. has warned of economic consequences over legislation described by Amnesty International as "draconian and overly broad." The leaders of the U.N. AIDS program, the U.S. President's Emergency Plan for AIDS Relief and the Global Fund in a joint statement Monday said they "are deeply concerned about the harmful impact" of the legislation on public health and the HIV response. "Uganda's progress on its HIV response is now in grave jeopardy," the statement said. "The Anti-Homosexuality Act 2023 will obstruct health education and the outreach that can help end AIDS as a public health threat." That statement noted that "stigma and discrimination associated with the passage of the Act has already led to reduced access to prevention as well as treatment services" for LGBTQ people. Anti-gay sentiment in Uganda has grown in recent weeks amid news coverage alleging sodomy in boarding schools, including a prestigious one for boys where a parent accused a teacher of abusing her son. The February decision of the Church of England 's national assembly to continue banning church weddings for same-sex couples while allowing priests to bless same-sex marriages and civil partnerships inflamed many in Uganda and elsewhere in Africa. Homosexuality is criminalized in more than 30 of Africa's 54 countries. Some Africans see it as behavior imported from abroad and not a sexual orientation. https://www.foxnews.com/politics/house-oversight-committee-taking-steps-to-hold-fbi-director-wray-in-contempt-of-congress-over-biden-document Republicans to hold FBI Director Wray in contempt of Congress over Biden document House Oversight Committee Chairman James Comer is taking steps to hold FBI Director Christopher Wray in contempt of Congress after the Bureau notified the panel it will not comply with its subpoena related to a possible criminal scheme involving then-Vice President Joe Biden. The FBI, though, said Tuesday evening it remains committed to cooperating with Congress, and will provide access to the document "in a format and setting that maintains confidentiality and protects important security interests and the integrity of FBI investigations." Comer, R-Ky., has subpoenaed the FBI for a document that allegedly describes a criminal scheme involving Biden and a foreign national and relating to the exchange of money for policy decisions. The document is an FBI-generated FD-1023 form. Comer first subpoenaed the document earlier this month. The FBI did not turn it over and instead explained that it needed to protect the Bureau's confidential human source program. Comer set another deadline last week, giving Wray until Tuesday, May 30, to turn over the document. After the deadline was set, Wray set up a call with Comer for Wednesday, May 31. However, the FBI notified the panel it would not provide the document to the committee by the Tuesday afternoon deadline. He added, "Americans deserve the truth, and the Oversight Committee will continue to demand transparency from this nation’s chief law enforcement agency." In response, the FBI told Fox News Digital that the bureau "remains committed to cooperating with the Committee in good faith."
This is Garrison Hardie with your CrossPolitic Daily News Brief for Wednesday, May 31st, 2023. https://www.christiantoday.com/article/archbishop.distressed.by.attacks.on.christians.in.india/140278.htm Archbishop 'distressed' by attacks on Christians in India The Archbishop of Canterbury has lamented violent attacks on indigenous tribal Christians in north-eastern India. Archbishop Justin Welby said he was "distressed" by the reports of violence coming out of Manipur state in recent weeks. Writing on Twitter, the Archbishop said he was praying that "justice and peace would prevail" in the region. The violence, carried out by Hindu nationalists, has killed dozens and displaced around 10,000 people, mostly Christians. Many churches and buildings belonging to Christians have also been destroyed. The Archbishop said he was praying "that regional authorities would protect all minority groups, including Christians and their places of worship, and that justice and peace would prevail". Open Doors last week shared reports from Christian partners on the ground fear that the violence will lead to a civil war. They have expressed disappointment at what they see as a lack of action by the Indian government and local authorities to quell the violence. According to Open Doors, at least 300 churches have been burned or demolished and 1,000 Christian homes have been destroyed in Manipur in the last few weeks. The NGO is providing support to Christians caught up in the violence but has warned that conditions are "grim", and many are still fearing for their lives. "If the situation continues civil war is inevitable," said an Open Doors partner who cannot be named for security reasons. "If there is a civil war the situation will only become more gruesome, more lives lost, properties destroyed and further open persecution of religious minorities." https://taskandpurpose.com/news/taliban-humvee-m240-iran-fight/ The Taliban is using leftover American gear to fight a border skirmish with Iran A gunfight broke out between Iranian border guards and Taliban fighters along the border between Iran and Afghanistan this weekend. Fighting killed three people in the biggest escalation between the two countries over water. And the Taliban brought out a big gun to help. Video posted to social media offered an up-close view of the skirmish, inside an unexpected place: an Humvee kitted out with an M240 machine gun. If that looks familiar it’s because those are some of the pieces of military equipment captured by the Taliban, now put into use for fighting other parties. Other accounts shared online reported heavy machine gun fire, as well as purported use of mortars and other explosives. Outside of the Humvee, Taliban fighters were spotted using AK-style rifles and RPGs to attack the Iranian position on the border. At least three people are confirmed to have died in Saturday’s gunfight, although accounts vary on how many belonged to each side. The Taliban claimed at least one of its fighters was killed, while an Iranian paper said all deaths were on Iran’s side, per al-Jazeera. The fighting took place in the Nimroz province of Afghanistan. As a result, the border crossing between Milak and Zaranj in Iran and Afghanistan, respectively, closed (it was not where the fighting took place). Both nations accused the other of starting the gunfight. The fighting between the two nations broke out amid political fights over water rights. Drought has been a serious issue in Afghanistan for the last three years. The Helmand River flows from Afghanistan into Iran and is dammed on the Afghan side. Earlier in May, Iranian President Ebrahim Raisi called on the Taliban not to restrict the flow of water. More than a year since the Taliban took control of Afghanistan, the group is using all kinds of seized American and NATO weapons. It’s not a new development. The Taliban regularly used captured American-provided equipment when fighting the U.S.-backed government. In the later years of the war, special Taliban units were spotted wearing American-style driving Humvees and even wielding weapons belonging to special operations units. During the fall of Kabul in 2021, Los Angeles Times reporter Nabih Bulos captured footage of Taliban fighters in the city dressed like special operations forces. When the U.S.-backed government fell and the Afghan security forces collapsed, the Taliban got its hand on a lot of leftover weapons and equipment. A 2022 report from the Pentagon’s lead inspector general for Operation Enduring Sentinel and Operation Freedom’s Sentinel found that approximately $7.12 billion in equipment was still in the country when the Taliban took over. That included everything from rifles to aircraft. https://www.newsmax.com/world/globaltalk/africa-uganda-gay-rights/2023/05/29/id/1121533/ Uganda Signs Anti-gay Law With Death Penalty for 'Aggravated Homosexuality' Uganda's president has signed into law tough new anti-gay legislation supported by many in this East African country but widely condemned by rights activists and others abroad. The version of the bill signed by President Yoweri Museveni does not criminalize those who identify as LGBTQ, a key concern for campaigners who condemned an earlier draft of the legislation as an egregious attack on human rights. But the new law still prescribes the death penalty for "aggravated homosexuality," which is defined as cases of sexual relations involving people infected with HIV as well as with minors and other categories of vulnerable people. A suspect convicted of "attempted aggravated homosexuality" can be imprisoned for up to 14 years, according to the legislation. Parliamentary Speaker Anita Among said in a statement the president had "answered the cries of our people" in signing the bill. "With a lot of humility, I thank my colleagues the Members of Parliament for withstanding all the pressure from bullies and doomsday conspiracy theorists in the interest of our country," the statement said. Museveni had returned the bill to the national assembly in April, asking for changes that would differentiate between identifying as LGBTQ and actually engaging in homosexual acts. That angered some lawmakers, including some who feared the president would proceed to veto the bill amid international pressure. Lawmakers passed an amended version of the bill earlier in May. Homosexuality was already illegal in Uganda under a colonial-era law criminalizing sexual activity "against the order of nature." The punishment for that offense is life imprisonment. The U.S. has warned of economic consequences over legislation described by Amnesty International as "draconian and overly broad." The leaders of the U.N. AIDS program, the U.S. President's Emergency Plan for AIDS Relief and the Global Fund in a joint statement Monday said they "are deeply concerned about the harmful impact" of the legislation on public health and the HIV response. "Uganda's progress on its HIV response is now in grave jeopardy," the statement said. "The Anti-Homosexuality Act 2023 will obstruct health education and the outreach that can help end AIDS as a public health threat." That statement noted that "stigma and discrimination associated with the passage of the Act has already led to reduced access to prevention as well as treatment services" for LGBTQ people. Anti-gay sentiment in Uganda has grown in recent weeks amid news coverage alleging sodomy in boarding schools, including a prestigious one for boys where a parent accused a teacher of abusing her son. The February decision of the Church of England 's national assembly to continue banning church weddings for same-sex couples while allowing priests to bless same-sex marriages and civil partnerships inflamed many in Uganda and elsewhere in Africa. Homosexuality is criminalized in more than 30 of Africa's 54 countries. Some Africans see it as behavior imported from abroad and not a sexual orientation. https://www.foxnews.com/politics/house-oversight-committee-taking-steps-to-hold-fbi-director-wray-in-contempt-of-congress-over-biden-document Republicans to hold FBI Director Wray in contempt of Congress over Biden document House Oversight Committee Chairman James Comer is taking steps to hold FBI Director Christopher Wray in contempt of Congress after the Bureau notified the panel it will not comply with its subpoena related to a possible criminal scheme involving then-Vice President Joe Biden. The FBI, though, said Tuesday evening it remains committed to cooperating with Congress, and will provide access to the document "in a format and setting that maintains confidentiality and protects important security interests and the integrity of FBI investigations." Comer, R-Ky., has subpoenaed the FBI for a document that allegedly describes a criminal scheme involving Biden and a foreign national and relating to the exchange of money for policy decisions. The document is an FBI-generated FD-1023 form. Comer first subpoenaed the document earlier this month. The FBI did not turn it over and instead explained that it needed to protect the Bureau's confidential human source program. Comer set another deadline last week, giving Wray until Tuesday, May 30, to turn over the document. After the deadline was set, Wray set up a call with Comer for Wednesday, May 31. However, the FBI notified the panel it would not provide the document to the committee by the Tuesday afternoon deadline. He added, "Americans deserve the truth, and the Oversight Committee will continue to demand transparency from this nation’s chief law enforcement agency." In response, the FBI told Fox News Digital that the bureau "remains committed to cooperating with the Committee in good faith."
20 years ago, as HIV and AIDS threatened vast populations in sub-Saharan Africa, Haiti, Guyana and Vietnam, the US Government made the largest investment in battling a pandemic. Known as the President's Emergency Plan for AIDS Relief (PEPFAR). May 27th marked the 20th anniversary of the creation of this bipartisan program which coordinated the work of government agencies and local governments to reduce the infections. Dr. Deborah Birx, who had a significant role in the program visits The Common Bridge to talk about PEPFAR's renewal. Don't be surprised when the discussion takes a turn to more current events. In part 2, Dr. Birx responds to Rich's questions about the decline in scientific credibility.Support the showEngage the conversation on Substack at The Common Bridge!
On today's program: Tim Scott, U.S. Senator from South Carolina, discusses the latest on the debt ceiling negotiations and how the President's Emergency Plan for AIDS Relief (PEPFAR) reauthorization is being used as a vehicle to push woke ideologies
Ambassador Dr. John N. Nkengasong, Ph.D. ( https://www.state.gov/biographies/john-n-nkengasong/ ), is U.S. Global AIDS Coordinator and Special Representative for Health Diplomacy, a position he was officially sworn in on June 13, 2022, where he leads, manages, and oversees the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). PEPFAR is the largest commitment by any nation to address a single disease in history, prevent millions of HIV infections, save lives, and make progress toward ending the HIV/AIDS pandemic. Born in Cameroon, Dr. Nkengasong is the first person of African origin to hold this position. In 2017, Dr. Nkengasong was appointed as the first Director of the Africa Centers for Disease Control and Prevention (Africa CDC) headquartered in Addis Ababa, Ethiopia. Through his leadership, a framework for moving Africa CDC into a full autonomous health agency of the Africa Union was established. Dr. Nkengasong led efforts to create policy frameworks to guide countries to establish and strengthen their public health institutes and defined and implemented a system to collate national surveillance data. He also led the COVID-19 response in Africa, coordinating with heads of state and governments across the continent, and among other achievements to fight the COVID-19 pandemic, he helped secure 400 million doses of COVID-19 vaccines at the height of vaccine scarcity. During his tenure, he was appointed as one of the World Health Organization's special envoys on COVID-19 preparedness and response. Dr. Nkengasong served as the U.S. Centers for Disease Control and Prevention (CDC) Division of Global HIV and Tuberculosis' International Laboratory Branch Chief and as the Associate Director for Laboratory Science. Subsequently, he served as Acting Deputy Director at the CDC Center for Global Health and Co-Chair of the PEPFAR's Laboratory Technical Working Group. As a leading virologist with over 30 years of experience in public health, Dr. Nkengasong was appointed as a board member for the International AIDS Vaccine Initiative in New York, and the Coalition for Epidemic Preparedness Innovation, in Norway. Dr. Nkengasong received his B.Sc. from the Faculty of Science, University of Yaoundé, Cameroon; his M.Sc. from the Institute of Tropical Medicine, Antwerp, Belgium; and his Ph.D. from the Faculty of Medicine, University of Brussels, Belgium. He also received a Diploma in Leadership and Management from the Kennedy School of Government at Harvard University. Dr. Nkengasong is the recipient of numerous prestigious awards and recognitions. Most recently, he served as one of the World Health Organization Director General's Special Envoys for COVID-19. In 2021, Dr. Nkengasong was recognized as Time Magazine's 100 Most Influential People, where he was described as “a modern-day hero.” Additional awards include the U.S. Secretary of Health and Human Services Award for excellence in Public Health Protection Research, the Shepard Award, the U.S. Director's Recognitions Award and the William Watson Medal of Excellence, the highest recognition awarded by CDC; which was awarded for outstanding contributions and leadership in advancing global laboratory services and programs to support the PEPFAR. Most recently, Dr. Nkengasong was invited to become a member of the National Academy of Medicine and he became the first-ever laureate of the Virchow Prize for Global Health, for his dedication to improving the health and wellbeing of the world's most vulnerable people. He has authored or co-authored over 250 peer-reviewed papers and book chapters in professional journals. Support the show
President George W. Bush joined 66th U.S. Secretary of State Dr. Condoleezza Rice and Former President of the United Republic of Tanzania Dr. Jakaya Mrisho Kikwete for a conversation during PEPFAR at 20, an event marking 20 years of the President's Emergency Plan for AIDS Relief (PEPFAR) hosted by the George W. Bush Institute. The trio discussed the inception of PEPFAR, its enormous impact, and how the program is a win for both partner countries and for U.S. foreign policy. Related:Pepfar at 20 eventA report series on lessons learned from PEPFAR's successRead: Building on PEPFAR's success: Is a win for U.S. foreign policy
Friday marks one year since the Russian invasion of Ukraine. U.S. Secretary of State Antony Blinken joins "CBS Mornings" to discuss the ongoing war and the increasing global tensions between world powers.This year marks 20 years since then-President George W. Bush enacted the President's Emergency Plan for AIDS Relief (PEPFAR) to fight the HIV/AIDS epidemic. Dr. Deborah Birx served as the U.S. Global AIDS Coordinator, implementing PEPFAR programs around the world. She joins "CBS Mornings" to discuss where we stand in the fight against HIV/AIDS and what work stills needs to be done.Actor Eugene Levy joins "CBS Mornings" for a closer look at his new Apple TV+ series, "The Reluctant Traveler," and whether a "Schitt's Creek" movie could be happening in the near future.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
The power of NMF is its ability to empower and uplift the next generation of healthcare leaders. Listen to how Carmen Villar, Vice President of Social Business Innovation at Merck & Co is #reimagininghealthcar by elevating the intersection of social and business impact while striving to create sustainable health systems to support improved health and well-being globally. Prior to joining Merck, Carmen was Chief of Staff at the Centers for Disease Control and Prevention (CDC). Carmen led the agency through both the West African Ebola and the Zika emergency responses. Her leadership was critical in providing coordination across the agency and with other US government counterparts and earned her the honor of the Presidential Meritorious Rank Award. She worked in both Nigeria and Zambia, providing leadership and oversight to CDC's programs as part of the President's Emergency Plan for AIDS Relief (PEPFAR). As a key health advisor to the US Ambassadors in Nigeria and Zambia, she also provided expert advice in critical public health areas such as Polio and Tuberculosis. Carmen started in government as a Presidential Management Fellow focusing on policy and program planning for HIV, STD, and TB prevention. Carmen has also overseen multi-site domestic and international HIV research projects in the areas of drug use, prevention of mother-to-child treatment, and vaccines. Prior to joining the CDC, she was the Policy Affairs Coordinator at the AIDS Healthcare Foundation and had also served as a Legislative Aide in the California Assembly. Carmen holds a Master's in Social Welfare from UC Berkeley and a Bachelor's in Anthropology from UC Berkley. She is currently a Board Member of NMF. National Medical Fellowships, Inc. believes a just and equitable world requires diverse healthcare leaders who not only bring diverse representation to the medical field but also lead the fight to eliminate health disparities. You can learn more about NMF at www.nmfonline.org
December 1 is World AIDS Day, and January 2023 marks 20 years of the President's Emergency Plan for AIDS Relief (PEPFAR), which provides for groundbreaking AIDS treatment, prevention, and research. In this episode of Big World, SIS dean Shannon Hader, an expert in infectious diseases and epidemiology and a global leader in the fight against HIV/AIDS, joins us to explore how the AIDS response informed policies during the outbreak of COVID-19 and how politics impacts the public perception of public health crises. Dean Hader discusses how PEPFAR's monumental achievements have influenced public health policy (3:22) and how PEPFAR continues to garner bipartisan, bicameral support from Congress, even throughout a time of intense political division (5:43). She explains how blame and shame are not sustainable or effective responses to an infectious disease (11:30). She also talks about the dangers of putting the goals of disease prevention and treatment in opposition to one another (13:23). How did the HIV community respond to the emergence of the COVID-19 virus (17:07)? While with UNAIDS, how did Hader help advise public health officials on how to protect human rights amid a crisis (18:51)? Hader answers these questions and discusses the importance of data in making sound decisions and targeting resources (21:01). The episode concludes as Hader shares how her impressive career in public health prepared her to lead a top-10 international relations school (27:17) and what she hopes to accomplish while at SIS (31:20). During our “Take Five” segment, Hader shares the five steps she would recommend to governments around the world to create and sustain positive forward momentum on AIDS research, prevention, and treatment (22:29).
PEPFAR, the U.S. President's Emergency Plan for AIDS Relief, has been credited with saving millions of lives in Africa. But as the new head of PEPFAR, Ambassador Dr. John Nkengasong, explains, the impact of PEPFAR extends even further beyond those who received lifesaving treatment.RelatedThe Bush Institute's Oral History of PEPFARPEPFAR at the U.S. State Department
This is Stephen Schmidt from the Gazette digital news desk and I'm here with your update for Wednesday, Oct. 5. The warmth is predicted to linger another day with a chance for rain Wednesday, with the temperatures dropping steeply by Friday. According to the National Weather Service, it will be partly sunny in the Cedar Rapids area with a high near 75 degrees. On Wednesday evening it will be partly cloudy, with a low of around 54 degrees. There will be a 40 percent of showers Wednesday evening, mostly between 4 p.m. and 7 p.m. A Linn County jury has found a Cedar Rapids woman who fatally stabbed her boyfriend guilty of a lesser charge after she had originally been charged with murder. Jacqueline Holmes, 38, faces up to five years in jail. After about a day and half of deliberations following more than five days of testimony, she was found guilty last Friday of the lesser charge of involuntary manslaughter — unintentionally causing the death of her boyfriend, Tremaine Williams, 35, on March 4, 2020. A retired Illinois law and psychology professor, who consults and testifies in cases involving domestic violence, said during the trial that https://www.thegazette.com/crime-courts/defense-expert-says-cedar-rapids-woman-on-trial-for-fatally-stabbing-her-boyfriend-is-a-battered-w/ (Holmes was a battered woman )and suffers from its effects. She said Holmes told her about three men who physically abused her, including Williams. The https://www.thegazette.com/crime-courts/prosecutor-says-woman-delayed-getting-boyfriend-911-help-after-stabbing-him/ (prosecution had argued that Holmes )delayed getting help for Williams after she stabbed him in the shoulder at a southwest Cedar Rapids house. There also was testimony from an investigator that Holmes repeatedly changed her version of what happened that night during recorded police interviews. A company seeking to build a carbon dioxide pipeline through five Iowa counties, including Linn, says it will hold a second round of public meetings after confirming some landowners did not get proper notice of its August meetings. Wolf Carbon Solutions, based in Alberta, Canada, held meetings Aug. 29-31 in Johnson, Cedar, Linn, Clinton and Scott counties to talk about a proposed 280-mile underground pipeline that could transport carbon dioxide from ADM plants in Cedar Rapids and Clinton to an underground site in central Illinois. But many of the people who attended those meetings said they had not been notified by certified mail and questioned whether the process was legal. The Iowa Utilities Board Sept. 23 ordered Wolf to explain within 10 days how public notice was provided and verify certified letters were sent. The company setting new meetings could delay their project, but doing so may be preferable to providing certified addresses from affected landowners. Companies proposing other CO2 pipelines in Iowa have resisted publishing the names of all affected landowners. Opponents want those names to help unite opposition. On Friday Former President George W. Bush will receive a humanitarian award and headline a fundraiser for the Herbert Hoover Presidential Library and Museum at the DoubleTree Hotel in downtown Cedar Rapids. But don't expect a lot of news coverage of his visit. As part of an agreement with Bush's staff, media coverage of the event is not allowed, said Brad Reiners, communications director for the Hoover Presidential Foundation. The museum will present Bush and former first lady Laura Bush its first Hoover Humanitarian Award for their work in Africa. The former president and former first lady have worked to combat HIV/AIDS across Africa through the President's Emergency Plan for Aids Relief. The effort has saved at least 18 million lives through critical care and treatment since 2003 when then-President Bush authorized it, according to the George W. Bush Presidential Center. Ticket sales for the fundraising banquet are closed. Proceeds will go toward a $20...
Ambassador John E. Lange (https://unfoundation.org/who-we-are/our-people/john-e-lange/) is Senior Fellow, Global Health Diplomacy, at the United Nations Foundation, a charitable organization headquartered in Washington, DC, that supports the United Nations and its activities. Ambassador Lange has extensive leadership experience in global health issues and longstanding involvement in United Nations affairs, focusing on issues related to global health security and the work of the World Health Organization. He also serves as the Chair of the Leadership Team of the Measles & Rubella Initiative. Ambassador Lange worked from 2009-2013 at the Bill & Melinda Gates Foundation, where he engaged in high-level advocacy with governments and international organizations to advance the Gates Foundation's global health and development goals in Africa. In 2012, he was the founding Co-Chair of the Polio Partners Group, the broad group of stakeholders in the Global Polio Eradication Initiative, and served in that role for a four-year term. Ambassador Lange had a distinguished 28-year career in the Foreign Service at the U.S. Department of State, where he was a pioneer in the field of global health diplomacy and a leader in pandemic preparedness and response. He served as the Special Representative on Avian and Pandemic Influenza (2006-2009); Deputy Inspector General; Deputy U.S. Global AIDS Coordinator at the inception of the President's Emergency Plan for AIDS Relief; and Associate Dean for Leadership and Management at the Foreign Service Institute, where he directed the Senior Seminar, the federal government's highest-level civilian/military joint training program. He was the U.S. Ambassador to Botswana and Special Representative to the Southern African Development Community (1999-2002), where he oversaw operations of seven U.S. Government agencies and made HIV/AIDS his signature issue. Ambassador Lange headed the U.S. Embassy in Dar es Salaam, Tanzania, as Charge d'Affaires during the August 7, 1998, Al-Qaeda bombing, for which he received the State Department's Distinguished Honor Award for "skilled leadership" and "extraordinary courage." From 1991 to 1995, while at the U.S. Mission to the United Nations in Geneva, Switzerland, Ambassador Lange managed U.S. humanitarian and refugee assistance channeled through international organizations. He also had tours of duty in the State Department Bureaus of African Affairs, Western Hemisphere Affairs and Management in Washington and at U.S. Embassies in Lomé, Togo; Paris, France; and Mexico City, Mexico. Prior to joining the diplomatic service in 1981, he worked for five years at the United Nations Association of the USA in New York. Ambassador Lange is the author of a case study in the book, Negotiating and Navigating Global Health: Case Studies in Global Health Diplomacy (2012), that describes the international negotiations on sharing of pandemic influenza viruses and access to vaccines when he led the U.S. delegation. He has delivered lectures on pandemics and other global health issues at Chatham House, London; the Council on Foreign Relations, New York; and numerous other venues. He has written numerous journal and magazine articles and blogs on the Dar es Salaam Embassy bombing, leadership in a crisis, humanitarian assistance, pandemic preparedness and response, and other global health issues.
Dr. Deborah Birx was drawn to science from a very young age. Along with her siblings, and with the full support of her parents, Dr. Birx soldered circuit boards, searched for fossils, and recorded measurements of solar eclipses while other kids her age colored and played hopscotch. Her early scientific exploration led Dr. Birx to study chemistry in college, where she became fascinated by infectious diseases. That fascination led her to medical school, the bedside, the lab, and eventually a 40+ year career as a public health servant. Throughout her career, Dr. Birx looked to the data for guidance. The data, she tells us, helps you to understand what is going on. From there, Dr. Birx adds, you've got to act. First, by planning your response, and second, by implementing your solution in the community. Dr. Birx tells us the second part is often lacking in the U.S. – “sometimes people in public health forget the first word is public and it really means population. And you have to work with everybody in the public and everybody in the population. So, stop making excuses, stop blaming it on people and fix it.” On this episode, we explore Dr. Birx's path from childhood scientist, to practicing physician, researcher, director of CDC's Division of Global HIV/AIDS (DGHA), Ambassador-at-Large, and U.S. Global AIDS Coordinator as part of the President's Emergency Plan for AIDS Relief (PEPFAR) program, and White House Coronavirus Response Coordinator under President Donald Trump (and believe it or not, still much more in-between!). We also discuss how there are 21st-century tools that are available today that can drastically change our experience with infectious disease and why we are not using them. Dr. Birx tells us “We don't have to accept in the 21st century that we continue to succumb to infectious diseases”. For full show notes and links, visit https://deepdive.tips/ ... Dr. Deborah Birx will be the keynote speaker at the upcoming GBAC Symposium on Air Considerations in Chicago on August 16 and 17, 2022. The Symposium is focused on improving the quality of indoor air in non-healthcare settings. Dr. Birx will talk about that in the context of COVID, and Monkey Pox, outlining effective innovations that are available for use today.
Dr. Paul Zeitz has been an activist for Social Justice before the term was widely known. His forward thinking and optimism led him to becoming a major part of the advocacy efforts that established global programs to combat AIDS, TB, and Malaria. He spearheaded advocacy for the President's Emergency Plan for AIDS Relief (PEPFAR), including advocacy to ensure an annual budget of $5 Billion. After nearly 20 years, PEPFAR is responsible for saving the lives of 40 million people. Dr. Zeitz served as a Director at the US Department of State where he catalyzed the formation of the Global Partnership For Sustainable Development Data which has hundreds of partners solving the issues of Social, economic, environmental, racial, and gender justice. His work has been endorsed by major figures including Alicia Keys, Archbishop Desmond Tutu, and Dr. Tedros Adhanom Ghebreyesus (Director General of the World Health Organization).
Dr. Nkengasong, Director of the Africa CDC and soon to be head of PEPFAR joined us for this 123rd episode, and the first episode of our Live From Munich mini-series, a collection of episodes recorded at the Munich Security Conference. He is a leader in the initiative to incorporate global health in security discussions like the Munich Security Conference. “We have seen how an outbreak of a disease can truly be a health security matter, and also human security, as well as even going as far as a national security threat.” The Covid-19 pandemic has shown us “the need for us to look at the security from a human perspective”, that “we are more connected as humanity”, and “the inequalities that we thought existed are more profound within countries between countries and between region than we thought”. As North America and Europe begin this murky transition to the next stage of the pandemic, Dr. Nkengasong is concerned that we will “begin to refer to COVID as a disease that will soon be over in the US. And then of course, because of that, it becomes one of the neglected tropical diseases where we now have to rely on foundations or charity to take care of.” He recently called for a pause in vaccine donations: “we're saying that we have a lot of vaccines in the country. Now our problem is vaccination”. “I'm a big believer in that we should always pause to evaluate where we are in respond, and then make corrective actions”. How will Africa overcome its major challenge of vaccine hesitancy? “I think every good public health practice as you and I know is local. The concepts are global, but in practice is local, which means Africa must take his own socio-cultural context and deal with it and then find the touch points” Dr. John Nkengasong is the Director of the Africa Centers for Disease Control and Prevention, and has been nominated by President Biden to be the next head of the Office of the Global AIDS Coordinator in charge of PEPFAR, the President's Emergency Plan for AIDS Relief.
Dr. Nkengasong, Director of the Africa CDC and soon to be head of PEPFAR joined us for this 123rd episode, and the first episode of our Live From Munich mini-series, a collection of episodes recorded at the Munich Security Conference. He is a leader in the initiative to incorporate global health in security discussions like the Munich Security Conference. “We have seen how an outbreak of a disease can truly be a health security matter, and also human security, as well as even going as far as a national security threat.” The Covid-19 pandemic has shown us “the need for us to look at the security from a human perspective”, that “we are more connected as humanity”, and “the inequalities that we thought existed are more profound within countries between countries and between regions than we thought”. As North America and Europe begin this murky transition to the next stage of the pandemic, Dr. Nkengasong is concerned that we will “begin to refer to COVID as a disease that will soon be over in the US. And then of course, because of that, it becomes one of the neglected tropical diseases where we now have to rely on foundations or charity to take care of.” He recently called for a pause in vaccine donations: “we're saying that we have a lot of vaccines in the country. Now our problem is vaccination”. “I'm a big believer in that we should always pause to evaluate where we are in response, and then make corrective actions”. How will Africa overcome its major challenge of vaccine hesitancy? “I think every good public health practice as you and I know is local. The concepts are global, but in practice is local, which means Africa must take its own socio-cultural context and deal with it and then find the touchpoints” Dr. John Nkengasong is the Director of the Africa Centres for Disease Control and Prevention, and has been nominated by President Biden to be the next head of the Office of the Global AIDS Coordinator in charge of PEPFAR, the President's Emergency Plan for AIDS Relief.
In this episode, oncologist Bryan Schneider and infectious disease expert Adrian Gardner from Indiana University, share what it has been like to get knocked down with COVID-19 twice, care for patients during the pandemic, lead the University's COVID response, and even a supreme court case on vaccination. Subscribe: Apple Podcasts, Google Podcasts | Additional resources: education.asco.org | Contact Us Air Date: 12/7/21 TRANSCRIPT [MUSIC PLAYING] SPEAKER: The purpose of this podcast is to educate and inform. This is not a substitute for medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. PAT LOEHRER: Hi. I'm Pat Loehrer. I'm a director of the Centers for Global Health and Health Equity at Indiana University Simon Cancer Center. DAVE JOHNSON: And I'm Dave Johnson. I'm a medical oncologist at UT Southwestern in Dallas, Texas. PAT LOEHRER: Well, welcome back to ASCO's education new podcast series entitled Oncology, Etc. Today, we'll be joined by two outstanding guests, Dr. Bryan Schneider and Dr. Adrian Gardner. We're going to do a deep dive about COVID-19. And Dave, I was thinking-- I was reflecting on my life. The thing in medicine is when new diseases come out. So in our earlier lives, when we started there, was no such thing as Lyme disease, HIV/AIDS-- tumors didn't exist. And then just in the last couple of years now, we have COVID-19, the SARS CoV 2. And I think as physicians, it's kind of exciting. What's your experience been with the COVID-19 in the wards at Parkland? DAVE JOHNSON: Well, it's been really, very challenging. You know, I don't know that the public yet has fully grasped the magnitude of this disease. I mean, 700,000-plus Americans have died of this disease. That's an astonishing number when you think about it. And I was just on the general medical wards just a couple of weeks ago with a wonderful team of residents and students. Patients with this disease are very sick. We often downplay it, but I'm telling you, these people are really quite ill and can get ill and symptomatic rapidly, within hours. So this is a serious illness. But I agree with you. One of the things I told the residents a year ago was to keep a journal, that there are a few times during the course of your training and career where a new disease emerges, and you can be part and parcel of that. And keeping a diary of what happened is something that I wish I had done when AIDS emerged back in the '80s, or other disease processes, like Lyme, as you mentioned. PAT LOEHRER: And syphilis for you, wasn't it? DAVE JOHNSON: Well, that was sort of the [LAUGHS] Hippocratic oath days, but yeah, no. I think that was-- I think-- I can't remember. We were hanging out together at the time, so I don't remember exactly. Yeah, no, it's been really remarkable. The thing that's been interesting to me is the response of individuals and their families to the disease, particularly once the vaccines came available. So maybe we can delve into that a little bit today, because I know one of our guests has actually experienced that himself, so we'll know more about that later. PAT LOEHRER: I don't think, to be honest, that we could have a better collective wisdom than we have today with Dr. Schneider and Dr. Gardner, who will talk about their personal and professional and I think the global impact of COVID. I don't think there's any two people better than that. The only thing we could do better is if Anthony Fauci was here by himself. But these guys are tremendous people. Dr. Gardner went to medical school at Brown, did his fellowship and infectious disease at Beth Israel, and then did his MPH at Harvard, and joined the faculty in Indiana University in 2012. When he was a student, he spent time in Kenya, with Joe Mamlin from Indiana University as part of the AMPATH program. And he came back to become the field director there. And he is just an outstanding person. He's now the director of the Center of Global Health for Indiana University and the Associate Dean for Global Health and has led the contact tracing for Indiana University. And he's going to give us some input from this. Bryan, again, I've known forever. He's just an outstanding medical oncologist. He is now a Professor of Medicine and Medical and Molecular Genetics here at IU. He's a Vera Bradley chair of oncology. He is the founding chair of our precision genomics program and just a superstar in breast cancer as well as pharmacogenomics and was one of the first to describe the unique neuropathy associated with the taxanes in breast cancer. So it's just a pleasure to have both of you here. DAVE JOHNSON: You know, Pat, it's great to have that talent there. It balances out the negativity of other faculty members. But that's great. Welcome, both of you. PAT LOEHRER: I loved you a minute ago. I've turned mute on from a distance here. Adrian, tell me a little bit about yourself, growing up and how you got to where you were. ADRIAN GARDNER: Sure, thanks. And thanks so much for the invitation and for being part of this and for the generous introduction. So as you said, Pat, I'm a product of an international environment. That's an important part of my upbringing, actually. I was born in Scotland to two parents that-- born and bred in Scotland and grew up in Scotland. I spent the first six years of my life really living in France and then moved to Lawrence, Kansas, which was quite a cultural shift, but spent four years there. And it was great, actually, time in my life to be there, before moving to the East Coast, where I went to school and did all my medical training. So I'd had international experiences before, and I think that was an important part of my upbringing and something I sought for my kids, in the sense that it just immediately resets your sense of the world and makes you feel like a global citizen as opposed to just sort of more limited-- the community you're surrounded by. But it really wasn't until my experience as a fourth-year medical student at Brown that I had the opportunity to see health care in a low-resource setting and see that. And that was a very powerful experience professionally and personally. And as you said, it was the time when Joe Mamlin was really just dreaming up what the HIV response was going to look like, this nice institutional partnership that we'd set up in Western Kenya. But we set it up in the middle of the global pandemic. And true to our mission of responding and leading with care, felt a need to respond to the HIV pandemic. And that started really by-- was motivated by personal interactions that Joe had with some individuals who he saw firsthand come back to life, the Lazarus effect that has been reported. And that really spawned this whole response, changed my career and certainly my life, and had profound effects on my life. So that's a bit of who I am as an individual and how I got to where I am today. PAT LOEHRER: And we're going to touch on some of the work that you're doing now. But before I do, Bryan, tell us a little bit about and your background, where you grew up and how you got to where you are today. BRYAN SCHNEIDER: Thanks to you, and Dave as well, for having me on. And this will be an interesting perspective, because I think I'm coming on here as the patient this time, so it'll be a different view. But in contradistinction to Adrian, I am a pure Hoosier. I was born in the southern part of the state and raised there and then drove three hours north to Indianapolis, where I've set up for the last 25 years, and just been really lucky to be here at Indiana University. And Pat, you may not even remember this-- about 25 years ago, you were my formal mentor for med school, and so one of the influences and sticking around here along with some other real greats along the way. So have done, as you mentioned, breast medical oncology here in genomics and have had an absolute blast. So thanks for having me on. PAT LOEHRER: Oh, we love having you. And just as an aside, Bryan-- one is I think the world of you, and so proud of what you've accomplished. But Bryan's backyard actually was the home of Henry Lynch, and where he first described Lynch syndrome down in southern Indiana. And I think no greater tribute in his legacy than what you have done with precision genomics. It's really terrific. DAVE JOHNSON: Yeah. Maybe we'll have some time to delve into that. But actually, I'm curious, Bryan-- you mentioned that you've come on as the patient. My understanding is you've had firsthand experience with COVID, not just as a physician, but as the recipient of that wonderful new virus. Maybe you could tell us a little about that? BRYAN SCHNEIDER: Yeah, an interesting experience to be sure. So about 2 and 1/2 months ago, I tested positive for COVID and got really sick. Yeah, my three-year-old son had brought it home from his preschool and infected his older brother, who's almost 12, and then my wife and myself. And so was a really fascinating experience, I guess, and brought about some aspects to the virus that I had never really thought about. PAT LOEHRER: Now, Bryan, you also had COVID before, too. BRYAN SCHNEIDER: Yes. And the first time-- I was probably one of the very, very early cases and got really sick with it and lost my sense of taste and smell. I actually got one of the purple fingers, which I went to the ER for. I thought I was having a or something. And at the time, those weren't well-recognized symptoms. And that loss of taste and smell went months for me. So, yeah, I think I have frankly had the infection twice. The second time, though, was documented and certainly got really sick with the second one. DAVE JOHNSON: Can you elaborate on your second case? When you say you got really sick, was it a respiratory illness or were there other symptoms? BRYAN SCHNEIDER: Yeah, there were two aspects to it that were interesting. I think the first was physical. I got a sense of fatigue that I don't know that I have ever experienced before. It was one that I literally just could not get out of bed. And you know, I lost about 10 to 15 pounds from just being anorectic. And I'm not an overly thick human to begin with. But the big one was shortness of breath. And we had a pulse ox at home. My wife's a pediatrician, and I was sating in the high 80s. And I work out five or six times a week, so keep in pretty good shape, and I was stopping midway up the stairs to sit down, because I felt really tachycardic and just lightheaded. And so that degree of physical punishment is something like I have never expected or felt before. But the psychological part of it was really something I did not expect. And one part of that was an odd sense of guilt. I was getting texts and calls from a lot of friends checking on me, and many were baffled and asking, hey, did you not get vaccinated? Or what was going on with that? And so that-- it was a very odd sensation to me, because I, of course, had been vaccinated and I mask and all those sort of things. The other was one of real fear. I worried-- you know, luckily, I guess, our family all got infected around the same time, so we didn't have to think about quarantine. But I started wondering, could I have infected a patient? I take care of immunosuppressed breast cancer patients, before I was symptomatic. And then even after I came back to work, I had quarantined for quite some time, but I was really fearful. I would find myself double masking, washing my hands incessantly, and even holding my breath when I was trying to listen to heart and lungs during examination. So that sort of psychology was something I don't think I really expected with this infection. DAVE JOHNSON: How long did it take you to get beyond that, or are you beyond that part? BRYAN SCHNEIDER: Yeah. You know, I feel back to my baseline now. And I certainly don't worry about it on a day-to-day basis now. But my first clinic or two back was really hard for me, psychologically and emotionally. And part of me even wondered, should I profess to all my patients that I've had COVID? Or what things can I do to help protect them? And again, it was that mental aspect that I just didn't really anticipate prior to heading back to my clinic. DAVE JOHNSON: You know, this is eerily reminiscent of the physician who's had cancer who experiences extreme fatigue for the first time, chemotherapy-induced fatigue, after having described it many, many times before-- BRYAN SCHNEIDER: Right. DAVE JOHNSON: --and who has a guilt sensation in many respects as well. So quite the experience, for sure. PAT LOEHRER: Dave was talking about himself, by the way. BRYAN SCHNEIDER: No, I can only imagine. And you're right. We do try to paint a picture to patients about how things are going to feel, and it's amazing. When it's internalized or when you're feeling, it's-- it can often bring about a sense of, wow, I don't know that I-- I may have underplayed this to some of my patients in the past. And it really does provide some degree of empathy that's hard to capture if you haven't felt it. DAVE JOHNSON: So when I was on the wards, Bryan, I must confess, there were times when we walked into a patient's room with COVID who, of course, had not been vaccinated long after the vaccines were approved. Our professionalism prevents us from doing anything other than taking care of those people, but I'm wondering how you feel about caring for patients who have not been vaccinated or refuse to be vaccinated. BRYAN SCHNEIDER: Yeah. I mean, I think probably similar to a lot of people listening here today, it's a bit frustrating. And I think we all take care of patients who have a really tough diagnosis. And we're in the interesting field of giving patients medications that really immunosuppresses them, so we spend time counseling on the fact that you may get really sick or hospitalized or even die from neutropenic sepsis. And I think that is something that rests really hard with patients who are already dealing with a life-threatening diagnosis. And so now, trying to do that counseling in the face of a global pandemic like we haven't seen for a hundred years has really brought around a sense of duress and distress in my patients like I've never seen before. You know, I even had a patient who moved away from her family to be quarantined during adjuvant therapy, which I, of course, recommended against. But it really impressed upon me how big a deal this was. And so to see their frustration, and then in contradistinction, understanding that some people didn't want to pitch in to help-- it was very frustrating and honestly just made me very sad for people who I know were really struggling with this. DAVE JOHNSON: Actually, I had one more question to ask you. You mentioned coming back-- did you, in fact, share your diagnosis with your patients? I mean, I-- when I had cancer and came back, I made a pact with myself that I wasn't going to do that. But then I learned that the nurses were telling patients that I had cancer, and I found that it actually was helpful to share that diagnosis with many of my patients so that they could ask questions and feel that they had someone who really had experienced what they were either going through or about to go through. So I'm wondering how you've shared your diagnosis of COVID with patients, if at all. BRYAN SCHNEIDER: No, that's a great question. And I may have followed a similar pattern. At first I didn't. I didn't know what to do, to be frank. I didn't know if my saying that would make that patient, in that moment, more stressed out or worried, and I certainly didn't want to add to that. So I took it upon myself to try to make myself as safe to them as possible. But now that I've had a little chance to reflect on it, I have shared it. And I think for some of my patients, it's been good for them to hear what that experience was like. I think it's also-- Dave, as you probably know, I think it also reminds them we're human, too, and we experience some difficulty with physical health and I think in some ways it allows us to bond in a little bit deeper way. DAVE JOHNSON: I agree. PAT LOEHRER: I want to turn the attention over to Adrian now. Adrian, you're in a unique position, obviously one because of your experience in Kenya, and we want to hear about that, but also your responsibility for Indiana University. What some of the listeners may recall is that there was a decision made that you were part of that actually mandated that students in Indiana University be required to have vaccination before they came to school. We were in Kenya at the time when we heard that there was some consideration about that from the state legislature in terms of how-- mandating that. And eventually, this was a case that in which eight students took this case to cohort that eventually reached to Amy Coney Barrett, who decided to find in favor of Indiana University. It was a landmark decision here. But tell us a little bit about your experience on the leadership role of COVID and the impact that you see in terms of yourself personally and from the field of the university. ADRIAN GARDNER: Yeah. Thanks, Pat. I think it's really two different worlds in my mind, in some ways, although clearly linked by this global pandemic. You know, I was just finishing my eight-year stint, essentially, in Kenya in March of 2020 when we got the news that the entire world was about to be declared a level 4 by the State Department. And well, that-- I remember actually talking to Joe Scodro on the phone. And he's like, what the heck does that mean? That's not in our playbook of what we do when things happen and we need to bring trainees home and sort of-- PAT LOEHRER: Scodro being the lead counsel for Indiana University here. ADRIAN GARDNER: Thank you. Yeah, yeah. So for me-- I mean, obviously I was making a transition back to a US-based career in this position as the Director for the Center for Global Health. But you know, I had a dramatic change in my position, right? I mean, who is going to do global health operations in the middle of a pandemic? Well, nobody, because nobody was traveling. So we had really shifted all of our Kenya operations to a virtual support. We pulled all our trainees and long-term faculty back, initially. And my own position here is-- got pulled into a leadership role in Indiana University's response to the pandemic, along with three other physician leaders. And we all took on a different component of the response. So I was involved in the contact tracing, in part because we had some experience with contact tracing and global settings and tuberculosis and HIV. And while the transmission dynamics are obviously quite dramatically different and has different implications, but some of the principles around contact tracing were similar in the sense that contact tracing is not about really a stick, but it's more about extending a carrot and extending the support that allows you then to create an enabling environment-- and a quick phone call, in this case-- to allow people to identify what it is to quarantine and isolate effectively. To get to the Supreme Court issues and around mandates-- I think it was fairly obvious-- we were part of a restart committee that had been put together by the Dean of the School of Medicine, Jay Hess, and it was fairly noncontroversial among that group that we were going to need vaccine as we marched through this. And we immediately set up a lot of testing infrastructure and what we called mitigation testing at that point of asymptomatic individuals in addition to creating systems that enabled people to-- with symptoms, to enable testing very quickly and to get results back and to get that whole infrastructure in place. But it was pretty obvious to us-- it was a group of medical, public health, and ethics and legal folks-- that we were going to need a high level of immunity to get back to anything normal, right? And as we began planning for the summer and the fall of 2021, it was like-- it's a no-brainer. I mean, the only way you're going to get high levels of immunity, if you want to bring people back into the same classroom, if you want to have people living in dormitories, if you want to have them engage in the normal activities that college kids want to engage in, then you've got to have a very high level of immunity. And the only way to really achieve that is going to be through vaccine mandates. And again, it wasn't-- it didn't feel unprecedented, because you have to get a whole bunch of vaccines when you go off to college or when you go to elementary school. And that's really the only way to achieve that high level of coverage that allows us to not have a bunch of measles in our environment. And we still have mumps, despite high levels of coverage. But yeah, it felt weirdly noncontroversial. But of course, the whole politicization, I think, of the whole response to the pandemic made this more controversial. And clearly, there are people that feel very strongly about it. But I think this-- framing it in a context of personal freedom versus public good has not been particularly healthy for us as a country. I guess I'm not terribly surprised that the Supreme Court ultimately ruled against the preliminary injunction. I think the formal case is still pending, but it's maybe been overtaken by events, because now there are government mandates that are requiring vaccine or regular testing of just about-- lots of different industries and government employees and things. So I think it was important that we took a stand on this. And I think it has set a precedent, I think, for other universities. There were initially some hospital systems doing the same. But I think it's made it a lot easier to keep moving through industries and health systems with this kind of decision. PAT LOEHRER: Parenthetically, there's-- this week, they announced the-- we've reached over a million cases of COVID in Indiana. But the lowest county for infectious rate is actually Monroe County, which is where Bloomington is, where Indiana University is. And it's less than half of the rate of the state. And so I think kudos to you and the staff that have done this. Just maybe briefly, could you reflect on your experiences in Kenya, here in the United States-- lessons learned by you or by the university or by public officials about the contrast? I am reflecting now about a patient I saw today, that-- we were talking about the booster vaccine. And unfortunately, in Kenya, most people haven't gotten their first vaccine, either. So reflect a little bit about the global impact as you've seen personally. ADRIAN GARDNER: Yeah. So again, I think it's felt like two different worlds, but obviously struggling with the same thing, right? So I think on a global perspective-- so Kenya has-- Kenya got off to a pretty good start because they were kind of late to the game when it came to COVID, and they were able to jump on and learn from some of the lessons about physical distancing and shutting things down that actually enabled them to escape in the beginning. Of course, there was probably transmission going on behind the scenes that we weren't detecting, and even till now, the numbers that are officially reported are really just the tip of the iceberg. I think know that. Kenya has only reported 250,000 cases and just over 5,000 fatalities nationwide since the beginning of the pandemic. But there are serology studies that suggest that 50%, 60% of the population may have actually been infected-- at least, right? And that's based on blood donor studies and things. So I mean, I think some of the initial challenges, obviously, around access to PPE-- as we think about health care settings there, which are-- our partnership is based in, as you know. It's just the lack of infection control and the ability to even think about infection control because you're lacking space. As you know, Pat, in many of these wards in low-resource settings, there are two patients in every bed. And one might have active pulmonary TB and one might be getting chemotherapy for breast cancer. And it's less than ideal. But as you think about how to respond to that, it's pretty hard when you don't have any space, right? I mean, we did a lot here in terms of retooling space and utilizing space that was not being used and putting in negative pressure rooms where they were needed and this kind of thing that just weren't options in Kenya. One good news was that I think in Kenya, in particular, the testing capacity was able to get an early jump because the HIV infrastructure, PEPFAR, the President's Emergency Plan for AIDS Relief, had established seven regional laboratories that were obviously running HIV viral loads and so had PCR platforms. And they were able to rapidly retool those and convert them into COVID testing laboratories for PCR. So that was good, but then never really got to the same point where we need to get to, which is that it's readily accessible to everyone in rural regions and rapid testing in order to inform triage protocols [INAUDIBLE] patients and try to figure out how to develop that. So there's been testing available, but just not in the quantities that were sufficient. You know, I think we've been able to work across virtual platforms to share knowledge about management and clinical protocol development. That's been another success story. Certainly our partnership is longstanding and so has allowed those relationships that have withstood the test of nonpersonal interaction. And of course, the biggest elephant in the room now is this issue of vaccine equity, as you pointed out. So about 5% of the population in Kenya has been vaccinated. Part of that is vaccine access. Part of it is probability distribution infrastructure. Think about low resource settings-- many of them do quite well with vaccine delivery, but they're early childhood vaccines, right? So they have whole infrastructure around maternal child health that's set up to do this. There's not a lot of infrastructure for rapidly mobilizing 50 million adults to try and get them in for a two-shot series. So how do you do that? I mean, yes there are some community assets in terms of community health workers and things, but so far, at least, the vaccine quantities available have not been sufficient to allow that kind of infrastructure to really take over, at least in Kenya. But it holds promise, I think. But then they also are up against the same, I think-- some of the same challenges that we face here in terms of vaccine misinformation and lack of trust. This is an area where I think trust is really key ingredient in health systems, and I think we've seen it in our own inequalities that have been made very, very obvious in our own country and really, the issue globally. And it's not a new lesson. We knew it from Ebola and other very obvious infectious diseases that have resulted in high degrees of death because of lack of trust. When I have taken care of patients here and I've had those same experiences that Dave was talking about earlier, where you want to just ask the patient, so why didn't you get vaccinated? As an infectious disease provider, we've been called in to a lot of these cases, and I've taken the opportunity to ask a couple of times-- not in a judgmental way, but trying to set the stage and just-- what is it about the system? And a lot of-- some of it is misinformation. Some of it is this politicization and political bias. But some of it is just a very subtle mistrust and this notion that you don't feel completely welcomed or resected within the health care setting. And that's enough to just turn it off to this point where, eh, I'm just not ready to do that. And I think that's sometimes more subtle than we appreciate, but it has a huge impact. DAVE JOHNSON: We're getting close to the end of our time. I want to pivot back, if I may, just for a quick moment to Bryan. This may be an out of-- from left field type of question, but we learned a lot about early chemotherapy from the infectious disease world. We took some of the infectious disease principles and applied them in the early years of chemotherapy. Do you think there's much to be learned from a precision medicine standpoint from the COVID pandemic? What are you taking away from not just your personal experience but the larger experience, if anything? Or is that just-- is it just too early to say? BRYAN SCHNEIDER: No, I mean-- I think I've always admired the speed and efficiency with which breakthroughs have happened in infectious disease. And I mean, the idea of a brand new virus coming on board a couple of years ago and coming to the point where we are today shows, I think, real innovation, but the ability to get behind a question and, as a community, answer it well. And I think from that standpoint, that's something that all disciplines, including oncology, can learn. I certainly think we're seeing more and more intersection, too, with the way we think about treating cancer and its impact on immunity. And so certainly in that way I think there's real connections. But I do think some of the innovations that were brought about from the NCI with the vaccines are going to really also herald in things that will be game-changers in the world of oncology and therapeutics as well. DAVE JOHNSON: That's great. PAT LOEHRER: If I can throw in something, too-- I think, Dave, particularly as we talk about global health, many of the cancers that we see in the low-to-middle income countries are caused by viruses. One of the number one causes of cancer in sub-Saharan Africa is cervical cancer. We could eradicate that by getting vaccines out there. In terms of the lessons learned, I think the lessons learned in oncology is that we need to deal more with population health and with prevention than we do with the treatment towards the end of the life. And hopefully that will be a lesson that we can take home with us around the world. ADRIAN GARDNER: Yeah, and Pat, I think we do need to do better as a global community in terms of sharing vaccine and getting manufacturing up, and not just for vaccines but PPE and therapeutics. It's just not fair, the world we live in now. And at least we all know that and we take it for granted in some ways. But it shouldn't be this unfair, right? And that's been part of the problem globally, and it's part of the problem in the United States. DAVE JOHNSON: Yeah. PAT LOEHRER: But the tail end also is access to drugs for chemotherapy, too, and to have radiation available for all these patients. So it is-- this access is an important part of health equity globally. And I think it behooves all of us to be involved with this mission. DAVE JOHNSON: Well, again, we've come to the end of our time. And we want to thank all of our listeners, but most of all, we really want to thank Bryan and Adrian for a wonderful interview. We really appreciate your time and you sharing your experiences with us. Thanks again to the listeners for tuning in to Oncology Etc. This is an ASCO educational podcast. We want to talk really about anything and everything, so if you have an idea for a topic or a guest, we invite you to share that with us and email us at education@ASCO.org. So thanks again. And remember, Pat, I before E except after C. PAT LOEHRER: [LAUGHS] Well, I'll see you later, then. DAVE JOHNSON: No, wait a minute. Wait a minute. Eight, leisure, sovereign, weight, weird, foreign, vein, neighbor-- apparently it doesn't work. [LAUGHTER] My second-grade teacher taught me that rule, and it's just wrong. [MUSIC PLAYING] SPEAKER: Thank you for listening to this week's episode. To make us part of your weekly routine, click Subscribe. Let us know what you think by leaving a review. For more information, visit the comprehensive e-learning center at elearning.asco.org.
US President Joe Biden has nominated Dr John Nkengasong to lead a public health programme on combating HIV/Aids, known as the President's Emergency Plan for Aids Relief.Dr Nkengasong is currently the head of the Africa CDC - the agency leading the fight against the Covid-19 pandemic.The US government initiative has been without a leader since February last year. Its former leader Deborah Birx left to join the US coronavirus task force.Experts say that many people were not getting tested while others were not able to take their medicine due to the interruption of supplies.
US President Joe Biden has nominated Dr John Nkengasong to lead a public health programme on combating HIV/Aids, known as the President's Emergency Plan for Aids Relief.Dr Nkengasong is currently the head of the Africa CDC - the agency leading the fight against the Covid-19 pandemic.The US government initiative has been without a leader since February last year. Its former leader Deborah Birx left to join the US coronavirus task force.Experts say that many people were not getting tested while others were not able to take their medicine due to the interruption of supplies.
US President Joe Biden has nominated Dr John Nkengasong to lead a public health programme on combating HIV/Aids, known as the President's Emergency Plan for Aids Relief.Dr Nkengasong is currently the head of the Africa CDC - the agency leading the fight against the Covid-19 pandemic.The US government initiative has been without a leader since February last year. Its former leader Deborah Birx left to join the US coronavirus task force.Experts say that many people were not getting tested while others were not able to take their medicine due to the interruption of supplies.
Host Carol Castiel speaks with veteran AIDS activist, journalist, and historian Emily Bass about her new book, To End a Plague: America's Fight to Defeat AIDS in Africa. Bass discusses the genesis and impact of PEPFAR, the President's Emergency Plan for AIDs Relief created by former President George W. Bush, its positive impact on Africa and challenges that remain in light of the coronavirus pandemic.
Host Carol Castiel speaks with veteran AIDS activist, journalist, and historian Emily Bass about her new book, To End a Plague: America's Fight to Defeat AIDS in Africa. Bass discusses the genesis and impact of PEPFAR, the President's Emergency Plan for AIDs Relief created by former President George W. Bush, its positive impact on Africa and challenges that remain in light of the coronavirus pandemic.
Dr. Birx, former Response Coordinator during the Trump administration of the White House Covid-19 Task Force, served also as the Global Health Ambassador and Coordinator of the President's Emergency Plan for AIDS Relief (PEPFAR) between April 2014 and January 2021. She joined us for an extended conversation on the accelerating changes surrounding us – the Delta variant surge, new discoveries regarding breakthrough infections among the vaccinated, continued vaccine hesitancy, and refusal that has prompted the declaration of “a pandemic of the unvaccinated.” As we speak, newly revised policies on masks and vaccinations are getting unveiled. What to make of this new phase, and where is it heading? We'll need far higher testing and genomic sequencing, intensified local engagement, a big push on accelerating therapies, and thinking ahead on what the future mix of vaccines will look like. Dr. Deborah Birx is a Senior Fellow at the George W. Bush Presidential Center
The latest episode of Px Pulse takes a deep dive into PEPFAR, The President's Emergency Plan for AIDS Relief. AVAC's former Director of Strategy and Content, Emily Bass, has just published To End a Plague: America's fight to end AIDS in Africa which documents its pioneering successes and its challenges.
#DidYouKnow: Prevention of Tuberculosis in People Living with HIV requires prevention interventions for both HIV infection and TB. This includes HIV counseling, testing, disclosure, partner testing and behavior modification to mention a few. Rumbidzai Venge speaks to Dr. Rachel Weber, HIV Services Branch Chief, CDC Zimbabwe and Dr. Blessing Mushangwe, Senior Program Manager, Zim-TTECH. Follow the conversation as they discuss preventing TB among people living with HIV in Zimbabwe. Courtesy of The U.S. President's Emergency Plan for AIDS Relief (PEPFAR)
We discussed a number of things including: 1. Richard's background and his impact on population health worldwide 2. Progress on the COVID-19 response - vaccines and treatments 3. Concerns about inequity in relation to the pandemic 4. Programs that are addressing these challenges Since the beginning of the AIDS epidemic, Richard Marlink, MD, has worked to establish HIV/AIDS research, training, and clinical care programs in the United States and abroad. He was instrumental in setting up the first HIV/AIDS clinic in Boston, and in the mid-1980s in Senegal, he was part of the team of Senegalese, French, and American researchers who discovered evidence for and then studied the disease outcomes of the second type of human AIDS virus, HIV-2. Previously at Harvard, Marlink helped create two partnerships with the government of Botswana: the 1996 Botswana-Harvard Partnership with the Harvard AIDS Initiative, where he was executive director, and the African Comprehensive HIV/AIDS Partnerships, a public-private partnership with the government of Botswana that was launched in 2000 with funding from the Bill and Melinda Gates and Merck foundations. Also in 2000, Marlink founded the Kitso AIDS Training Program, which would become Botswana's national AIDS training program. Kitso means “knowledge” in the local Setswana language. Marlink was the principal investigator for “The Tshepo Study,” the first large-scale antiretroviral treatment study in southern Africa, funded by the Bristol-Myers Squibb Foundation's Secure the Future initiative. His research in the region also includes clinical and epidemiological evaluations to help determine how antiretroviral treatment and national treatment programs can best be accomplished in Africa. Since 2000, programs he has created and/or led have trained tens of thousands of health care workers and helped establish national programs on the care, treatment, and prevention of HIV/AIDS in several African countries. Following the 2003 launch of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) to combat global HIV/AIDS, the largest commitment by any nation to combat a single disease in history, Marlink was Botswana's country director for the Botswana-Harvard PEPFAR effort. In addition, while serving as scientific director and vice president for implementation at the Elizabeth Glaser Pediatric AIDS Foundation, he was principal investigator of Project HEART, another PEPFAR Track 1.0 effort in five African countries. Project HEART began in 2004 and by 2011 had placed more than one million people living with HIV into clinical care sites in Cote d'Ivoire, Mozambique, South Africa, Tanzania, and Zambia. More than 565,000 were placed on life-saving antiretroviral treatment.
Join us for a rare visit with one of America's most trusted medical figures and leading experts on infectious disease, and take advantage of this unique opportunity to ask your questions directly. Dr. Fauci was appointed director of NIAID in 1984. He oversees an extensive portfolio of basic and applied research to prevent, diagnose, and treat established infectious diseases including HIV/AIDS, respiratory infections, tuberculosis and malaria as well as emerging diseases such as Ebola and Zika....and of course, COVID 19. He has advised six presidents on domestic and global health issues. He was one of the principal architects of the President's Emergency Plan for AIDS Relief (PEPFAR), a program that has saved millions of lives throughout the developing world. Dr. Fauci is the recipient of numerous prestigious awards, including the Presidential Medal of Freedom (the highest honor given to a civilian by the president of the United States) and the National Medal of Science. Learn more about your ad choices. Visit megaphone.fm/adchoices
Dr. Shepherd has worked in key areas like Botswana to address infectious diseases. He shares with listeners How HIV and TB are still tremendous problems in many parts of the world, Why the covid-19 shutdown has frozen many global treatment centers for infectious diseases like HIV and tuberculosis, and How tuberculosis stands as the top infectious disease killer in the world. Dr. James Shepherd is an infectious disease physician at Yale, New Haven hospital. For the past 20 years, he has advised and worked in TB and HIV global treatment programs. For example, he worked in Nigeria to roll out HIV treatment programs through the US-funded President's Emergency Plan for AIDS Relief. He also ran the CDC's TB and HIV research program in Botswana to address HIV symptoms and curtail TB spread, which has one of the most severe TB and HIV co-epidemics in the world, and worked with the CDC WHO contingent in India, advising on their national TB program. He describes his work with governments and health issues in smaller countries, which have a lot more challenges. He comments that one has to get creative, adapt, and work around issues and prioritize because there isn't the luxury of picking and choosing. He adds that there's a lot of pragmatism: these parts of the world are limited by funds so they have to make very hard choices for their people. He also tells listeners about the covid-19 shutdown's effects on some of these programs, how the lack of PPE, resources, and the "cold chain" supply of vaccines and medicines are no longer reaching places like Botswana. He adds how they handled the covid-19 precautions very well from the start and have very limited cases, but are suffering from this lack of other needs met. Therefore, Dr. Shepherd expresses his concern for the near future of TB and HIV symptoms relief, prevention, and treatments as well as the lack of vaccines like measles. For more information on infectious diseases from a global perspective, he suggests seeing web pages from philanthropic organizations like the global health section of the Gates Foundation and the UK's Wellcome Foundation.
In this episode of AIDS 2020, Steve and Andrew speak with Ambassador Deborah Birx, U.S. Global AIDS Coordinator and Special Representative for Global Health Diplomacy. Ambassador Birx has been on the front lines of the HIV/AIDS response both in the U.S. and around the world since the earliest days of the epidemic, and has led PEPFAR (the President's Emergency Plan for AIDS Relief) for six years. She previously served as Director of Centers for Disease Control and Prevention's Division of Global HIV/AIDS, and as the Director of the U.S. Military HIV Research Program at the Walter Reed Army Institute of Research. They discuss the work PEPFAR is doing to prioritize the health and education of young women, the need for stronger evidence and accountability in HIV programming, and making the impossible possible with diplomacy and partnerships.
Lieutenant Colonel (ret.) Sam Yingst lives with his wife Katie and 4 daughters in Zambia. His job is Chief of Laboratory Infrastructure and Support, US Centers for Disease Control in Zambia. He talks about the role of the US mission in Zambia and the long-lasting impact of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) started under President George W. Bush. Sam recalls critical times in his Army career when his role in monitoring and fighting infectious were a global priority. Sam's daughters attend international schools and his wife Katie works for an NGO focused on women and infant health issues in Afghanistan. Sam reflects on the values he learned at West Point and the enduring influence they have had on his life.
Deborah Birx is Ambassador-at-large and serves as the U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy. She chats about creating a 180 PowerPoint slide to convince the White House the Army needed to be part of the President's Emergency Plan for Aids Relief. She also shares how U.S. dollars have helped save millions of lives in Africa.
The President's Emergency Plan for AIDS Relief (PEPFAR) is a program that was born from bipartisan legislation in 2003 under George W. Bush's administration. It was the biggest global health investment for a single disease by any country in the world, and still is today. We sit down with Caitlin Horrigan from Planned Parenthood Federation of America to discuss the evolution of PEPFAR, the ways in which it has provided care for HIV/AIDS patients around the world, and the attacks it is now facing from the Trump administration. Support the show (https://www.reprosfightback.com/take-action#donate)
1.8 million HIV-infected people will die over the next 10 years in South Africa if US President Donald Trump cut foreign aid supporting HIV/AIDS treatment. This is according to a global study by the Annals of Internal Medicine. According to scientists and researchers globaly; sky-rocketing deaths in the African nations would far outweigh savings.The President's Emergency Plan for Aids Relief (PEPFAR) funding will now be $5 billion per year compared to the previous $6 billion, However, US State Department says no patient currently receiving antiretroviral therapy through PEPFAR funds will lose that treatment. Tsepiso Makwetla spoke to Treatment Action Campaign's General Secretary, Anele Yawa
Michael Gerson is a nationally syndicated columnist who appears twice weekly in the Washington Post. He is the author of Heroic Conservatism (HarperOne, 2007) and co-author of City of Man: Religion and Politics in a New Era (Moody, 2010). Gerson serves as Senior Advisor at ONE, a bipartisan organization dedicated to the fight against extreme poverty and preventable diseases. He is the Hastert Fellow at the J. Dennis Hastert Center for Economics, Government, and Public Policy at Wheaton College in Illinois. He serves on the United States Holocaust Memorial Council, the Holocaust Memorial Museum's Committee on Conscience, the Board of Directors of Bread for the World, the Initiative for Global Development Leadership Council, and the Board of Directors of the International Rescue Committee. He is co-Chair of The Poverty Forum and Co-Chair of the Catholic/Evangelical Dialogue with Dr. Ron Sider. From 2006 to 2009, Gerson was the Roger Hertog Senior Fellow at the Council on Foreign Relations (CFR). Before joining CFR in 2006, Gerson was a top aide to President George W. Bush as Assistant to the President for Policy and Strategic Planning. He was a key administration advocate for the President's Emergency Plan for AIDS Relief (PEPFAR), the President's Malaria Initiative (PMI), the fight against global sex trafficking, and funding for women's justice and empowerment issues. Prior to that appointment, he served in the White House as Deputy Assistant to the President and Director of Presidential Speechwriting and Assistant to the President for Speechwriting and Policy Advisor. Gerson joined Bush's presidential campaign in early 1999 as chief speechwriter and a senior policy adviser. He was previously a senior editor covering politics at U.S. News and World Report. Gerson was a speechwriter and policy adviser for Jack Kemp and a speechwriter for Bob Dole during the 1996 presidential campaign. He has also served Senator Dan Coats of Indiana as Policy Director. Gerson is a graduate of Wheaton College in Illinois. He grew up in the St. Louis area and now lives with his wife and sons in northern Virginia.
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