Take as Directed

Sheryl Gay Stolberg, New York Times, offers her reflections on HHS Secretary Robert F. Kennedy Jr’s tenure over the past fifteen months. His vaccine agenda has always been an “outlier”—“an unpopular agenda”—yet it remains at the core of his identity. He has now “hit a wall.” Casey Means’ nomination to be U.S. Surgeon General is stalled; the recruitment of a CDC Director is stalled; Judge Murphy has put a hold on the ACIP and changes in the children’s vaccine regimen. Why did the White House not see the downside? “Fundamentally President Trump does not really care about health.” The MAHA movement, most interested in pesticides and eating healthy foods, “took a leap of faith,” signing on to Trump, yet is now outraged by the White House Executive Order declaring phosphorous—the base of the pesticide glyphosate—as a national security matter. Divorce may follow. “Rumors have been flying” that Secretary Kennedy may be leaving after the midterms. Who will replace him? “Mehmet Oz.”

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

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

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

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

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