A Shot in the Arm Podcast

Episode: Looking Ahead: Global Health in 2025
Date: January 6, 2025
Host: Ben Plumley

Episode Overview

This episode kicks off 2025 with host Ben Plumley examining the critical trends, urgent challenges, and unexplored opportunities facing global health in the year ahead. From the increasing collision of politics and health policy, the state of the HIV response, new innovations, and pandemic preparedness to the mounting crisis of trust in science and healthcare, Ben offers a candid, at times deeply personal reflection on what’s at stake and where the global health community must go next.

Key Discussion Points & Insights

1. Policy versus Politics in Global Health

Timestamp: 00:40

• Traditionally, maximizing health and incentivizing innovation were bipartisan, policy-driven goals.
• Since COVID-19 and increasing populist politics, global health is becoming a battleground of political contention.
• Quote: "What has helped me has been a debate on Blue Sky and particularly a thread from HIV activist and Yale academic Greg Gonzalez on the pitfalls of trying to find common ground with denialists." (01:52)
• Ben references historic missteps, like South Africa's HIV denialism in the 2000s (over 330,000 unnecessary deaths) and Brexit misinformation—illustrating the deadly consequences when politics trumps evidence-based policy.

2. The Ongoing Fight for Trans Health and Rights

Timestamp: 03:08

• The trans community faces escalating attacks worldwide.
• A Shot in the Arm will partner with Global Action for Trans Equality and the San Francisco Community Health Center for a podcast series spotlighting these challenges and the importance of standing firmly for trans rights.
• Quote: "Trans rights are absolutely all of our business while being firm on our values."
• Ben urges the community to “ditch our preoccupation with purity” and build wide-reaching alliances to combat the negative impact of populism.

3. HIV Response: At a Crossroads

Timestamp: 04:00

• HIV remains a global health crisis; AIDS will still be a significant issue post-2030.
• Key questions: Will PEPFAR be reauthorized? Will the Global Fund be replenished?
• Ben expresses concern over complacency: "Have we blinded ourselves to a sloppy faith in the end of AIDS epidemic by 2030 rhetoric?" (05:00)
• Excitement about biomedical innovations, especially new capsid inhibitors—long-acting treatments that could transform HIV care (six-monthly or annual injections).
• Notable Moment: Shoutout to co-host Yvette Raphael’s 2024 episode covering this innovation and the critical need to make such advances accessible, not just available.

4. Pandemic Preparedness & New Threats

Timestamp: 06:33

• H5N1 avian flu is a genuine and growing concern, with the potential risk of a more severe pandemic than COVID-19.
• COVID-19 persists: Need for annual vaccines and more research, particularly on long Covid.
• Ben shares personal impact: "After three infections, I still have residual brain fog and certainly a lack of sense of smell. Above all, I have a deep frustration beyond belief at the lack of research into the impact of COVID on other inflammation related diseases like Crohn's disease, which is something I live with." (07:26)
• Highlights the need for robust pandemic preparedness, better diagnostic platforms, and resilient supply chains.

5. The WHO Pandemic Treaty and Vaccine Equity

Timestamp: 07:45

• Mentions Nina Schwab's active, insightful reporting on the WHO pandemic treaty negotiations.
• Strong case for regional vaccine manufacturing hubs to prevent vaccine nationalism—as seen during C-19.
• Points out that “northern populist politics” and outdated intellectual property arrangements continue to block progress.

6. Innovation, Beyond Infectious Disease

Timestamp: 08:49

• Interviewed Petro Terre Blanche (Aphrygen, Africa's only MRNA R&D hub)—tracking their progress this year.
• Co-host Jeff Sturchio will focus on broad innovation:
  • End of viral hepatitis?
  • Advances in cancer vaccines and therapies
  • Nuanced understanding of inflammation and chronic disease
  • Undervalued priorities: Elderly care and mental health
• Personal story: Ben's experience with his mother's passing and exposure to the “medieval and barbaric” aspects of elderly care; upcoming episodes will tackle this theme.

7. Service Delivery Challenges

Timestamp: 10:38

• Echoes Dr. Eric Goosby: “We have great drugs, great technology, but it's making sure they reach people.”
• Calls for medicines/vaccines robust to real-world conditions (not dependent on extreme cold chains), and better diagnostics and expanded provider roles (e.g., nurse practitioners prescribing in underserved contexts).

8. The Crisis of Trust

Timestamp: 11:40

• Details partnership with Heidi Larson’s Global Listening Project (70-country, 70,000-person study).
• Survey examines: Who do people trust post-COVID? Who will they turn to in a future crisis?
• Quote: “Perhaps the most intriguing thing about the study...is what we do now. How do we stem the tide of distrust in our institutions?” (12:39)
• Cites lessons from the early HIV epidemic: distrust can evolve into partnership—but only through engagement.

9. Populism, Misinformation, and Digital Communication

Timestamp: 13:44

• Uses pop culture to illustrate: likens Elon Musk's current societal influence and platform to the hubris of “Peter Weyland” in the Alien movies.
• Quote: “Musk and his social media platform...are now focal points for unfettered misinformation and lies. How did he get there?” (14:16)
• Comments on the far right’s savvy use of digital platforms, and the global health sector’s struggle to keep up.
• Pushes the field to master new communication forms beyond peer-reviewed journals—"brash, accessible, short and longer form digital vehicles" (16:40).
• Warns of echo chamber effects on newer platforms like Blue Sky.

10. Building Unlikely Alliances

Timestamp: 17:36

• Argues the need to collaborate with new partners:
  • Business sector
  • Religious leaders (mentions a Global Listening Project/Gates Foundation initiative in Kenya and Nigeria around gender norms)
• Future episodes will feature these collaborations.
• Podcasts are an “underutilized opportunity” for the field.

11. Looking Forward: Expanding Voices & Outreach

Timestamp: 18:26

• Shoutout to Devex for their development sector reporting.
• Plans for more diverse guests and cross-podcast collaborations to broaden audience reach.

Notable Quotes & Memorable Moments

• On political challenges:
  "The world of global health is going to have to be creative to remain relevant at a time when it is more needed than ever." (01:10)

• On HIV/AIDS progress:
  "10 years ago you could imagine a trajectory that would ultimately consign HIV to history in, say, the way polio has been. I don't have that sense of imagination today." (05:10)

• On innovation delivery:
  “It’s how you deliver biomedical innovation to the people who need it that makes that innovation a real game changer.” (06:16)

• On personal experience:
  "After three infections, I still have residual brain fog and certainly a lack of sense of smell. Above all, I have a deep frustration beyond belief at the lack of research into the impact of COVID on other inflammation related diseases like Crohn's disease, which is something I live with." (07:26)

• On misinformation:
  “Musk and his social media platform...are now focal points for unfettered misinformation and lies.” (14:16)

• On digital communication:
  "We need to expand our reach from not just peer reviewed journals, but to include brash, accessible, short and longer form digital vehicles." (16:40)

Timestamps for Key Segments

• 00:40 – Policy vs. Politics: Trust, denialism, historic consequences
• 03:08 – Trans health rights, purity politics, forging new alliances
• 04:00 – The state of HIV: Innovation, complacency, integration
• 06:33 – Pandemic preparedness: Avian flu, COVID-19’s continued impact
• 07:45 – WHO treaty, vaccine manufacturing, equity
• 08:49 – Broader biomedical innovation, elderly care, and mental health
• 10:38 – Service delivery: Reaching patients, robust supply chains
• 11:40 – Crisis of trust: Global Listening Project findings
• 13:44 – Populism, Musk, misinformation, digital communications
• 17:36 – Strategic partnerships with business and faith groups
• 18:26 – Podcasting, media expansion, upcoming plans

Tone & Language

The episode is candid, questioning, and at times urgent, but consistently hopeful and proactive. Ben uses personal narrative and historical reflection, blending analytic depth with advocacy, and invites audience participation and critique.

Final Thoughts

Ben Plumley closes by welcoming listeners’ input on global health issues they want addressed in future episodes and affirms the show’s commitment to expanding its reach, diversity of voices, and impact in 2025.

“It's going to be a year 2025, no doubt about it, but I hope we can all stay engaged, positive, and continue to make an impact.” (19:10)