This research project was sponsored by the International Institutions and Global Governance program and made possible by the generous support of the Robina Foundation.

• Rapporteur Report: Can Safety Be Ensured in a Time of Increased Globalization? (PDF)

In collaboration with the United Nations Joint Programme on HIV/AIDS (UNAIDS), the Global Health Program at CFR helped create the UNAIDS High Level Commission on HIV Prevention. The commission was supported by a Scientific Advisory Panel chaired by Laurie Garrett, which provided intellectual leadership and scientific backing. The goal of the commission and scientific advisory panel was to advance the "prevention revolution" called for by UNAIDS Executive Director Michel Sidibé and provide a road map for generating the necessary political will at the highest levels to overcome the cultural, gender, and resource barriers to reaching zero new HIV infections.

The call for a "prevention revolution" comes amid three major changes that have occurred in the last year in the HIV pandemic: the global financial crisis has slowed the rate of growth in support of HIV treatment costs for poor countries, raising concern that continued expansion of the global epidemic will outstrip donor support of treatment; changes in U.S. foreign assistance programs have placed greater emphasis on disease prevention and program accountability; two dramatic research breakthroughs have demonstrated that it is possible to slow the spread of HIV sexually through use of a new formulation of vaginal microbicides, and through daily oral dosing with anti-HIV drugs. Combined, these changes mean that preventing further expansion of the global pandemic is imperative, and it is possible.

For ten months the scientific panel, chaired by Laurie Garrett, analyzed evidence for new strategies to control HIV, presenting the Commission with the Declaration and Statement for its approval. Commission cochairs--both Nobel laureates--Françoise Barré-Sinoussi and Rev. Desmond Tutu, will now lead the commissioners on a global HIV prevention campaign.

The declaration and statement below, written by Laurie Garrett and the Scientific Advisory Panel, were released on December 1, 2010, World AIDS Day, and call on world leaders to act swiftly and accelerate the decline in new HIV infections and spark the prevention revolution.

• Declaration of the UNAIDS High Level Commission on HIV Prevention

• Statement in Support of the Declaration of the UNAIDS High Level Commission on HIV Prevention

On August 24, 2009, the President's Council of Advisors on Science and Technology (PCAST) released its "Report to the President on U.S. Preparations for 2009-H1N1 Influenza," predicting, among other things, that the H1N1 (aka "swine flu") pandemic would resurge in North America in September, peaking by mid-October, causing infection and illness to up to half the U.S. population before the end of 2009. The PCAST assessment also suggested that H1N1 vaccines would not be available for the general public until well after the mid-October peak, and the epidemic would surge so rapidly that it could overwhelm hospitals, medical supplies, and intensive care units, leading to as many as 90,000 deaths in the U.S. The predicted surge held special significance for schools, parents, and employers, as sick-outs and school closures could impact productivity. Despite months of preparation, supplies of vaccines, medicines, and protective gear were expected to be inadequate, and global competition for essential tools for pandemic control and treatment would be fierce. One billion doses of H1N1 vaccine were ordered from several pharmaceutical companies, and the bulk of that supply was prioritized for ten wealthy nations, particularly the U.S. Little, if any, vaccine, medicine, or protective gear was expected to be ready, affordable, and distributed for the bottom four billion poorest people on Earth.

The CFR meeting was convened at the predicted peak of the North American pandemic. Will the PCAST model have proven correct? Looking forward, what can be scientifically forecast regarding shifts in the virology and epidemiology of the H1N1 pandemic? What are the economic and financial impacts of the outbreak? What have been, and can be predicted to be, the foreign policy implications of the pandemic and related competition for medical and public health tools?

These meetings were made possible through the generous support of the Robina Foundation and Richard Brown.

In 2006, CFR Senior Fellows Isobel Coleman and Laurie Garrett launched the CFR Maternal Health Program to raise awareness and suggest policies that would help improve maternal survival worldwide. With the generous support of the John D. and Catherine T. MacArthur Foundation, the CFR Maternal Health Program convened a symposium on June 11 and 12, 2008, in Washington, DC, and New York entitled, "Rethinking Maternal Health." The symposium examined issues surrounding maternal health in the context of U.S. foreign assistance. A summary of the symposium is available below.

Summary of sessions 1 - 3 (PDF)

The Series was developed with the global public health practice at McKinsey & Company.

The goal of the series is to examine proven technologies that are known to be life-saving, but are not yet in widespread use in poor countries. A number of questions will be discussed, including: What are the barriers to ubiquitous use? What controversies surround them? Are there specific funding issues in Congress or in the Executive branch that currently make support for these efforts difficult, or impossible? Are there domestic political issues in the U.S. that limit their application? Are there reasons that desirability of these innovations is limited, on the ground in target countries? Are there novel ways to overcome current barriers to implementation, including different economic models?

A CFR general meeting and four roundtables will take place throughout spring and summer of 2007 where medical technologies such as male circumcision, HPV vaccine, eyeglasses, HIV vaccine, and sterile syringes will be discussed.

This day-long conference, which was held at the Council on Foreign Relations in New York, examined preparedness and planning efforts in the United States as the world faces the possibility of an influenza pandemic caused by H5N1, the avian flu virus.