A Shot in the Arm Podcast

At the AIDS 2026 Global AIDS Conference in Rio de Janeiro, Ben interviews Dr. mike Reed about how global health technology succeeds or fails depending less on the tools than on governance, ownership, community co-design, and alignment with ministries of health and other relevant government authorities. Reed contrasts Rwanda’s scaled Zipline drone deliveries and a government-led “sovereign” AI large language model and real-time health dashboards with the many HIV AI pilots that never scale due to weak partnerships, poor interoperability, and lack of sustainable financing. They discuss AI’s potential to support marginalized communities with stigma-free access to information and care navigation, alongside risks around privacy, market capture by big tech, and the need for fair value exchange when community data trains models. Reed highlights a “force multiplier checklist,” Botswana’s youth-designed prevention campaign, and the need to speed up rigorous implementation science and data-to-action timelines. 00:00 Intro 00:32 Drones and donor tech 03:45 Why pilots fail 06:56 Rooting tech locally 10:59 Sovereign AI example 12:43 AI for key populations 18:28 Governance and commons 25:06 Force multiplier checklist 29:36 Data sovereignty rules 31:24 Faster science with AI 36:19 Optimistic closing 41:12 Thanks and wrap Learn more about the book: https://bit.ly/redefining-global-health More from UCSF Institute for Global Health Sciences: https://globalhealthsciences.ucsf.edu Check Out mike Reid’s Substack: https://substack.com/@reimaginingglobalhealth Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! What would it take for global health to avoid decline? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health — and look out for a dedicated sub channel for Redefining Global Health in the 21st Century under A Shot in the Arm’s YouTube home. Redefining Global Health in the 21st Century: The Podcast (Playlist on Youtube) https://bit.ly/rgh-book A Shot in the Arm Podcast Youtube (Main Channel) https://youtube.com/@shotarmpodcast

Recorded at AIDS 2026 in Rio de Janeiro at the Roche Diagnostics booth, host Ben Plumley speaks with Professor Pedro Cahn (Fundación Huésped, Argentina) and Dr. Rupa Patel (Whitman-Walker Health, Washington, DC) about why diagnostics—often overlooked in the HIV continuum—are the essential entry point to prevention and care, especially amid reduced funding. They discuss late diagnosis and loss to follow-up, structural barriers like clinic access and hours, and the need for community-led, person-centered delivery models including outreach brigades, mobile and home-based services, and task shifting to peers and other health workers. The conversation covers integrating point-of-care and lab testing, the promise and risks of self-testing with real-time linkage to support, and linking HIV diagnostics with broader health needs such as TB, STIs, diabetes, and cancer screening to advance equity and progress toward 95-95-95. 00:00 Welcome and Setup 01:22 Live Booth Kickoff 02:20 Why Diagnostics Matter 07:11 Late Diagnosis and Equity 12:15 Reimagining Care Delivery 19:28 Outreach Testing in Practice 22:53 Point of Care vs Lab 27:28 Self Testing Debate 34:35 Building Integrated Platforms 38:30 Policy and Provider Barriers 43:43 Closing Calls to Action Guests: Professor Pedro Cahn Scientific Director Fundación Huésped, Argentina Dr. Rupa R. Patel Biomedical HIV Prevention Clinical and Research Lead Whitman Walker Institute and Health, Washington D.C. Roche Diagnostics https://diagnostics.roche.com AIDS 2026 https://www.iasociety.org/conferences/aids2026 Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health. #hivaids #HIV #AIDS #globalhealth #AIDS2026 #RocheDiagnostics

Recorded at the AIDS 2026 conference in Rio de Janeiro, Ben and Dr. mike Reid discuss how climate disruption will exacerbate existing infectious diseases, enable emerging threats, and worsen non-infectious conditions, arguing global health must anticipate and mitigate climate-health impacts. They note health was sidelined at COP Egypt 2025 and that few national climate plans include health adaptation budgets. Case studies contrast Pakistan’s 2022 floods—2.6 million new malaria cases, fivefold dengue increase, and 20% of primary care facilities underwater—with Mozambique’s Cyclone Idai response, where PEPFAR-supported HIV infrastructure enabled faster recovery through reliable supply chains, information systems, energy backups, and workforce support. They emphasize integrated, resilient primary care and scaled community health workforces (e.g., Ethiopia), including community-delivered mental health care, amid shrinking donor support. mike explains applying Kate Raworth’s “donut economics” to climate-health financing, referencing the Bridgetown Initiative and proposing climate-health bonds, while also highlighting greener delivery, regional manufacturing, and lower-emission prevention tools like lenacapavir and cabotegravir. 00:00 Live from Rio 00:52 Climate-Driven Disease 03:26 Health Plans Missing 05:31 Resilient Systems 06:10 Pakistan Flood Case 08:00 Mozambique Cyclone Ida 11:35 Primary Care Backbone 12:27 Community Health Workforce 14:22 Conference Funding Shift 17:09 Donut Economics Explained 20:55 Cameroon Donut Priorities 22:25 Why Leaders Ignore Health 23:32 Financing Climate Health 29:57 Sustainable Global Health 32:09 One Key Investment 33:34 Rio Networking Surprise 35:02 Wrap-Up and Credits Learn more about the book: https://bit.ly/redefining-global-health More from UCSF Institute for Global Health Sciences: https://globalhealthsciences.ucsf.edu Check Out mike Reid’s Substack: https://substack.com/@reimaginingglobalhealth Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! What would it take for global health to avoid decline? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health — and look out for a dedicated sub channel for Redefining Global Health in the 21st Century under A Shot in the Arm’s YouTube home. Redefining Global Health in the 21st Century: The Podcast (Playlist on Youtube) https://bit.ly/rgh-book A Shot in the Arm Podcast Youtube (Main Channel) https://youtube.com/@shotarmpodcast

In this episode of Redefining Global Health in the 21st Century, Ben chats with authors mike Reid and Eric Goosby about how funding shocks become life-and-death realities, starting with a case from Zambia after the January 2025 U.S. pause and cuts to PEPFAR that left many without antiretrovirals and destabilized HIV services in a system heavily dependent on U.S. support. They describe behind-the-scenes efforts to warn political leaders, on-the-ground resilience and improvisation, and the emotional toll of what they view as an abandonment of dialogue. The discussion explores whether donor dependency was a design choice, the roles donors should play (equity gaps, global public goods, and underwriting transitions), and options such as co-investment requirements, government-to-government funding, debt-to-health swaps, public financial management support, domestic resource mobilization (including sin taxes), and potential roles for development finance and sovereign wealth funds, while stressing the need to define a clear destination for health financing and country ownership. 00:00 Welcome and Book Intro 00:29 Zambia Funding Shock 02:26 Why Zambia Matters 05:58 Scrambling After PEPFAR Pause 07:58 Resilience and System Fragility 09:58 Eric Goosby Reaction 15:37 Dependency by Design 18:44 Colonial Debt Reality 22:25 What Solidarity Looks Like 26:10 Donor Funding Roles 30:21 Accountability and Oversight 32:50 Co Investment and Direct Funding 35:37 Debt Relief as Co Investment 36:46 Debt for Health Swaps 37:46 Modernizing Gavi and Global Fund 41:26 Local Accountability and Trust 45:26 Post Aid Era Roadmap 48:19 Building Country Ownership 53:46 Sovereign Wealth Fund Ideas 58:04 New Finance Tools and Taxes 01:00:04 Defining the Destination 01:04:03 Call to Action and Thanks Learn more about the book: https://bit.ly/redefining-global-health More from UCSF Institute for Global Health Sciences: https://globalhealthsciences.ucsf.edu Check Out mike Reid’s Substack: https://substack.com/@reimaginingglobalhealth Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! What would it take for global health to avoid decline? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health — and look out for a dedicated sub channel for Redefining Global Health in the 21st Century under A Shot in the Arm’s YouTube home. Redefining Global Health in the 21st Century: The Podcast (Playlist on Youtube) https://bit.ly/rgh-book A Shot in the Arm Podcast Youtube (Main Channel) https://youtube.com/@shotarmpodcast

This episode was made in partnership with the International AIDS Society (IAS), Young Leaders Programme. ---- Host Ben Plumley wraps up the A Shot in the Arm Podcast from AIDS 2026 in Rio de Janeiro with Zarawu Adams, a medical scientist from Salama Clinic in Accra, Ghana, reflecting on an exhausting but valuable week balancing conference sessions with the IAS’ Young Leaders Programme. Adams highlights research linking antiretroviral treatment to metabolic crises such as type 2 diabetes, including work focused on pregnant women, and confirms through conversations with scientific leaders that this issue is still under-emphasized. She describes the Young Leaders program as a diverse international advocacy network across HIV and other infectious diseases that builds connections, fills gaps, and broadens engagement beyond science to policy, innovation, and activism. Adams emphasizes resilience, the funding crisis, and the urgent need to tackle stigma and discrimination – particularly as a driver of suicide, while noting increased visibility for LGBT communities within the IAS space. 00:00 Welcome to Rio 00:53 Metabolic Risks Spotlight 03:15 Young Leaders Program 04:53 Networking and Advice 07:26 Stigma and Discrimination 08:32 Activism and Funding Crisis 10:36 Resilience and New Ideas 14:27 Priority on Stigma 15:41 LGBTQ and Closing Reflections 17:54 Final Thanks and Sign Off Guests: Zarawu Adams Medical Scientist, Salama Clinic, Accra, Ghana AIDS 2026 https://www.iasociety.org/conferences/aids2026 Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health. #hivaids #HIV #AIDS #globalhealth #AIDS2026 #IAS

Host Ben Plumley speaks with Solange Baptiste Simon and Othoman Mellouk of the International Treatment Preparedness Coalition (ITPC) about their packed treatment pre-conference and concerns that treatment is being sidelined amid heavy focus on PrEP and prevention. They argue the prevention-versus-treatment framing is false, emphasizing a continuum from testing to prevention to treatment, and describe on-the-ground chaos as HIV services are integrated into broader chronic care with overstretched health workers and communities. They discuss a “strange” AIDS 2026 marked by funding cuts and reduced PEPFAR influence, uneven country leadership, and a shift from scientific innovation to challenges of financing, manufacturing, regulation, and equitable delivery of long-acting technologies. They caution against product-driven responses, stress human rights and stigma realities, and conclude that community power, involvement, and resourcing remain central to sustainable solutions. 00:00 Welcome and Guests 01:08 Treatment Preconference Highlights 03:13 Prevention vs Treatment Debate 05:00 Continuum of Care Reality 07:34 Clinic Integration Chaos 10:07 Conference Avoiding Hard Truths 14:58 Post PEPFAR Future 18:39 Product Hype vs Access 22:58 Fiscal Space and Priorities 25:13 Beyond Biomedical Fixes 30:19 2030 Targets Reality Check 32:29 Crossroads and Policy Choices 36:15 Community Hope and Closing 38:23 Final Thanks and Signoff Guests: Solange Baptiste Simon Executive Director, ITPC Othoman Mellouk Access to Medicines & Diagnostic Lead, ITPC ITPC Global https://itpcglobal.org AIDS 2026 https://www.iasociety.org/conferences/aids2026 Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health. #hivaids #HIV #AIDS #globalhealth #AIDS2026 #ITPC

At AIDS 2026 in Rio de Janeiro, host Ben Plumley speaks with Wame Jallow, Jerop Limo, and JulieBrenda Waweru about Shuga Global’s evolution from the MTV Staying Alive Foundation and why entertainment-education remains relevant for HIV prevention and youth health. They discuss how Shuga’s storytelling reflects young people’s lived realities, helps break taboos, builds agency, and connects audiences to services through a broader ecosystem that includes peer education, screenings, and chatbots. The guests describe how Gen Z’s autonomy, digital media habits, and demand for solutions require new ways of communicating health, while addressing backlash, misinformation, and harmful online influences. They also share reflections from the conference on shifting resources, community leadership, new prevention and treatment options, and the need to fund and empower youth-led solutions through stronger government and civil society collaboration. 00:00 Welcome and Guests 01:14 What Is Shuga Now 01:22 From MTV to Global Movement 02:38 Proof Entertainment Works 04:54 Why Shuga Still Matters 07:28 Fan Stories and Impact 09:16 Gen Z Needs New Approach 14:23 Solutions Not Lectures 16:14 Youth Activism and Health Demands 17:45 Media Shift And Backlash 18:32 Short Clips For Health 19:02 Shuga As Holistic Support 21:18 Competing With Misinformation 22:45 Trust And Community Dialogue 24:43 Conference Takeaways 26:34 Science And Choice Agenda 27:30 Youth Power And Funding 30:56 Partnership With Government 32:21 Watch Shuga And Wrap Up Guests Wame Jallow Executive Director, Shuga Global Jerop Limo Executive Director, Ambassador For Youth and Adolescent Reproductive Health Program (AYARHEP) JulieBrenda Waweru Actress, Shuga Mashariki , Shuga Global Shuga Global https://shuga.global AIDS 2026 https://www.iasociety.org/conferences/aids2026 Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health. #hivaids #HIV #AIDS #globalhealth #AIDS2026 #Shuga #ShugaGlobal

This episode was made in partnership with the International AIDS Society (IAS), Young Leaders Programme. ---- Host Ben Plumley records from a windy Rio de Janeiro at AIDS 2026 with IAS Young Leaders guests Zarawu Adams (Ghana), Xandro Xu (USA), and returning guest Mengfei Li (Hong Kong). Adams discusses research on antiretroviral therapy–related metabolic complications and an app concept to monitor metabolic panels to prevent type 2 diabetes among patients on treatment. Xu presents research on how civic engagement and political empowerment relate to more frequent HIV testing among LGBTQ+ people in the United States, with findings highlighting benefits for transgender communities. Li shares success from a hand-dance campaign and a poster on why U=U messaging struggles to gain traction across Asia Pacific, noting ongoing knowledge gaps. They reflect on conference networking, stigma, funding uncertainty, integration with broader health priorities, optimism, collaboration, communication, and self-care as they commit to long-term HIV work. 00:00 Welcome and Guests 00:49 Metabolic Crisis Research 02:39 Civic Engagement and Testing 05:19 Hand Dance Campaign Wins 06:38 U Equals U Awareness Gap 08:43 Conference Takeaways 13:09 Why We Chose HIV Work 16:58 Can We End HIV 22:42 What Fuels Optimism 25:13 Family and Health Advocacy 28:31 HIV Fatigue and Funding Cuts 31:10 Lessons and Final Advice 37:37 Closing Thanks Guests: Zarawu Adams IAS Young Leader Medical Scientist, Salama Clinic Accra, Ghana Xandro Xu IAS Young Leader Researcher & Advocate, University of Pennsylvania alum Mengfei Li IAS Young Leader PhD Candidate, The University of Hong Kong AIDS 2026 https://www.iasociety.org/conferences/aids2026 Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health. #hivaids #HIV #AIDS #globalhealth #AIDS2026

On the first full day of AIDS 2026 in Rio, the A Shot in the Arm podcast (with the International AIDS Societies Young Leaders Program) captures excitement about new HIV science alongside anxiety over PEPFAR-related funding cuts and debate about reliance on a single donor. Guests include Florence, a Botswana-Harvard lab research scientist studying HIV/HBV coinfection and occult hepatitis B, reporting mutation findings (notably in the HBx region) and urging more inclusive OBI screening and greater HBV visibility at AIDS conferences; Bernard, a Nigerian doctor practicing emergency medicine in Russia, proposing integrating HIV awareness into existing emergency/ambulance systems to reduce stigma and cost; and returning guest Maggie Duncan, who presents work improving the Intact Proviral DNA Assay for measuring HIV reservoirs across subtypes. They discuss partnerships, private sector roles, long-term post-2030 HIV response, stigma, and unequal access to technologies and reagents. 00:00 Welcome From Rio 00:30 Conference Mood Check 01:08 PEPFAR Tensions 02:13 Meet The Guests 02:30 Florence HBV HIV Research 06:04 Clinical Coinfection Basics 07:08 Bernard Emergency Integration 10:18 Stigma Sparked A Pivot 11:45 Maggie Reservoir Assay 13:53 Florence Poster Deep Dive 19:18 Partnerships And Funding 22:58 Private Sector Debate 27:18 Beyond 2030 Future Outlook 31:27 Access Equity And Stigma 34:47 Closing Thanks Guests: Florence Gaone, IAS Young Leader: Research Scientist, Botswana Harvard Health Partnership Bernard Adorbe, IAS Young Leader: Medical doctor- Hospital of Emergency Medical Services, Rostov on don, Russia Maggie Duncan, IAS Young Leader: PhD Student at the Faculty of Health Sciences, Simon Fraser University Vancouver Canada AIDS 2026 https://www.iasociety.org/conferences/aids2026 Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health. #hivaids #HIV #AIDS #globalhealth #AIDS2026

From AIDS 2026 in Rio de Janeiro, host Ben Plumley talks with International AIDS Society Young Leaders Edmond Soko (Zambia, Grassroots Soccer) and Noah Mancuso (Atlanta, Emory/RTI) about where the HIV epidemic is heading. Edmond describes using soccer-based, play-focused curricula to deliver HIV prevention education and reach rural adolescents who struggle to access services. Noah outlines three posters: a systematic review on barriers and facilitators to injectable PrEP for adolescent girls and young women, an analysis of how US federal funding cuts affect geographic access to PrEP in Atlanta, and a review of 20 years of mobile health interventions showing limited translation into real-world apps. They discuss new prevention innovations like a monthly pill and a weekly prevention pill with earlier access planning, the promise and risks of AI and telehealth for reducing stigma and improving access, shifting funding realities, and ongoing activism and optimism for epidemic control. 00:00 Welcome to AIDS 2026 00:50 Meet the Young Leaders 01:24 Edmond’s Grassroots Soccer Work 03:00 Noah’s Path into HIV Research 04:09 Posters and New Findings 07:12 Soccer as Prevention Strategy 08:30 Conference Vibe and Tensions 10:24 New Prevention Innovations 12:11 Careers and Funding Cut Reality 13:34 Optimism and Activism 17:03 AI and Digital Health Trends 21:46 Telehealth Access and Stigma 25:16 Next Generation Takeaways 27:10 Closing Thanks and Sign Off AIDS 2026 https://www.iasociety.org/conferences/aids2026 Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health. #hivaids #HIV #AIDS #globalhealth

Ben launches the first of six daily A Shot in the Arm Podcast episodes from AIDS 2026 in Rio de Janeiro, produced with the International AIDS Society and its Young Leaders program. He interviews two young leaders: Mengfei, a Hong Kong–based PhD researcher in health communication who studies how to translate HIV science on social media and promotes U=U (Undetectable = Untransmittable), and Maggie Duncan from Vancouver, a PhD researcher focused on characterizing and improving quantification of the HIV reservoir to better measure cure strategies. They discuss why HIV is uniquely complex scientifically and socially, persistent stigma and lack of U=U awareness among young people in Asia Pacific, and Mengfei‘s U=U hand-dance campaign expanding from social media to offline events. Both present on Tuesday, with a U=U pop-up Wednesday in the Global Village. 00:00 Welcome to AIDS 2026 00:44 Meet the Young Leaders 01:07 Mengfei on Health Communication 03:26 U Equals U Explained 03:49 Maggie on HIV Reservoirs 06:41 What Makes HIV Unique 09:39 Stigma Across Generations 11:32 Talking HIV With Peers 15:50 Hand Dance U Equals U Campaign 21:30 Conference Plans and Wrap Up 23:16 Credits and Goodbye AIDS 2026 https://www.iasociety.org/conferences/aids2026 Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health. #hivaids #HIV #AIDS #globalhealth

From AIDS 2026 in Rio de Janeiro, A Shot in the Arm Podcast hosts, Ben and Yvette, discuss why convening the global AIDS community still matters amid major financial challenges and shifts in U.S. aid. They emphasize “humanity first,” the need for African leadership, sovereignty in HIV financing, and learning how programs survived when aid decreased because “the community stayed.” They discuss remembering people lost due to changes in American aid and reject “America First” approaches in favor of multilateral collaboration. They also highlight scientific innovation and access issues, including once-monthly PrEP, once-weekly treatment, new combinations, and the importance of real choice to address treatment fatigue, along with growing interest in African manufacturing and policies like South Africa’s BEE requirements. 00:00 Welcome to Rio 00:53 Why This Conference Matters 01:42 Funding Sovereignty Debate 03:57 Resilience After Aid Cuts 05:43 New HIV Science Pipeline 07:31 Choice and Local Manufacturing 11:24 Rejecting America First 13:29 Community Power and Wrap Up AIDS 2026, the 26th International AIDS Conference https://www.iasociety.org/conferences/aids2026 APHA - Advocates for the Prevention of HIV in Africa https://www.apha.org.za Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health. #hivaids #HIV #AIDS #globalhealth

In this episode of AIDS 2060, Ben explores how the climate crisis may disrupt the global HIV response with diplomat, author, and podcaster Arthur Snell, marking the U.S. launch of Snell’s book Elemental: The New Geography of Climate Change and How We Survive It. They discuss climate-driven population movements globally (from the Sahel to Central America and even within the U.S.), the political rise of hard-line migration policies, and how populism and disinformation can undermine science-based health and climate action. Snell outlines Africa’s potential as an energy superpower through critical minerals, agriculture, and renewable electricity exports enabled by new transmission technology, while Ben notes HIV risks linked to large male workforces and urban migration. The conversation also covers wildfire-related health impacts, pandemic risks from warming and thawing regions, and the need to rebuild trust and plan for food security and mobility beyond 2030. 00:00 Climate Crisis Meets HIV 01:29 Introducing Arthur Snell 02:10 Snell’s Diplomatic Journey 06:20 Surviving a Hotter World 09:02 Climate Migration Goes Global 13:37 Heat and Relocation in the West 17:35 Africa’s Energy Opportunity 20:44 Renewables and Global Power Grids 25:02 HIV Risks in New Economies 27:31 Populism and Misinformation 29:29 Populism Meets Denial 30:32 Net Zero Under Attack 32:09 Disaster Spin Machine 34:17 HIV Echoes Populism 37:01 Brexit Lessons on Emotion 39:13 Wildfires Health Toll 42:35 Firefighting and Solidarity 44:21 Thawing Ice Pandemic Risk 47:47 Trust Over Technocracy 50:46 Mobility Food and Futures 02:18 Closing Thanks and Next Steps Check out Arthur’s Book: Elemental: The New Geography of Climate Change and How We Survive it https://www.londonreviewbookshop.co.uk/stock/elemental-the-new-geography-of-climate-change-and-how-we-survive-it-the-first-comprehensive-account-of-the-geopolitics-of-climate-change-arthu Check out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health.

In this episode of “Redefining Global Health in the 21st Century,” Ben speaks with authors Dr. mike Reed and Professor Eric Goosby about how COVID exposed the geopolitical ramifications of Global Health, using Serbia’s vaccine deals with China, Russia, Pfizer, and AstraZeneca as a case study. They argue the era of a single global health superpower is fading and discuss a multipolar future shaped by “middle powers,” alongside the consequences of the US stepping back from traditional global health commitments, including leaving the WHO. The conversation critiques bureaucratic, duplicative governance and vaccine inequity, examines China’s largely transactional health role and the limited donor potential of the BRICS nations, and warns that the US defunding of South Africa’s HIV program harms HIV research more broadly. They call for stronger WHO implementation and decentralized rapid-response capacity, greater accountability, and less credit-seeking, while condemning tying lifesaving aid to transactional commercial arrangements, for example access to minerals and other commodities. 00:00 Serbia Vaccine Surprise 01:45 Multipolar Health Governance 05:04 US Retreat and Local Ownership 08:33 Why WHO Faces Critique 11:08 China Steps Into the Gap 17:04 BRICS Limits and Leverage 22:15 South Africa Research Stakes 24:54 WHO Reform and Decentralization 34:36 WHO Beyond Guidelines 36:29 Pandemic Governance Gaps 38:36 Climate Zoonoses Preparedness 39:45 Trust And Fragmentation 42:01 Rapid Response Blueprint 45:38 Inclusive Accountable Governance 49:36 Post Aid Future Financing 52:53 Hard Power Moral Costs 58:54 New Compact Conclusion 59:48 Humble Leadership Lessons 01:03:01 Thanks And Where To Listen Learn more about the book: https://bit.ly/redefining-global-health More from UCSF Institute for Global Health Sciences: https://globalhealthsciences.ucsf.edu Check out mike Reid’s Substack: https://substack.com/@reimaginingglobalhealth Check out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! What would it take for global health to avoid decline? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health — and look out for a dedicated sub channel for Redefining Global Health in the 21st Century under A Shot in the Arm’s YouTube home. Redefining Global Health in the 21st Century: The Podcast (Playlist on Youtube) https://bit.ly/rgh-podcast A Shot in the Arm Podcast Youtube (Main Channel) https://youtube.com/@shotarmpodcast

HIV prevention advocate Siviwe Gaika urges policymakers, governments, and donors to expand the HIV prevention “choice basket,” emphasizing long-acting injectable PrEP (cabotegravir) as WHO-recommended, safe, and highly effective, and calling for funding, youth-friendly delivery, streamlined national guidelines, and transparent accountability; she also acknowledges Glggobal Fund investment and South Africa’s commitment to long-acting innovation and local manufacturing. In the AIDS 2060 episode, host Ben interviews APHA executive director Yvette Raphael about why the world is not on track to end AIDS as a public health threat by 2030, the impact of shifting U.S. funding, and the need for country-led responses, health sovereignty, and dignity for key populations. Raphael centers feminist prevention advocacy, the Choice Manifesto, intergenerational leadership, better trial inclusion and post-trial access, and warns about misinformation on social media. 00:00 Youth Prevention Reality 00:55 Meet Yvette Raphael 02:21 Are We On Track 06:02 Funding Shockwaves 08:39 Self Reliance Now 12:04 Southern Led Response 15:55 Why Prevention Matters 20:41 Choice Manifesto Fight 23:15 Africa As A Market 25:51 Youth Boom Stakes 30:12 Let Youth Lead 31:49 Mentoring Future Leaders 33:01 Message to Our Future Selves 34:27 Pregnancy in Clinical Trials 38:25 Post Trial Access Rights 40:53 Why Youth Still Fear HIV 42:27 Social Media Misinformation 45:58 Health Sovereignty and Aid 50:31 Documenting Community Lessons 52:47 Pan African Collaboration 55:22 Let Young People Thrive 57:00 Closing Thanks and Next Steps Advocates for the Prevention of HIV in Africa https://www.apha.org.za Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health.

Host Ben Plumley welcomes Professor Heidi Larson (London School of Hygiene & Tropical Medicine) and Dr. Mark Anderson (Pattern Computer/Strategic News Service) to discuss innovation and equity in global health through the lens of “entropy” as chaos in human and data systems. Larson reflects on vaccine confidence as a window into societal trust in government, science, technology, and information, and announces a new Lancet Commission on rethinking misinformation, health, and human security. Anderson explains pattern-based, hypothesis-free discovery, critiques large language models as probabilistic and untrustworthy for life‑critical medical decisions and emphasizes explainable AI. They explore how rapid technological and social change, emotional determinants of health, and social media contribute to fragmentation, and outline plans to collaborate on macro-level patterns driving trust and misinformation while expanding access to Pattern’s discovery tools through international programs. 00:00 Welcome and Theme 01:01 Meet Heidi Larson 03:52 Meet Mark Anderson 05:42 How They Connected 09:48 Defining Entropy 12:18 Why AI Is Untrustworthy 14:53 Heidi on Life Imbalance 19:19 Mark Pattern Thinking 23:05 Pattern Discovery Example 23:41 Gene Pattern Breakthrough 24:39 Least Action Across History 26:21 Rethinking Misinformation Systems 31:53 Macro Patterns vs Specialization 34:22 Explainable AI for Humans 35:43 Vaccine Confidence Signals 42:23 Predictions and Broken Patterns 43:49 Collaboration Plans Ahead 45:49 Global Discovery Program Rollout 48:06 Trust and Communication Wrap 49:33 Closing Credits and Thanks Pattern Computer https://www.patterncomputer.com Strategic News Service https://www.stratnews.com Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments!

Ben Plumley speaks with Dr. mike Reid and Eric Goosby about their new book Redefining Global Health in the 21st Century, focusing on epistemology—how global health defines knowledge, evidence, and success. They argue global health has overprioritized biomedical metrics and donor-driven targets, often sidelining local knowledge, community co-design, and broader measures like sustainability, equity, and trust. Using examples from HIV/TB programming, maternal health, differentiated service delivery, and integration vs vertical programs, they discuss how humility and partnership shape effective, resilient responses and how “measurement is rarely neutral.” The conversation addresses threats to key populations under current political decisions, the need for epistemic justice and a preferential option for the poor, failures in academic authorship equity, and how shifts in US leadership and the climate crisis may reshape global health governance. They also stress better explaining global health’s value to taxpayers. 00:00 Local Wisdom vs Evidence 00:55 Meet the Authors 01:45 Epistemology and Priorities 05:09 Epistemic Humility 08:51 PEPFAR Lessons on Partnership 10:39 Measurement Is Not Neutral 13:18 Motivation and Co-Design 21:09 Integration vs Vertical Programs 25:05 Equity and Key Populations 32:06 Politics and Funding Dilemmas 34:31 Moral Case for Care 36:09 Domestic Front Lines 36:56 Beyond Us Versus Them 40:10 Epistemology and Donor Power 44:15 Inclusive Leadership Priorities 47:37 Vacuum After US Retreat 51:09 Climate as Next Crisis 55:34 Decolonizing Academic Incentives 57:55 Preferential Option for Poor 01:00:27 Selling Global Health at Home 01:04:36 Three Arguments for Taxpayers 01:06:56 Closing Reflections and Next Episode Learn more about the book: https://bit.ly/redefining-global-health More from UCSF Institute for Global Health Sciences: https://globalhealthsciences.ucsf.edu Check Out mike Reid’s Substack: https://substack.com/@reimaginingglobalhealth Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! What would it take for global health to avoid decline? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health — and look out for a dedicated sub channel for Redefining Global Health in the 21st Century under A Shot in the Arm’s YouTube home. Redefining Global Health in the 21st Century: The Podcast (Playlist on Youtube) https://youtube.com/playlist?list=PLW7yagTEtywqvW9_bs6heRikREgwS9sE9&si=TuNEdwcA9Z-VKLH A Shot in the Arm Podcast Youtube (Main Channel) https://youtube.com/@shotarmpodcast

Why does an undetectable HIV viral load sometimes flip to “detectable” — and what does that actually mean for the patient? Host Ben Plumley talks with Ben LaBrot (Professor of Global Medicine, USC; Medical Affairs Lead, Roche Molecular Diagnostics) and Daniel Griffin, MD (Chief of Infectious Disease, Island Infectious Disease Medical, Instructor of Clinical Medicine, Columbia University, Host, This Week in Virology) about the “viral blip” — a brief, low-level detectable result that occurs even in patients on fully effective antiretroviral therapy. The conversation covers the science behind ultra-sensitive viral load assays, the real meaning of U=U (undetectable = untransmittable), why lab handling and patient illness can cause a temporary blip, and why so many patients are blindsided by results in their MyChart before their doctor has a chance to explain. Ben and Daniel also discuss “prebunking” — preparing patients in advance — and the underused role of community health workers in HIV education. Topics: HIV, viral load, U=U, undetectable, antiretroviral therapy, infectious disease, diagnostics, patient communication, global health. 00:00 Welcome and Setup 00:13 The Viral Blip Riddle 01:20 Meet the Guests 04:02 Why Blips Matter Now 05:54 Assay Sensitivity and LOD 06:22 What Undetectable Means 08:36 U Equals U Confusion 12:50 MyChart Panic and Context 17:09 Prebunking Patient Fear 18:21 Why Blips Happen 20:59 Tech Problem Analog Fix 22:26 Testing Noise Sources 23:28 RNA Fragments Explained 25:16 Sample Handling Pitfalls 26:46 Reporting Low Copy Results 29:02 Managing Patient Anxiety 33:14 When a Blip Matters 36:12 Changing the Landscape 40:48 Community Outreach Ideas 43:12 Key Takeaways Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health.

In this second episode of AIDS2060, Ben sits down with Dr Andrew Kambugu, Executive Director of the Infectious Disease Institute at Makere University in Kampala Uganda. They discuss the state of the clinical response to HIV in Africa, and Andrew sets out a research and implementation agenda that gives equal weight to HIV prevention, treatment and diagnosis. He compares it to floor cleaning: you have to switch the water off at its source and not rely exclusively on mopping water up on the floor. In other words, African solutions for African problems of an epidemic that we know how to treat but can’t control rates of infection across the continent. 00:00 AIDS 2060 episode 2 intro 02:20 Three pillar overview 02:58 Prevention breakthroughs 04:19 Treatment momentum risks 06:00 Injectables and dual therapy 08:24 Integrating chronic care 10:12 Circumcision and ownership 14:07 Rethinking optimization 20:03 Africa led R & D 26:02 Africa CDC and AMA 27:42 Building Regulatory Capacity 28:21 Private Sector Momentum 29:37 Uganda Manufacturing Model 31:55 Academia Industry R&D 33:35 Africa Research Priorities 36:44 Biotech and Diagnostics 44:55 Funding and Innovation 49:51 Closing Thanks and Outro Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health.

A Shot in the Arm Media in partnership with UCSF Institute for Global Health launched a nine-part series to explore the future of global health built around the book Redefining Global Health in the 21st Century, co-authored by Dr. mike Reid (UCSF Institute for Global Health Sciences) and Ambassador Eric Goosby (former U.S. Global AIDS Coordinator and former PEPFAR Chief Medical Officer). In this episode, what if the greatest threat to global health isn't a new virus — it's us? Our funding fatigue, our outdated playbook, our addiction to replication over adaptation. We've saved millions of lives. But are we sleepwalking inexorably into decline, into the enshittocene. Eric and mike don’t think so. And they’ve written a book, “Redefining Global Health in the 21st Century, that sets out an alternative, optimistic future. In this episode, they reflect on the end of the old order, and the implications for innovation and scale up into a new era in global health. mike and Eric are hosted by Ben Plumley from A Shot In The Arm Media. 00:00 Series Kickoff Recap 01:25 Early Wins Foundations 02:07 Global Fund and PEPFAR Tensions 04:40 What Worked Best 06:29 Malawi Dependency Shock 08:48 Why Systems Collapsed 12:50 Donor Ecosystem Incentives 18:30 Designing Better Partnerships 23:25 New Players Multipolar Era 27:21 Philanthropy Promise and Peril 31:44 Limits of Philanthropy 32:24 Gates Foundation Lessons 33:41 Sustainability Commitments 35:56 Country Led Coordination 37:45 Innovation Beyond Tech Fixes 39:28 Private Sector as Resource Motor 42:02 Equity Risks and Guardrails 44:24 Indigenous Knowledge in Trials 48:08 From Pilots to Scale 52:19 Access and Global Rollout Rules 54:34 Paradigm Shift Takeaways 55:25 Episode Wrap and Next Steps Learn more about the book: https://bit.ly/redefining-global-health More from UCSF Institute for Global Health Sciences: https://globalhealthsciences.ucsf.edu Check Out mike Reid’s Substack: https://substack.com/@reimaginingglobalhealth Check Out Ben’s Substack: https://substack.com/@benplumley1 Join the Conversation! What would it take for global health to avoid decline? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health — and look out for a dedicated sub channel for Redefining Global Health in the 21st Century under A Shot in the Arm’s YouTube home. Redefining Global Health in the 21st Century: The Podcast (Playlist on Youtube) https://youtube.com/playlist?list=PLW7yagTEtywqvW9_bs6heRikREgwS9sE9&si=Tu-NEdwcA9Z-VKLH A Shot in the Arm Podcast Youtube (Main Channel) https://youtube.com/@shotarmpodcast