Redefining Global Health in the 21st Century: A New Series on Why Global Health Is at a Crossroads
Episode Description
A Shot in the Arm Media launches a new nine-part series produced in partnership with the UCSF Institute for Global Health Sciences, 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 prologue episode, Reid and Goosby explain why they wrote the book, what defined the “golden era” of global health since the early 2000s—the Global Fund, PEPFAR, Gavi—and why that progress now feels at risk under the Trump administration's cuts to USAID and PEPFAR. They introduce the book's central metaphor, borrowed from Cory Doctorow's concept of “enshittification,” to ask whether global health institutions are on the brink of decay, and argue that decline is a choice, not a destiny. The conversation previews the arc of the series—covering the old order, governance, financing, climate, technology and AI, and self-care for health workers—and closes with a call for honesty, bipartisanship and accountability, grounded in the legacies of Nelson Mandela and Steve Biko.
00:00 Introduction: Is the Greatest Threat to Global Health... Us?
00:49 Launching the Series: Redefining Global Health in the 21st Century
02:06 Meet the Authors: Dr. Mike Reid and Ambassador Eric Goosby
02:32 Why They Wrote This Book
03:28 Writing Through the Trump Transition
05:28 The Golden Era of Global Health
08:04 Shared Responsibility and Its Roots
10:21 What's Unraveling Now
11:34 Vancouver 1996 and the Roots of the Reckoning
12:18 Honoring Health Workers and Naming the Moral Injury
14:18 What Would Have to Change, Structurally and Politically
17:50 “Enshittification” and the Risk of Global Health Decline
20:30 Kuhn, Paradigm Shifts, and a New Vision for Global Health
22:17 Goosby's 38,000-Foot View: Aligning Need, Access and Governance
25:16 Reid on Financing, Governance, Science and New Tools
28:06 Mapping the Series and the Book's Chapters
32:11 Reform Agenda or Transformation Agenda?
35:19 Letters to My Daughters: Making Global Health Personal
37:31 Why Global Health Matters at Home
41:12 Does the Field Still Reflect Why We Got Into It?
43:18 Bipartisanship, Nelson Mandela and Steve Biko
46:18 Toward a Reckoning: Truth, Reconciliation and Accountability
51:02 “Not on Our Watch”
53:27 Holding the Administration to Account
56:32 The Book, Its Price, and Where to Find It
58:23 Sign-Off and What's Coming in Episode Two
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!
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Redefining Global Health in the 21st Century (Playlist on Youtube)
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