Episode 56: The legacy of AIDS shapes government's response to Ebola

Ebola has killed nearly 5,000 people and put America and the world on high alert. In contrast, the world’s worst pandemic, AIDS, hit the U.S. three decades ago and was largely ignored. Because of that, hundreds and then thousands fell sick and died of AIDS before the U.S. government even mentioned it publicly.

“The country had never had much of a discussion about homosexuality, they loathed us and feared us,” says long-time AIDS activist Peter Staley.

In those bleak years, activists organized, staged dramatic protests, and demanded new procedures at the Food and Drug Administration and the National Institutes of Health -- procedures that could help Ebola patients today.

“The openness to using experimental treatments and vaccines is a legacy of the AIDS epidemic and AIDS activists,” says Mark Harrington, director of the Treatment Action Group, an organization founded at the height of the crisis.

The lessons learned from AIDS are informing the world’s response to Ebola. But, says Harrington, it’s also clear there are lessons the world didn’t learn.

“We don’t really have a good rapid response system and these outbreaks are going to keep happening until we have better health systems in place in poor countries.”

On this week’s DecodeDC podcast, host Andrea Seabrook explores the legacy of the AIDS crisis, and its reverberations in the world’s response to Ebola.

Episode 55: Tackling unwanted pregnancies: a conversation with Isabel Sawhill

A staggering number of young women are having babies today who say they didn’t mean to get pregnant. New statistics from the Brookings Institution show that, among American women under age 30, more than 70% of pregnancies are unintended.

In her new book, “Generation Unbound: Drifting into Sex and Parenthood without Marriage,” Brookings fellow Isabel Sawhill tackles the hot-button issues of poverty, contraception and having children out of wedlock.

DecodeDC host Andrea Seabrook talked to her for our latest podcast. Here’s an edited excerpt from their conversation:

Andrea Seabrook: You have a couple of different prescriptions for what the government should do. One seems to focus on the fertility of women, that women who want to make it into the middle class or to break this cycle, should be on long-term birth control. Tell me a little bit about that idea.

Isabel Sawhill: Right now, the amount of unintended and unwanted pregnancies we have in the United States is enormous. Fifty percent of all pregnancies in the U.S. are unintended.

For single women under 30, unmarried women under 30, it’s 73%. So this is not a minor problem. This is the norm that people are having babies before they’re ready, and before they say themselves they want them.

Think about the following statistics: If you and your partner are using a condom after five years, your chances of getting pregnant are 63%. People haven’t been told that. If you’re on the pill, your chances of getting pregnant after five years are 38%. Now if you’re on long acting contraceptives like the IUD or implant, your chances are 2% after five years.

So it makes a huge difference what kind of contraception you use. We’ve had all of this debate about birth control, but very little discussion about how much difference it makes what kind you use.

Andrea Seabrook: Your work is controversial. Some people seem to think, ‘Oh, she just doesn’t want those poor kids or those brown kids to have babies.’ What’s your response?

Isabel Sawhill: This is a hugely important issue. So of course there’s huge sensitivity in this country to any suspicion that someone might be trying to prevent births to low income or minority women. And I looked at that issue very carefully and what I think people don’t realize is that the data show that rates of unintended and unwanted pregnancies are three or four times among low income women as they are amongst higher income women. The same for minority versus whites. Minority women are having huge rates of unintended pregnancy. Why shouldn't we want to empower them to align their fertility outcomes or behavior with what they really want? It’s not doing anybody a favor to allow them to have a child that came too soon or that they didn’t want.

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Episode 54: Disaster Prone: What you get may depend more on where you live than what you lost

This week on the DecodeDC podcast we’re talking to Scripps national investigative reporter Lee Bowman about his story on the disaster behind federal disaster aid.

When your house or town gets destroyed by a hurricane or a tornado, you may expect the federal government to step in and help. But whether you get money from the feds may depend more on where you live than on the extent of the damage.

The original idea behind federal disaster aid was to help only when the damage and scope of an event exceeded state and local resources. Now we have something called “disaster inflation” – many smaller storms that used to be handled by state funds are getting the national disaster label and the dollars that come with it.

The boom in federal disaster declarations by Presidents George W. Bush and Barack Obama is stretching resources at the Federal Emergency Management Agency (FEMA) and costing taxpayers billions. These two presidents are responsible for 38 percent of all disasters declared since the federal aid programs began in 1953 – and it’s not because the weather is getting that much worse. 

FEMA has come under fire for distributing aid disproportionately, as some see it, often disqualifying serious emergencies in large states while giving cash to more routine events in smaller states. And with so many more national disaster declarations – and with the agency stretched thin – sometimes FEMA spends more to run an operation then delivering aid for the disaster.

But politicians love to say yes when it comes to spending money to help people at home.  So don’t expect any campaign slogans calling for less federal disaster aid or any changes in how the money gets distributed.

Episode 53: Exit Interview: Rep. Henry Waxman reflects on 40 years in Congress

On April 14, 1994, the top executives of America’s seven largest tobacco companies filed into the hearing room before the House Energy and Commerce Subcommittee on Health and the Environment. Before speaking, the CEOs took an oath to tell the truth, the whole truth, and nothing but the truth – as most witnesses before Congress do. Each man then proceeded to testify that cigarettes and nicotine are not addictive. It was a moment that would change America’s relationship with tobacco.

On March 17, 2005, six of the most important Major League Baseball players at the time sat side-by-side before the House Government Reform Committee: Alex Rodriguez, Jose Canseco, Curt Schilling, Rafael Palmeiro, Mark McGwire and Sammy Sosa. With fans, kids, and reporters watching, most of the players refused to admit they were aware of the illegal use of steroids in baseball, or downplayed the breadth of the problem, until the question was posed to Jose Canseco. He told the assembled congressmen that a “large number of players” were using drugs, and that the trainers, managers and even team owners knew about it. It was a moment that would turn around Major League Baseball’s response to rampant drug use.

The work of one individual congressman was critical to both of these historic hearings: Rep. Henry Waxman, D-Calif. In both cases it was Waxman’s vision of bringing together the most important people at a sweet-spot in history that led to major changes in American culture.

After a four-decade career in Congress, Waxman announced this year that this term would be his last. As part of DecodeDC’s “Exit Interviews” series, podcast host Andrea Seabrook talks to Waxman about his career – and about mastering the art of the congressional hearing.  

Episode 52: The Vicar of Baghdad

He is called the Vicar of Baghdad, though his life couldn’t be more different from the average English vicar.

The Reverend Canon Andrew White leads St. George’s Church, the last Anglican church in Iraq. He also runs a clinic that sees thousands of patients a month, and a food program that feeds hundreds every week – regardless of their beliefs or religious affiliation.

But though this work is much admired, it is not what has made Rev. White famous. As president of the Foundation for Relief and Reconciliation in the Middle East, White has forged personal relationships with the heads of opposing Muslim groups in Iraq. He is one of the precious few people in the world who has the trust of both Sunni and Shia leaders.

Because of this, and because of the gritty humanitarian aid he extends to Iraqis, White says he is a danger to terrorists, especially ISIS, the brutal group ruling over large swaths of Iraq and Syria.

“I do not allow them to maintain their own extremist positions, and I do not allow them to say, ‘look, we have got to fight against the other’,” White says.

In this week’s DecodeDC podcast, host Andrea Seabrook sits down with Rev. White in the Library of Congress. He describes the danger and difficulty of continuing his work in Baghdad, and what keeps him going. White says he is driven to go deeper into the conflict, and tells Seabrook:

“You do that by listening to those who might be against you. Who is my enemy? It is the person whose story I haven’t heard. And so you listen to their story, you get to know who they are, and you befriend them. You eat with them, you become their neighbor. And then you can bring about change.”