The American Democracy and Health Security Initiative takes its name from the deeply-rooted belief of its founders that American democracy and health security are inextricable. American health security depends on maximizing our ability to live in a free society and manage a public health emergency simultaneously. Likewise, the health of our democracy depends on citizens’ faith in our institutions—our schools, workplaces, and especially our government—to protect them in a crisis. We must find a way forward that both respects the individual freedoms we hold dear and supports the collective good—and do so now, before the next devastating health emergency strikes. 

We believe that path forward is illuminated by state and local leaders who innovated in the pandemic’s darkest days. To chronicle these innovations, we interviewed in 2023-2024 a diverse cross-section of current and former state, local, tribal, and federal leaders across the health, business, education, and community service sectors. These leaders—lamplighters—reveal a host of solutions, strategies and systems—practical, actionable steps—to advance America’s health security, which are reflected in our Findings and Recommendations.

The American Democracy and Health Security Initiative is led by three organizations dedicated to finding bipartisan solutions to health security, and whose leaders have considerable policy experience in the executive and legislative branches of the U.S. government, the private sector, academia, and across presidential administrations of both parties: The Pandemic Center at the Brown University School of Public Health, works across disciplines and sectors to analyze evidence, educate a new generation of leaders, and ensure this work is translated to effective policy and practice around the globe; COVID Collaborative is a comprehensive and bipartisan assembly of leading experts in health, education, and the economy—and leaders representing the diversity of America—that develops consensus recommendations and engages with state and local leaders across America; and the Center for Strategic and International Studies (CSIS) Bipartisan Alliance for Global Health Security convenes Members of Congress, senior leaders, and subject matter experts to advance a concrete, forward-leaning agenda for U.S. global health security strategy. The initiative has been assisted by the National Academy for State Health Policy, and it was made possible through support from the CDC Foundation.

Disclaimer: All views, positions, and conclusions expressed in this publication should be understood to be solely those of the authors associated with The Pandemic Center at the Brown University School of Public Health, The CSIS Bipartisan Alliance for Global Health Security, and The COVID Collaborative. Language included in this report does not imply institutional endorsement by the organizations that authors represent. We are grateful to the lamplighters featured here for their efforts that informed this work, but they were not asked to endorse these findings and recommendations nor the issue papers, executive summary and introduction featured here.