1 00:00:15,076 --> 00:00:21,596 Speaker 1: Pushkin, I'm may Have Higgins, and this is Solvable Interviews 2 00:00:21,596 --> 00:00:24,676 Speaker 1: with the world's most innovative thinkers working to solve the 3 00:00:24,716 --> 00:00:27,956 Speaker 1: world's biggest problems. My name is Steve Davis and the 4 00:00:27,996 --> 00:00:32,556 Speaker 1: President and CEO of PATH, and my solvable is that 5 00:00:32,636 --> 00:00:37,156 Speaker 1: we can in the next couple of decades eliminate or 6 00:00:37,236 --> 00:00:41,196 Speaker 1: eradicate five to ten diseases that are causing enormous human 7 00:00:41,236 --> 00:00:44,876 Speaker 1: suffering today. So our solvable today is a scary one 8 00:00:44,956 --> 00:00:49,156 Speaker 1: and an exciting one, eliminating or eradicating a number of 9 00:00:49,276 --> 00:00:52,636 Speaker 1: horrific diseases. If you want to freak yourself out and 10 00:00:52,636 --> 00:00:55,156 Speaker 1: you've got some time, you could check out the roll 11 00:00:55,276 --> 00:00:59,036 Speaker 1: call of the top diseases on the World Health Organizations 12 00:00:59,116 --> 00:01:03,916 Speaker 1: hit List. That list includes ebola and zeka and something 13 00:01:03,916 --> 00:01:08,116 Speaker 1: called disease X, which represents the knowledge that a serious 14 00:01:08,116 --> 00:01:11,316 Speaker 1: international epidemic could be caused by something that we don't 15 00:01:11,316 --> 00:01:14,876 Speaker 1: even know about yet. Disease X sounds terrifying, but of 16 00:01:14,916 --> 00:01:17,756 Speaker 1: course there are plenty diseases that we do know about 17 00:01:18,196 --> 00:01:20,916 Speaker 1: which we can try to fight, and they're the ones 18 00:01:20,956 --> 00:01:23,876 Speaker 1: you're going to hear Steve Davis talk about in this episode. 19 00:01:24,596 --> 00:01:27,396 Speaker 1: These diseases are some of the world's biggest killers, and 20 00:01:27,556 --> 00:01:32,276 Speaker 1: the organization Steve runs Path is working to either eradicate 21 00:01:32,476 --> 00:01:36,516 Speaker 1: or eliminate them. So top of Steve's list is polio. 22 00:01:37,236 --> 00:01:39,996 Speaker 1: Polio is one of the most feared diseases of the 23 00:01:40,036 --> 00:01:44,596 Speaker 1: twentieth century. It can cause permanent paralysis, and it's potentially deadly. 24 00:01:45,236 --> 00:01:48,396 Speaker 1: There's no cure for polio, but there is a vaccine. 25 00:01:48,956 --> 00:01:52,956 Speaker 1: Successful vaccination programs mean the US has been polio free 26 00:01:52,996 --> 00:01:56,676 Speaker 1: since nineteen seventy nine, and globally the number of reported 27 00:01:56,716 --> 00:02:00,916 Speaker 1: cases has fallen by ninety nine percent in thirty years. 28 00:02:00,916 --> 00:02:04,436 Speaker 1: But as you hear Steve say, the hardest part is 29 00:02:04,516 --> 00:02:07,036 Speaker 1: getting to the last few cases to wipe out the 30 00:02:07,116 --> 00:02:11,116 Speaker 1: disease for good. Another disase that is close to eradication 31 00:02:11,356 --> 00:02:14,836 Speaker 1: is malaria. It can feel like a flu, or it 32 00:02:14,836 --> 00:02:18,156 Speaker 1: can be a lot more severe, requiring urgent treatment and 33 00:02:18,276 --> 00:02:22,996 Speaker 1: actually endangering your life. The drive to wipe out malaria 34 00:02:23,156 --> 00:02:25,116 Speaker 1: is one of the best known, and the World Health 35 00:02:25,236 --> 00:02:30,036 Speaker 1: Organization publishes an annual report on the disease. However, last 36 00:02:30,076 --> 00:02:33,756 Speaker 1: year they wrote that after great success in reducing infections, 37 00:02:34,116 --> 00:02:38,036 Speaker 1: there'd be no progress made between twenty fifteen and twenty seventeen. 38 00:02:38,676 --> 00:02:41,556 Speaker 1: In twenty seventeen, there were two hundred and nineteen million 39 00:02:41,636 --> 00:02:44,676 Speaker 1: cases of the illness and it kills more than four 40 00:02:44,756 --> 00:02:50,596 Speaker 1: hundred thousand people. Steve also mentions riverblindness, and that's caused 41 00:02:50,596 --> 00:02:54,156 Speaker 1: by a parasitic worm transmitted to humans when they're bitten 42 00:02:54,196 --> 00:02:59,516 Speaker 1: by infected black flies. Riverblindness is found most often on 43 00:02:59,556 --> 00:03:04,796 Speaker 1: the African continent, but it's also in Yemen, Brazil, and Venezuela. 44 00:03:04,956 --> 00:03:09,116 Speaker 1: More than two hundred million people are at risk of riverblindness, 45 00:03:09,236 --> 00:03:13,596 Speaker 1: the world second leading infectious cause of blindness, so obviously 46 00:03:13,756 --> 00:03:17,876 Speaker 1: it can cause vision loss, but also severe skin diseases 47 00:03:17,916 --> 00:03:22,356 Speaker 1: and neurological damage. There's no vaccine for it, but countries 48 00:03:22,356 --> 00:03:26,156 Speaker 1: have been doing huge work to control and treat new infections. 49 00:03:26,676 --> 00:03:28,916 Speaker 1: Columbia was the first country in the world to be 50 00:03:29,036 --> 00:03:33,036 Speaker 1: verified and declared free of river blindness, then Ecuador in 51 00:03:33,076 --> 00:03:37,036 Speaker 1: twenty fourteen, Mexico in two thousan fifteen, and Guatemala in 52 00:03:37,156 --> 00:03:41,876 Speaker 1: two thousand and sixteen. Steve Davis describes himself as a 53 00:03:41,956 --> 00:03:46,476 Speaker 1: transformative innovator with a passion for global health and saving lives, 54 00:03:46,996 --> 00:03:49,556 Speaker 1: and he goes about doing this daily in his role 55 00:03:49,636 --> 00:03:53,436 Speaker 1: as President and CEO of PATH. Now, I love the 56 00:03:53,476 --> 00:03:56,876 Speaker 1: way this organization started out back in the nineteen seventies. 57 00:03:56,916 --> 00:03:59,876 Speaker 1: There was a bunch of researchers in Seattle looking to 58 00:03:59,916 --> 00:04:04,276 Speaker 1: help Chinese manufacturers make better quality condoms. Isn't not just 59 00:04:04,396 --> 00:04:08,916 Speaker 1: classic Seattle behavior and that was it. From their start 60 00:04:09,116 --> 00:04:13,076 Speaker 1: in family planning, PATH have now become a global charitable 61 00:04:13,156 --> 00:04:19,836 Speaker 1: conglomerate developing devices, medicines and services. Steve says PATH exists 62 00:04:19,956 --> 00:04:23,516 Speaker 1: because access to good health too often depends on where 63 00:04:23,516 --> 00:04:27,676 Speaker 1: we were born, our race, gender, ethnicity, age, and class. 64 00:04:28,436 --> 00:04:32,556 Speaker 1: His organization tries not only to improve individual health but 65 00:04:32,636 --> 00:04:37,076 Speaker 1: also the delivery of healthcare in developing countries. That includes 66 00:04:37,156 --> 00:04:41,476 Speaker 1: helping to build digital systems like mapping and data analytics 67 00:04:41,516 --> 00:04:44,276 Speaker 1: tools that are used to fight ebola in the Democratic 68 00:04:44,276 --> 00:04:48,356 Speaker 1: Republic of Congo. The scope of Path's work is vast 69 00:04:48,916 --> 00:04:52,036 Speaker 1: now unusually as an NGEO, almost all of their work 70 00:04:52,156 --> 00:04:55,996 Speaker 1: involves the private sector. That could be biopharma or digital 71 00:04:56,036 --> 00:05:00,396 Speaker 1: distribution anything. They try to bring private sector assets and 72 00:05:00,636 --> 00:05:04,396 Speaker 1: their ideas to bear on these huge global problems which 73 00:05:04,476 --> 00:05:08,876 Speaker 1: might not otherwise seem commercially attractive. We'll hear more now 74 00:05:09,236 --> 00:05:13,636 Speaker 1: this conversation with Jacob Weisberg. Okay, here we go. There 75 00:05:13,676 --> 00:05:18,916 Speaker 1: are many many diseases that kill hundreds of millions of 76 00:05:18,916 --> 00:05:22,676 Speaker 1: people a here that are actually preventable, that we know 77 00:05:23,756 --> 00:05:27,116 Speaker 1: how to treat it and hopefully how to even prevent it, 78 00:05:27,556 --> 00:05:31,876 Speaker 1: but that the problem is we're not getting enough access 79 00:05:31,916 --> 00:05:33,996 Speaker 1: to the people that need it the most of the 80 00:05:34,036 --> 00:05:39,156 Speaker 1: tools and the solutions. So the opportunity is now we 81 00:05:39,196 --> 00:05:43,476 Speaker 1: are in this extraordinary moment in history, or we're actually 82 00:05:43,516 --> 00:05:46,916 Speaker 1: pursuing to actually get rid of some of the oldest 83 00:05:47,116 --> 00:05:49,996 Speaker 1: killers on the face of the earth. What's brought you 84 00:05:50,156 --> 00:05:55,716 Speaker 1: to this problem? Well, I'm neither technologist by heart or 85 00:05:55,756 --> 00:05:59,436 Speaker 1: a doctor, but I do know and I believe in 86 00:05:59,476 --> 00:06:04,676 Speaker 1: the power of technology and human spirit together can conquer 87 00:06:04,716 --> 00:06:07,476 Speaker 1: a lot of things. And we've seen that already. And 88 00:06:07,556 --> 00:06:09,996 Speaker 1: what's so exciting is I think we're in a space 89 00:06:10,076 --> 00:06:13,796 Speaker 1: square in a time and history where those two things 90 00:06:13,836 --> 00:06:17,396 Speaker 1: have come together to actually vanish some of the world's 91 00:06:17,436 --> 00:06:21,116 Speaker 1: oldest killers. And I'm very inspired by the fact that 92 00:06:21,316 --> 00:06:24,676 Speaker 1: not only do we have political will and commitment at 93 00:06:24,716 --> 00:06:27,316 Speaker 1: a scale around a few of these diseases that we've 94 00:06:27,356 --> 00:06:31,996 Speaker 1: never seen before, we also have the technology, including both 95 00:06:32,036 --> 00:06:37,956 Speaker 1: the biochemical technology of better vaccines, better medicines. But really 96 00:06:37,996 --> 00:06:41,396 Speaker 1: importantly now is we have the digital tools to get 97 00:06:41,436 --> 00:06:45,796 Speaker 1: to know where to go, to map, to do geospatial awareness, 98 00:06:45,916 --> 00:06:48,836 Speaker 1: to all the things that it takes to actually identify 99 00:06:48,956 --> 00:06:51,036 Speaker 1: where the outbreak is or where the problem is and 100 00:06:51,116 --> 00:06:53,396 Speaker 1: how to get to them. And then of course we 101 00:06:53,436 --> 00:06:56,916 Speaker 1: also have a lot of political commitments, so we have 102 00:06:56,996 --> 00:07:01,316 Speaker 1: countries that are more capable to go after these diseases 103 00:07:01,356 --> 00:07:05,116 Speaker 1: and commitments to that. But in all of human history, 104 00:07:05,156 --> 00:07:10,436 Speaker 1: if I've got this right, we've only eradicated one disease, smallpox, 105 00:07:10,436 --> 00:07:14,436 Speaker 1: and that was maybe forty plus years ago. So what 106 00:07:14,716 --> 00:07:17,876 Speaker 1: is it about technology or what leap have we made 107 00:07:18,236 --> 00:07:22,676 Speaker 1: that makes you're solvable eliminating or eradicating five to ten 108 00:07:22,716 --> 00:07:26,156 Speaker 1: diseases in a few decades conceivable? Yeah, Well, it is 109 00:07:26,356 --> 00:07:28,756 Speaker 1: fascinating that in all of human history there's been only 110 00:07:28,796 --> 00:07:32,476 Speaker 1: one human disease that we've eradicated, and that is smallpox. 111 00:07:33,236 --> 00:07:37,036 Speaker 1: And I should be sure to distinguish between eradication, which 112 00:07:37,076 --> 00:07:41,076 Speaker 1: is completely eliminating the disease and really the potential for 113 00:07:41,116 --> 00:07:44,756 Speaker 1: the disease versus elimination, which is seeing how that get 114 00:07:44,836 --> 00:07:47,276 Speaker 1: in a region. We've really gotten rid of the problem, 115 00:07:47,316 --> 00:07:50,076 Speaker 1: and it is actually so the number has gotten so 116 00:07:50,156 --> 00:07:52,636 Speaker 1: low that it is it really will be very difficult 117 00:07:52,676 --> 00:07:55,996 Speaker 1: for it to re enter that region. But what's happened 118 00:07:56,276 --> 00:07:59,076 Speaker 1: is I think a few things. One is, human health 119 00:07:59,156 --> 00:08:03,356 Speaker 1: has just improved vastly over the last number of decades, 120 00:08:03,436 --> 00:08:06,916 Speaker 1: and we've produced children mortality by about forty percent in 121 00:08:06,956 --> 00:08:10,356 Speaker 1: the last twenty years. We've seen a lot of other improvements, 122 00:08:10,356 --> 00:08:13,276 Speaker 1: and that is actually giving us sort of a platform 123 00:08:13,436 --> 00:08:15,996 Speaker 1: to actually go after the really hard stuff, which is 124 00:08:16,036 --> 00:08:20,236 Speaker 1: to eliminate eradicate diseases. Secondly, there's been a large commitment 125 00:08:20,756 --> 00:08:23,276 Speaker 1: in the global community over the last twenty years to 126 00:08:24,316 --> 00:08:27,636 Speaker 1: global health and including what we see and in the 127 00:08:27,836 --> 00:08:32,396 Speaker 1: SDGs as around human health. The SDGs are the Sustainable 128 00:08:32,476 --> 00:08:37,156 Speaker 1: Development Goals, These commitments by countries around the world, including 129 00:08:37,196 --> 00:08:41,436 Speaker 1: a commitment to improved human health in a significant way. 130 00:08:42,116 --> 00:08:44,276 Speaker 1: I think the biggest two things really are that we 131 00:08:44,516 --> 00:08:48,796 Speaker 1: have money in the system, whether it's commitments made by governments, 132 00:08:48,836 --> 00:08:53,756 Speaker 1: commitments made by large foundations to actually target the eradication 133 00:08:53,836 --> 00:08:58,236 Speaker 1: of polio, the eradication of guinea worm, and the elimination 134 00:08:58,356 --> 00:09:01,636 Speaker 1: of malaria in many regions of the world. The elimination 135 00:09:01,716 --> 00:09:05,916 Speaker 1: of rabies, elimination of river blindness. And this is a 136 00:09:05,956 --> 00:09:10,156 Speaker 1: new level of commitment, including a political commitment, a funding 137 00:09:10,196 --> 00:09:12,956 Speaker 1: commitment that is enabled a lot of this to happen. 138 00:09:13,476 --> 00:09:17,076 Speaker 1: And then finally, I would say maybe the biggest game 139 00:09:17,156 --> 00:09:23,076 Speaker 1: changer is the digital revolution that's enabled us to understand 140 00:09:23,116 --> 00:09:28,716 Speaker 1: the data better, to target the communities, better to isolate cases, 141 00:09:28,756 --> 00:09:34,236 Speaker 1: easier to share information better. All of that comes together 142 00:09:34,756 --> 00:09:39,516 Speaker 1: to make a very powerful combination toward elimination or eradication. 143 00:09:39,996 --> 00:09:43,236 Speaker 1: You mentioned a few different human diseases which I'm really 144 00:09:43,236 --> 00:09:45,716 Speaker 1: interested in, But what's the next one do you think 145 00:09:45,756 --> 00:09:48,716 Speaker 1: to be eradicated? Is it polio? Yeah? The likely two 146 00:09:48,796 --> 00:09:52,556 Speaker 1: diseases for eradication the next few years. Actually, we're just 147 00:09:52,796 --> 00:09:56,516 Speaker 1: literally in the final stages is polio, which there's a 148 00:09:56,636 --> 00:10:00,716 Speaker 1: large global commitment too. It's not quite getting to the 149 00:10:00,756 --> 00:10:02,876 Speaker 1: finish line as fast as we thought, but we'll get 150 00:10:02,916 --> 00:10:04,796 Speaker 1: there in the next couple of years. We're down to 151 00:10:04,876 --> 00:10:07,756 Speaker 1: I think about thirty cases a total in the world 152 00:10:08,036 --> 00:10:11,076 Speaker 1: in three countries, and then guinea worm is very likely 153 00:10:11,116 --> 00:10:14,716 Speaker 1: again given very large commitment to that effort. And then 154 00:10:14,756 --> 00:10:19,116 Speaker 1: there's a suite of about fifteen diseases that the WHO, 155 00:10:19,316 --> 00:10:22,436 Speaker 1: the World Health Organization, has put on a list for 156 00:10:22,956 --> 00:10:27,716 Speaker 1: potential for either elimination or eradication. Some of those are 157 00:10:27,796 --> 00:10:30,876 Speaker 1: quite hard to do. Probably the one we're working with 158 00:10:30,916 --> 00:10:34,556 Speaker 1: the most is malaria, which is a huge problem in 159 00:10:34,596 --> 00:10:38,116 Speaker 1: the world still. It kills around four hundred to five 160 00:10:38,196 --> 00:10:41,756 Speaker 1: hundred thousand people a year, and yet we do have 161 00:10:41,916 --> 00:10:46,756 Speaker 1: many many countries that are year by year being declared 162 00:10:47,356 --> 00:10:50,396 Speaker 1: malaria free. And so just this last year, I think 163 00:10:50,396 --> 00:10:52,476 Speaker 1: four countries in the last two years have been declared 164 00:10:52,516 --> 00:10:55,316 Speaker 1: malaria free. And that's the kind of work we now 165 00:10:55,356 --> 00:10:57,716 Speaker 1: have to keep working on. There's a kind of paradox 166 00:10:57,836 --> 00:11:01,956 Speaker 1: around the effort to finally eliminate or eradicated disease, isn't 167 00:11:01,996 --> 00:11:04,996 Speaker 1: there in that when you're down to just a few cases, 168 00:11:05,356 --> 00:11:08,076 Speaker 1: you spend a lot of money on those few cases, 169 00:11:08,156 --> 00:11:10,716 Speaker 1: and you could spend that saved money to save a 170 00:11:10,716 --> 00:11:14,596 Speaker 1: lot more lives targeting a much more prevalent disease. How 171 00:11:14,596 --> 00:11:17,716 Speaker 1: do you deal with that in the community and philanthropic 172 00:11:17,796 --> 00:11:21,796 Speaker 1: world and the scientific world that you live in. Yeah, well, 173 00:11:21,876 --> 00:11:27,316 Speaker 1: disease elimination and particularly disease eradication is not a no brainer. 174 00:11:27,676 --> 00:11:29,916 Speaker 1: I mean it's obviously not a no brainer in terms 175 00:11:29,956 --> 00:11:32,196 Speaker 1: of how hard it is and to pull all this 176 00:11:32,316 --> 00:11:36,596 Speaker 1: together and also get the social and cultural peace right 177 00:11:36,716 --> 00:11:39,796 Speaker 1: along with the technology and data peace. But it's also 178 00:11:39,916 --> 00:11:43,276 Speaker 1: not a no brainer from a sort of political and 179 00:11:43,636 --> 00:11:49,436 Speaker 1: financial strategy, because in fact, the last cases become astronomically 180 00:11:49,556 --> 00:11:53,276 Speaker 1: expensive because either the hardest to get, and so a 181 00:11:53,316 --> 00:11:55,436 Speaker 1: lot of effort needs to go into finding them and 182 00:11:55,516 --> 00:11:58,116 Speaker 1: isolating them and getting rid of them. And some people 183 00:11:58,116 --> 00:12:01,716 Speaker 1: could argue the money we're spending to eliminate or excuse me, 184 00:12:01,756 --> 00:12:05,116 Speaker 1: eradicate polio, we could have taken that and done something 185 00:12:05,116 --> 00:12:08,076 Speaker 1: else with a different disease or a different set of problems. 186 00:12:08,116 --> 00:12:11,236 Speaker 1: But there's three reasons why I think make the compelling 187 00:12:11,276 --> 00:12:14,996 Speaker 1: case why we need to pursue this. One is still 188 00:12:15,596 --> 00:12:19,876 Speaker 1: you know, the potential to end the suffering and death 189 00:12:20,556 --> 00:12:24,396 Speaker 1: of people in the world who are vulnerable at diseases 190 00:12:24,636 --> 00:12:26,956 Speaker 1: that you and I aren't because we've made the commitment 191 00:12:27,116 --> 00:12:30,676 Speaker 1: here to do that is the moral reason we have 192 00:12:30,756 --> 00:12:33,076 Speaker 1: to We know how to do it. Let's go finish 193 00:12:33,116 --> 00:12:36,636 Speaker 1: the job, and let's make sure people are valued equally. 194 00:12:37,116 --> 00:12:41,236 Speaker 1: There's a second reason, which is the potential for ongoing 195 00:12:41,756 --> 00:12:45,796 Speaker 1: cost saving. So the estimation is in the tens to 196 00:12:45,916 --> 00:12:49,116 Speaker 1: twenty billion numbers around what it will save the world 197 00:12:49,516 --> 00:12:52,596 Speaker 1: once we eliminate polio from having to treat it and 198 00:12:52,716 --> 00:12:55,876 Speaker 1: manage it over the time. And then the final I 199 00:12:55,916 --> 00:13:00,516 Speaker 1: think is a strong belief that we need to demonstrate 200 00:13:00,716 --> 00:13:03,716 Speaker 1: to the world that we can actually get this job done, 201 00:13:04,156 --> 00:13:07,196 Speaker 1: because then when we go back to the global community, 202 00:13:07,316 --> 00:13:12,076 Speaker 1: whether it's taxpayers or legislators or funders, there is a 203 00:13:12,116 --> 00:13:15,476 Speaker 1: commitment that we can actually set a target, get it done, 204 00:13:15,836 --> 00:13:18,196 Speaker 1: and go after the next one. Yeah. I mean nobody 205 00:13:18,236 --> 00:13:20,636 Speaker 1: wants to march behind the banner that says let's almost 206 00:13:20,716 --> 00:13:23,396 Speaker 1: eliminate polio, right, I mean you need a level of 207 00:13:23,556 --> 00:13:27,596 Speaker 1: inspiration around an ambitious goal that says people have been 208 00:13:27,636 --> 00:13:32,636 Speaker 1: suffering for centuries from this, let's get rid of it forever. Yeah. 209 00:13:32,676 --> 00:13:38,316 Speaker 1: That's why I think it's exciting solvable because it's eminently doable, 210 00:13:38,556 --> 00:13:42,276 Speaker 1: although wildly difficult. But it's also there's a little bit 211 00:13:42,316 --> 00:13:46,196 Speaker 1: like the moment is now that we haven't ever had 212 00:13:46,196 --> 00:13:48,916 Speaker 1: this experience before. I mean, yes, there was one and 213 00:13:49,236 --> 00:13:53,916 Speaker 1: huge success called smallpox. But the idea that we can 214 00:13:53,996 --> 00:13:57,116 Speaker 1: sit at tables which I'm actually sitting at and talking 215 00:13:57,156 --> 00:14:00,636 Speaker 1: about which disease and how in what countries can we 216 00:14:00,676 --> 00:14:04,116 Speaker 1: eliminate it or could we take a global eradication strategy 217 00:14:04,676 --> 00:14:07,596 Speaker 1: is pretty remarkable in the scheme of things. So you 218 00:14:07,716 --> 00:14:10,796 Speaker 1: talked about data as the thing that really enables the 219 00:14:10,876 --> 00:14:15,756 Speaker 1: breakthrough here, But for data, you need good reporting. In 220 00:14:16,076 --> 00:14:18,916 Speaker 1: these countries where many of these diseases they are most prevalent, 221 00:14:19,356 --> 00:14:24,276 Speaker 1: don't have developed medical systems, they don't necessarily have good reporting. 222 00:14:24,516 --> 00:14:26,756 Speaker 1: I mean, I love the idea that we can visualize 223 00:14:26,756 --> 00:14:30,116 Speaker 1: these hotspots and pinpoint them, but how do we necessarily 224 00:14:30,196 --> 00:14:34,716 Speaker 1: know how it's happening. Well, again, getting the right data 225 00:14:34,876 --> 00:14:39,636 Speaker 1: and digital capabilities and infrastructure around these problems is not 226 00:14:39,836 --> 00:14:43,156 Speaker 1: trivial problem to solve. And the good news, I think 227 00:14:43,276 --> 00:14:46,676 Speaker 1: is there's quite a bit of energy and again investment 228 00:14:47,556 --> 00:14:51,516 Speaker 1: now know how in countries to do this. And the 229 00:14:51,636 --> 00:14:54,636 Speaker 1: other is that these systems that are being built are 230 00:14:54,716 --> 00:14:58,556 Speaker 1: not only being built around an elimination disease strategy, but 231 00:14:58,596 --> 00:15:02,436 Speaker 1: they're improving hopefully the national health system altogether. And so 232 00:15:02,476 --> 00:15:06,596 Speaker 1: the promises that we'll have improvement both around a disease 233 00:15:06,636 --> 00:15:09,436 Speaker 1: area and for the whole health system. But you know, 234 00:15:09,596 --> 00:15:12,076 Speaker 1: quality is always a challenge. Can we get the right 235 00:15:12,116 --> 00:15:15,156 Speaker 1: tools to the right people, Can we measure and validate 236 00:15:15,276 --> 00:15:19,076 Speaker 1: numbers in a correct way. But you know, we've certainly 237 00:15:19,116 --> 00:15:23,556 Speaker 1: seen through the polio eradication efforts, and my group helped 238 00:15:23,596 --> 00:15:27,916 Speaker 1: set up the emergency operations centers and did the geospatial mapping, 239 00:15:27,916 --> 00:15:31,036 Speaker 1: et cetera for some of the recent abola outbreaks in 240 00:15:31,116 --> 00:15:35,076 Speaker 1: the Democratic Republic of Congo. And while that's a very 241 00:15:35,156 --> 00:15:38,516 Speaker 1: difficult problem in it, there's all sorts of complications. The 242 00:15:38,596 --> 00:15:42,236 Speaker 1: data quality of what we know, where we know it, 243 00:15:42,356 --> 00:15:45,076 Speaker 1: how fast we know it is actually quite remarkable how 244 00:15:45,196 --> 00:15:49,636 Speaker 1: much it's improved. Who sets the priorities of which diseases 245 00:15:50,196 --> 00:15:52,876 Speaker 1: we go after? There are different places in the world, 246 00:15:52,956 --> 00:15:57,716 Speaker 1: they affect different constituencies. You have a quick list that 247 00:15:57,836 --> 00:16:00,436 Speaker 1: it's polio, guinea worm. You seem to know what the 248 00:16:00,516 --> 00:16:04,636 Speaker 1: order is. Yeah, Well, the official list is the WHO, 249 00:16:04,756 --> 00:16:07,596 Speaker 1: the World Health Organization and all of the member states 250 00:16:07,636 --> 00:16:10,996 Speaker 1: of the United Nations onto that. So that that and 251 00:16:11,036 --> 00:16:14,316 Speaker 1: that's where my list is. Here's the numbers. But then 252 00:16:14,356 --> 00:16:18,556 Speaker 1: there's you know, things that influence those selections. Certainly one 253 00:16:18,596 --> 00:16:21,356 Speaker 1: of them is just the state of the science. Do 254 00:16:21,476 --> 00:16:24,156 Speaker 1: we have a good vaccine do we have the right 255 00:16:24,236 --> 00:16:28,236 Speaker 1: diagnostic tools. All those things will matter in terms of feasibility. 256 00:16:28,276 --> 00:16:31,676 Speaker 1: And then the other is the again the funding and 257 00:16:31,716 --> 00:16:34,156 Speaker 1: political commitment, and that can be at a regional level. 258 00:16:34,236 --> 00:16:38,356 Speaker 1: So India recently stepped up and has committed to we 259 00:16:38,396 --> 00:16:42,316 Speaker 1: are going to eliminate malaria. Zambia has recently put a 260 00:16:42,356 --> 00:16:46,996 Speaker 1: declaration from their president that they're going to eliminate malaria 261 00:16:47,036 --> 00:16:49,796 Speaker 1: in their region and so. And that then comes with 262 00:16:49,796 --> 00:16:54,316 Speaker 1: both domestic funding and also global funding to support those efforts, 263 00:16:54,636 --> 00:16:58,476 Speaker 1: and that that actually obviously influences where on those lists 264 00:16:58,516 --> 00:17:01,316 Speaker 1: we end up putting our energy and time. The big 265 00:17:01,316 --> 00:17:06,916 Speaker 1: pharmaceutical companies work in their profit driven enterprises, and we've 266 00:17:06,956 --> 00:17:09,956 Speaker 1: had this problem with incentives that the poor people who 267 00:17:09,956 --> 00:17:14,156 Speaker 1: suffer most from disease are not buyers of expensive pharmaceuticals. 268 00:17:14,236 --> 00:17:18,236 Speaker 1: Are we getting better at dealing with the pharmaceutical companies 269 00:17:18,236 --> 00:17:21,076 Speaker 1: and getting them to do the kind of research we 270 00:17:21,156 --> 00:17:25,836 Speaker 1: need to create drugs. There's no question we're doing better. 271 00:17:26,036 --> 00:17:28,876 Speaker 1: And I sit with the CEOs of many of those 272 00:17:28,876 --> 00:17:31,876 Speaker 1: companies and see the progress we've made over the last 273 00:17:31,916 --> 00:17:34,756 Speaker 1: fifteen years due to a lot of different efforts and 274 00:17:35,196 --> 00:17:38,756 Speaker 1: leadership that we are making vast improvements, both in terms 275 00:17:38,756 --> 00:17:43,556 Speaker 1: of commitments to research and development, to commitments to access, 276 00:17:43,596 --> 00:17:49,236 Speaker 1: to commitments to participation in these global undertakings. That said, 277 00:17:49,436 --> 00:17:52,076 Speaker 1: you know better is a relative term. We still have 278 00:17:52,356 --> 00:17:55,156 Speaker 1: some work to do, and it's it's still not a 279 00:17:55,196 --> 00:17:58,796 Speaker 1: slam dunk. There are several things that you're absolutely correct. 280 00:17:58,876 --> 00:18:03,476 Speaker 1: The vast majority of these diseases are diseases, which are 281 00:18:03,756 --> 00:18:07,276 Speaker 1: diseases are the poor, and that the reason rich people 282 00:18:07,316 --> 00:18:10,756 Speaker 1: aren't getting most of diseases. I mean, for instance, HIV 283 00:18:10,916 --> 00:18:13,516 Speaker 1: is not on either of those lists, but HIV is 284 00:18:13,556 --> 00:18:16,396 Speaker 1: a disease that the rich and the poor world both have, 285 00:18:16,516 --> 00:18:19,996 Speaker 1: and therefore there's incentive for investments in those kinds of diseases. 286 00:18:20,436 --> 00:18:24,116 Speaker 1: Where there's not as much incentives, we've created mechanisms to 287 00:18:24,796 --> 00:18:29,876 Speaker 1: enable pharmaceutical companies and biotech and other companies to engage. 288 00:18:29,916 --> 00:18:33,396 Speaker 1: So we've either there's like the END Fund, the end 289 00:18:33,596 --> 00:18:36,076 Speaker 1: E and D Fund, which has been set up to 290 00:18:36,116 --> 00:18:40,276 Speaker 1: provide more incentives to go after some of diseases they're 291 00:18:40,836 --> 00:18:43,996 Speaker 1: My organization works on a number of vaccines that are 292 00:18:44,076 --> 00:18:47,196 Speaker 1: not there's no really market force for them, but if 293 00:18:47,236 --> 00:18:51,436 Speaker 1: we can get some philanthropic money to de risk that innovation, 294 00:18:51,876 --> 00:18:54,396 Speaker 1: then that companies are willing to do it and do 295 00:18:54,436 --> 00:18:57,356 Speaker 1: it quite well. So we're working on a whole bunch 296 00:18:57,356 --> 00:19:00,316 Speaker 1: of different ways to ensure that there's a market if 297 00:19:00,356 --> 00:19:03,876 Speaker 1: somebody does invest, to find ways to subsidize or de 298 00:19:03,996 --> 00:19:07,236 Speaker 1: risk some of this for some companies, and literally just 299 00:19:07,316 --> 00:19:09,676 Speaker 1: to get the companies at the table able to commit 300 00:19:09,716 --> 00:19:13,276 Speaker 1: to it as part of their larger scientific commitment. It 301 00:19:13,396 --> 00:19:16,316 Speaker 1: must just drive you crazy to see people dying of 302 00:19:16,596 --> 00:19:18,916 Speaker 1: disease in the developing world, and then people in the 303 00:19:18,996 --> 00:19:23,956 Speaker 1: developed world have these superstitions against vaccination, which very much 304 00:19:23,996 --> 00:19:27,916 Speaker 1: controversy right now. But why is that happening? And if 305 00:19:27,916 --> 00:19:31,436 Speaker 1: they knew what you knew, would people not be resistant 306 00:19:31,436 --> 00:19:37,156 Speaker 1: to vaccinating their children. Absolutely, to disconnect between being rural 307 00:19:37,196 --> 00:19:39,756 Speaker 1: Ethiopian a couple of days and where you know a 308 00:19:39,916 --> 00:19:44,916 Speaker 1: mother will be desperate to get her child to a 309 00:19:44,996 --> 00:19:49,156 Speaker 1: vaccine campaign and to get that vaccination, and then I 310 00:19:49,196 --> 00:19:52,796 Speaker 1: will fly home to my home state in Washington State, 311 00:19:52,876 --> 00:19:56,316 Speaker 1: where we have measles outbreaks and all sorts of things 312 00:19:56,316 --> 00:20:00,236 Speaker 1: from the anti vACC movement, And there is a concern 313 00:20:00,436 --> 00:20:02,516 Speaker 1: and a great concern for those of us working in 314 00:20:02,516 --> 00:20:06,236 Speaker 1: the field that the larger what's called vaccine hesitancy, that 315 00:20:06,316 --> 00:20:09,036 Speaker 1: you know, kind of concern whether it's some of it's 316 00:20:09,236 --> 00:20:13,196 Speaker 1: coming out of a lot of disinformation that's been propagated 317 00:20:13,236 --> 00:20:16,116 Speaker 1: by social media and other plays, but some of it 318 00:20:16,236 --> 00:20:20,636 Speaker 1: is coming from just more concern about in some ways 319 00:20:20,636 --> 00:20:23,916 Speaker 1: a victim of success that the more we've been able 320 00:20:23,956 --> 00:20:27,916 Speaker 1: to innovate, we are vaccinating against more and more diseases. 321 00:20:27,956 --> 00:20:31,076 Speaker 1: So suddenly parents are like, wait a minute, how many 322 00:20:31,516 --> 00:20:33,716 Speaker 1: shots of is my kid going to get? And then 323 00:20:33,796 --> 00:20:36,476 Speaker 1: some of it is is simply you know, we have 324 00:20:36,676 --> 00:20:39,476 Speaker 1: had some challenges in parts of the world where the 325 00:20:39,876 --> 00:20:42,796 Speaker 1: vaccine didn't go well. There was corruption in China and 326 00:20:42,836 --> 00:20:45,836 Speaker 1: the Philippines recently, and that doesn't help. So we're in 327 00:20:45,876 --> 00:20:50,476 Speaker 1: this larger work of trying to get more people in 328 00:20:50,516 --> 00:20:54,356 Speaker 1: a place. I mean, vaccines are effective, they're cost effective, 329 00:20:54,356 --> 00:20:58,316 Speaker 1: they're preventable, they're great global health tool. But we are 330 00:20:58,316 --> 00:21:01,836 Speaker 1: fighting another battle now, which is once we get it's 331 00:21:01,876 --> 00:21:04,716 Speaker 1: hard enough to get the scientific tool and get access 332 00:21:04,796 --> 00:21:08,156 Speaker 1: figured out and great demand for these and get them 333 00:21:08,356 --> 00:21:10,956 Speaker 1: remain cold old until they get out to a village 334 00:21:10,996 --> 00:21:14,156 Speaker 1: and get the village leaders to the commitment for social 335 00:21:14,236 --> 00:21:18,036 Speaker 1: change there and then to have this larger noise about 336 00:21:18,316 --> 00:21:21,276 Speaker 1: vaccines is a new problem we're actually having to face. 337 00:21:21,756 --> 00:21:24,196 Speaker 1: I like that you said that the solvable is to 338 00:21:24,236 --> 00:21:27,516 Speaker 1: eradicate or eliminate the range of five to ten diseases 339 00:21:27,556 --> 00:21:30,716 Speaker 1: over a few decades. I noted that when Mark Zuckerberg 340 00:21:30,756 --> 00:21:33,396 Speaker 1: set up his foundation, he said the goal was to 341 00:21:33,516 --> 00:21:36,916 Speaker 1: eliminate all disease, and it just seemed to me so 342 00:21:37,036 --> 00:21:39,876 Speaker 1: unrealistic given what we were just talking about, that there's 343 00:21:39,916 --> 00:21:43,996 Speaker 1: been one human disease eradicated. It's not a miscalculation or 344 00:21:44,076 --> 00:21:48,036 Speaker 1: misunderstanding on his part. Yeah, I mean, of all thes R, 345 00:21:48,356 --> 00:21:50,276 Speaker 1: I don't know what Mark was talking about it. I mean, 346 00:21:50,316 --> 00:21:52,756 Speaker 1: it looks good on a headline, but maybe if a 347 00:21:52,876 --> 00:21:55,716 Speaker 1: future I hope the planet lasts that long. But in 348 00:21:55,796 --> 00:21:59,796 Speaker 1: there's some future where maybe we understand the body so differently, 349 00:21:59,996 --> 00:22:03,196 Speaker 1: or we understand sort of fundamental organic chemistry so differently 350 00:22:03,196 --> 00:22:06,156 Speaker 1: that this all changes. But first of all, we have 351 00:22:06,316 --> 00:22:09,916 Speaker 1: new diseases popping up. There's thousands of diseases in the world, 352 00:22:09,956 --> 00:22:12,196 Speaker 1: and now most of them most of us don't know about, 353 00:22:12,316 --> 00:22:15,036 Speaker 1: or rarely do we get them. And they morph and 354 00:22:15,076 --> 00:22:18,276 Speaker 1: they keep changing and they keep arising. So we need 355 00:22:18,316 --> 00:22:21,276 Speaker 1: to be hyper focused on the things that we can 356 00:22:21,356 --> 00:22:24,996 Speaker 1: get done and not overstate the case. And I also 357 00:22:25,076 --> 00:22:28,316 Speaker 1: think that we have a hard enough time actually just 358 00:22:28,396 --> 00:22:32,236 Speaker 1: getting people to believe that there is the opportunity to 359 00:22:33,036 --> 00:22:36,236 Speaker 1: generally improve human health, which has been proved vastly, but 360 00:22:36,316 --> 00:22:38,636 Speaker 1: there's still a lot of you know, sort of negative 361 00:22:38,676 --> 00:22:41,796 Speaker 1: headlines about it. It's all a waste of money. And 362 00:22:41,836 --> 00:22:44,356 Speaker 1: then the second is the belief that we can even 363 00:22:44,396 --> 00:22:47,476 Speaker 1: eliminate one disease. There's still some people doubting whether we'll 364 00:22:47,476 --> 00:22:49,876 Speaker 1: get all across the line on polio. So I'm sticking 365 00:22:49,916 --> 00:22:52,876 Speaker 1: with one, one or two at a time. What's going 366 00:22:52,916 --> 00:22:56,036 Speaker 1: to happen when polio is finally eradicated? Is there going 367 00:22:56,076 --> 00:22:58,876 Speaker 1: to be a ceremony? Is there going to be an award? 368 00:22:59,116 --> 00:23:01,676 Speaker 1: Is there going to be a day of global celebration? 369 00:23:01,756 --> 00:23:04,996 Speaker 1: I mean there should be, right, I suspect there's you know, 370 00:23:05,276 --> 00:23:07,836 Speaker 1: somebody's thinking about that already. It's like they think about 371 00:23:07,836 --> 00:23:10,676 Speaker 1: the queen's funeral and they've got a plan, but they 372 00:23:10,716 --> 00:23:13,396 Speaker 1: can't talk about it. Look, first of all, it's a 373 00:23:13,476 --> 00:23:17,036 Speaker 1: long process. So just to be clear that who makes 374 00:23:17,036 --> 00:23:20,836 Speaker 1: these declarations and there's a long protocol on what it 375 00:23:20,876 --> 00:23:25,516 Speaker 1: takes to declare something eliminated and then eradicated, and there's 376 00:23:25,516 --> 00:23:28,436 Speaker 1: a waiting period, so it takes a number three years 377 00:23:28,476 --> 00:23:31,476 Speaker 1: after the last case. So if that occurs, it's they 378 00:23:31,476 --> 00:23:33,756 Speaker 1: will know at a long time and ahead and of advance. 379 00:23:33,796 --> 00:23:36,116 Speaker 1: But you know, there are two things there should be 380 00:23:36,156 --> 00:23:39,236 Speaker 1: if we are successful we the global community, there should 381 00:23:39,276 --> 00:23:42,316 Speaker 1: be a cause for human celebration. It's a commitment to 382 00:23:42,396 --> 00:23:47,196 Speaker 1: science and human suffering ending and something to celebrate. But 383 00:23:47,396 --> 00:23:50,596 Speaker 1: what's actually most interesting about that is to figure out 384 00:23:50,676 --> 00:23:53,956 Speaker 1: sort of how to take that energy and those assets 385 00:23:53,996 --> 00:23:56,356 Speaker 1: and that political movement and that science and what do 386 00:23:56,396 --> 00:23:58,836 Speaker 1: we do next with that? And so we're already in 387 00:23:58,916 --> 00:24:03,076 Speaker 1: conversations about the so called polio legacy. What happens with 388 00:24:03,156 --> 00:24:05,836 Speaker 1: all that capacity that it just doesn't go away and 389 00:24:05,916 --> 00:24:07,916 Speaker 1: we can go tackle the next thing and the next thing, 390 00:24:07,956 --> 00:24:10,396 Speaker 1: and how that's managed than the transition is going to 391 00:24:10,396 --> 00:24:12,676 Speaker 1: be important. See what are some of the things our 392 00:24:12,716 --> 00:24:15,756 Speaker 1: listeners can do? And I'm talking about listeners who aren't 393 00:24:15,756 --> 00:24:19,276 Speaker 1: Bill Gates and who aren't epidemiologists, but who just care 394 00:24:19,316 --> 00:24:22,676 Speaker 1: about this problem, want to contribute to the solvable you've 395 00:24:22,716 --> 00:24:25,916 Speaker 1: been talking about. Well, I think there's three things that 396 00:24:26,156 --> 00:24:28,876 Speaker 1: listeners can do in this but one is find out more. 397 00:24:29,116 --> 00:24:31,316 Speaker 1: I think this is one of those areas that for 398 00:24:31,356 --> 00:24:34,156 Speaker 1: some reason, I think it's got lost in the storyline. 399 00:24:34,476 --> 00:24:37,676 Speaker 1: I sometimes talk about the focus on the trend lines, 400 00:24:37,796 --> 00:24:41,676 Speaker 1: not always the headlines, and even though they're less interesting sometimes, 401 00:24:41,676 --> 00:24:43,756 Speaker 1: but this trend line is good that we are making 402 00:24:43,956 --> 00:24:47,156 Speaker 1: progress on a lot of human diseases and we can 403 00:24:47,196 --> 00:24:50,036 Speaker 1: eliminate and eradicate them, So, you know, learn more about 404 00:24:50,076 --> 00:24:53,396 Speaker 1: that incredibly interesting trend line that's happening in their lifetime. 405 00:24:53,836 --> 00:24:57,036 Speaker 1: Second of all, there's all sorts of ways you can participate, 406 00:24:57,516 --> 00:25:02,036 Speaker 1: everything from how Rotary members end up being very active 407 00:25:02,036 --> 00:25:04,956 Speaker 1: in both the polio and the malaria campaign. There's ngeos 408 00:25:05,156 --> 00:25:09,356 Speaker 1: and organizations around the world doing work in this area, 409 00:25:09,396 --> 00:25:13,156 Speaker 1: and they can identify those and get online and attract 410 00:25:13,156 --> 00:25:16,036 Speaker 1: them and support them. And I guess the third, which 411 00:25:16,036 --> 00:25:17,956 Speaker 1: I actually in some ways is the biggest, is just 412 00:25:18,036 --> 00:25:20,596 Speaker 1: believe we can get this done. You know, we live 413 00:25:20,636 --> 00:25:23,516 Speaker 1: in a time of a lot of concern about the 414 00:25:23,516 --> 00:25:27,516 Speaker 1: future of the species and the planet, and there's legitimate issues, 415 00:25:27,956 --> 00:25:30,316 Speaker 1: but there again, there's a lot of evidence that we 416 00:25:30,396 --> 00:25:33,236 Speaker 1: can do a lot of pretty miraculous things when we 417 00:25:33,276 --> 00:25:36,636 Speaker 1: get our heads together and our acts together, and those 418 00:25:36,676 --> 00:25:39,236 Speaker 1: things can lead to the next great thing. And I 419 00:25:39,276 --> 00:25:42,836 Speaker 1: think turning kind of outrage at the world we live 420 00:25:42,876 --> 00:25:45,676 Speaker 1: in too, optimism is the challenge ahead of us, and 421 00:25:45,716 --> 00:25:49,116 Speaker 1: I would love to see more optimists. And this is 422 00:25:49,116 --> 00:25:51,916 Speaker 1: a great proofpoint that there should be some optimism. Steve, 423 00:25:52,036 --> 00:25:57,356 Speaker 1: thanks for joining us. Unsolvable. Thank you. Combining political will, 424 00:25:57,596 --> 00:26:01,316 Speaker 1: new technology, medical know how I'm private business is a 425 00:26:01,436 --> 00:26:04,836 Speaker 1: juggling act that not many people could handle. So it 426 00:26:04,916 --> 00:26:09,356 Speaker 1: was incredible to hear about Steve's work. So many feelings right, 427 00:26:09,516 --> 00:26:12,756 Speaker 1: Like it's scary to know that new diseases are popping 428 00:26:12,796 --> 00:26:15,596 Speaker 1: up all the time, but it's also bolstering to hear 429 00:26:15,636 --> 00:26:18,996 Speaker 1: that when we take the time to look, the trajectory 430 00:26:19,036 --> 00:26:22,316 Speaker 1: is headed in the right way. More and more humans 431 00:26:22,356 --> 00:26:25,476 Speaker 1: are beating diseases and it's a good track to be on. 432 00:26:26,556 --> 00:26:29,396 Speaker 1: And how about that solvable that Steve offers us at 433 00:26:29,396 --> 00:26:32,236 Speaker 1: the end of his interview, about believing that this can 434 00:26:32,276 --> 00:26:36,276 Speaker 1: be done and turning our outrage into optimism. That's a 435 00:26:36,316 --> 00:26:39,916 Speaker 1: sentiment that could sound trite, but it's actually a really 436 00:26:39,916 --> 00:26:43,236 Speaker 1: courageous way to face all of the precarity that we're 437 00:26:43,236 --> 00:26:47,116 Speaker 1: facing as a species and as a planet, and it 438 00:26:47,196 --> 00:26:50,316 Speaker 1: was so fun to hear him dunking on Mark Zuckerberg. 439 00:26:50,676 --> 00:26:55,676 Speaker 1: The Best Solvable is a collaboration between Pushkin Industries and 440 00:26:55,756 --> 00:27:00,076 Speaker 1: the Rockefella Foundation, with production by Laura Hyde, Hester Kant, 441 00:27:00,196 --> 00:27:03,956 Speaker 1: Laura Sheeter, and Ruth Barnes from Chalk and Blade. Pushkin's 442 00:27:03,956 --> 00:27:08,876 Speaker 1: executive producer is Neia LaBelle, Research by Sheer, Vincent, engineering 443 00:27:08,876 --> 00:27:12,676 Speaker 1: by Jason Gambrell and the great folks at GSI Studios. 444 00:27:13,156 --> 00:27:16,836 Speaker 1: Original music composed by Pascal Wise and special thanks to 445 00:27:17,076 --> 00:27:22,116 Speaker 1: Maggie Taylor, Heather Fine, Julia Barton, Carli Mgliori, Jacob Weisberg, 446 00:27:22,196 --> 00:27:25,756 Speaker 1: and Malcolm Gladwell. You can learn more about solving today's 447 00:27:25,796 --> 00:27:31,436 Speaker 1: biggest problems at Rockefeller Foundation dot org, slash solvable. I'm 448 00:27:31,476 --> 00:27:33,356 Speaker 1: Mave Higgins. Now go solve it.