1 00:00:15,076 --> 00:00:25,076 Speaker 1: Pushkin, this is solvable. I'm Jacob Weisberg. In my lifetime too, 2 00:00:25,116 --> 00:00:28,956 Speaker 1: and I'm sixty one. I have never seen this level 3 00:00:29,076 --> 00:00:35,356 Speaker 1: of engagement in attention to the social pathologies that face 4 00:00:35,476 --> 00:00:38,556 Speaker 1: us and also the pathogens that face us beyond the 5 00:00:38,596 --> 00:00:42,956 Speaker 1: social pathologies. According to the UN, disruptions resulting from the 6 00:00:42,996 --> 00:00:47,716 Speaker 1: global pandemic could push an estimated seventy one million people 7 00:00:48,036 --> 00:00:52,556 Speaker 1: back into extreme poverty. That represents the first rise in 8 00:00:52,636 --> 00:00:56,556 Speaker 1: extreme poverty since nineteen ninety eight. With every ounce of 9 00:00:56,596 --> 00:01:00,636 Speaker 1: our energy, we need to direct ourselves to making this 10 00:01:00,756 --> 00:01:05,356 Speaker 1: a temporary setback. Today we're bringing you the first episode 11 00:01:05,356 --> 00:01:09,156 Speaker 1: in our Setback series, a collection of conversations about the 12 00:01:09,156 --> 00:01:13,196 Speaker 1: pandemics impact on education, hunger, and of course global health. 13 00:01:13,916 --> 00:01:16,596 Speaker 1: And it's fitting that we're starting today with one of 14 00:01:16,596 --> 00:01:20,396 Speaker 1: my personal heroes, doctor Paul Farmer. As much as anyone 15 00:01:20,436 --> 00:01:22,796 Speaker 1: I can think of, Farmer has changed the way the 16 00:01:22,836 --> 00:01:26,556 Speaker 1: world looks at the unequal distribution of healthcare. He has 17 00:01:26,596 --> 00:01:29,836 Speaker 1: spent the last forty years committed to improving health equity 18 00:01:29,876 --> 00:01:34,076 Speaker 1: across the world, most notably establishing long running medical support 19 00:01:34,156 --> 00:01:38,476 Speaker 1: services for communities in Haiti and Rwanda. He's the author 20 00:01:38,516 --> 00:01:41,236 Speaker 1: of a fascinating new book that I'd call a medical 21 00:01:41,236 --> 00:01:46,316 Speaker 1: and moral thriller. It's titled Fevers, Feuds, and Diamonds, about 22 00:01:46,316 --> 00:01:51,116 Speaker 1: the twenty fourteen Ebola outbreak in West Africa. It's intensely 23 00:01:51,156 --> 00:01:55,556 Speaker 1: relevant to understanding the global impact of COVID nineteen. Everyone 24 00:01:55,596 --> 00:01:59,796 Speaker 1: knows that COVID vaccines are being distributed unequally. What's less 25 00:01:59,836 --> 00:02:04,556 Speaker 1: appreciated is that disruptions from the pandemic are increasing inequality 26 00:02:04,596 --> 00:02:08,556 Speaker 1: in the distribution of other health resources. This could ultimately 27 00:02:08,596 --> 00:02:11,556 Speaker 1: lead to hundreds of thousands of additional deaths for children 28 00:02:11,636 --> 00:02:15,796 Speaker 1: under five, and caused tens of thousands of additional maternal deaths. 29 00:02:15,996 --> 00:02:18,916 Speaker 1: And I retain plenty of optimism. We have tools at 30 00:02:18,916 --> 00:02:22,396 Speaker 1: our disposal that would have been unimaginable just a couple 31 00:02:22,436 --> 00:02:25,836 Speaker 1: of decades ago, but the will to deploy them and 32 00:02:25,916 --> 00:02:30,676 Speaker 1: deploy them justly still has to be summoned. In April 33 00:02:30,676 --> 00:02:34,396 Speaker 1: twenty twenty, the World Health Organization, along with the European 34 00:02:34,396 --> 00:02:37,876 Speaker 1: Commission and the Bill and Melinda Gates Foundation, launched a 35 00:02:37,916 --> 00:02:41,596 Speaker 1: plan to get COVID vaccines to low income countries. It's 36 00:02:41,596 --> 00:02:45,156 Speaker 1: referred to as covacs. There are many reasons to do 37 00:02:45,196 --> 00:02:48,396 Speaker 1: this and The best ones, in my view are that 38 00:02:48,676 --> 00:02:51,156 Speaker 1: science and the fruits of science ought to be evenly 39 00:02:51,196 --> 00:02:56,436 Speaker 1: distributed like human capacity is. For all the devastation he seemed, 40 00:02:56,796 --> 00:03:00,996 Speaker 1: Farmer remains hopeful that the setbacks from the pandemic don't 41 00:03:00,996 --> 00:03:04,556 Speaker 1: have to mean a more unequal distribution of healthcare going forward. 42 00:03:05,276 --> 00:03:09,156 Speaker 1: I'm Paul Farmer. The inadequate health resources of pork in 43 00:03:09,636 --> 00:03:13,396 Speaker 1: a poor underserved people in affluent ones are a problem 44 00:03:13,436 --> 00:03:20,036 Speaker 1: we can solve. Paul Farmer is a professor at Harvard 45 00:03:20,036 --> 00:03:23,756 Speaker 1: Medical School, chief of Global health Equity at Brigham and 46 00:03:23,796 --> 00:03:26,876 Speaker 1: Women's Hospital in Boston, and the co founder of the 47 00:03:26,996 --> 00:03:30,636 Speaker 1: organization Partners in Health. I began by asking him to 48 00:03:30,676 --> 00:03:35,116 Speaker 1: describe the global healthcare situation in his own words. Well, 49 00:03:35,156 --> 00:03:39,356 Speaker 1: I mean, right now, we could focus almost entirely on 50 00:03:39,396 --> 00:03:42,596 Speaker 1: the setbacks. You know, one of the biggest problems we've 51 00:03:42,596 --> 00:03:44,796 Speaker 1: faced all over the world is that with a shutdown, 52 00:03:45,116 --> 00:03:50,876 Speaker 1: obviously people aren't able to readily access their care. What 53 00:03:50,996 --> 00:03:52,916 Speaker 1: if they have cancer, what if they have diabetes, what 54 00:03:52,996 --> 00:03:56,636 Speaker 1: if they have severe hypertension. So you know, those are 55 00:03:57,276 --> 00:04:00,556 Speaker 1: ranking problems I think to anybody who's involved in global health. 56 00:04:00,836 --> 00:04:03,796 Speaker 1: But that's just the tip of the Iceberg. A lot 57 00:04:03,836 --> 00:04:07,476 Speaker 1: of the efforts that we have engaged in to address 58 00:04:07,556 --> 00:04:12,916 Speaker 1: social determinants of ill health are also being setback. Economic 59 00:04:13,116 --> 00:04:19,316 Speaker 1: educational programs, cultural endeavors, employment opportunities. There's been a major 60 00:04:19,396 --> 00:04:22,916 Speaker 1: contraction and anti poverty efforts overall. So it's going to 61 00:04:22,996 --> 00:04:27,316 Speaker 1: be a troubling reflection on what's happened this past year 62 00:04:27,756 --> 00:04:30,676 Speaker 1: and a last I'm worried it's going to be projected 63 00:04:30,676 --> 00:04:33,316 Speaker 1: forward into a future as well. Paul. There are two 64 00:04:33,316 --> 00:04:35,916 Speaker 1: different ways to think about the future in this setback. 65 00:04:36,516 --> 00:04:38,996 Speaker 1: One is that it's just a temporary setback where we 66 00:04:39,116 --> 00:04:41,436 Speaker 1: lose a year and quickly get back to where we were. 67 00:04:41,916 --> 00:04:44,516 Speaker 1: The other is that it's a twenty year setback. How 68 00:04:44,516 --> 00:04:46,636 Speaker 1: do you see it, well, I mean I see it 69 00:04:46,676 --> 00:04:52,756 Speaker 1: as a struggle between those two options. With every ounce 70 00:04:52,836 --> 00:04:56,916 Speaker 1: of our energy, we need to direct ourselves to making 71 00:04:56,916 --> 00:05:01,996 Speaker 1: this a temporary setback. That's going to require rapid engagement 72 00:05:02,076 --> 00:05:05,036 Speaker 1: in responding to some of these social problems and medical 73 00:05:05,036 --> 00:05:11,956 Speaker 1: problems and health problems. But every week, month, season that 74 00:05:12,076 --> 00:05:15,476 Speaker 1: goes by where we can't point to a resumption of 75 00:05:16,036 --> 00:05:18,396 Speaker 1: some of these economic and social activities is going to 76 00:05:18,436 --> 00:05:23,956 Speaker 1: mean more likelihood that the setback will endure, and so 77 00:05:24,036 --> 00:05:26,636 Speaker 1: I mean, I retain plenty of optimism. We have tools 78 00:05:26,796 --> 00:05:30,516 Speaker 1: at our disposal that would have been unimaginable just a 79 00:05:30,556 --> 00:05:34,836 Speaker 1: couple of decades ago, but the will to deploy them 80 00:05:34,836 --> 00:05:39,436 Speaker 1: and deploy them justly still has to be summoned. There's 81 00:05:39,476 --> 00:05:45,676 Speaker 1: certainly more consciousness about healthcare disparities in this country on 82 00:05:45,716 --> 00:05:51,036 Speaker 1: the basis of race and socioeconomic status. Then I remember 83 00:05:51,076 --> 00:05:54,596 Speaker 1: in the conversation for a long time, do you see 84 00:05:54,636 --> 00:05:58,436 Speaker 1: the pandemic as any kind of awakening, either in the 85 00:05:58,556 --> 00:06:03,196 Speaker 1: United States or globally about the disparities between the global 86 00:06:03,276 --> 00:06:06,676 Speaker 1: North and the global solve wealthier countries and poorer countries. 87 00:06:07,556 --> 00:06:10,676 Speaker 1: For sure. I mean in my lifetime too, and I'm 88 00:06:10,796 --> 00:06:15,036 Speaker 1: sixty one, I have never seen this level of engagement 89 00:06:15,676 --> 00:06:20,756 Speaker 1: in attention to the social pathologies that face us, and 90 00:06:20,836 --> 00:06:24,676 Speaker 1: also the pathogens that face us beyond the social pathologies. 91 00:06:25,036 --> 00:06:27,636 Speaker 1: So you know they're they're from the very beginning, even 92 00:06:27,716 --> 00:06:31,516 Speaker 1: before the murder of George Floyd, there was reason to 93 00:06:31,636 --> 00:06:34,996 Speaker 1: think that, you know, such a catastrophic series of events 94 00:06:35,076 --> 00:06:37,876 Speaker 1: could awaken a lot of people about the need for 95 00:06:38,876 --> 00:06:42,676 Speaker 1: a better safety net, for example, health insurance, unemployment, insurance 96 00:06:43,196 --> 00:06:47,876 Speaker 1: protection for vulnerable workers, prisoners, people who've been you know, 97 00:06:48,076 --> 00:06:53,236 Speaker 1: shoved around onto reservations and meat packing plants. I think 98 00:06:53,276 --> 00:06:57,356 Speaker 1: that sense of possibility is still very much alive, this 99 00:06:57,596 --> 00:07:02,036 Speaker 1: heightened awareness of our vulnerability, of our collective vulnerability, but 100 00:07:02,156 --> 00:07:06,516 Speaker 1: also our heightened awareness of the inequalities of vulnerability. So 101 00:07:06,956 --> 00:07:10,356 Speaker 1: you know, I would proceed up domistically even if I 102 00:07:10,396 --> 00:07:14,796 Speaker 1: weren't convinced, because that may be just psychologically necessary. But 103 00:07:14,876 --> 00:07:17,516 Speaker 1: I think this is very real, and we have to 104 00:07:17,676 --> 00:07:20,596 Speaker 1: act promptly while people are still alive to some of 105 00:07:20,636 --> 00:07:25,836 Speaker 1: these challenges before they fade away. Your new book, Fevers, Feuds, 106 00:07:25,836 --> 00:07:28,876 Speaker 1: and Diamonds is about the Ebola epidemic that broke out 107 00:07:28,916 --> 00:07:32,636 Speaker 1: in West Africa in two fourteen, and one of my 108 00:07:33,116 --> 00:07:36,876 Speaker 1: takeaways reading it was that a lot of the harms 109 00:07:36,996 --> 00:07:41,756 Speaker 1: we think of as coming from the disease are really 110 00:07:41,796 --> 00:07:46,316 Speaker 1: the harms coming from the underlying healthcare system, in place 111 00:07:46,396 --> 00:07:49,836 Speaker 1: or not in place. What I mean is that, right 112 00:07:49,956 --> 00:07:52,636 Speaker 1: that we are attributing things to the novelty of a 113 00:07:52,716 --> 00:07:58,076 Speaker 1: virus that in many case just project reflections of what 114 00:07:58,156 --> 00:08:00,996 Speaker 1: was there in terms of our capacity to deal with 115 00:08:01,236 --> 00:08:04,516 Speaker 1: a healthcare crisis of any kind. You know every time 116 00:08:04,596 --> 00:08:08,836 Speaker 1: there is a health crisis, and a pandemic is the 117 00:08:09,116 --> 00:08:13,396 Speaker 1: classic example. Once you're sick, who lives and who dies? 118 00:08:13,516 --> 00:08:16,996 Speaker 1: And on both scores, I think we're seeing, not just 119 00:08:17,076 --> 00:08:20,156 Speaker 1: in the United States but across the world, a reflection 120 00:08:20,276 --> 00:08:24,876 Speaker 1: not just of the novelty of the pathogen, but what's 121 00:08:24,916 --> 00:08:29,116 Speaker 1: the opposite of novelty, the longstanding nature of our social pathologies. 122 00:08:29,676 --> 00:08:34,436 Speaker 1: Social disparities are our social pathologies make things worse. The 123 00:08:34,476 --> 00:08:37,556 Speaker 1: good news is that means we can alter that risk, 124 00:08:37,756 --> 00:08:40,836 Speaker 1: because although we don't alter the shape of viruses, yet, 125 00:08:41,156 --> 00:08:44,356 Speaker 1: we can't alter the shape of our social conditions. I 126 00:08:44,476 --> 00:08:46,876 Speaker 1: think often about an article you wrote some years ago 127 00:08:46,916 --> 00:08:49,076 Speaker 1: that I think might have had that title, who Lives 128 00:08:49,076 --> 00:08:53,156 Speaker 1: and Who Dies? And you talked about, if I remember 129 00:08:53,156 --> 00:08:56,436 Speaker 1: it right, what you called stupid death, and you told 130 00:08:56,476 --> 00:08:59,876 Speaker 1: the story of a traffic accident you had I think 131 00:08:59,876 --> 00:09:02,276 Speaker 1: maybe when you were still a medical student or many 132 00:09:02,356 --> 00:09:04,436 Speaker 1: years ago, when you were hit by a car and 133 00:09:04,476 --> 00:09:08,196 Speaker 1: it was theorious but because you've got high quality medical care, 134 00:09:09,316 --> 00:09:12,276 Speaker 1: we lived, and probably it didn't it didn't do you 135 00:09:12,476 --> 00:09:15,236 Speaker 1: the kind of permanent harm it would have somewhere else 136 00:09:15,236 --> 00:09:18,396 Speaker 1: in the world. And then you talked about another accident 137 00:09:18,516 --> 00:09:21,236 Speaker 1: to someone you knew, I think in Haiti. You know 138 00:09:21,356 --> 00:09:25,436 Speaker 1: the term that I got, that expression stupid deaths from 139 00:09:25,996 --> 00:09:28,876 Speaker 1: from Haiti. I heard it in my first years there, 140 00:09:28,916 --> 00:09:32,196 Speaker 1: and I went there in nineteen eighty three for the 141 00:09:32,196 --> 00:09:34,276 Speaker 1: first time, and I'm still working in the same parts 142 00:09:34,276 --> 00:09:38,596 Speaker 1: of Haiti. And you know, in those early years, not 143 00:09:38,636 --> 00:09:41,116 Speaker 1: only did I hear about stupid deaths, I saw some 144 00:09:41,196 --> 00:09:43,916 Speaker 1: of them. And those happened to be the years in 145 00:09:43,956 --> 00:09:47,076 Speaker 1: which I was hit by a car in Cambridge, Massachusetts, 146 00:09:47,396 --> 00:09:51,516 Speaker 1: and knew right there lying in the street that you know, 147 00:09:51,676 --> 00:09:55,676 Speaker 1: I would be okay, you know, And I was comparing 148 00:09:55,716 --> 00:09:58,836 Speaker 1: that to the kind of circumstance that is faced by 149 00:09:58,876 --> 00:10:00,996 Speaker 1: all too many to this day. You know. It's it's 150 00:10:01,036 --> 00:10:03,476 Speaker 1: as if, you know, someone would say to you after 151 00:10:03,516 --> 00:10:05,436 Speaker 1: you've been hit by a car, well, you should have 152 00:10:05,476 --> 00:10:08,476 Speaker 1: looked both ways before you crossed the street, right, And 153 00:10:08,516 --> 00:10:12,556 Speaker 1: it's not very helpful to look back and explain away 154 00:10:12,716 --> 00:10:16,476 Speaker 1: these disparities of risk and outcome without making an intervention 155 00:10:16,676 --> 00:10:20,836 Speaker 1: to lessen that risk. Here we're facing a respiratory pathogen 156 00:10:21,756 --> 00:10:24,836 Speaker 1: and it's a different set of needs, but I think 157 00:10:24,836 --> 00:10:29,196 Speaker 1: the needs are nonetheless material as well as social meaning, 158 00:10:29,676 --> 00:10:32,356 Speaker 1: you know, do we have the staff, the stuff, the space, 159 00:10:32,396 --> 00:10:34,916 Speaker 1: and the systems to respond to our health crisis. So 160 00:10:35,036 --> 00:10:37,356 Speaker 1: right now we're talking about COVID, but we could be 161 00:10:37,356 --> 00:10:43,516 Speaker 1: talking about surgical trauma, or AIDS, or ebola or any 162 00:10:43,516 --> 00:10:46,836 Speaker 1: one of a series of maternal mortality and Sierra leone. 163 00:10:47,036 --> 00:10:51,716 Speaker 1: Each of those problems requires and always has a set 164 00:10:51,756 --> 00:10:56,756 Speaker 1: of material responses, which you know, I've just summarized as staff, stuff, space, systems, 165 00:10:56,756 --> 00:10:59,956 Speaker 1: and support. And I got all that, you know, as 166 00:10:59,956 --> 00:11:03,876 Speaker 1: a medical student transferred from one hospital to another and 167 00:11:04,316 --> 00:11:07,956 Speaker 1: then to rehab and then to having surgical care that 168 00:11:07,996 --> 00:11:13,316 Speaker 1: I needed, except I knew I would those disparities staff stuff, systems. 169 00:11:13,316 --> 00:11:14,556 Speaker 1: It's a bit of a tongue twister. I think I 170 00:11:14,596 --> 00:11:18,356 Speaker 1: got it right. Are not exactly reflected with COVID nineteen 171 00:11:18,476 --> 00:11:22,076 Speaker 1: the way you might expect. There's an article in The 172 00:11:22,076 --> 00:11:26,356 Speaker 1: New Yorker that Sanartha Mukherjee wrote that looks into that 173 00:11:26,476 --> 00:11:29,876 Speaker 1: a little bit. Nigeria, for example, one of the countries 174 00:11:29,916 --> 00:11:32,796 Speaker 1: you talk about in your book in relation to ebola, 175 00:11:33,276 --> 00:11:36,316 Speaker 1: doesn't seem to be getting hit at hard. United States, 176 00:11:36,396 --> 00:11:40,596 Speaker 1: obviously wealthiest country, you know, most expensive systems, has gotten 177 00:11:40,676 --> 00:11:43,236 Speaker 1: hit very hard, but focusing particularly on the question that 178 00:11:43,316 --> 00:11:46,956 Speaker 1: why some poorer countries, some countries in the developing world, 179 00:11:47,596 --> 00:11:51,436 Speaker 1: are not having the experience of the pandemic that's a 180 00:11:51,556 --> 00:11:54,076 Speaker 1: severe Why do you think that is? Well, you know, 181 00:11:54,116 --> 00:11:59,156 Speaker 1: I'm going to try and resist the conventional explanations. I 182 00:11:59,196 --> 00:12:02,956 Speaker 1: will mention them. They include the age structure of the population. 183 00:12:03,756 --> 00:12:11,876 Speaker 1: There's less obesity, there's asthma, diabetes, hybrid tension, there's perhaps 184 00:12:11,956 --> 00:12:16,356 Speaker 1: less of it in a largely younger population. But instead 185 00:12:16,356 --> 00:12:20,396 Speaker 1: of focusing on the susceptibility or the nature of the 186 00:12:20,516 --> 00:12:22,916 Speaker 1: virus alone, it's also a risk to focus on the 187 00:12:22,996 --> 00:12:27,356 Speaker 1: nature of the individual and the physiology of an individual alone, 188 00:12:28,076 --> 00:12:31,116 Speaker 1: and instead we have to also bring into other questions 189 00:12:31,156 --> 00:12:35,556 Speaker 1: like it's not unthinkable, of course, that some of these 190 00:12:35,596 --> 00:12:39,836 Speaker 1: places have had very robust public health responses to COVID, 191 00:12:40,836 --> 00:12:43,316 Speaker 1: and that they deserve some of the credits, the credit 192 00:12:43,356 --> 00:12:46,556 Speaker 1: the humans deserves some of the credits for having been 193 00:12:46,556 --> 00:12:49,516 Speaker 1: the architects of this response. Let me just take Rwanda, 194 00:12:49,916 --> 00:12:52,676 Speaker 1: a country where I lived on and off for a decade. 195 00:12:53,236 --> 00:12:56,316 Speaker 1: The quality of their response to COVID, both in terms 196 00:12:56,356 --> 00:13:00,796 Speaker 1: of prevention and in care, has been pretty pretty damn good. 197 00:13:01,196 --> 00:13:03,876 Speaker 1: So all this to say, Jacob, I think that when 198 00:13:03,916 --> 00:13:06,796 Speaker 1: we go back, or when we start to explore this 199 00:13:06,916 --> 00:13:10,476 Speaker 1: even now, we're going to be called to come up 200 00:13:10,516 --> 00:13:14,836 Speaker 1: with lists of factors that could explain these disparities and 201 00:13:14,996 --> 00:13:17,876 Speaker 1: also sort them out and put them in order. I 202 00:13:17,876 --> 00:13:22,036 Speaker 1: imagine that folks in Singapore and China and Taiwan are 203 00:13:22,076 --> 00:13:27,196 Speaker 1: justifiably proud of their ability to bring this their fraction 204 00:13:27,196 --> 00:13:31,756 Speaker 1: of the pandemic under control. We could be justifiably proud, 205 00:13:31,796 --> 00:13:34,556 Speaker 1: for example, in the United States, of our ability to 206 00:13:35,476 --> 00:13:38,476 Speaker 1: martial scientific research to come up with vaccines in such 207 00:13:38,516 --> 00:13:41,556 Speaker 1: short order. But we're probably not called to be proud 208 00:13:42,036 --> 00:13:45,756 Speaker 1: of our public health delivery system, which is very patchwork 209 00:13:45,956 --> 00:13:49,436 Speaker 1: and it's also underfunded massively. If you were to compare 210 00:13:49,996 --> 00:13:52,676 Speaker 1: Rwanda to the United States, not just in terms of 211 00:13:52,716 --> 00:13:56,716 Speaker 1: their programmatic response to the pandemic, but the fraction of 212 00:13:56,756 --> 00:14:00,556 Speaker 1: their public treasury that they put into public health and healthcare, 213 00:14:00,796 --> 00:14:05,396 Speaker 1: it's much much larger than the United States the public treasury. 214 00:14:05,436 --> 00:14:10,716 Speaker 1: So they're also prioritizing public health very high up on 215 00:14:10,756 --> 00:14:13,516 Speaker 1: their agenda. It's not some black box mystery where we 216 00:14:13,516 --> 00:14:16,676 Speaker 1: have to say, well, what is it about Rwandans that 217 00:14:16,796 --> 00:14:20,076 Speaker 1: makes them so invulnerable to disease. It's not the case 218 00:14:20,156 --> 00:14:22,996 Speaker 1: at all. It's rather, what is it about their response 219 00:14:22,996 --> 00:14:25,476 Speaker 1: that has made them able to do a better job 220 00:14:25,476 --> 00:14:27,716 Speaker 1: than we have here in the United States. The reason 221 00:14:27,756 --> 00:14:30,356 Speaker 1: to ask that is not to win an argument, but 222 00:14:30,596 --> 00:14:35,516 Speaker 1: rather to learn from our colleagues and the experience of Rwanda. Paul, 223 00:14:35,516 --> 00:14:38,076 Speaker 1: you've talked about a kind of nihilistic thinking which can 224 00:14:38,116 --> 00:14:43,836 Speaker 1: take effect in relation to public health problems that seem insoluble. Recently, 225 00:14:43,836 --> 00:14:47,516 Speaker 1: I've seen you use this term containment nihilism to talk 226 00:14:47,556 --> 00:14:50,716 Speaker 1: about what we can't do in relation to the pandemic. 227 00:14:50,756 --> 00:14:53,116 Speaker 1: Can you explain a little more what you mean about that. 228 00:14:53,676 --> 00:14:56,636 Speaker 1: You know, one of the things that I've seen again 229 00:14:56,716 --> 00:14:59,196 Speaker 1: and again in my clinical practice over the years is 230 00:14:59,676 --> 00:15:02,636 Speaker 1: clinical nihilism. You know, the argument that, oh, we can't 231 00:15:02,676 --> 00:15:05,876 Speaker 1: do anything for these people, they're too poor. It's not 232 00:15:05,956 --> 00:15:09,796 Speaker 1: cost effective, not feasible, not sustainable, not even prudent. Now, 233 00:15:09,836 --> 00:15:13,196 Speaker 1: of course, those are also predominantly black and brown people, right, 234 00:15:13,916 --> 00:15:17,036 Speaker 1: So that's clinical nihilism, and it's a very hard sell 235 00:15:17,076 --> 00:15:20,236 Speaker 1: in the United States, you know, I mean, would you 236 00:15:20,476 --> 00:15:24,156 Speaker 1: openly argue for a different standard of care for the 237 00:15:24,156 --> 00:15:27,636 Speaker 1: bronx than Manhattan. It would be a very difficult sell politically. 238 00:15:28,076 --> 00:15:30,676 Speaker 1: It's the functional equivalent of Jim Crowe. But it's just 239 00:15:30,916 --> 00:15:34,356 Speaker 1: not something that you can sell. But we do see 240 00:15:34,356 --> 00:15:36,396 Speaker 1: a different kind of nihilism in the United States, and 241 00:15:36,396 --> 00:15:39,196 Speaker 1: that's containment nihilism. And it was so striking, you know, 242 00:15:39,596 --> 00:15:42,356 Speaker 1: every time we made a suggestion like we should do 243 00:15:42,396 --> 00:15:47,596 Speaker 1: more contact tracing, we'd find takers, even governors of entire 244 00:15:47,676 --> 00:15:51,516 Speaker 1: states like Massachusetts. Right, But it's not anything that ever 245 00:15:51,596 --> 00:15:57,516 Speaker 1: became a national program yet. That's containment nihilism, right. And 246 00:15:57,556 --> 00:16:01,556 Speaker 1: then after the really dramatic moment of having the President 247 00:16:01,596 --> 00:16:03,956 Speaker 1: of the Republic gets sick, you remember the next day 248 00:16:03,996 --> 00:16:07,916 Speaker 1: after his hospitalization, his chief of staff said, we are 249 00:16:07,956 --> 00:16:10,436 Speaker 1: not going to contain the pandemic. We're going to only 250 00:16:10,476 --> 00:16:14,396 Speaker 1: do this through vaccination. So again, that's about as eloquent 251 00:16:14,436 --> 00:16:18,876 Speaker 1: a statement of containment nihilism as you can get. It's 252 00:16:18,916 --> 00:16:24,356 Speaker 1: a great phrase for surrender. It's a great it's a surrender. Right. Unfortunately, 253 00:16:24,396 --> 00:16:28,716 Speaker 1: even with great vaccines, we have to do contact tracing, 254 00:16:28,796 --> 00:16:32,196 Speaker 1: we have to observe social distancing, we have to mask 255 00:16:32,676 --> 00:16:37,156 Speaker 1: all of the conventional public health demands really are still 256 00:16:37,196 --> 00:16:39,236 Speaker 1: out there and we'll be around for a while. But 257 00:16:39,476 --> 00:16:43,636 Speaker 1: containment nihilism is not what we saw in the Ebola 258 00:16:43,716 --> 00:16:47,236 Speaker 1: epidemic and West Africa. There was clinical nihilism, and I 259 00:16:47,276 --> 00:16:48,996 Speaker 1: think here in the States we're seeing a lot more 260 00:16:49,036 --> 00:16:54,156 Speaker 1: containment nihilism. Paul, How does the roll out of vaccination 261 00:16:55,036 --> 00:16:59,836 Speaker 1: globally look to you in terms of equity? I mean, 262 00:17:00,116 --> 00:17:03,436 Speaker 1: there are many developing countries where essentially no one has 263 00:17:03,476 --> 00:17:06,716 Speaker 1: been vaccinated. As you said, the vaccination seems to be 264 00:17:06,796 --> 00:17:09,996 Speaker 1: part of the success story. That say, it's both in 265 00:17:10,076 --> 00:17:13,636 Speaker 1: terms of the development and the rollout. I don't know. Overall, 266 00:17:13,636 --> 00:17:16,876 Speaker 1: it's not going badly. The numbers that are accelerating, you know, 267 00:17:16,956 --> 00:17:20,076 Speaker 1: things seem pretty good. But we just see this vast gap. 268 00:17:20,156 --> 00:17:22,356 Speaker 1: You know, it seems that our whole country is going 269 00:17:22,396 --> 00:17:25,556 Speaker 1: to be vaccinated before a lot of poor countries are 270 00:17:25,596 --> 00:17:29,636 Speaker 1: vaccinated at all. Yeah, I mean, this is the great worry. 271 00:17:29,676 --> 00:17:33,316 Speaker 1: I will say that there's a fairly massive coalition of 272 00:17:33,356 --> 00:17:38,716 Speaker 1: people coming together to try and diminish vaccine inequality or 273 00:17:38,796 --> 00:17:41,916 Speaker 1: vaccine apartheid, or wherever we call it. I mean, supply 274 00:17:42,116 --> 00:17:45,356 Speaker 1: is the problem. There will be other problems with distribution, 275 00:17:45,396 --> 00:17:47,556 Speaker 1: but you can't have the distribution challenges if you don't 276 00:17:47,556 --> 00:17:50,916 Speaker 1: have the supply the mechanisms that have been pulled together 277 00:17:50,996 --> 00:17:53,316 Speaker 1: to address this, and you've probably already heard of or 278 00:17:53,396 --> 00:17:58,156 Speaker 1: spoken about covacs, but the targets are still not high enough. 279 00:17:58,156 --> 00:17:59,916 Speaker 1: They're not as high as the R oneans want them 280 00:17:59,916 --> 00:18:03,036 Speaker 1: to be. It's something like countries with barely more than 281 00:18:03,236 --> 00:18:07,316 Speaker 1: ten percent of the world's population have already cornered the market, 282 00:18:07,316 --> 00:18:10,796 Speaker 1: have already bought actually about half of all the doses. 283 00:18:11,916 --> 00:18:13,876 Speaker 1: And you know there are going to be lots of 284 00:18:14,516 --> 00:18:18,716 Speaker 1: complaints about that, of course, and legitimate complaints, so we're 285 00:18:18,716 --> 00:18:21,396 Speaker 1: really going to have to again redouble our efforts to 286 00:18:21,436 --> 00:18:26,876 Speaker 1: address this. The timeline of implementation, if you want to 287 00:18:26,876 --> 00:18:30,156 Speaker 1: call it that, the time between the development of an 288 00:18:30,156 --> 00:18:33,956 Speaker 1: effective technology that could be a medicine or a vaccine 289 00:18:34,436 --> 00:18:38,836 Speaker 1: and its widespread distribution is usually measured in decades. But 290 00:18:38,956 --> 00:18:41,276 Speaker 1: as people now know in the United States as well, 291 00:18:42,076 --> 00:18:47,596 Speaker 1: if there's ongoing community transmission of the coronavirus, the novel coronavirus, 292 00:18:48,436 --> 00:18:51,596 Speaker 1: then there's going to be ongoing mutation and the emergence 293 00:18:51,596 --> 00:18:56,036 Speaker 1: of new and more troubling variants, which is already occurring, 294 00:18:56,476 --> 00:19:00,276 Speaker 1: is sure to increase so that's one of the you know, 295 00:19:00,316 --> 00:19:03,996 Speaker 1: one of the reasons that I'm not suggesting we use 296 00:19:04,076 --> 00:19:08,636 Speaker 1: fear to stimulate more investment in vaccine equity. I'm just 297 00:19:08,676 --> 00:19:12,396 Speaker 1: saying people should know that there is a There are 298 00:19:12,436 --> 00:19:15,636 Speaker 1: many reasons to do this, and the best ones, in 299 00:19:15,676 --> 00:19:18,676 Speaker 1: my view, are that science and the fruits of science 300 00:19:18,716 --> 00:19:23,076 Speaker 1: ought to be evenly distributed, like human capacity is. We 301 00:19:23,196 --> 00:19:26,716 Speaker 1: got the COVID nineteen vaccine really fast. The system worked 302 00:19:26,956 --> 00:19:30,876 Speaker 1: in that case, but for other diseases that primarily affect 303 00:19:31,356 --> 00:19:35,756 Speaker 1: the global South, we don't have vaccines, or at the 304 00:19:35,836 --> 00:19:39,316 Speaker 1: very least, vaccine development can take a very long time. 305 00:19:39,716 --> 00:19:41,356 Speaker 1: So how can we have a system that does a 306 00:19:41,396 --> 00:19:47,236 Speaker 1: better job of eradicating diseases that primarily affect the developing 307 00:19:47,276 --> 00:19:50,876 Speaker 1: world and not the rich countries. Sometimes we talk about 308 00:19:50,956 --> 00:19:56,516 Speaker 1: the discovery science, right, the basic science, discoveries, the development 309 00:19:56,516 --> 00:19:58,036 Speaker 1: of the new tools, A lot of that is done 310 00:19:58,036 --> 00:20:01,436 Speaker 1: by pharma and biotech, right, and then finally the delivery. 311 00:20:01,996 --> 00:20:05,276 Speaker 1: So getting from the first day of discovery to the 312 00:20:05,356 --> 00:20:09,236 Speaker 1: third day of delivery requires the assistance. I'm sure a 313 00:20:09,236 --> 00:20:11,916 Speaker 1: lot of these companies that you know are know how 314 00:20:11,956 --> 00:20:16,276 Speaker 1: to make tools, whether those be medical treatments, or vaccines, 315 00:20:16,716 --> 00:20:18,956 Speaker 1: So we just need to bring everybody on board. I 316 00:20:18,956 --> 00:20:22,316 Speaker 1: don't want to sound like I'm singing kumbaya, but again, 317 00:20:22,476 --> 00:20:27,196 Speaker 1: there's even a cold headed logic would say, well, if 318 00:20:27,356 --> 00:20:32,756 Speaker 1: there's already COVID vaccine in rural Rwanda, that means that 319 00:20:33,596 --> 00:20:37,076 Speaker 1: you could move quickly. It's possible to see vaccine in 320 00:20:37,116 --> 00:20:39,836 Speaker 1: the field in the arms of people who in the 321 00:20:39,836 --> 00:20:42,516 Speaker 1: past have been shut out of medical modernity. But they 322 00:20:42,556 --> 00:20:44,836 Speaker 1: don't need to be. And that's one reason that my 323 00:20:44,916 --> 00:20:50,636 Speaker 1: solvable problem is to argue that these are not insurmountable problems, 324 00:20:50,796 --> 00:20:53,516 Speaker 1: none of them. Yeah, that's really interesting. I mean you've 325 00:20:53,596 --> 00:20:56,316 Speaker 1: changed the terms of the debate from how do you 326 00:20:56,396 --> 00:20:59,836 Speaker 1: do it? Instead of whether it can be done? You've 327 00:20:59,876 --> 00:21:03,916 Speaker 1: made it. Yeah, I hope that. I hope. I mean 328 00:21:03,956 --> 00:21:07,356 Speaker 1: I would love to claim that I put that on 329 00:21:07,396 --> 00:21:12,476 Speaker 1: my tombstone, know because you know, how are you going 330 00:21:12,516 --> 00:21:15,716 Speaker 1: to put a man on the moon with that kind 331 00:21:15,756 --> 00:21:18,036 Speaker 1: of logic? You know, can we do this? It had 332 00:21:18,116 --> 00:21:20,836 Speaker 1: to be how do we do this? I assume, I 333 00:21:20,876 --> 00:21:25,196 Speaker 1: mean I wasn't there, but that's when you didn't take on. Yeah, 334 00:21:25,436 --> 00:21:28,876 Speaker 1: in medicine and public health, it's hard to point to 335 00:21:28,996 --> 00:21:33,836 Speaker 1: any example of sustained attention to a health problem that 336 00:21:33,956 --> 00:21:39,156 Speaker 1: resulted in failure because you know, implementation was impossible. It's 337 00:21:39,236 --> 00:21:41,196 Speaker 1: it wants you to say, how do we do this? 338 00:21:41,356 --> 00:21:44,276 Speaker 1: Rather than should we do this? I mean part of 339 00:21:44,316 --> 00:21:47,716 Speaker 1: me wanted to say, you're halfway there. Bill Gates and 340 00:21:47,756 --> 00:21:50,196 Speaker 1: the Gates Foundation, who played a very big role in 341 00:21:50,236 --> 00:21:54,756 Speaker 1: the Kovac's program, he have thought a lot about this problem. 342 00:21:54,876 --> 00:21:58,836 Speaker 1: He takes the position very explicitly all lives have equal value. 343 00:21:58,836 --> 00:22:00,876 Speaker 1: I mean, he says something, you know, very similar to 344 00:22:00,916 --> 00:22:03,596 Speaker 1: the kind of thing you say. But he also takes 345 00:22:03,596 --> 00:22:07,476 Speaker 1: the view around vaccines that you need the profit motive 346 00:22:08,116 --> 00:22:12,276 Speaker 1: and the private sector to drive the innovation and development 347 00:22:12,316 --> 00:22:16,676 Speaker 1: around vaccines, and that they need patent protections, and often 348 00:22:16,756 --> 00:22:20,276 Speaker 1: you hear criticism of that that the patent protections in 349 00:22:20,316 --> 00:22:23,916 Speaker 1: particular keep vaccine prices high and keep vaccines out of 350 00:22:23,956 --> 00:22:27,036 Speaker 1: the out of reach for the poorest countries. Do you 351 00:22:27,116 --> 00:22:31,716 Speaker 1: think his approach is right or the best available solution 352 00:22:32,036 --> 00:22:35,916 Speaker 1: or neither, Well, you know, I think, And first of all, 353 00:22:35,916 --> 00:22:39,836 Speaker 1: I don't doubt that his work and the world I'm 354 00:22:39,836 --> 00:22:42,716 Speaker 1: talking about the work of the foundation is premised on 355 00:22:42,756 --> 00:22:46,356 Speaker 1: this notion that all lives have equal value, don't doubt it, 356 00:22:46,756 --> 00:22:51,636 Speaker 1: and have some experience discussing these matters with him. I 357 00:22:51,676 --> 00:22:56,556 Speaker 1: also don't doubt that a great titan of industry knows 358 00:22:56,716 --> 00:22:59,596 Speaker 1: things that I would never know about things like patents. 359 00:23:00,196 --> 00:23:03,556 Speaker 1: But I also I further believe that people like me 360 00:23:03,676 --> 00:23:05,836 Speaker 1: have something to add even if we don't know a 361 00:23:05,836 --> 00:23:08,636 Speaker 1: lot about trade agreements. When I say people, I mean 362 00:23:08,676 --> 00:23:12,556 Speaker 1: I mean clinicians, nurses, doctors, community health workers. You know, 363 00:23:12,636 --> 00:23:16,916 Speaker 1: we have responsibilities as well to communities that we're serving, 364 00:23:17,276 --> 00:23:20,156 Speaker 1: and if those communities are not well served by current 365 00:23:20,196 --> 00:23:23,756 Speaker 1: trade arrangements, including patent law, then we should suspend or 366 00:23:23,796 --> 00:23:26,156 Speaker 1: wave them in the middle of crises like this. This 367 00:23:26,236 --> 00:23:29,196 Speaker 1: is a global health emergency the likes of which we've 368 00:23:29,196 --> 00:23:32,316 Speaker 1: not seen in our lifetime. I would imagine that many 369 00:23:32,356 --> 00:23:35,636 Speaker 1: people in industry, and including in the farm industry, could 370 00:23:35,676 --> 00:23:40,156 Speaker 1: agree there are moments when you would wave intellectual property 371 00:23:40,236 --> 00:23:43,756 Speaker 1: rights in order to increase production. And you know, right 372 00:23:43,796 --> 00:23:46,516 Speaker 1: now we're in a situation, as you know, where a 373 00:23:46,556 --> 00:23:49,716 Speaker 1: production is, the chain is the chief barrier. It's supply 374 00:23:49,836 --> 00:23:52,876 Speaker 1: as a chief barrier. And so if a country like 375 00:23:52,996 --> 00:23:56,996 Speaker 1: Rwanda can convince those who do hold patent rights over 376 00:23:57,116 --> 00:24:01,556 Speaker 1: new technologies like mrina vaccines, that they too could participate 377 00:24:01,676 --> 00:24:05,316 Speaker 1: in the production of vaccines and in their distribution elsewhere 378 00:24:05,356 --> 00:24:07,076 Speaker 1: in the world. I think that would be a good 379 00:24:07,116 --> 00:24:10,756 Speaker 1: thing for the species. Meaning our spec Paul, I wanted 380 00:24:10,796 --> 00:24:13,316 Speaker 1: to step back and ask you a more personal question. 381 00:24:13,356 --> 00:24:16,236 Speaker 1: It's a question I'd like to ask all our guests, Unsolvable, 382 00:24:16,476 --> 00:24:21,276 Speaker 1: which is essentially, how did this become your life's work? 383 00:24:21,916 --> 00:24:27,116 Speaker 1: How did you end up devoting yourself to global health equity? 384 00:24:27,196 --> 00:24:30,036 Speaker 1: I can answer in one word, which is uncharacteristic of 385 00:24:30,076 --> 00:24:36,636 Speaker 1: me Haiti, meaning the brevity part is uncharacteristic. I went 386 00:24:37,356 --> 00:24:41,996 Speaker 1: almost by accident to Haiti between college and medical school 387 00:24:42,716 --> 00:24:46,996 Speaker 1: and learn things there in one year that I think 388 00:24:47,876 --> 00:24:50,876 Speaker 1: it would have taken me many years to absorb in 389 00:24:50,996 --> 00:24:54,876 Speaker 1: a classroom, for example. And that's where I learned both 390 00:24:54,916 --> 00:24:58,356 Speaker 1: the devastating toll of not having a safety net, but 391 00:24:58,476 --> 00:25:02,996 Speaker 1: also the almost shameful facility with which one could be 392 00:25:03,036 --> 00:25:06,076 Speaker 1: put in place. The other regular question we like to 393 00:25:06,116 --> 00:25:10,316 Speaker 1: ask Unsolvable Paul is what can listener do? And in 394 00:25:10,356 --> 00:25:14,076 Speaker 1: this case, it's to make up for the setbacks brought 395 00:25:14,076 --> 00:25:17,276 Speaker 1: by the pandemic. I might divide it into two separate answers. 396 00:25:17,356 --> 00:25:21,796 Speaker 1: One is, you know, talking about those increased and highlighted 397 00:25:21,796 --> 00:25:26,236 Speaker 1: disparities in the United States, but then in terms of 398 00:25:26,276 --> 00:25:29,756 Speaker 1: the global gap, in the global shortfalls. You know, I 399 00:25:30,436 --> 00:25:33,716 Speaker 1: would love to see people the age of my students 400 00:25:35,676 --> 00:25:39,596 Speaker 1: grasp on to this as they're you know, a hankering 401 00:25:39,676 --> 00:25:43,236 Speaker 1: that will endure, that they will keep pushing forward an 402 00:25:43,276 --> 00:25:46,596 Speaker 1: equity agenda, and I don't mind calling a social justice agenda. 403 00:25:46,636 --> 00:25:50,076 Speaker 1: What's wrong with social justice? That's almost asking people to 404 00:25:50,236 --> 00:25:54,516 Speaker 1: make a stance part of their response, just a personal stance. 405 00:25:54,676 --> 00:25:57,476 Speaker 1: I am against these kinds of health disparities. I am 406 00:25:57,516 --> 00:26:02,956 Speaker 1: for their decrease. And then there are a specific tasks 407 00:26:02,996 --> 00:26:06,676 Speaker 1: I mean partners in health of course, which is really 408 00:26:06,716 --> 00:26:10,036 Speaker 1: the implementation arm of anything I have. I'd say in 409 00:26:10,036 --> 00:26:13,036 Speaker 1: a lot of places I work requires pragmatic solidarity. In 410 00:26:13,156 --> 00:26:16,036 Speaker 1: order to do this work, we need support. And it's 411 00:26:16,036 --> 00:26:19,236 Speaker 1: not just in far off places. We need support in Massachusetts, 412 00:26:19,276 --> 00:26:21,876 Speaker 1: in Nabel Nation, in new work and immacaly. You know, 413 00:26:21,916 --> 00:26:26,596 Speaker 1: there's a long list of really pragmatic matters that we 414 00:26:26,676 --> 00:26:29,716 Speaker 1: need to address. I'll just give one example. If in 415 00:26:29,716 --> 00:26:33,036 Speaker 1: the state of Massachusetts, which is a very blessed state 416 00:26:33,116 --> 00:26:36,716 Speaker 1: in terms of overall wealth. In terms of a safety net, 417 00:26:37,516 --> 00:26:41,396 Speaker 1: the great majority of the people who we encounter in 418 00:26:41,476 --> 00:26:44,876 Speaker 1: our work doing contact tracing in Massachusetts those who need 419 00:26:44,996 --> 00:26:49,236 Speaker 1: social support, eighty percent of them cite food insecurity eight 420 00:26:49,556 --> 00:26:53,236 Speaker 1: zero percent. And you know, we live in a country 421 00:26:53,236 --> 00:26:57,036 Speaker 1: where there's enough to feed everybody. That's another very pragmatic 422 00:26:57,076 --> 00:27:00,236 Speaker 1: example of the kind of assistance people need. And it 423 00:27:00,276 --> 00:27:02,356 Speaker 1: also includes all the other things that you think about, 424 00:27:02,436 --> 00:27:06,796 Speaker 1: like not being evicted, or having unemployment insurance, or help 425 00:27:07,476 --> 00:27:10,156 Speaker 1: for the disabled who need to get their vaccines or 426 00:27:11,836 --> 00:27:16,236 Speaker 1: in home care. On the global level, it's a very 427 00:27:16,276 --> 00:27:19,716 Speaker 1: similar kind of set of concerns, at least for the 428 00:27:19,756 --> 00:27:22,236 Speaker 1: patients I know best and the populations I know best. 429 00:27:22,316 --> 00:27:25,836 Speaker 1: They are concerned with the same set of problems. Getting 430 00:27:25,836 --> 00:27:30,596 Speaker 1: their kids back in school, resuming their activities, and opening 431 00:27:30,676 --> 00:27:34,516 Speaker 1: up the clinical services and educational services that they want. 432 00:27:34,876 --> 00:27:37,916 Speaker 1: Again requires a lot of pragmatic solidarity. And I only 433 00:27:37,996 --> 00:27:40,676 Speaker 1: say that because you know, what is it the partners 434 00:27:40,676 --> 00:27:43,396 Speaker 1: and Health is doing beyond that, not much. It's really 435 00:27:43,396 --> 00:27:47,036 Speaker 1: pragmatic solidarity. Sometimes we're saying, Okay, we'll help you build 436 00:27:47,076 --> 00:27:49,636 Speaker 1: a hospital, or we'll help you start a medical school, 437 00:27:50,036 --> 00:27:54,076 Speaker 1: but it's still the pragmatic part of it's still there, 438 00:27:54,116 --> 00:27:57,276 Speaker 1: and I just hope more and more people who are 439 00:27:57,316 --> 00:28:00,836 Speaker 1: listening get involved in global health equity. That's kind of 440 00:28:00,876 --> 00:28:02,876 Speaker 1: the term we use rather than public health. It's a 441 00:28:02,996 --> 00:28:06,716 Speaker 1: role for everybody. Paul, It's an inspiration and always a 442 00:28:06,716 --> 00:28:08,676 Speaker 1: pleasure to talk to you. Thank you so much for 443 00:28:08,756 --> 00:28:11,956 Speaker 1: joining us, Unsolvable. It's great to see you, Jacob. Thank you. 444 00:28:15,276 --> 00:28:18,516 Speaker 1: Paul Farmer is a professor at Harvard Medical School. He's 445 00:28:18,636 --> 00:28:21,876 Speaker 1: Chief of Global Health Equity at Brigham and Women's Hospital 446 00:28:21,916 --> 00:28:25,716 Speaker 1: in Boston and the co founder of the organization Partners 447 00:28:25,716 --> 00:28:30,116 Speaker 1: in Health. His new book is called Fevers, Feuds and Diamonds, 448 00:28:30,396 --> 00:28:34,156 Speaker 1: Ebola and the Ravages of History. To learn more about 449 00:28:34,156 --> 00:28:39,356 Speaker 1: international health resources, disease prevention, and poverty eradication, please check 450 00:28:39,356 --> 00:28:43,236 Speaker 1: out the links in our episode notes. Solvable Senior producer 451 00:28:43,276 --> 00:28:47,516 Speaker 1: is Jocelyn Frank, Research in booking by Lisa Dunn. Catherine 452 00:28:47,556 --> 00:28:51,076 Speaker 1: Girardou is our managing producer, and our executive producer is 453 00:28:51,116 --> 00:28:56,196 Speaker 1: Mia Loebell. Special thanks to Heather Fame, Kadijah Holland, Maya Konig, 454 00:28:56,476 --> 00:29:01,796 Speaker 1: Emily Rostak, Eric Sandler, Carly Mgliori, John Schnar's, Christina Sullivan, 455 00:29:01,836 --> 00:29:05,756 Speaker 1: and Maggie Taylor. Solvable is a production of Pushkin Industries. 456 00:29:06,076 --> 00:29:08,796 Speaker 1: If you like the show, please remember to share, rate, 457 00:29:08,876 --> 00:29:11,116 Speaker 1: and review it. It helps us get the word up. 458 00:29:11,756 --> 00:29:15,036 Speaker 1: You can find Pushkin Podcasts wherever you listen, including on 459 00:29:15,116 --> 00:29:19,596 Speaker 1: the iHeartRadio app and Apple Podcasts. I'm Jacob Weisberg.