You should put Reylo as the first option on a random poll in the bonus round
you know what? sure. i'll do this for the surprise round couple to spice things up. i just queued it for 6:27pm est tomorrow and i will also take this opportunity to apologize in advance for the horrors we are about to inflict on you all.
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Hi. I've started writing a semi-weekly TB Newsletter, if you're interested in that kind of thing. Here's the second letter--about public-private partnerships, leprosy, and my forthcoming big announcement about expanding access to tuberculosis care. You'll hear more about that on Thursday. Anyway, here's the newsletter. You can sign up here.
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In advance of the Big Announcement this Thursday, I made a vlogbrothers video today on how we end TB–with the comprehensive care plan often known as S-T-P, which is short for “Search, Treat, and Prevent.” But one thing I didn’t discuss in that video is the downstream benefits of comprehensive TB care.
Once you’ve hired community health workers to screen for TB, it becomes much easier to screen for other illnesses like diabetes, high blood pressure, and non-TB lung issues (especially lung cancer). TB is notoriously a disease of vicious cycles–a disease of malnutrition that makes malnutrition worse, a disease of poverty that makes poverty worse, and so on–but addressing TB can be a story of virtuous cycles: TB survivors become TB advocates, as I’ve seen with my friend Henry in Sierra Leone. More effective TB treatment leads to less stigmatization of the disease, as communities come to see the disease as curable and survivable rather than terrifying and deadly. And better access to TB care leads to a stronger overall healthcare system, because more community health workers are better connected to more primary healthcare clinics, which allows communities to better address all kinds of health problems.
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Mycobacterium tuberculosis is not the only bacteria of its family that causes a lot of human suffering; there is a closely related species called mycobacterium leprae that causes the disease known as Hansen's Disease, or more commonly leprosy. There are still around 200,000 cases of leprosy diagnosed each year around the world, and while the disease is curable, it also remains–especially if not caught and treated early–a significant driver of suffering and disability in our world.
There are many connections between TB and leprosy: Not only are the bacteria that cause these illnesses very similar, but patients have often expressed similarities in experience. TB patients who were encouraged or forced to live in sanitariums often compared themselves to lepers. One disheartening parallel between the diseases is that in both cases, those living with these illnesses are often abandoned by their families and must make new social connections within the new community of “leper” or “consumptive.” Also, both Hansen’s Disease and TB continue to exist largely because of systemic failures rather than due to a lack of knowledge or technology.
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I really recommend Dr. Salmaan Keshavjee’s TED talk about how we ended TB in the U.S., and how we can end it using the same strategy around the world.
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Last link from me today: I’ve been thinking a lot about the complex intersection between public and private investment (for reasons that will be clear on Thursday!) and I keep coming back to one infographic in an excellent paper (https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0256883) about the public money that was poured into the creation of the GeneXpert Machine, which can quickly and accurately test for TB. The GeneXpert machine has created a lot of profit for Danaher’s shareholders, and it has also created some societal benefit, but it could create a lot more societal benefit if it created less profit for Danaher’s shareholders. This tension seems to me one of the defining features of 21st century life. Anyway, here is the infographic:
That’s the money–over $250,000,000 of it–that came from taxpayers (mostly in the U.S. and Europe) to fund the creation of the GeneXpert Machine. And yet, this tech largely funded by the public is controlled entirely by private enterprise. I’m troubled by that model of value allocation, even if I still believe that private money and private enterprise have important roles to play in fueling innovation. But taking a quarter billion dollars of public money and then claiming total ownership over a technology, and using that ownership to deny the technology to the world’s poorest people, seems like a deeply flawed system of resource distribution to me.
I’ll see you on Thursday. I’m nervous and excited.
DFTBA,
John
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Nico and Percy's dynamic through the series is eternally funny to me, because it's just. like.
Percy's having a constant mental struggle between his fatal flaw of loyalty with a promise he made to Bianca to protect Nico, versus his Big 3 kid desire to maim other Big 3 kids / Poseidon descendant urge to totally maim Nico specifically. He hates Nico so so much. He thinks Nico's annoying and weird at best, and creepy/sketchy when he's older. The only positive thoughts Percy has towards Nico are "He's Bianca's brother and Bianca was my friend and I owe her/He's Hazel's brother and Hazel is my friend and would kill me if I was mean to him," "He's a powerful asset and useful ally (if questionable)," and "He's kinda pathetic and I feel maybe a little bad about it." Percy has multiple occasions throughout the series where he strongly considers - and on one occasionally actually goes through with - throttling Nico.
Meanwhile, Nico is following around Percy like a lost puppy. He explicitly can never bring himself to even dislike anything about Percy no matter how hard he tries. He has a whole bit in BoO where he's mentally going "UGH he's so stupid BUT IT'S ENDEARING HOW DARE HE." He's totally smitten. He's making deals with his dad for Percy. He's making convoluted plans to help Percy stand a chance against Kronos. During the entirety of BoTL it's like he's playing tsundere - "I'm helping NOT PERCY SPECIFICALLY with this quest! Me helping Percy would be SILLY because I DEFINITELY HATE HIM." Then he proceeds to show up to Percy's birthday party to basically ask him on a weird date and spend the entire next book scrambling around trying to help him or protect him or impress him. And Percy could not give less of a shit.
Just. That dynamic is so funny to me. Percy is the founder of the Nico Protection Club in that he's the one they're all protecting Nico from and meanwhile Nico is throwing himself at Percy to the point where the literal god of gay love calls him out on it.
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