Good morning, John. I hesitate to bring this up. But a couple of times, out here on the Internet, I have seen people say something like, "John Green only cares about tuberculosis." 

Obviously, this is a little bit silly, but it gets under my skin. And so it's something I've spent a fair amount of time thinking about. So first things first, problems are bad. Some problems can be solved in some places by people building businesses that solve that problem, and then selling the solution, like farmers grow food and sell it. Twitter grows outrage and sells it. That kinda thing. 

But lots of problems don't have systems that can help their solutions sustain themselves, by which I mean, not every solution has a good business model. But, again, problems are bad, and so some people will sometimes pay enough attention to them to bring solutions, even when the solutions are not currently economically self-sustaining. And in many parts of the world, tuberculosis is one of these kinds of problems. 

So, John. This week, you uploaded a video about the work being done to try and fight tuberculosis in the Philippines, and we found, you and I, very quickly, that it was not doing well. Fewer people than usual who saw the thumbnail were choosing to watch the video. And when that happens, YouTube starts to show that thumbnail and title to fewer people. It's a bit of a feedback loop. If fewer people see the title and thumbnail and think, "I'm gonna click on that," then YouTube is like, "Well, I'll show them something else that they'll be more likely to click on." So you, sleep-deprived and with twelve hours of time difference between where you usually are and where you were, you texted me, and you said, "Oh boy, do I need an improved thumbnail or something." And I replied, "I'm on it." 

So I started thinking about how I might be able to change that title and thumbnail so that more people would choose to click on it. And what I did, in order to do that, was I just started thinking about the video. And I started thinking, then, about you. And I started to think about how you see the world. And that opened my eyes to something I think is very interesting. So I would like to introduce everybody here to three qualities of problems. 

Number one is how big the problem is, which we can think of mostly through the lens of suffering. And that might be hunger, or grief, or fear, or sickness, or death, or instability, but something is making it impossible or very hard for people to thrive. 

Number two is how difficult it is to alleviate that suffering. Like, as a very basic example, there could be two countries that both have health crises, but one is in active civil war, and so that health crisis would be easier to address in one place than another. 

Now, in a lot of ways, those are the only two things that should matter. But there is a third thing that I think might matter more than both of them. I don't know exactly what to call it; it's not exactly visibility, but I'm gonna call it visibility. Like, it's just how easy it is to see and feel the problem. How easy it is to pay attention to it. 

A lot of stuff goes into visibility. Like, "Is this a contentious topic in society that's gonna spur discourse? Is the suffering the result of a disaster and feels like news so it's being covered by the news a lot? Is it affecting a group of people who we have some amount of kinship with? Does the suffering intersect with an existing narrative? Is it easy to photograph or film? Can we see ourselves experiencing something similar, or does the cause of the suffering feel distant?" And more than that, lots of stuff that I'm sure I don't even understand. 

But visibilty matters a great deal. And perhaps more than the magnitude of the suffering or the ease of the solution. And because of this, it turns out, most of the problems that are very big and very visible are very hard. If they were big, visible, and easy, they would've been solved by now. But, there are quite a number of problems that are very big and actually solvable, they just have low visibility.

And so when people say—and this is not a lot of people, but when they say, "Why does John Green only care about tuberculosis?," I think what they might mean is, "Why is John Green focused on a problem that no one else is focused on?" And with the lens of these, like, three qualities of a problem, the question answers itself.

John, your genius is that you're focused on a problem that people don't care that much about, because the fact that people don't care that much about it is the main reason the problem exists. If it were more visible, if it were more salient, if it felt heavier and more important, it actually would've been solved by now. 

Here's a crazy thing that I know. Something like one-thirtieth of the money we spend on cancer treatment would be enough to cut the number of people with active tuberculosis by 80 or 90 percent. The per-patient cost of a case of cancer in the U.S. is somewhere north of $100,000. The per-patient cost of tuberculosis is right around $1,000. 

But this is not an indictment of people not caring. We are humans. We care about the things we care about, and expanding our circle of empathy is, in some ways, actually contrary to our nature. 

But John, we're YouTubers. And what do YouTubers do? They figure out how to get attention! So your video was doing badly. It was trending toward being our worst-performing video in many months. The terrible thing about algorithmic platforms is they amplify tiny signals. Our second best–performing video of the last couple of months had just one percent higher engagement. But YouTube, through its quest to always be serving people something that's just a little bit more inticing, amplifies that signal. 

So armed with what I had learned from thinking about you and what you're doing in the Philippines, I started workshopping titles, testing which one got the most engagement. And unsurprisingly, I ended up with a title that does intersect with a narrative that we are more engaged with, and—I think understandably—are outraged by. 

Sometimes, we use our powers because it's nice to watch the numbers go up. But you, John, more than anyone I know, you use your powers to put attention where it is most deserved. And now, that exact same video that you put together while sleep-deprived on the other side of the world, with just a different title and thumbnail, is on track to be our second most–viewed video of the last few months. People do care! They do! The responses to that video have showed that people care. And to those who say that John Green cares only about tuberculosis, do you even know?!

Because the news of this week gets even better. John, right now, you are planting seeds, but you were planting seeds six years ago as well, when you uploaded your first video from Sierra Leone. Shortly after that, you and I pledged to raise 25 million dollars to build a hospital with no idea how we would do it. But we didn't just do it. We exceeded the goal. How did we do it?

Hundreds of thousands of sock sales. Dozens of major gifts. An entire store that donates its profit to charity. Many Nerdfighters giving one-off gifts, giving monthly, and today, now, a solution for a problem that just wasn't visible enough for many people to see exists in the real world. 

That seed that you started working on with Partners In Health and the Sierra Leonean Ministry of Health has grown into a real thing. The ribbon has just been cut at the Maternal Center of Excellence at Koidu Government Hospital thanks— (choked up) I'm gonna—

Thanks to this community, thanks to Partners In Health, and thanks to the Sierra Leonean Ministry of Health. A facility built by and for and staffed by Sierra Leoneans, the MCOE is not only an investment in the health of the community but also the economy, medical education, and health infrastructure of Sierra Leone and Kono District.

Every person who has helped to support the MCOE, whether with silly socks or a monthly donation or a $300,000 gift, every one of those supports not just mothers but entire communities. And I say that the seed has grown, but the story of this hospital is just beginning. The MCOE is a state-of-the-art facility designed to give women and newborns the care they need and deserve. It expands the maternity ward and special care baby unit from 48 beds to 120, including the nation's first neonatal intensive care unit. It's equipped with everything needed for world-class care: reliable electricity, piped oxygen, and surgical suites. 

And when the doors open in early 2026, lives will be saved immediately, but the real impact, measured in healthier mothers, stronger families, and a more resilient health system, will grow over years. The MCOE is more than a building. From employing local women on the construction site to training health workers and building sustainable infrastructure, Partners In Health and the Ministry of Health are working hand-in-hand with the community to ensure this lasts. 

That's the real work. And it is being done on the ground by wonderful people, and I am so grateful to them, and I am so grateful to everybody who ever supported this project, in any way, whether it was just watching these videos. 

John. I'd say I hope you're doing better with the jetlag, but I know you're not. I'll see you on Tuesday.