Good morning, Hank. It's Wednesday. God, I love these Pizzamas shirts, available only for the next 10 days at pizzamas.com. So, listen, two things.

First, thank you for reminding me that your proposed Wikipedia talk page used to read: “Just because you have a notable brother does not convey notoriety,” which, chef’s kiss, perfect. You may be the more notable brother today, but I will always be the first notable brother, at least in the eyes of Wikipedia editors.

Secondly, I have been thinking, as I often do, about hope and whether it is justified in this or any moment. And I've been thinking specifically about two really hopeful news stories that haven't been in the news and why they haven't been in the news.

Let's start with tuberculosis, since everything is tuberculosis. So back in the 1990s, the WHO-recommended therapy for people living with multidrug-resistant tuberculosis was so-called "supportive care," which meant wait for them to die.

Curing multidrug-resistant tuberculosis in poor communities was seen as, one, impossible, and two, even if possible, a terrible use of resources because it cost about $30,000 per person.

But then, Partners In Health started treating people with MDR-TB in Peru, proving that it wasn't impossible to cure them in a famous study published in The Lancet. And after that, the cost of treating multidrug-resistant tuberculosis came down because it turned out that none of the drugs were actually under patent. It's just like, no one had bothered to make them generically.

Soon it cost about $3,000 to cure a person with multidrug-resistant tuberculosis. And the WHO began recommending treatment at last.

And that was very good news, not only for people living with multidrug-resistant tuberculosis, but also for everyone else because by stopping chains of infection, people, including potentially you, never got MDR-TB.

But $3,000 is, of course, still a lot of money. So since then, advocates, including many people watching this video, have been pressuring governments and pharmaceutical companies to drive the price down further. One famous example of this is pressuring Johnson & Johnson to abandon attempts to evergreen their patent for the critical MDR-TB drug bedaquiline. And since bedaquiline went off patent, the price of bedaquiline has dropped by about 60% just in two years.

And just a couple weeks ago, the Stop TB Partnership announced that curing multidrug-resistant tuberculosis no longer costs $30,000 or $3,000, but less than $300. That's over a 99% price drop since PIH started proving that MDR-TB is curable in poor communities, Hank. And it is a concrete example of life getting better for the most vulnerable among us through a broad, decades-long collaboration. It was too slow, the progress is still insufficient, but it is real.

And for some reason, it's not news. I mean, I haven't seen it reported anywhere. And trust me, I pay attention to tuberculosis news.

All right, before the other story, I have to tell you about the 2025 Pizzamas pin subscription, which comes with bookplates each month and features me and my mustache as a different character in literature each month, beginning with Frankenstein? Which incidentally is a very tubercular novel, but that's another video. This is the only way to get your Pizzamas all year round, Hank, pizzamas.com. Okay, back to the video.

So the other news story that isn't getting much attention at this moment despite being incredibly important news is the massive reduction in maternal mortality in what used to be the epicenter of that crisis.

So as you can see here, globally we've made some progress on maternal mortality since 2015, but it's been slow and it actually got worse the year after COVID emerged because so many healthcare systems were under such intense strain.

So globally we've reduced maternal mortality by about 23% in the last 10 years, which is progress, but kind of uninspiring progress, to be honest with you, not least because in the decade before that the progress was faster.

But in Sierra Leone in that same time period, maternal mortality has dropped by over 60%. I mean, a decade ago, Hank, if you went to Koidu Government Hospital in the Kono District in Sierra Leone, you would have found no 24-hour electricity, no running water, no blood bank, no functioning X-ray machine, very few medicines, no or very little paid staff, and as a result, very few patients.

Now there is all of that and much more. And as a result, maternal mortality has declined precipitously at the hospital and will decline more with the opening next month of the Maternal Center of Excellence at the hospital.

Now, this is primarily a result of the Sierra Leonean government investing in health and healthcare workers. But private philanthropy has played an important role, and we have played an important role in that private philanthropy. By “we,” I mean, like, all of us watching this video.

If you've bought a silly Pizzamas shirt or donated monthly to Partners In Health or just encouraged people to care about the global maternal mortality crisis, you have played a role in this story. And I'm sorry that it's not front-page news. I believe that it should be, but it is real cause for hope.

Now, Hank, neither of these causes for hope should in any way negate or minimize the many reasons to feel outrage, which truly are legion. In many ways, the world is getting worse, especially for the most vulnerable among us. And I'm not saying that progress is inevitable or that the world will get better. I'm saying these are two examples to remind us that the world can get better.

And I just want to offer you one last reason to feel hopeful. This feels like the end of the story, inevitably, right? Like, our lives always feel like a story that begins with the day of our birth and ends today, the most recent day possible.

But today is not the end of the story. Today is the middle of the story. And in a strengthening Sierra Leonean healthcare system and in lowering costs for multidrug-resistant tuberculosis, I see examples of how activism works. It works over many years. It is difficult. It is hard work. It often goes unappreciated. It doesn't make the news, but it works.

We can change the story. In fact, we will change the story because the human story is always changing. Hank, I'll see you tomorrow.