Good morning, Hank.

It’s Tuesday. Three things.

One, I have an essay  in the Washington Post about tuberculosis. Two, there's a new Crash Course  lecture about the history of tuberculosis. And three, Danaher.  Two sentence backstory.

The company Cepheid, owned by the  larger conglomerate Danaher, makes these amazing GeneXpert tests,  which are the best available tests for tuberculosis. But similar cartridges  can also test for HIV or hepatitis, or extensively drug resistant tuberculosis.  Recently, our community helped pressure Danaher to lower the price  of their standard tuberculosis test cartridge, which resulted in literally  millions more people per year being able to access high quality testing.  But the tests for extensively drug resistant tuberculosis, HIV, hepatitis, etc.  All remain far too expensive. So several organizations have come  together to ask for a drop in test pricing for low and middle income countries,  and you can sign their petition at the link in the doobly doo.

Now, I know it  often feels like signing petitions is just a shout into the void, but I would  argue that in this case it isn't. Because, one, Danaher has shown a willingness  to respond to polite but insistent pressure. And two, this kind of thing appears to  be the only way to bring change in the system as currently understood  by Danaher.

Because right now, there's exactly one group of people who  benefit from Danaher charging an over 300% markup in the world's  poorest countries for, say, an HIV test. Poor communities certainly don't benefit, right?  Like, as Partners in Health puts it - in every country where they work,  if the cost per cartridge were lowered,  we could expand access significantly. People with HIV don't benefit, as it's  harder than it needs to be to access quality testing.

The social order doesn't  benefit, as the human community wants HIV to be diagnosed quickly  and accurately. And I would argue that most Danaher employees don't  benefit either. Like most people who work at Cepheid did not get into their  lab or tech work because they wanted to make piles of money, but instead  because they wanted to make these amazing tests that can absolutely  transform healthcare globally.

They want their tech and research to be  creating the maximal possible societal benefit, and there's plenty of money  to be made in rich countries in order to fund that research and their livelihoods.  The only person who benefits from Danaher's price gouging is, for lack  of a better term, me. Because Danaher is a publicly traded company  and I am a shareholder. Now, in the current system, Danaher has a  responsibility to us shareholders.

It is legally obligated to do what is in  our best interest because we own the company. And at least as far as I  understand Danaher's position, they don't feel they can make decisions  that would harm the shareholders, even when that would benefit the  entirety of humanity. So I bought a tiny slice of Danaher recently, partly  to say thanks for lowering the price of that standard TB cartridge,  but mostly because it allows me to attend certain meetings and talk with  other shareholders about how they're profiting off of price gouging the  world's poorest people and those who serve them.

I just think it's  important for my fellow shareholders to understand this, because they're  literally the only people who benefit from this profiteering. Like each of us  makes about a dollar per share in profit dividends every year, which  amounts to only like $10 for me. But for Danaher’s co-founders,  Steven and Mitchell Rales, they each make over $25 million a year just in  dividends.

Now, not all of that comes from overcharging the poor for HIV  and tuberculosis tests. In fact, very little of it does. Danaher makes over  $4 billion a year in profit.

Less than 1% of that comes from Cepheid  overcharging for test prices in low and middle income countries.  Which is actually why I think they can be convinced to change.  Because when I hear that a company's primary obligation is not to its employees  or its customers or the social order, but instead to its shareholders,  what I hear is that the only way to get Danaher to do the right thing is to  cost them more in reputational harm than they make from overcharging  the poor. And petitions can help do that, along with other forms of polite but  impassioned pressure. Five or 10,000 people having a negative  opinion of your company and caring enough to sign a petition  makes it harder to recruit and more expensive to market, and so on.  It's a real problem, as is negative publicity.

And there's currently quite  a bit of that for Danaher, not only in the Washington Post, but also online,  on Threads and Instagram and Facebook and Twitter, or whatever  Twitter is now called. There's even a “lower your test prices” version of  Flappy Bird, which I, for one, find utterly addictive. Combine that with  the Danaher employees who have been heroically speaking up and  letting their voices be heard, and it starts to get pretty expensive not to  lower your test prices.

Expensive enough one would hope that Danaher  will consider lowering test prices, not just for the standard tuberculosis  test, but for all of their tests in low and middle income countries.  And if we haven't made it expensive enough, rest assured that we will  continue until we do so. Please sign the petition linked in the video info  below and continue to ask Danaher to lower their prices. This shareholder,  for one, would appreciate it.

Hank, I'll see you on Friday.