Good morning, Hank, it's Tuesday. So this is my last, like, normal video of 2023 and as years go, uh, I won't be sad to say goodbye to this one. It's been a rough year, but I've been thinking a lot about hope and how and where to find it, and maybe this can be one example of how and where.

So for the last few weeks, the Time for 5 coalition of TB activists have been calling renewed attention to the price of drug-resistant TB test cartridges. There are advertisements on bike shares and on a bus stop near the headquarters of the company that makes the cartridges and also there is an ad in today's Washington Post, which is where the company in question—Danaher—is headquartered. So one thing we don't talk about enough is that these test cartridges are amazing. I mean, in a couple hours, caregivers can know which antibiotics a particular individual's tuberculosis will respond to and then usually that means that it can be cured within 6 to 9 months of the right antibiotic regimen.

I know of one TB survivor—Phumeza Tisile—who during her three years and eight months of drug-resistant TB treatment, took between 20 and 30,000 pills and also lost her hearing because of a drug that, it turns out, she didn't even need to take. All that happened because at the time, this miraculous test didn't exist and now it does exist, which is a cause for hope and celebration. It's also such a testament to the power of research and the scientific method and the sharing and diffusion of knowledge and to the talent and hard work of the people who work at Cepheid, the subsidiary of Danaher, that makes these tests. Because I haven't been particularly good at being hopeful lately, I don't think I've spent enough time marveling at the astonishing multi-generational global collaboration that has led to all of this progress, like, if we hadn't identified the bacterium that causes tuberculosis in 1882, if we hadn't come up with increasingly better strategies to kill that bacterium, we wouldn't be here today. TB wouldn't be curable.

This is where I find hope in community, in collaboration, in making meaning together, by making change together. I find hope in the Wes of my life. The We of TB fighters. The We of Nerdfighteria. The We of my family. The We of Indianapolis. It's getting weird to say "we" over and over again, but you know what I mean. I think I'm looking for hope and collaboration and community because that's where people together can battle what Kurt Vonnegut called, "the terrible disease of loneliness," while also battling other diseases like tuberculosis and other forms of injustice. But of course, collaboration doesn't mean never disagreeing. It means often disagreeing, hopefully, in respectful and empathetic but still passionate ways. Because when lots of people are working together to find the best way through, within that lots of people, there will always be divergent value systems and perspectives and everything else. And that's not just okay, it's essential.

Like, here's one example of what I mean: Danaher and Cepheid have lowered the price of their standard TB test cartridge and pledged not to make a profit in low and middle-income countries on those tests, which is amazing. But they haven't lowered the price of their test cartridge for drug-resistant TB, which I'm sure from their perspective makes sense, but from our perspective as TB fighters doesn't make sense because our only priority is lowering the global burden of tuberculosis, which we think is best accomplished through cheaper and more abundant testing. That's a big disagreement over an issue that contributes to hundreds of thousands of deaths every year, but Danaher is not the enemy. Tuberculosis is the enemy.

To end TB, we need each other and I think together we can drive down costs further and make testing more affordable. That's my hope. Is it naïve? I just don't think it is because I've seen hope be realized before. It's utterly unacceptable that 200,000 people are gonna die of drug-resistant tuberculosis this year, and that most of those people will never be able to access one of those amazing molecular tests because there simply aren't enough of them available. It's very frustrating to me that with existing resources, we could test twice as many people and Danaher could still make money if the tests cost half as much. All of that is discouraging, but what is encouraging to me is the broad multi-generational series of breakthroughs that led to this test in the first place, and my belief that activists and advocates working together can find ways to get more tests to more people more affordably. And Danaher can, and I believe will, be an ally in that fight.

Hank, I think it's safe to say that this has been the hardest year of your life and what you've been through has been brutal. It's also been one of the hardest years of my life. But I finished the year feeling that there are two human capacities that have carried us this far, and by us, I mean both you and me and the broader Us; Our capacity for collaboration and our capacity for hope. To hope is to refuse to accept the world as it is and it is through collaboration, and indeed, only through collaboration, that we can bring about a better world.

Hank, I'll see you on Friday.