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In which John is a bit surprised to have such good news to share--while also acknowledging this isn't over. Learn more about the deal struck between Danaher and the Global Fund, the Stop TB Partnership, and USAID:

Danaher's press release committing to zero profit and third-party verification:

Join me and other TB writers for an awesome discussion this Friday in New York City (Also available via livestream!!). Register here: (first come first serve!)

This is very good news for people living with tuberculosis, and expands testing capabilities significantly. But it also isn't the end. Further progress could be made, especially with extensively drug resistant TB test cartridges--and we should advocate for that respectfully and compassionately.

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Good morning, Hank, it's Tuesday.

So last week I made a video about the company Cepheid and their parent company Danaher's amazing but expensive tuberculosis tests. And like minutes ago as I'm recording this, USAID, the Global Fund, and the Stop TB Partnership issued a joint statement saying that Danaher's standard TB cartridge would reduce in price from $10 to $7.97, which isn't the 50% reduction we hoped for, but is extremely extremely significant. And it's significant in part because Danaher has committed to making no profit in poor countries from their standard TB cartridge. Also I've heard that Danaher is committed to allowing a third party to come in and verify their at cost pricing and to do so on a regular basis so that if the cost of manufacturing goes down, the cost of the test will too. Also Danaher just agreed to improved maintenance conditions, making it easier to fix the GeneXpert tests when they break. All the of this is, um, amazing news.

Just to state the obvious, this is really important progress for those living with and fighting TB and it's a big win for our community as well as the folks we've worked in deep partnership with—many of whom have been involved in this fight for years. Doctors Without Borders, the Treatment Action Group, and Partners in Health among others. Here's why it's a big deal: Let's say Cepheid sells 10 million of these cartridges per year at the reduced price. Over a decade, that will save the world's most impoverished communities $200 million. But I know it's easy to think about this stuff in terms of numbers or dollars, but I also wanna think about it in terms of people's individual experiences. Like last week on vlogbrothers, we hosted a live stream that included one of my heroes, the TB Survivor and activist Phumeza Tesile whose TB took over a month to diagnose.

Phumeza: Because they saw the situation I was in. I mean, I was like my lowest weight 32 kg, and what it is in pounds in America, I don't know.

John: That's 70.

Phumeza: It's very thin. So they said I must do a chest X-ray and then I go to another clinic to get a chest X-ray and then I was diagnosed through the chest X-ray.

And because she was only diagnosed via chest X-ray, her doctors didn't know that she had drug-resistant TB and so she was put on the wrong drug regimen at first. And eventually, she was in continuous treatment for over three and a half years, during which she had to take over 20,000 pills. And if Phumeza had been diagnosed immediately and accurately with a GeneXpert test, she could have been spared so much suffering. She might not have lost her hearing or had to go through years of disabling illness. That's the kind of change in individual lives less expensive GeneXpert tests can bring, and so when we talk about millions more tests being available, we're really talking about the opportunity to help transform millions of lives for the better.

Now despite all this, I do still have some mixed feelings. Like, I take Danaher at their word that $7.97 is their cost, but I look at the cost of the XDR—the extensively drug resistant tuberculosis test—and I just wish that had also reduced in price. And I do hope that eventually Cepheid and Danaher may take a similar approach with their XDR cartridges as they have with their standard ones because I just think it would be such good news for patients and also for the world because it would help us to prevent the most dangerous strains of TB. Also I've heard that some folks involved in this, including potentially people in our community, have resorted to name calling and even threats toward people who work at these companies, and I wanna be very clear. That is unacceptable. It is a total violation of our community's guidelines for activism and also it makes everything worse. So please, and I realize I'm talking to a tiny minority of people here, but please don't do that ever. I've experienced those threats and all they make me feel is resentment and fear and anger, which makes mutual understanding and compromise vastly more difficult.

So yeah, there are definitely some complicated feelings here, and I do think we should continue to advocate for lower cost diagnostics, especially for those XDR TB cartridges. But we need to do that in a way that is polite and respectful and also reflects the reality that these companies have made choices that expand access to diagnostics for the people who need the most. So yeah, the work is definitely not finished. Really, it's just beginning. This week I'm gonna be in New York to continue conversations about tuberculosis at the United Nations which is a weird thing to say. Also on Friday, I'm gonna be part of an author event at NYU with some of my heroes and it's free. You should come, link in the doobly-doo.

Hank, the last thing I want to say is this. Early in 2007, way back when we were just beginning Brotherhood 2.0, I was hospitalized for an infection between my eye and my brain. And Hank, you asked people in our community to take pictures of them with stuff on their heads to cheer me up. And of the 400 or so people who regularly watch those videos, about 350 people sent in pictures, and this was before it was easy to send digital pictures. This was before the iPhone. And when I was in this hospital bed watching that video, seeing all these people with ridiculous stuff on their heads, it was the first time when I thought, "My God, this community has a lot of energy in it. They want to do interesting stuff together." I just remember thinking this feels like it could be really special. And so it has proven to be. I mean, the idea that 16 and a half years later, the organizational and creative talents of Nerdfighteria would be harnessed together, not to cheer up one guy in a hospital, but to expand TB treatment and diagnostics to millions. That is awesome. I am genuinely in awe of you and you are truly made of awesome.

Hank, I just want to leave you with three words that I've had to learn over and over again these last 17 years. Never underestimate Nerdfighteria. I'll see you on Friday.