The Joe Rogan Experience - Joe Rogan Experience #1261 - Peter Hotez

00:00:07.000 And we're live!

00:00:09.000 How are you, sir?

00:00:10.000 How are you?

00:00:10.000 Good to see you again.

00:00:11.000 I'm thrilled to be here.

00:00:12.000 Thanks for doing this, man.

00:00:13.000 Thanks for having me.

00:00:14.000 I should tell people before we get started, I did not know when I asked you to come back on that you were heavily involved in this whole vaccine debate.

00:00:23.000 What I wanted to have you on to talk about is tropical diseases, because I remember when we did that sci-fi show, you explained to me that some ungodly percentage of people that live in tropical climates are infected by parasites.

00:00:36.000 That's right.

00:00:36.000 Well, my day job is developing vaccines for tropical diseases.

00:00:40.000 We develop the vaccines no one else will make because they're for the world's poorest people.

00:00:44.000 So we call them tropical diseases, but they really are diseases of poverty.

00:00:48.000 The vaccine issue, the advocacy issue around vaccines and autism is kind of a new thing that I got drawn into just because I'm a parent of an adult daughter with autism and I make vaccines, so it was a natural that I'd get drawn into it.

00:01:03.000 Yeah, so when I said that you were going to come on, then I got inundated by people that are...

00:01:10.000 You know, the vaccine thing is such a polarizing issue.

00:01:15.000 Yeah, it's awful.

00:01:15.000 And so many people seem to think they absolutely know...

00:01:21.000 What causes what?

00:01:22.000 Especially when it comes to something like autism, which is a huge issue in this country.

00:01:28.000 It's a huge issue around the world.

00:01:29.000 And it didn't used to seem to be.

00:01:32.000 The question is, was that because it was undiagnosed?

00:01:35.000 Was that because it's more prevalent today?

00:01:40.000 What do you think?

00:01:40.000 What is your take on this?

00:01:41.000 Well, I don't think we really know.

00:01:43.000 One thing's for sure, we're diagnosing people with autism who we diagnosed as something else in the past, you know, whether it was, you know, really horrible diagnosis.

00:01:54.000 We'd use pejorative terms like mental retardation.

00:01:56.000 What's the matter, Jamie?

00:01:57.000 Sorry.

00:01:58.000 My bad.

00:01:59.000 Just telling you the clock was off.

00:02:01.000 Oh, okay.

00:02:02.000 Sorry.

00:02:03.000 Should we start again?

00:02:04.000 No, no, no.

00:02:05.000 It's okay.

00:02:05.000 He was just telling me that our clock is screwed up because of the daylight savings time.

00:02:09.000 Oh, right.

00:02:09.000 Sorry.

00:02:10.000 Totally unrelated to what you were saying.

00:02:12.000 The whole country's clock is screwed up because of the daylight savings time.

00:02:15.000 So we don't know.

00:02:17.000 We don't...

00:02:18.000 Well, you know, one thing's clear.

00:02:20.000 The number of diagnoses is going up.

00:02:22.000 But part of that is because what we used to call pejorative things like mental retardation now get thrown into the autism category.

00:02:31.000 They do.

00:02:32.000 Absolutely.

00:02:33.000 How so?

00:02:46.000 Is that based on aptitude tests?

00:02:51.000 Like how do they decide?

00:02:53.000 Is that what's autism?

00:02:54.000 They have a list of diagnostic categories.

00:02:58.000 But it's not like you could test someone if they test positive for a disease.

00:03:02.000 That's right.

00:03:03.000 Well, although one of the interesting side pieces to this is there's a group of people out there who self-identify themselves as the autistics.

00:03:14.000 And they get very resentful or hurt when they're called a disease or a disorder.

00:03:20.000 Because they say, well, we're not an epidemic, we're a person.

00:03:24.000 And it's part of this whole neurodiversity movement, which is quite interesting.

00:03:29.000 Neurodiversity movement.

00:03:30.000 Right.

00:03:30.000 They say they're neurodiverse, that they, you know, maybe think differently from others and they respond differently than others, but they're not, quote, abnormal.

00:03:38.000 And I think they have a good argument.

00:03:41.000 I heard a crazy argument once with someone that was...

00:03:44.000 So the point is that it's, you know, the impairment, like Rachel, my daughter, it's not so much her autism that thwarts her, you know, ability to have partners or to have a meaningful career.

00:03:59.000 It's the fact that she has profound, in her case, profound intellectual disability that goes along with it.

00:04:06.000 I forget what I was going to say.

00:04:07.000 So when they say that people have...

00:04:13.000 There's a spectrum, right?

00:04:15.000 And some people who are autistic have incredible abilities.

00:04:19.000 That's right.

00:04:19.000 They have incredible mathematical abilities, musical abilities, language abilities, and then some people do not.

00:04:25.000 Some people have legitimate issues.

00:04:27.000 Yeah, with Rachel's case, my daughter, she has a pretty good verbal IQ, 80-90, but she has a very low performance IQ in 40. She can't do simple math. 1.00

00:04:35.000 She can't count money. 0.78

00:04:37.000 Fortunately, Goodwill Industries came to her rescue and our rescue, and now she works there two hours a day sorting clothes, and that's been really meaningful for her to get a paycheck.

00:04:46.000 Oh, that's great.

00:04:47.000 Even if it's minimum wage, yeah.

00:04:48.000 Right, just to do something and feel...

00:04:50.000 Yeah, right.

00:04:50.000 And feel part of the mix.

00:04:52.000 Yeah.

00:04:52.000 That's huge.

00:04:53.000 That's huge for everyone, right?

00:04:54.000 Absolutely.

00:04:55.000 Yeah.

00:04:55.000 Absolutely.

00:04:58.000 So it's not like you can test positive for syphilis or you can test positive for the flu.

00:05:03.000 Right.

00:05:03.000 Although now, as I say, that's why I don't like using those terms because it puts people on the autism spectrum as though they have a disease or a disorder, which I don't like to do.

00:05:15.000 But if it is a disorder, no?

00:05:17.000 Well, now we know there are 99 genes that are linked to autism.

00:05:22.000 But why is it a bad thing to say that you have a disorder if it's just a disorder?

00:05:26.000 People have disorders.

00:05:28.000 It's a fact.

00:05:29.000 Well, you know, a lot of the individuals that self-identify themselves as the autistics don't like to think of themselves as a disorder.

00:05:37.000 They like to think of themselves as different, but not necessarily as a disorder.

00:05:41.000 Right, but that doesn't help us when we're trying to discuss it, does it?

00:05:44.000 Yeah, it gets hard to talk about.

00:05:47.000 Well, also, they're trying to stop you from talking about it in a certain fashion, which is actually accurate, right? 1.00

00:05:53.000 They have an issue.

00:05:55.000 There is an issue. 0.99

00:05:56.000 To say there's no issue is kind of ridiculous.

00:05:58.000 I mean, there's a reason why so many people are so concerned about autism and vaccines and just autism in general, whether it's environmental pollution factors or whatever.

00:06:06.000 Right, but what they like to do is they like to make the distinction between autism...

00:06:10.000 That neurodiversity thing and actually having intellectual disabilities that go along with it.

00:06:16.000 Okay.

00:06:16.000 Maybe it's a bit of semantics also, but they feel strongly about it.

00:06:19.000 Right.

00:06:20.000 Now, if we don't know what causes autism...

00:06:23.000 Well, we do.

00:06:24.000 We do.

00:06:24.000 Well, we're getting there very closely.

00:06:27.000 So we've now...

00:06:28.000 There was a very important paper produced by...

00:06:31.000 written by a group at the Broad Institute at Harvard at MIT, which is one of the premier genetics genomics organizations in the country, And they've now identified 99 genes.

00:06:42.000 It's a huge team of scientists, not only at the Broad, including scientists at Baylor College of Medicine.

00:06:47.000 99 genes involved in autism, all involved in early fetal development, early brain development in the first and second trimester of pregnancy.

00:07:00.000 So now we're starting to really get our arms around what autism is.

00:07:03.000 And that's one of the things I talk about in the book.

00:07:05.000 I mean, We have learned so much in the last couple of years about autism, how it begins early fetal development well before kids ever see vaccines.

00:07:14.000 And that's one of the reasons I say vaccines did not cause Rachel's autism.

00:07:18.000 Vaccines don't cause autism because autism is already underway in early brain development.

00:07:24.000 Is it possible that some people have this tendency towards autism and it's exacerbated by vaccines?

00:07:31.000 I don't think so.

00:07:32.000 I think what happens is the Sequence of events happens during pregnancy, but the full clinical expression of autism often doesn't happen until 18 or 19 months of age.

00:07:45.000 Like Rachel, for instance, wasn't actually diagnosed until 19 months of age.

00:07:49.000 And there's some fabulous studies now showing that that clinical expression of autism actually coincides with a big increase in the volume of the brain.

00:08:01.000 You can actually show on serial Magnetic Resonance Imaging, serial MRI, how the brain volume starts to increase.

00:08:10.000 And that's very important because parents will often remember, oh my kid got vaccinated around 18 months of age or 15 months of age.

00:08:18.000 I want to link the two.

00:08:19.000 But now you can go back to six months of age.

00:08:23.000 And this is studies done at the University of North Carolina Chapel Hill showing so that you could do an MRI at six months of age.

00:08:29.000 And they can predict now, they say with 90% accuracy, Which of the kids will go on to develop autism?

00:08:36.000 What are they seeing?

00:08:40.000 We can go into detail in the paper, but they can see certain things on signatures on MRI that tell them that this kid is going to go on to Okay, so in fact there is a way to test positive for autism then with this serial MRI. That's what they think, right.

00:08:55.000 And now we have the 99 genes, so we can even take it back further by doing what's called whole exome sequencing.

00:09:02.000 Sequencing all the DNA, all the expressed DNA. Of an individual.

00:09:07.000 And in Rachel's case, we did that and we actually found a mutation in a gene controlling neuronal connections, which makes a lot of sense if you think about what autism is.

00:09:16.000 Yeah, of course.

00:09:17.000 So there is a way to show whether children will be more likely to develop autism and there is a way to look at their brain through fMRI at a very early age.

00:09:28.000 And also do genetic sequence.

00:09:31.000 So it's not simply a matter of how they perform on cognitive tests.

00:09:36.000 That's right.

00:09:36.000 We're getting much better at getting arms around the diagnosis.

00:09:40.000 Why do you think there's so many people that have these anecdotal stories of their child getting vaccinated, especially large doses of vaccines when they hit them with like 10 in a row, and then all of a sudden, or measles, mumps, and rebellious, the one that gets repeated over and over again.

00:09:54.000 That's the one that made my child have autism.

00:09:56.000 I've heard that so many times.

00:09:58.000 And I've heard it from friends, from friends that have children that have autism.

00:10:02.000 They had a child, their child got the measles, mumps, rebellious shot, and then immediately there was a very distinct change in the child's behavior.

00:10:09.000 Well, no question when you get the measles, mumps, rubella vaccine, many times kids cry and things like that.

00:10:15.000 And then autism will then begin sometime between the first and second year of life.

00:10:19.000 So it's logical to want to connect the two.

00:10:22.000 But now we know it's not even plausible because we know If you go back to that MRI at six months of age or go back prenatally, we can even determine which kids are going to go on to develop autism.

00:10:33.000 And then complementing it, our massive epidemiologic studies done on over one million kids.

00:10:41.000 In fact, a new paper was just released this week showing that kids who get the MMR vaccine are no more likely to get autism than kids who don't get the MMR vaccine.

00:10:55.000 And the converse is also true.

00:10:57.000 Kids on the autism spectrum are no more likely to have gotten the MMR vaccine than kids not on the autism spectrum.

00:11:04.000 So it's a combination of those big studies of over one million kids together with knowing what autism is that completely rules out the possibility.

00:11:14.000 Right, so these genes, and the issue with these genes, and then the ability to scan the brain with the serial MRI, so you can tell which children have the propensity.

00:11:28.000 Is it possible that children have all these issues and then do not get autism, or do 100% of those children with those issues get autism?

00:11:36.000 That's a good question.

00:11:37.000 I don't know.

00:11:38.000 I'm a vaccine scientist.

00:11:40.000 You're not a biologist?

00:11:41.000 Well, I'm a biologist, but I'm a vaccine scientist who's really tried to do a deep dive in autism doing research on the book.

00:11:49.000 Versus human development.

00:11:50.000 Right.

00:11:51.000 Okay, so what you're saying though is that if a child does not have these mutations and does not have these issues that are present during a serial MRI, that they will not go on to develop autism.

00:12:04.000 Is that true?

00:12:04.000 As far as we can tell.

00:12:05.000 As far as we can tell.

00:12:06.000 So children without those issues who get vaccinated have no problems, which most children have no problems, right?

00:12:16.000 Yeah, I mean, you know, we've learned a lot about the risk of vaccines and the numbers are extraordinary.

00:12:23.000 I mean, the risk of a severe adverse event happening After getting a vaccine is roughly on the order of 1 in a million between between 1 in a million and 1 in 10 million.

00:12:35.000 So and I found an internet report once that the likelihood of getting struck by lightning is 1 in 700,000.

00:12:42.000 So it's, you know, the likelihood of having a severe event after a vaccine is your odds are better of getting struck by lightning than And when you say severe event, what do you mean by severe event, though?

00:12:53.000 Well, there's actually a table that's put out by the National Vaccine Compensation Act that includes shoulder injury, that's one, encephalitis.

00:13:07.000 Shoulder injury?

00:13:08.000 Yeah, that's actually on the list.

00:13:09.000 From the actual injection point?

00:13:11.000 Yeah, injecting it in the wrong place.

00:13:13.000 Oh, so it goes into the joint or something like that?

00:13:15.000 Yeah.

00:13:16.000 Is that common?

00:13:17.000 No.

00:13:18.000 No.

00:13:18.000 So...

00:13:20.000 There have been issues where children have adverse effects and reactions to vaccines.

00:13:26.000 What do you attribute those to?

00:13:28.000 One in a million.

00:13:29.000 I think in some cases...

00:13:30.000 Biological variability?

00:13:32.000 I think in some cases, inadvertently, if it's a live virus vaccine, like the measles, mumps, rubella vaccine, and you have an underlying immune deficiency that wasn't picked up before, then that virus can replicate better.

00:13:43.000 But very rare things like that.

00:13:45.000 Right.

00:13:46.000 So, as far as you know, children who are healthy who get a vaccine, it's not biologically possible for them to develop these traits, these mutations in the genes, and these issues that you see present?

00:14:01.000 As best we can tell right now, that seems to be the case, right?

00:14:05.000 As best you can tell right now, it's a great thing to say.

00:14:09.000 But for people that are like, hmm, on the outside, what does that mean?

00:14:13.000 I'm not a doctor.

00:14:14.000 I'm not smart enough to understand what Dr. Hotez is saying here.

00:14:18.000 What is he saying?

00:14:19.000 As best as we can tell.

00:14:20.000 How much can we tell?

00:14:21.000 So here's what we can tell.

00:14:22.000 We know, studies number one million children, that there's no link between vaccines and autism.

00:14:29.000 That's number one.

00:14:31.000 So let me parse this out in two bits.

00:14:35.000 So there's the studies on over one million children showing that vaccines do not cause autism.

00:14:40.000 That's part one.

00:14:41.000 And then I'll do a deeper dive on each of them.

00:14:44.000 The second part shows not only is there massive evidence that there's no link between vaccines and autism, there's no plausibility because we know so much about autism and how it begins in pregnancy.

00:14:55.000 So let's go back to the first part.

00:14:58.000 The first part is studies on over one million children.

00:15:00.000 One of the things that the anti-vaccine lobby does It's not really a game, but what they do is play this kind of thing of vaccine whack-a-mole because at first they alleged it was the MMR vaccine.

00:15:14.000 And that came out of the study that was published in The Lancet in 1998. Then another group came along and said, no, no, no, we didn't mean the MMR vaccine.

00:15:22.000 We meant the thimerosal preservative that used to be in vaccine.

00:15:26.000 And the scientific community not only debunked the MMR link, they debunked the thimerosal link.

00:15:32.000 Then the anti-vaccine lobby came along and said, no, no, we didn't mean that.

00:15:36.000 We're spacing vaccines too close together.

00:15:38.000 Then they changed it around again, saying now it's the alum or aluminum in vaccines.

00:15:44.000 And then each time the scientific community responds with massive epidemiologic studies showing just absolutely none of those things are true.

00:15:51.000 And do you think that it's just, when you look at, say if there's one in a million that has an issue with this, and it's not autism, by the way.

00:16:01.000 So whatever those issues are, that they hear these stories and these stories do accumulate because there's 300 plus million people in this country and over 10, 20 years of one in a million, you develop a significant history of cases where children did have issues with vaccines.

00:16:22.000 So these people hear about these stories, and people are terrified.

00:16:26.000 Obviously, I have children.

00:16:28.000 You become very overprotective of your children.

00:16:31.000 You worry a lot.

00:16:32.000 And then you also don't know, like, why do they get so many shots all in a row like that?

00:16:36.000 Why does a baby get 10 shots in a day? 0.73

00:16:39.000 That seems crazy.

00:16:40.000 Well, they don't get 10 shots in a day.

00:16:41.000 Most of the vaccines are now combined.

00:16:44.000 So, for instance, in one vaccine...

00:16:46.000 We can vaccinate against diphtheria, pertussis, tetanus, polio, haemophilus influenzae type B, which is a terrible cause of meningitis, and in some cases not even hepatitis.

00:17:02.000 So one shot is protected.

00:17:03.000 Well, it's combined and there's all sorts of studies showing that it's safe to combine them and it's fantastic.

00:17:09.000 Now you can vaccinate with one shot against six diseases.

00:17:12.000 And these are life-threatening diseases.

00:17:14.000 Right.

00:17:14.000 So the only concern is the child's immune system when they're bombarded with this one.

00:17:20.000 So a lot of times it causes them to be tired or they get sick.

00:17:24.000 But the point is the immune system is not bombarded.

00:17:26.000 I think that's another kind of a misnomer or a misunderstanding that's put out by the anti-vaccine lobby.

00:17:33.000 Remember, the child's gut, the intestines, and the respiratory tree are organs of antigen presentation.

00:17:42.000 A baby, on average, is exposed to hundreds of new antigens every day.

00:17:47.000 So the idea that you're going to, quote, overwhelm the immune system...

00:17:51.000 With a vaccine against six diseases just doesn't make any sense.

00:17:54.000 Again, this is all phony baloney stuff put out by the anti-vaccine lobby.

00:17:59.000 Let's be clear.

00:18:00.000 The anti-vaccine lobby owns the internet right now.

00:18:04.000 What does that mean?

00:18:05.000 What that means is they've put out now, by some estimates, 500 anti-vaccine websites so that every time you put the word vaccine into a search engine, whether it's Yahoo or Google, you're going to get anti-vaccine misinformation.

00:18:19.000 That's number one.

00:18:21.000 Second, we know now it's amplified on social media like Facebook, other forms of social media.

00:18:29.000 So third, look at the Amazon site.

00:18:33.000 I mean, it's incredible.

00:18:35.000 So my book, this book, the good news is it's – I think right now it's the highest-rated pro-vaccine book on Amazon.

00:18:42.000 The bad news is overall it's ranked about 20 because there's 19 other phony baloney anti-vaccine books ahead of it.

00:18:49.000 So Amazon is the biggest purveyor now of anti-vaccine books.

00:18:53.000 Wait, it gets even worse.

00:18:54.000 Then you also have now – they've become politicized.

00:18:58.000 They have political action committees in multiple states.

00:19:01.000 Lobbying state legislators about plying them with false information about what vaccines do.

00:19:11.000 And the problem is we don't have a robust system of pro-vaccine advocacy to counter it.

00:19:20.000 So we don't really hear as much as we need to from the federal government, from the CDC, from the Surgeon General.

00:19:26.000 So unfortunately in this country the defense of vaccines It falls to a handful of academics like myself.

00:19:33.000 I'm an academic.

00:19:34.000 I wrote a book.

00:19:35.000 What chance do I stand against this major media empire?

00:19:41.000 Why do you think that exists?

00:19:42.000 Why do you think there is this major media empire that's against vaccines?

00:19:46.000 That's a great question.

00:19:47.000 What's the motivation, number one?

00:19:49.000 And number two, where's the money coming from?

00:19:51.000 There's real money behind this.

00:19:52.000 There's millions of dollars behind this to put out phony documentaries and phony books.

00:19:58.000 What's a good phony documentary to point to?

00:20:00.000 Well, I'm a little reluctant to say it because they're so litigious. 1.00

00:20:04.000 And I don't have the means to defend a lawsuit and things like that.

00:20:09.000 Right.

00:20:10.000 But they're out there.

00:20:13.000 That's why I usually don't name specific names.

00:20:16.000 I understand.

00:20:17.000 These documentaries, what do you think their motivation is?

00:20:19.000 Do you think they earnestly believe that vaccines do cause harm or vaccines do cause autism?

00:20:27.000 I don't know.

00:20:27.000 I mean, is there some kind of other agenda that they have?

00:20:32.000 I mean, we do know in some cases that some elements of the anti-vaccine lobby are promoting phony autism therapies.

00:20:42.000 They're doing terrible things, like this thing called MMS, which are bleach enemas.

00:20:46.000 What?

00:20:47.000 Yeah, giving bleach enemas to kids.

00:20:49.000 To children?

00:20:50.000 To children.

00:20:50.000 Bleach?

00:20:51.000 Why bleach?

00:20:52.000 Because they're cleansing the immune system.

00:20:55.000 They're cleansing them of toxins.

00:20:56.000 No, it's really awful stuff.

00:20:58.000 And they're doing chelation therapy, which is very dangerous.

00:21:01.000 What is that?

00:21:02.000 That's where they claim kids are overdosed with toxic metals, so they give a chemical that actually can chelate the metal.

00:21:09.000 But it can chelate your calcium and then put you into a fatal arrhythmia as well.

00:21:14.000 Who's doing this chelation therapy?

00:21:16.000 You can Google it.

00:21:18.000 Are these doctors?

00:21:21.000 In some cases, they're doctors, unfortunately, or other health professionals.

00:21:26.000 I'm sure you've studied this.

00:21:28.000 What is the evidence?

00:21:28.000 There's no evidence.

00:21:30.000 And then they're doing hyperbaric therapy, which is really bad.

00:21:35.000 Hyperbaric therapy is bad?

00:21:36.000 Well, it doesn't do anything for autism, that's for sure.

00:21:39.000 But it's good for recovering from injuries?

00:21:42.000 Yeah, but who knows what it's doing to a young kid, right?

00:21:46.000 So you shouldn't be doing that.

00:21:49.000 Then that's one.

00:21:51.000 So how much of this is being driven by By financial motivation peddling these phony autism therapies, I can't say.

00:22:00.000 My sense is that's not the big piece of this.

00:22:03.000 There's also some reports now of Russian bots and trolls that are amplifying this and sowing political instability in the country.

00:22:11.000 But again, you add that all up, the phony autism therapies, the Russian bots and trolls, in my mind, That really doesn't get our arms around the big driver of this thing.

00:22:22.000 So I think we really need some good investigative journalists to look into this.

00:22:26.000 Well, do you think that there's some sort of a concerted effort, or do you think that it's just a bunch of people that really believe that vaccines do cause autism, they don't truly understand the science, they haven't talked to someone like you, and maybe they have this idea that's cemented in their mind and they're not willing to...

00:22:43.000 Look at it objectively and look at the full spectrum of possibilities and look at the science behind what you guys are saying.

00:22:49.000 Because in their head they've been saying vaccines cause autism.

00:22:53.000 They've been saying it for so long that once someone gets that and they're connected to that, it's very difficult for them to shift gears.

00:23:01.000 People have a really hard time not being married to an idea.

00:23:04.000 Yeah, no, I agree that.

00:23:06.000 You know, when I talk and I spend a lot of time going around the country giving what are called grand rounds lectures to hospitals and medical schools, pediatric grand rounds, so I've had the chance to talk to a lot of pediatricians and nurses and nurse practitioners and more than a few parents.

00:23:23.000 My impression is most of the parents Who are called to be so-called vaccine hesitant, is the word of the day, are not really deeply dug in.

00:23:34.000 I mean, you can have a conversation with them and explain to them, like we're talking now in a very, you know, non-technical way, you know, the evidence showing vaccines don't cause autism and the lack of plausibility given...

00:23:47.000 That it begins in pregnancy and they'll vaccinate their kids. 0.98

00:23:51.000 There is another percentage, and I don't know what the percentage is, but there's 10, 15 percent that are deeply dug in and are wholly invested in this conspiracy theory that the government is in cahoots with the pharmaceutical companies and blah, blah, blah.

00:24:07.000 And then if you try to talk them out of it, they just think you're part of the conspiracy.

00:24:12.000 So it's sort of a no-win approach there.

00:24:14.000 But most parents you can have a good conversation with.

00:24:17.000 Most parents, yeah.

00:24:19.000 It's not necessarily even most parents, right?

00:24:21.000 I mean, what you're dealing with is these people that maybe they're into a bunch of different alternate therapies, a bunch of different kinds of cleansing.

00:24:29.000 There's a lot of that nonsense that you find online where, I mean, look, there's legitimate...

00:24:35.000 But I guess my point is parents don't get the chance because they're so inundated with phony anti-vaccine information.

00:24:48.000 If they do a Google search.

00:24:49.000 Yeah, or whatever, you know, whatever search they do.

00:24:52.000 So what do you think should be done?

00:24:54.000 Should there be a pro-vaccine documentary that makes sense?

00:24:59.000 Thanks for that question.

00:25:00.000 I think there's three things that need to be done.

00:25:02.000 I think, first of all, some of this anti-vaccine media empire needs to be dismantled.

00:25:07.000 Dismantled.

00:25:09.000 But who's to say whether they're wrong or right?

00:25:11.000 It seems like there should be some sort of a debate, right?

00:25:14.000 Like if there's someone who's saying that there's some evidence that vaccines cause debate, you're saying there's no evidence that vaccines cause autism, and you're saying there's no evidence that vaccines cause autism, there should be a debate where there's some sort of a monitored conversation Where you can have you versus someone else and break this down.

00:25:39.000 Yeah, but that's a two-edged sword, too, because then it gives some false legitimacy to the anti-vaccine side.

00:25:47.000 It's like debating does smoking cause cancer?

00:25:49.000 Yeah, but isn't there already a problem?

00:25:51.000 I mean, it seems like if there's this many...

00:25:54.000 If you do a Google search and you're just overwhelmed with anti-value, it seems like the fight has already been lost, if that's the case.

00:26:01.000 That's right.

00:26:02.000 So giving them legitimacy.

00:26:03.000 It's not necessarily giving them legitimacy.

00:26:05.000 It's giving them, you rather, a forum to dismiss their legitimacy.

00:26:10.000 Yeah, I mean, I think, you know, part of what has to be done is, I mean, and this gets into all sorts of First Amendment issues, and I'm not a lawyer, but, you know, the idea that Amazon now is putting out all of these phony books and phony documentaries.

00:26:26.000 Well, they're just a distributor, right?

00:26:28.000 I mean, they don't have to go over every book that they sell with a fine-toothed cone.

00:26:31.000 Well, but maybe they should.

00:26:32.000 I mean, not a fine-toothed cone, but maybe there should be some screening.

00:26:35.000 Maybe Amazon, maybe Facebook should all be hiring chief scientific officers to...

00:26:40.000 You know, putting some stops on the dissemination of information because it's harming children.

00:26:46.000 I mean, the reason I get passionate about it, the reason I actually wrote the book is kind of interesting.

00:26:53.000 It actually happened before all of these big measles outbreaks that we've been having.

00:26:58.000 I noticed that in Texas, my laboratories at Texas Children's Hospital and Baylor College of Medicine, we noticed that there was a steep increase I think we're good to go.

00:27:28.000 This misinformation campaign.

00:27:30.000 And I was really troubled by the fact that there was no response to it.

00:27:34.000 And that drove me to write the book.

00:27:36.000 So the point is now Texas is very vulnerable to measles outbreaks.

00:27:41.000 And I say measles more than the others because that's the most highly contagious disease.

00:27:46.000 What's the danger of a child getting measles?

00:27:48.000 And is there any benefit to a child getting measles in terms of their immune system?

00:27:52.000 No, there's no benefit.

00:27:53.000 And that's one of the phony books they put out.

00:27:55.000 It's called Melanie's Marvelous Measles.

00:27:57.000 I mean, it's awful.

00:27:59.000 What do they say in that book?

00:28:00.000 They say build your immune system. 0.99

00:28:02.000 It does not?

00:28:03.000 It does not.

00:28:04.000 Remember, so let's go back a little bit.

00:28:08.000 Smallpox was eradicated in the late 1970s through vaccination.

00:28:12.000 Once smallpox was eradicated, eradicated measles was arguably the single-eating killer of children globally.

00:28:19.000 2.6 million children died every year of measles because it causes measles pneumonia, measles encephalitis.

00:28:26.000 Talk about permanent neurologic injury.

00:28:28.000 That's a bad actor, measles.

00:28:30.000 And then deafness and all.

00:28:31.000 And then through global vaccination campaigns, we brought it down By the year 2000, to about half a million kids dying.

00:28:39.000 And then the Gates Foundation put up $750 million to create the Gavi Alliance, the Global Alliance for Vaccines and Immunization.

00:28:47.000 We've brought it down now to 100,000.

00:28:49.000 But now measles is coming back.

00:28:51.000 Europe's a disaster right now.

00:28:53.000 We've got 80,000 measles cases in 2018 in Europe, and now it's coming back to the US. And so my worry is this anti-vaccine media empire started out as a fringe group, but now it's really affecting public health, allowing a deadly disease like measles to come back.

00:29:10.000 Do you think if there's some sort of definitive evidence that shows to the general public, like you could show it to them, like this is what causes autism, we've narrowed it down to these genes, and it has nothing to do with vaccines.

00:29:23.000 If you give these vaccines to people without these genes, there is no way they're going to get autism.

00:29:27.000 They get autism specifically because of these variations in their genes.

00:29:31.000 You just summarized the book.

00:29:34.000 Right.

00:29:34.000 But I mean...

00:29:36.000 They need more than a book, right?

00:29:37.000 Right.

00:29:37.000 It does disturb me when I hear about all these kids getting measles.

00:29:41.000 And not just measles, but in some places polio has made a resurgence.

00:29:47.000 Well, polio, you know, we're down to about three countries that still have transmission of wild-type polio.

00:29:54.000 It's Nigeria, Pakistan, Afghanistan, so hopefully we're getting arms around polio.

00:29:58.000 But measles is now roaring back with a vengeance.

00:30:02.000 But haven't people contracted polio outside of those areas?

00:30:05.000 I mean, those are the areas where it's common.

00:30:06.000 Every now and then some cases pop up.

00:30:08.000 We had some, you know, wherever, and this can get onto a whole other topic, wherever there's collapse, In health systems, infrastructure, such as from war, political instability, these diseases can come back.

00:30:20.000 They can come back, and the people that are vulnerable are the children that are not immunized.

00:30:24.000 That's right.

00:30:24.000 And when you're immunized, you're not vulnerable.

00:30:26.000 That's right.

00:30:28.000 It's a really confusing thing for people because on the outside, people always want to think that big pharma...

00:30:35.000 I've said some terrible things about big pharma, and the reason being is painkillers. 0.90

00:30:40.000 Because painkillers and antidepressants, and there's SSRIs, which are overprescribed, and the painkiller one kills me because I know people directly that have been addicted to these goddamn things, and the doctors are passing them out like candy. 0.95

00:30:53.000 Yeah. 0.96

00:30:54.000 People look at big pharma as being, oh, these are the monsters that push this.

00:30:58.000 They're also the people that give you things that save people's lives.

00:31:01.000 There's a lot going on there.

00:31:03.000 Yeah, I'm no big defender of the big pharmaceutical companies.

00:31:07.000 I mean, one of the things that the insults that anti-vaxxers hurl at me is they say I'm a shill for industry.

00:31:14.000 They say I'm secretly taking money from Merck and Jackson Smith. 0.99

00:31:19.000 That's all crap. 0.98

00:31:20.000 I don't take a penny from them and it's not even realistic. 0.99

00:31:25.000 How do you get paid?

00:31:25.000 Just from the university?

00:31:27.000 I get paid by the university and some of my salaries offset by grants from non-profit foundations.

00:31:38.000 And then they say, I'm secretly making millions of dollars for our vaccines for Hook, Gorman, Schistosomiasis, and Chagas.

00:31:44.000 What are you doing with all that money?

00:31:45.000 Because my wife says, if only that were the case, right?

00:31:48.000 These are diseases of the poorest of the poor.

00:31:50.000 I'll never make a penny on these diseases.

00:31:52.000 In fact, you know, one of the frustrations I have with the big pharmaceutical companies Is we've gotten, made a lot of progress with our vaccines.

00:32:00.000 We've gone all the way from discovery through early phase process development and manufacturing and IND filing with the FDA, Investigational New Drug Applications, but we're getting kind of stuck at phase one, phase two clinical trials because we don't have the big pharma money to take us all the way to licensure.

00:32:16.000 So I've had a lot of meetings with the big pharmaceutical companies to see if they can partner with us, and so far that hasn't happened.

00:32:23.000 So has there ever been any discussion or any interest in creating some sort of a compelling documentary that's pro-vaccination that can counter all these things? 0.69

00:32:34.000 Because there's quite a few health-related documentaries that I know are horseshit.

00:32:39.000 Because I've talked to actual real scientists and clinical researchers that say, like, all these things they're saying are wrong, and this is why they're wrong, and you could show this if they're wrong. 0.89

00:32:49.000 And then when someone says, hey, I saw this documentary, it says that all you should eat is toast, you could say, listen, man, you've got to go here and watch this, and it'll show you why that's nonsense.

00:32:59.000 Is there anything like that right now, or is there any discussion?

00:33:02.000 Not right now.

00:33:03.000 There are some discussions, but we're a long way off from that.

00:33:07.000 And the problem is the anti-vaccine documentaries are being widely distributed, widely sold.

00:33:13.000 And those people that are talking about it, here's the other problem.

00:33:16.000 Whenever I talk to someone about, I've been doing this a lot lately, where I talk to someone about something they're passionate about, I go, what books have you read on it?

00:33:23.000 And it's like, well, I saw this documentary.

00:33:26.000 Well, and there are books.

00:33:28.000 In fact, there's 19 ahead of mine.

00:33:32.000 Right, but...

00:33:33.000 Books that are written by actual researchers, people that have spent decades in labs understanding what's going on, you don't really, you know, you don't get a lot of that from the people that are anti-anything.

00:33:47.000 Right.

00:33:47.000 Well, that's why I wrote the new book.

00:33:49.000 It's a very confusing thing for parents, because you're scared.

00:33:52.000 You know, you have this little tiny baby that you love more than anything in this world, and then the doctors say, hey, we've got this round of vaccines coming, and you're just terrified that you're going to do something to your child that's going to turn your child into a Someone who's compromised.

00:34:05.000 Yeah, and the point is, the problem is these diseases are back now, and so the urgency to vaccinate is now more than ever.

00:34:13.000 I mean, remember, right now, look what's going on in Vancouver, Washington right now where the measles outbreak is underway.

00:34:19.000 The ones who are at greatest risk are infants under the age of 12 months, not yet old enough to get their vaccine.

00:34:27.000 So that if you're a parent right now living in Vancouver, Washington, you're terrified.

00:34:31.000 You're terrified about taking your baby out to Walmart or the public library.

00:34:34.000 Because they can't get that vaccine yet.

00:34:38.000 So now the disease is coming back because the older kids are catching it.

00:34:41.000 Yeah, and the anti-vaccine lobby uses terms like personal liberties and medical freedom.

00:34:47.000 Well, we're the personal liberties of this parent now who's terrified to take his or her infant.

00:34:52.000 When you say anti-vaccine lobby, now I know that Robert Kennedy Jr., he's a big one.

00:34:58.000 He's a big one.

00:34:59.000 And he seems like a very intelligent guy.

00:35:01.000 How could he not be aware of the science behind this?

00:35:05.000 What is he getting wrong?

00:35:06.000 What he's getting wrong is just about everything.

00:35:09.000 He's formed an organization called Children's Health Defense.

00:35:15.000 He had a press conference about it, I think it was September, October of last year.

00:35:21.000 It is probably one of the best organized anti-vaccine groups out there.

00:35:24.000 And he's doing other things other than vaccines.

00:35:26.000 He's doing a lot of things about environmental health and things like that.

00:35:30.000 I don't know any part of that business.

00:35:31.000 I've only followed what he does with vaccines.

00:35:34.000 But it's all nonsense.

00:35:36.000 Why is he doing this about vaccines?

00:35:38.000 I don't know.

00:35:39.000 I mean, you have to ask him, what's his motivation?

00:35:41.000 Would he be a guy that you would want to have a debate with or have a discussion with?

00:35:44.000 But again, I mean, I'm uncomfortable with the idea of a debate because it's like debating, I don't know, it's like debating a Holocaust denier, whether the Holocaust exists.

00:35:54.000 I mean, not that this rises to the same level.

00:35:56.000 I understand what you're saying, but if you're, again, I want to bring this up, if you're complaining there's 19 books ahead of yours that are anti-vaccine books, you've already lost the battle.

00:36:06.000 It's time to regroup.

00:36:08.000 And maybe regrouping would be confronting someone with actual scientific information.

00:36:12.000 I mean, you are a real doctor.

00:36:13.000 You're a guy who actually studies this.

00:36:15.000 And you're a man who understands the science.

00:36:17.000 You're a legitimate academic.

00:36:19.000 You could actually put a dent in this with a real conversation.

00:36:24.000 Yeah, potentially.

00:36:25.000 Potentially.

00:36:26.000 Yeah, I mean, what would he be able to say?

00:36:27.000 Like, what is his take on it?

00:36:29.000 Well, remember, he's an attorney, and he's very clever, right?

00:36:34.000 And he knows how to, presumably knows how to do arguments in court, and what am I? I'm a scientist.

00:36:40.000 Right, but do you think that he wants to deceive people?

00:36:42.000 Or do you think that maybe he's just incorrect in his accumulation of data?

00:36:47.000 Yeah, I can't say what his motivation is, but his information is highly misleading.

00:36:56.000 Now, what else is, you say, the lobby?

00:37:00.000 Is this an organized thing?

00:37:02.000 Good question.

00:37:04.000 Again, we need somebody who really wants to do a deep dive in this and kind of dissect out the pieces to understand.

00:37:12.000 But it's impressive what you've got out there in terms of the hundreds of websites and the amplification on social media and everything else.

00:37:20.000 Are there just one or two or three groups behind it, or is it a random collection of Right.

00:37:27.000 That needs to be looked at.

00:37:29.000 That does need to be.

00:37:29.000 Now, what do you think is causing autism?

00:37:33.000 And in your personal estimation, do you think that there's a rise in the factors that are causing autism or do you think that it's a rise in the understanding of these variables that contribute to it that you could diagnose people with and that before they were previously undiagnosed?

00:37:53.000 I think most of it is that, that we're just diagnosing it more, we're including individuals in the autism category that we didn't before.

00:38:00.000 And by the way, the numbers are about to go up even more because we're getting better at diagnosing girls and women with autism.

00:38:07.000 Which is also quite interesting.

00:38:08.000 We used to say it was 10 to 1 boys to girls.

00:38:10.000 And now we know there are a lot more girls and women on the autism spectrum.

00:38:14.000 It's just that they're usually more verbal and they can camouflage it better.

00:38:18.000 But they have very high rates of comorbidities like obsessive compulsive disorder, attention deficit hyperactivity disorder.

00:38:26.000 A lot of the teenage girls with eating disorders now they're finding could actually be on the autism spectrum.

00:38:32.000 So the numbers are about to go up again.

00:38:34.000 I mean, that's just an example.

00:38:35.000 I mean, I guess what you're really trying to get at, is it beyond that?

00:38:39.000 Is there a bona fide increase beyond the number of diagnoses?

00:38:45.000 And that one I'm still not sure about.

00:38:48.000 Yeah, I read an article about early onset gender dysphoria being connected to young girls with autism.

00:38:53.000 There's a disproportionate number of girls with gender dysphoria who turned out to be also autistic.

00:38:59.000 Right, I've heard that as well.

00:39:00.000 So it's really fascinating to think about it.

00:39:03.000 Unfortunate and fascinating at the same time, right?

00:39:05.000 There's a nice paper by a very good environmental scientist named Phil Landrigan, He used to be at Mount Sinai now.

00:39:14.000 I think he's at Boston College now.

00:39:16.000 And he publishes about five or six chemicals in the environment, which if you're exposed to for long periods of time during early pregnancy, Your child will be born with some features that resemble autism.

00:39:31.000 Do you know what those chemicals are?

00:39:32.000 So I have to remember, I talk about them in the book.

00:39:35.000 One of them is Depakote, valproic acid, which is a psychiatric medicine used as a mood stabilizer or an antidepressant.

00:39:44.000 So prolonged use of Depakote during pregnancy has been linked to Something that resembles autism.

00:39:53.000 Is this a common medication?

00:39:55.000 It's a common medication, but now that we know this information, we don't use it anymore.

00:39:59.000 And so one of the things that I've been saying to people like Bobby Kennedy and everything else, if you really think there's some environmental link to autism, We've got a list of at least six chemicals during early exposure and pregnancy that are probably causing mutations and things like that that are leading to autism.

00:40:17.000 Why isn't anybody looking into that?

00:40:19.000 It's just crazy.

00:40:20.000 I mean, so all the focus goes into vaccines and it kind of sucks all the oxygen out of the room so that, you know, really understanding the search for autism gets delayed or in some cases doesn't get pursued at all.

00:40:34.000 Or the other thing that happens in many state legislatures and things like that, the focus is so much about vaccines that we don't talk about what autism parents really need.

00:40:43.000 I mean, what do I need for Rachel?

00:40:44.000 We need employment counseling and help.

00:40:47.000 We need mental health counseling.

00:40:48.000 What do we do after we're gone?

00:40:50.000 Rachel right now is living with us. 0.65

00:40:52.000 I turned 60. My wife is 58. What happens to us 10, 15, 20 years from now?

00:40:58.000 There's no roadmap.

00:40:59.000 Right.

00:41:00.000 So all of that gets shunted aside because of these phony baloney anti-vaccine arguments.

00:41:05.000 And that's why I get angry.

00:41:07.000 That's when I start to realize these guys, in addition to affecting public health, are actually hurting autism families as well.

00:41:14.000 Well, that makes sense.

00:41:16.000 And I can completely understand why this would upset you, especially as a scientist.

00:41:20.000 Now, when you're talking about these various chemicals that you think do contribute to or possibly cause autism, maybe we should really concentrate on that and publish something about this.

00:41:34.000 Is there an article that people can go to that says something about this?

00:41:38.000 There is.

00:41:39.000 I talk about it in the book.

00:41:40.000 If I open up the book, I can provide it for you.

00:41:43.000 Is there anything that people can read online about this without going to your book?

00:41:48.000 Probably.

00:41:49.000 You know, one of the problems that we face in this country is that we put a lot of scientific articles behind paywalls, which is a real source of frustration for me.

00:41:57.000 Why do they do that?

00:41:58.000 Well, one of the things that I've done now is I'm one of the I founded an open access journal called the Public Library of Science Neglected Tropical Diseases so that anybody with a computer, you know, an internet connection and a printer can download the articles free of charge.

00:42:15.000 And we need more of that.

00:42:17.000 That's great.

00:42:18.000 But right now, if someone wants to find out these chemicals, they have to buy your book or buy...

00:42:25.000 Some sort of access to scientific papers?

00:42:27.000 Yeah, I'm not sure with that particular paper whether it's behind a paywall or not.

00:42:31.000 I'll have to look.

00:42:33.000 Besides measles, what other diseases are more prevalent now because of people not vaccinating their kids?

00:42:41.000 There's three diseases that I worry about the most, actually four.

00:42:44.000 Well, whooping cough is another one, so that's one.

00:42:47.000 But the other one I worry about is the flu vaccine.

00:42:49.000 Kids aren't getting their flu vaccine.

00:42:51.000 Last year in the 2018 flu epidemic, Yeah.

00:43:11.000 Well, so that's, again, an idea that was heavily pushed by the anti-vaccine lobby.

00:43:16.000 Here's the story.

00:43:18.000 You're right, partially right.

00:43:20.000 Last year, there was not a perfect match between the virus and the vaccine, the killed virus and the vaccine, and the wild-type flu strain that was out there.

00:43:32.000 But it was good enough to prevent you from dying, and it was good enough to likely prevent you from being hospitalized.

00:43:40.000 So it would have an effect even if you did get the flu?

00:43:42.000 That's right, because there was enough cross-protection so that it would mitigate the symptoms.

00:43:46.000 That's confusing to people because if they have the flu, they say, oh, well, then it didn't work.

00:43:50.000 That's right, but it did, because it prevented you from getting sick and dying.

00:43:54.000 And again, that was a message that never really got out in 2018. Okay, well let's talk about someone like me, who's a healthy person.

00:44:01.000 I've had the flu before, but I don't usually get a flu shot.

00:44:05.000 That's crazy.

00:44:06.000 You should.

00:44:07.000 Why is that?

00:44:07.000 Especially now as you're getting older.

00:44:09.000 Why is that?

00:44:10.000 Because flu is probably the single leading infectious disease killer of adults in the United States.

00:44:18.000 But every time I've had it, it's really been like just a couple of days out, I rest, I drink a lot of fluids.

00:44:23.000 Well, you got lucky, my friend.

00:44:24.000 Is that what it is?

00:44:25.000 Is it luck or is it health, taking care of yourself, maintaining your immune system?

00:44:29.000 So if you look at the 80,000 adults who died in the influenza epidemic of 2018 in the United States, you're right.

00:44:38.000 A lot of them had underlying Things like diabetes or non-communical, you know, cardiovascular disease or underlying respiratory disease.

00:44:49.000 Maybe they were smokers.

00:44:51.000 But there's still thousands of individuals who are perfectly healthy who died of influenza.

00:44:58.000 So when you don't get your flu vaccine, you're taking a terrible chance.

00:45:02.000 And why not?

00:45:03.000 I mean, what are you risking by getting the flu vaccine?

00:45:05.000 I'm busy, bro.

00:45:07.000 You know what?

00:45:08.000 You know where I get my vaccinations?

00:45:11.000 Walgreens?

00:45:12.000 Even better.

00:45:13.000 We have a big grocery store chain in Texas, a big supermarket called HEB. Do you get it up the nose?

00:45:19.000 I get the injection, right?

00:45:21.000 The pharmacist.

00:45:23.000 All of my vaccines I've gotten for the last few years have been given by the pharmacist.

00:45:26.000 Interesting.

00:45:27.000 Couldn't be easier.

00:45:28.000 Have you ever gotten the flu since you've been getting the vaccine every year?

00:45:33.000 Well, you know, I've gotten sick with a sore throat and feeling crummy.

00:45:41.000 Was that a mild case of flu?

00:45:43.000 I can't really tell.

00:45:44.000 Okay.

00:45:45.000 But you've never gotten sick right after you got a vaccine.

00:45:48.000 Some people do, right?

00:45:50.000 No.

00:45:50.000 Some people do get a vaccine and then they have an adverse reaction to it?

00:45:54.000 Well, sometimes, you know, after getting your vaccine, you can get some soreness and you can feel maybe a slight fever for a few hours or a day, but usually you're fine.

00:46:05.000 What is that?

00:46:06.000 What is that?

00:46:07.000 Yeah, what is that fever?

00:46:08.000 Why are you getting a fever?

00:46:09.000 Because the vaccine is stimulating the immune system and stimulating the inflammatory system.

00:46:16.000 So even though you feel like you're getting sick because of the vaccine, it's actually good for your immune system.

00:46:21.000 That's right.

00:46:22.000 And you're not really sick.

00:46:23.000 I mean, it's nothing like nearly as bad as getting the flu.

00:46:26.000 The other vaccine, now that you're getting up there, you have to start considering is the shingles vaccine, Shingrix.

00:46:33.000 And that's a great vaccine.

00:46:35.000 It hurts, though, for a couple of days.

00:46:38.000 Do you take care of your immune system in other ways?

00:46:41.000 Do you take probiotics?

00:46:43.000 Are you cautious about your diet?

00:46:46.000 I'm not as cautious about my diet as I should be.

00:46:49.000 I'm a junk foodaholic, actually.

00:46:52.000 Well, that seems like a terrible thing for your health.

00:46:53.000 It is a terrible thing for my health and something my wife is working on.

00:46:57.000 But that seems ridiculous for someone who works with health.

00:46:59.000 Yeah, yeah.

00:47:01.000 What's going on with you, man?

00:47:02.000 Sometimes, man.

00:47:02.000 I just don't get it right.

00:47:04.000 How often?

00:47:06.000 How often?

00:47:06.000 How often do I steal a bag of chips or something like that?

00:47:09.000 How often do you eat garbage?

00:47:11.000 I don't know. 0.97

00:47:12.000 Hopefully not every day.

00:47:14.000 Hopefully not every day.

00:47:15.000 Maybe a couple of times a week.

00:47:18.000 Rachel, my daughter with autism, that's like our thing is to go to the, it's called the burger joint, or to Shake Shack to get a cheeseburger.

00:47:29.000 We'll sneak some fries.

00:47:32.000 Living large, we call it.

00:47:34.000 Like that mouth pleasure so much, you're willing to sacrifice a little bit of health.

00:47:38.000 I have to concede that's the case.

00:47:44.000 I don't have to tell you, but there's a large body of data that connects poor diet to a host of diseases.

00:47:50.000 Mm-hmm.

00:47:52.000 That seems like a crazy decision for a guy in your line of work.

00:47:56.000 There you go.

00:47:56.000 Sometimes it's not all brain.

00:48:02.000 It's something else.

00:48:03.000 But I mean, if you ate healthy food, I mean, the thing is your body starts craving healthy food.

00:48:09.000 You start feeling positive results.

00:48:10.000 Yeah, no question.

00:48:11.000 No question about it.

00:48:12.000 Do you take vitamins?

00:48:14.000 I don't take vitamins.

00:48:15.000 Really?

00:48:15.000 Wow.

00:48:16.000 I don't think they do.

00:48:17.000 I don't think they're needed.

00:48:18.000 What?

00:48:19.000 Hold up, hold up, hold up.

00:48:21.000 You don't think they're needed while you're eating junk food?

00:48:23.000 Well, hopefully I'm not only eating junk food.

00:48:26.000 You know, there's a large body of clinical research on the efficacy of vitamins, especially vitamins D, vitamins...

00:48:34.000 I have taken vitamin D for periods, the recommendation of my internist, yeah.

00:48:39.000 What about essential fatty acids, which are great for your brain, fish oil, all these different things that are fantastic.

00:48:45.000 I'm not going to argue with you.

00:48:47.000 What is going on with you, doctor?

00:48:49.000 You got it over me.

00:48:52.000 Listen, you would have a much better argument, don't you think?

00:48:56.000 You're making my wife stay here. 1.00

00:48:57.000 If you're taking care of yourself 100% instead of just concentrating.

00:49:01.000 But you still need your vaccines.

00:49:02.000 I'm sure you do, but vaccines aren't going to prevent cancer.

00:49:06.000 No, that's true.

00:49:07.000 Right.

00:49:08.000 And there's a lot of diseases.

00:49:10.000 Or diabetes or cardiovascular disease.

00:49:12.000 A lot of these diseases are connected directly to diet.

00:49:15.000 Right.

00:49:15.000 Yeah.

00:49:16.000 Come on.

00:49:17.000 And other lifestyle changes.

00:49:19.000 Yeah.

00:49:20.000 Sedentary life.

00:49:21.000 I try to go on the treadmill for 30 minutes every morning.

00:49:23.000 I do.

00:49:24.000 Actually, I'm pretty good about that.

00:49:25.000 Yeah?

00:49:25.000 30 minutes every morning.

00:49:27.000 Why don't you just go for an actual walk?

00:49:28.000 It's more interesting.

00:49:29.000 I do that too.

00:49:29.000 Do you have a dog?

00:49:30.000 No, but I do them with 30 minutes on the treadmill in the morning and then I take a long walk with my wife in the evening.

00:49:36.000 Oh, that's good.

00:49:37.000 But the thing that knocks the crap out of you is the travel. 0.75

00:49:40.000 Yes.

00:49:41.000 I find that very frustrating because you don't exercise and then you don't eat well and you don't control the diet as well.

00:49:47.000 So that's… Well, I have a solution to that.

00:49:51.000 Eat well and exercise.

00:49:52.000 Those are the solutions to that.

00:49:54.000 Just do it.

00:49:55.000 I treat it like I'm brushing my teeth.

00:49:56.000 I brush my teeth every day.

00:49:57.000 I exercise every day, too.

00:49:59.000 So when I travel, I don't have an option.

00:50:02.000 When I land, I go to the gym.

00:50:05.000 This is how it goes.

00:50:06.000 I land, I get in my hotel room, I put my shorts on, I go to the gym.

00:50:10.000 Yeah, I do that, too.

00:50:12.000 It's the only way.

00:50:13.000 If you have to do it, if you say this is just what gets done, this is how you do it.

00:50:18.000 Yeah, I try to be really compulsive about that.

00:50:20.000 Yeah, I have it written out.

00:50:21.000 I know what I'm going to do.

00:50:23.000 Especially if it's great if the hotel has a good gym.

00:50:27.000 If they have weights and a bunch of different...

00:50:30.000 Or I'll run outside if we don't have it.

00:50:32.000 You run?

00:50:32.000 Yeah.

00:50:33.000 Do you?

00:50:33.000 Not very well.

00:50:34.000 No, but you do?

00:50:35.000 Okay.

00:50:36.000 We're going to get you healthy, buddy.

00:50:37.000 Yeah.

00:50:37.000 Can't be pushing only chemicals in injectable forms to facilitate health.

00:50:43.000 Fair enough.

00:50:44.000 Yeah.

00:50:44.000 Not chemicals, they're vaccines.

00:50:46.000 Oh, I'm sorry.

00:50:46.000 What's in them?

00:50:47.000 What?

00:50:48.000 I mean, it's some sort of chemical, no?

00:50:50.000 No, they're antigens, right?

00:50:51.000 Right.

00:50:52.000 What's the fluid?

00:50:53.000 Macromolecules.

00:50:54.000 What's the liquid stuff?

00:50:55.000 Typically, it would be saline or salt water.

00:50:59.000 Right.

00:51:01.000 Now, what is missing from today's vaccine protocol, if anything?

00:51:08.000 In terms of diseases we should be vaccinating for, but we're not?

00:51:11.000 Is there anything?

00:51:12.000 Yeah, there certainly are.

00:51:14.000 One of them is a big problem among young infants, especially premature infants, called RSV, respiratory syncytial virus infection.

00:51:23.000 What does that come from?

00:51:24.000 It's a respiratory virus that peaks around the same time that flu does.

00:51:29.000 So it's a very severe respiratory illness.

00:51:32.000 So this is, again, one of those vaccines that's not a big moneymaker.

00:51:36.000 So the Bill and Melinda Gates Foundation is trying to Provide grants for supporting that one.

00:51:42.000 That's a good one.

00:51:43.000 And then there are all the diseases that affect poor people both in developing countries and even among the poor in the United States.

00:51:51.000 That's the subject of this book?

00:51:52.000 That's the next one called Blue Marble Health.

00:51:55.000 The next one.

00:51:56.000 So this is not released yet?

00:51:57.000 No, this is out.

00:51:58.000 This actually preceded this one.

00:52:01.000 Now this book is all about poor people and infectious diseases and the rise of these infectious diseases even in the United States.

00:52:09.000 That's right.

00:52:10.000 So, you know, when we think about, so I, you know, led this big campaign to raise awareness of something called neglected tropical diseases or NTDs.

00:52:21.000 These are the most common afflictions of people living in poverty.

00:52:26.000 I call them the most important disease you've never heard of.

00:52:28.000 There are diseases like schistosomiasis and Chagas disease and Leishmaniasis.

00:52:34.000 And I've been devoting my life to seeing if we could develop vaccines for those diseases in the nonprofit sector, because the big pharmaceutical companies just aren't going to take these on.

00:52:47.000 So we're trying to do it in the nonprofit sector.

00:52:49.000 But this book, the Blue Marble Health book, came out of some number crunching that I did using data from the World Health Organization or something called the Institute for Health Metrics and Evaluation, which is based in Seattle, Washington.

00:53:03.000 I found something very surprising, and that is most of the world's poverty-related diseases are not necessarily in the poorest, most devastated countries of Africa, meaning like Democratic Republic of Congo or Central African Republic.

00:53:19.000 They're there, but on a numbers basis, Most of these poverty-related diseases are actually in the G20 economies, the 20 wealthiest economies, together with Nigeria, which is not a G20 country but has an economy bigger than the bottom three or four.

00:53:36.000 So that was pretty amazing for me to find that out because At first, I didn't believe the numbers because I said, well, how could it be if they're poverty-related diseases?

00:53:46.000 Why are they in the 20 wealthiest economies?

00:53:49.000 Then I realized that it's among the poor living in wealthy countries.

00:53:54.000 So the poorest of the rich today now account for most of the world's poverty-related diseases.

00:54:01.000 And what's the cause of this?

00:54:04.000 So why the link with poverty?

00:54:06.000 So that's a great – so one of the things I do in the book is I ask that, well, what is it about poverty that's making you susceptible?

00:54:12.000 I don't think we really know.

00:54:13.000 I mean clearly in some cases if you live in poor dilapidated housing without window screens, Things like mosquitoes and kissing bugs and sand flies can get inside the house.

00:54:24.000 Or if you look in poor neighborhoods like in and around Houston, you see a lot of environmental degradation around the neighborhood.

00:54:33.000 You see discarded tires that breed 80s gypti mosquito or standing water.

00:54:38.000 What did the tires do?

00:54:41.000 Discarded tires?

00:54:42.000 Yeah.

00:54:42.000 So one of the best habitats for the mosquito that transmits dengue and Zika and chikungunya and yellow fever are discarded tires.

00:54:53.000 That's what they love.

00:54:55.000 So if you go into poor neighborhoods, you'll see a lot of tire dumping, for instance.

00:55:00.000 And those are habitats for that Aedes aegypti mosquito, including here in Southern California as well.

00:55:06.000 So is it when the water gets in the tire and creates a small puddle?

00:55:08.000 That's right.

00:55:08.000 A little bit of water.

00:55:09.000 That's exactly it, yeah.

00:55:11.000 You know, I moved into a house once in Encino, down the street from here, in fact, and no one had lived in the house for about a year and a half, two years, and the pool had not been taken care of, and I went out into the pool and it was green and there were schools of mosquito larvae.

00:55:28.000 Mosquito heaven.

00:55:29.000 Mosquito heaven, yeah.

00:55:30.000 So strange.

00:55:32.000 So yeah, absolutely.

00:55:33.000 You go into poor neighborhoods, abandoned swimming pools, things like that.

00:55:37.000 That's where we're getting a number of these diseases.

00:55:40.000 We don't have very many mosquitoes in Southern California.

00:55:42.000 I mean, it's really kind of amazing in that regard.

00:55:44.000 Well, it depends.

00:55:45.000 So, you know, in some counties where they do aggressive spraying and things like that, you won't.

00:55:50.000 But in many counties, probably in some of the poorer counties, poorer districts, you still do.

00:55:55.000 But, I mean, in terms of the way it is on the East Coast. 0.99

00:55:58.000 Like, I grew up in Boston, and in the summertime, you just have fucking mosquitoes everywhere. 0.99

00:56:03.000 You just can't get away from them. 0.97

00:56:04.000 And then I've been to Alaska, which is the craziest place I've ever been to in my life in terms of mosquitoes.

00:56:09.000 Have you been?

00:56:10.000 I haven't been to Alaska.

00:56:12.000 It's hilarious.

00:56:12.000 You get out of your car and they attack you like a horde of birds.

00:56:16.000 That's because you only get one month of the year to do it.

00:56:19.000 So they're super aggressive and they're also very large.

00:56:22.000 The big problem is along the Gulf Coast of the U.S. We have that Aedes aegypti mosquito and that's why I got so worried about Zika virus hitting the Gulf Coast of the U.S. Yeah.

00:56:32.000 Mosquitoes in other countries obviously contain malaria.

00:56:36.000 I mean, we've been very fortunate that that's never made it over to here.

00:56:39.000 Well, no.

00:56:40.000 Malaria used to be widespread in the United States.

00:56:44.000 Both the one that was a real killer disease called falciparum malaria on the Gulf Coast and even up into Illinois in the Ohio River Valley we had a lot of malaria caused by VIVAX in the 1800s.

00:56:57.000 In fact, there's a book Written by Dickens when he visited the United States called Martin Chuzzlewit when he describes all these sickly people in Illinois and Cairo, Illinois and the confluence of the Mississippi and the Ohio River.

00:57:10.000 He's clearly describing malaria.

00:57:12.000 Wow.

00:57:13.000 I did not know.

00:57:14.000 So what stopped it?

00:57:16.000 So that's a great question.

00:57:18.000 So there's actually a very nice book written by a medical historian at Duke University named Margaret Humphries called Malaria, Race and Poverty.

00:57:27.000 And she has a hypothesis, but I think she's onto something, that malaria dropped in association with aggressive economic development.

00:57:39.000 So that the FDR's New Deal included something called the Agricultural Adjustment Act that got people off with agrarian pursuits and put them into factories. 0.89

00:57:51.000 Quality housing went up and that's probably what caused a lot of the reduction in these tropical diseases.

00:57:58.000 Remember, they're really diseases of poverty.

00:58:00.000 In fact, I spent a lot of time working in China and I'm seeing that play out right now in China.

00:58:06.000 It's a very aggressive program of economic development, mostly in the eastern part of the country.

00:58:12.000 But in the southwest part of the country, you go into Yunnan, Sichuan provinces, you go back in time 75 years and you still see those diseases.

00:58:20.000 So do you think that the best cure or the best way to stop malaria would be just to increase the economy of these areas in Africa where they're experiencing it?

00:58:29.000 Clearly, economic development is a very potent driver.

00:58:32.000 Now, what it is about economic development, we still don't have our arms around that yet, but economic development is very important, just like for the neglected tropical diseases we studied.

00:58:41.000 But, you know, unfortunately for many countries, economic development is still decades away, so that's the rationale for developing these vaccines.

00:58:50.000 Is it because economic development moves people into more urban environments where there's less tropical diseases?

00:58:55.000 I think that's part of it, although now we're seeing some tropical diseases thrive in urbanized environments like yellow fever and Zika and dengue as well.

00:59:03.000 So it's not only urbanization.

00:59:05.000 It has to be urbanization with good planning.

00:59:08.000 That's not done unchecked.

00:59:09.000 That outstrips the infrastructure in terms of water and sanitation.

00:59:13.000 So this brings me to the thing that I wanted to talk to you about in the first place, because this is what you brought up to me when we were doing this sci-fi show, and you said something to me that has been haunting me ever since, that the vast majority of people that live in tropical climates have parasites.

00:59:31.000 Mm-hmm.

00:59:32.000 The vast majority.

00:59:34.000 Yeah, that's right.

00:59:34.000 That's right.

00:59:35.000 There's things like Toxoplasma, Gondi.

00:59:39.000 So let's look at the hit parade, right?

00:59:41.000 The top one is one called Ascoriasis, intestinal roundworm.

00:59:45.000 The estimates are on 800 million people have Ascoriasis roundworms in their bellies.

00:59:50.000 Whoa! 0.71

00:59:51.000 800 million.

00:59:52.000 So more than 1 in 10 people on the planet, and mostly people who live in extreme poverty.

00:59:59.000 400 million have hookworm infection.

01:00:02.000 400 million have whipworms.

01:00:04.000 A lot of these are wormy diseases.

01:00:06.000 200 million people with scabies, which is an ectoparasite on the skin that causes terrible itching and secondary bacterial infections.

01:00:16.000 Schistosomiasis is another one.

01:00:17.000 The point is almost every single person who is in extreme poverty has one of these what I call neglected tropical diseases.

01:00:26.000 And one of the interesting features about them is they're very debilitating.

01:00:30.000 So they not only occur in the setting of poverty, but I think they reinforce poverty because they make people too sick to go to work.

01:00:38.000 We can show they shave IQ points off of kids when they have them. 0.98

01:00:42.000 Well, this is the hookworm connection to the idea of the slack-jawed, dumb southerner in the United States of America. 0.62

01:00:50.000 And now one of the things that we have found, so Rogelio Mejia on my faculty, working with an environmental activist named Katherine Coleman Flowers, In Alabama found that hookworm is still present in Alabama.

01:01:02.000 Explain that to people so they understand what we're talking about because for the longest time there was this stereotype about people that live in the South that they were dull-minded and that this could be directly connected to hookworm infection which had run rampant.

01:01:19.000 Right, there was even the term given, they called it the germ of laziness, that hookworm infection because it causes severe anemia.

01:01:27.000 So if you're walking around with terrible anemia, of course, you're not feeling up to working a full day and all that sort of stuff.

01:01:35.000 Hookworm was widely present in the southeastern United States at the turn of the 20th century.

01:01:40.000 And then as malaria went on with economic development, so did hookworm infection as well.

01:01:46.000 But we still have pockets in this country.

01:01:47.000 And this wasn't understood at the time, right?

01:01:50.000 They didn't know that these people were infected with hookworm?

01:01:55.000 Forever, no, up until very recently.

01:01:57.000 So the cause of hookworm wasn't discovered until 1900. What is that cause?

01:02:01.000 It's called Nicator Americanis, the American killer, and that's the name of the worm.

01:02:06.000 And this is from walking barefoot? 0.50

01:02:07.000 Or that goes in through the hands or enters all parts of the body.

01:02:12.000 But it's very common to get it from walking barefoot, which was more common in the South.

01:02:16.000 Right, right.

01:02:16.000 And so that's one of the diseases we've made a vaccine for that's now in clinical trials.

01:02:22.000 Yeah, when I found that one out, I was like, oh my god, well that's it.

01:02:26.000 That totally makes sense.

01:02:27.000 Because for the longest time, there was that stereotype.

01:02:30.000 And then when you find out that it's directly connected to a massive infection of this disease, this worm.

01:02:36.000 So these are the diseases that are holding back people who live in poverty.

01:02:40.000 Originally, I thought only in places like The poorest countries in sub-Saharan Africa or Southeast Asia, but now I realize it's these pockets of poverty across the entire planet that people are affected by these diseases.

01:02:52.000 And these diseases can be vaccinated?

01:02:54.000 We're trying to prove that we can make a vaccine against them.

01:02:57.000 And there is a hookworm vaccine, right?

01:02:59.000 Right now in clinical trials.

01:03:00.000 Just in clinical trials?

01:03:01.000 That's right.

01:03:01.000 Now, wasn't there a Lyme disease vaccine, but the problem was it was actually causing people to get Lyme disease?

01:03:07.000 So that's a – talk about controversial topics.

01:03:10.000 So there was a Lyme disease vaccine that was developed actually from a colleague of mine at Yale University.

01:03:18.000 And they licensed it, I think it was to GlaxoSmithKline.

01:03:21.000 And they developed it as – they called it LymeRx.

01:03:24.000 It was the Lyme disease vaccine.

01:03:26.000 And actually most of the studies suggest that it actually worked pretty well.

01:03:30.000 The problem was there were a number of people who felt that the vaccine made them worse or they said they had chronic Lyme disease, that it wasn't effective.

01:03:39.000 So it was really a market perception problem more than anything else and ultimately it hurt the bottom line of the company and they withdrew it from the market.

01:03:48.000 A good friend of mine's dad got the vaccine and then got Lyme disease.

01:03:51.000 They think he got Lyme disease from the vaccine.

01:03:55.000 Probably not.

01:03:56.000 Probably is a weird word for someone with Lyme disease.

01:03:58.000 That's being nice.

01:03:59.000 No, he didn't get Lyme disease.

01:04:01.000 No way?

01:04:01.000 Impossible?

01:04:02.000 Impossible, because Lyme disease is caused by the Lyme bacteria, the spirochete, called Borrelia burgdorferi, and the vaccine is not a live vaccine.

01:04:11.000 It's a recombinant protein-based vaccine, so it's not possible.

01:04:15.000 So there's nothing in that vaccine that could have caused this adverse reaction that they directly attribute to that vaccine?

01:04:21.000 Probably not.

01:04:23.000 Again, you're saying probably...

01:04:24.000 Well, I don't know the patient.

01:04:26.000 I haven't examined the injury, so I hate to...

01:04:28.000 They swear.

01:04:29.000 I mean, that's the narrative of that household.

01:04:31.000 Well, again, you know, it's reinforced by a lot of negative information out there on the internet.

01:04:35.000 Yeah, but it's also reinforced by the fact they pulled the vaccine.

01:04:38.000 Well, they pulled the vaccine not because it wasn't working but because of market perception and all that sort of – and that was a time before the number of cases of Lyme disease have really taken off.

01:04:49.000 That seems strange to me because they didn't pull the measles, mumps, rembellia vaccine because of perception.

01:04:55.000 Why would they pull the Lyme disease vaccine because of perception?

01:04:58.000 I think the reason was because the cost-benefit equation works a little differently.

01:05:05.000 With measles, measles is a killer disease.

01:05:08.000 Lyme disease was not a killer disease. 0.74

01:05:10.000 But goddammit, it's wrecking people now.

01:05:12.000 In some cases. 0.90

01:05:13.000 It seems to be connected to a host of other ailments too, correct?

01:05:20.000 Like Lyme disease, it exacerbates a bunch of different, maybe possibly even existing health issues.

01:05:26.000 Well, you have to be careful.

01:05:28.000 And this gets into another controversial rabbit hole.

01:05:33.000 I'm not sure we want to get into or not today.

01:05:34.000 But the Infectious Disease Society of America, for instance, has come out with a strong statement saying that there's really no such thing as chronic Lyme disease.

01:05:44.000 And the scientific evidence does not support something called chronic Lyme disease, yet there are lots of people suffering with chronic debilitating illness who claim that it's caused by Lyme disease.

01:05:56.000 So this is something that is out there right now.

01:06:00.000 Why is there a debate?

01:06:01.000 Why are they saying that there is no such thing as chronic Lyme disease?

01:06:06.000 What's their evidence?

01:06:07.000 The evidence is that there's no evidence that they can detect spirochetes in the body in many cases.

01:06:15.000 People who have had Lyme disease don't have persistent evidence of having antibodies any longer to the Lyme spirochete.

01:06:24.000 So it's a whole different area.

01:06:27.000 Right, but they do have this chronic inflammation and pain in their joints and their body starts breaking down.

01:06:32.000 They have something, but it doesn't seem to be.

01:06:35.000 The Infectious Disease Society of America, which is one of the lead infectious disease bodies in our country, and I'm not an expert on Lyme disease, so I'm not too comfortable going there with you, are saying that there's no evidence that that's actually associated with active infection with Lyme disease.

01:06:52.000 How are they describing it?

01:06:56.000 So what's causing all of these?

01:06:58.000 Unknown.

01:07:01.000 But isn't it bizarre that these same people got Lyme disease first and then had all these host of issues afterwards?

01:07:08.000 Well, I guess part of the problem is in some cases they had Lyme disease first, in some cases they really didn't have Lyme disease.

01:07:14.000 Unfortunately, there are a number of unscrupulous healthcare providers and even physicians out there that are making a misdiagnosis of Lyme disease or in some cases they're actually taking everyone who comes through the door and diagnosing them with Lyme disease.

01:07:33.000 I'm sure you're aware of the Lone Star Tick and the allergy to red meat.

01:07:37.000 Yeah, right.

01:07:38.000 That's really fascinating, isn't it?

01:07:39.000 Yeah, and that's another one that's on the rise, correct?

01:07:42.000 Yeah.

01:07:42.000 Well, actually, all tick-borne diseases are on the rise now, possibly because of climate change, which is another factor in our country that's doing that.

01:07:50.000 So we're seeing, you know, if you look now at what are the big drivers of infectious diseases right now, not only in the U.S., but globally.

01:08:01.000 There are really some interesting forces, and a lot of them are social determinants.

01:08:05.000 So a big one is poverty.

01:08:07.000 That's a huge one.

01:08:08.000 The other big one is political instability in war because it interrupts public health control measures.

01:08:14.000 So, for instance, Venezuela, which was leading public health control in Latin America for decades, You know, with the collapse of the economy in the Chavez era now into the Madura area, we've got a terrible situation where we've had measles return in a big way,

01:08:32.000 so huge numbers of cases of measles.

01:08:35.000 We've had all the neglected tropical diseases come back, as well as malaria, Chagas disease, Leishmaniasis.

01:08:43.000 So it's really interesting how that is destabilizing the whole region because now Venezuela As one of the largest diasporas of people, as big as the diaspora coming out of Syria and Iraq.

01:08:54.000 So now the diseases are moving into adjacent areas of Brazil and Colombia and Ecuador.

01:08:59.000 And so it's really – and that's another big driver is political instability.

01:09:03.000 The third one we think is climate change may be very important.

01:09:08.000 So why did we see this big surge of chikungunya virus infection in the Western Hemisphere or Zika?

01:09:16.000 We don't really understand the forces of that.

01:09:18.000 And what's going on in southern Europe right now is quite concerning.

01:09:21.000 We've had malaria return to Greece after it's been gone for 70 years.

01:09:26.000 Malaria has returned to Italy.

01:09:28.000 We're seeing schistosomiasis, a neglected tropical disease, on the island of Corsica.

01:09:32.000 We've got dengue, chikungunya, West Nile virus across Italy, Spain, Portugal.

01:09:41.000 So we're trying to understand why that is, and there's some thought that climate change may be a big driver of that.

01:09:47.000 Now what other infectious diseases, or parasites rather, do they have vaccines for?

01:09:54.000 Do they have a vaccine for toxo?

01:09:56.000 There's no vaccine for toxoplasmosis.

01:09:59.000 There's a prototype malaria vaccine.

01:10:03.000 There's a malaria vaccine, it's called Mosquerix, that's the trade name that was developed, supported with a lot of funding from the Bill and Melinda Gates Foundation and working in partnership with GlaxoSmithKline.

01:10:19.000 And that malaria vaccine now has been approved for use in children by the European Medicine Agency.

01:10:26.000 And it's being introduced now in three countries in Africa, Malawi, Ghana, and I forgot the third one.

01:10:33.000 I think it was 10-7.

01:10:33.000 Is there an adverse reaction that people have to that stuff?

01:10:36.000 Because I know the traditional malaria medication, I had friends that took it and had horrible nightmares.

01:10:42.000 Oh, yeah.

01:10:42.000 Malarium is terrible, yeah.

01:10:44.000 It gives you very lurid dreams.

01:10:45.000 Yeah.

01:10:46.000 Yeah, no.

01:10:46.000 And so far, no.

01:10:48.000 And so when you say children, how old are the children that they're vaccinating with this?

01:10:53.000 Well, the problem that you get into with malaria is that before six months of age, you have maternal antibodies.

01:11:01.000 Remember, you're born with antibodies from your mother and they'll start to wane by six months of age.

01:11:06.000 So the ones who get hospitalized with what's called cerebral malaria, which is a devastating condition, or severe malaria anemia, which is also a killer, are those children between six months of age and five years of age.

01:11:22.000 So those are the ones that we want to protect.

01:11:25.000 And it's one of the leading killers of children globally, right?

01:11:28.000 And we don't have a vaccine.

01:11:30.000 Sickle cell is connected to it, correct?

01:11:32.000 Sickle cell, it has something to do with people developing an immunity to malaria?

01:11:40.000 Yeah, I'm surprised you knew that.

01:11:42.000 I found out from Tiffany Haddish.

01:11:43.000 Who's Tiffany Haddish? 1.00

01:11:44.000 How dare you?

01:11:45.000 She's a very funny comedian. 0.99

01:11:47.000 Okay.

01:11:48.000 I'm sure she is.

01:11:50.000 Well, she's right.

01:11:52.000 It's not really immunity, but it's a natural protection.

01:11:55.000 So individuals who have the sickle cell trait seem to be partially resistant to malaria.

01:12:03.000 And that's the thinking why the gene for sickle cell has been preserved in Africa Yeah, we were actually discussing it because a friend that I grew up with died from it.

01:12:21.000 So it seems to only exist in African Americans or Africans.

01:12:25.000 Is that correct?

01:12:26.000 No, there's some other places as well, but predominantly in African and among African Americans.

01:12:32.000 Or people whose ancestors came from these tropical climates.

01:12:35.000 Right, right.

01:12:36.000 Yeah, so it's really quite an amazing story.

01:12:39.000 So there's no vaccine for toxoplasmosis.

01:12:45.000 Is there anything on the horizon?

01:12:47.000 Is there anything we've worked on?

01:12:48.000 Because that's a big one, right?

01:12:50.000 It's a real big problem among people with HIV-AIDS, for instance, because it reactivates your toxoplasmosis and I even see it in kids sometimes.

01:13:01.000 Reactivates it?

01:13:02.000 How so?

01:13:02.000 Well, what happens is in some countries up to 30% of people are actually infected with toxoplasma.

01:13:11.000 And the parasite has the ability to undergo a dormancy state in the body until your immune system gets compromised either because of AIDS or because if you get some kind of medicine that suppresses your immune system and then it can reactivate it and cause what's called cerebral toxoplasmosis,

01:13:29.000 which is quite serious.

01:13:30.000 So most people handle their toxoplasmosis very well.

01:13:34.000 You know, you die with it and don't even know you have it, but in some cases it gets reactivated.

01:13:40.000 Right now, there doesn't seem to be a lot of incentive for developing a toxoplasmosis vaccine, although I'd be very interested to work on something like that.

01:13:49.000 Why would there be no incentive?

01:13:50.000 It's such a large-scale disease.

01:13:52.000 It's hundreds of millions of people worldwide, right?

01:13:54.000 That's right.

01:13:55.000 And part of the problem is we have almost no information The actual number of people who have it and how extensive it is.

01:14:04.000 So we call that disease burden.

01:14:06.000 We don't have good disease burden estimates of toxoplasmosis.

01:14:10.000 I'm scared to get tested.

01:14:11.000 I've had a bunch of cats.

01:14:12.000 I've had feral cats.

01:14:13.000 And I'm crazy.

01:14:14.000 Well, there's a good chance you are infected, but as long as your immune system is intact, then you're okay.

01:14:19.000 Now there is a related disease from cats called Toxicoriasis and that's a parasitic worm infection we're finding in the United States among the poor.

01:14:29.000 So what happens is if you go into poor neighborhoods, you see a lot of feral cats and dogs in poor neighborhoods, almost 100% of them have this worm in their intestines and they're seeding the environment with eggs in their feces and the feces are spread.

01:14:44.000 All over the poor neighborhoods, kids come into contact with them, and the worm has the ability to migrate through the brain across cerebral toxicoriasis.

01:14:53.000 And I think it's an important cause of developmental delays.

01:14:56.000 It's one of those neglected diseases in the U.S. I talk about in the book.

01:15:01.000 And there's no vaccine for that either?

01:15:02.000 There's no vaccine for it.

01:15:03.000 And we have very little awareness about it.

01:15:05.000 Wow.

01:15:05.000 Yeah, I've never even heard of it until just now.

01:15:07.000 Right.

01:15:08.000 And that's not rare.

01:15:09.000 I mean, in some cases, you know, up to 10% of certain populations like African Americans living in poverty are infected with it.

01:15:18.000 And it's primarily pets, or is it rodents as well?

01:15:21.000 Mostly stray dogs.

01:15:23.000 It's not even pets.

01:15:24.000 It's mostly stray dogs and cats.

01:15:25.000 And this is an example of a neglected tropical disease.

01:15:30.000 Here's a disease of up to 10% of African Americans living in poverty in the United States, and almost nobody is studying it.

01:15:38.000 Wow.

01:15:39.000 And it can affect the way your mind functions.

01:15:41.000 Right.

01:15:42.000 And it's been linked now to developmental delays.

01:15:45.000 So, you know, everybody wants to know why, you know, kids living in poverty have developmental delays and people just assume it's because they live in deprived environments and that sort of thing.

01:15:55.000 But I think Toxicoriasis is an important underlying reason for it.

01:15:59.000 And this is an example of a neglected disease.

01:16:02.000 You know, we, I mean, everybody's heard of Ebola, right?

01:16:05.000 And everyone's worried about Ebola and the truth is Ebola is never going to come to the United States.

01:16:10.000 Why is that?

01:16:11.000 Because it's too difficult to transmit.

01:16:14.000 Unless you have a complete collapse in the health system, we're never going to have Ebola epidemics in the United States.

01:16:19.000 But here's a disease of 10% of African Americans living in poverty, and no one's heard of it, and there's no incentive to study it.

01:16:26.000 So that's why I'm trying to raise awareness about these poverty-related diseases in the United States.

01:16:31.000 I don't understand why people don't talk about that one.

01:16:33.000 That one seems insane.

01:16:35.000 Absolutely.

01:16:36.000 It's a no-brainer, right?

01:16:38.000 But it's very hard to get people to care about diseases of poverty.

01:16:42.000 And this is one of the striking things about when I wrote the book, was I've had a lot of success getting people to care about neglected tropical diseases in Africa and worked with the U.S. Agency for International Development, To support a package of medicines that's now being administered to over a billion people annually.

01:17:02.000 And that, you know, is one of my proudest accomplishments is helping to raise awareness about neglected tropical diseases like we've been talking about, hookworm and schistosomiasis in Africa, Asia, Latin America.

01:17:12.000 But the minute I talk about poverty-related diseases in the U.S., The lights go out.

01:17:18.000 I don't know.

01:17:19.000 I can't figure out what I'm doing wrong.

01:17:22.000 I've had so much success getting people to care about NTDs, neglected tropical diseases, in poor developing countries.

01:17:30.000 But there's been no response to this book.

01:17:36.000 And the estimates that I come up in the book are we have 12 million Americans live in poverty with a neglected tropical disease.

01:17:44.000 Toxicoriasis is one of them.

01:17:45.000 Another one is Chagas disease.

01:17:47.000 And the list goes on.

01:17:49.000 And it's been very hard to get people to care about the poor in this country.

01:17:52.000 I think?

01:18:04.000 I think?

01:18:12.000 It still exists, but it's going away.

01:18:14.000 What we're seeing is a general rise in all economies.

01:18:20.000 Some African countries have 8% or 9% economic growth, but it's all leaving behind a bottom segment of society. 0.98

01:18:26.000 And so I don't care where you show me poverty, whether it's in Texas or Alabama or Nigeria or Bangladesh, I will show you these poverty-related diseases.

01:18:36.000 And, you know, I know – what's her name?

01:18:40.000 AOC, the congresswoman from New York, has talked a little bit about hookworm in Alabama.

01:18:45.000 So last time I was in Washington, I dropped off a copy of the book in her office, but no response yet.

01:18:51.000 Well, she's probably pretty busy too.

01:18:52.000 Yeah, she's doing a lot of other stuff.

01:18:54.000 If you had a magic wand and someone said – You could do whatever you want to fix this.

01:19:00.000 What would you do?

01:19:01.000 So I did meet with a couple of people on the hill and they asked me that question, what's the magic wand?

01:19:09.000 And there's a couple of things.

01:19:11.000 One, we need to actually look for these diseases because the problem is the diseases that cause are very subtle, like developmental delays.

01:19:19.000 So that if you're a kid who lives in poverty with developmental delays, the pediatrician doesn't even think to do a test for toxicoriasis.

01:19:27.000 So we need to raise awareness.

01:19:30.000 We need to go into poor communities across the country and actually take a blood test and actually measure for the presence of that disease or that parasite.

01:19:40.000 Once you find that disease, what would you do then?

01:19:42.000 Well, it depends on the disease.

01:19:44.000 In some cases, we have treatments for it.

01:19:45.000 The treatment for toxicoriasis is a five-day course of a simple pill of albendazole.

01:19:51.000 And it cures it?

01:19:52.000 And it cures it.

01:19:53.000 Really?

01:19:53.000 Yeah.

01:19:54.000 So we have interventions.

01:19:56.000 So one, doing what I call active surveillance, looking for these diseases.

01:20:01.000 The other one...

01:20:02.000 is really trying to understand how these diseases are transmitted.

01:20:07.000 What is it about poor neighborhoods that is facilitating transmission?

01:20:11.000 I think the third problem is the diagnostic tests themselves because they're very complicated tests.

01:20:17.000 Sometimes they're done at the Centers for Disease Control and Prevention, our lab, our National School of Tropical Medicine does a few of them.

01:20:25.000 But it's not like when you go for blood work in your doctor and you get a little lab slip from Quest Diagnostics with the blood chemistries, the blood counts.

01:20:34.000 There's no box there for toxicoriasis and chagas.

01:20:38.000 So we need more improved tests, point of care diagnostic tests.

01:20:43.000 Not just improved tests, but just letting people know it's something.

01:20:46.000 Yeah, and so they don't have to send it off to the CDC or to our National School of Tropical Medicine.

01:20:52.000 Is there a treatment for toxo?

01:20:54.000 There is a treatment for toxoplasmosis.

01:20:56.000 What is it?

01:20:58.000 It's a paramethamine sulfa drug, but it requires a long treatment course.

01:21:03.000 How long?

01:21:04.000 I'd have to look up the number of days.

01:21:06.000 I haven't treated a patient with toxoplasmosis in a while, but...

01:21:10.000 And it kills it effectively?

01:21:12.000 It can, yeah.

01:21:12.000 Really?

01:21:13.000 Yeah.

01:21:13.000 Oh, I thought it was something you kept for life.

01:21:15.000 Well, if you don't get treated.

01:21:16.000 Right.

01:21:17.000 Okay.

01:21:17.000 And then if you're immune compromised and it comes back, then that's a problem as well.

01:21:23.000 So most people that have it really don't even know they have it.

01:21:26.000 That's right.

01:21:26.000 And actually, most people who have neglected tropical diseases don't know they have it.

01:21:31.000 In Texas, for instance, we have transmission of a parasitic disease called Chagas disease.

01:21:37.000 It's a cause of heart disease.

01:21:41.000 Members of our faculty were actually able to track down individuals who had donated blood And the Gulf Coast Regional Blood Authority actually found people positive for Chagas disease.

01:21:56.000 They were told to go see their primary health care provider.

01:22:00.000 And unfortunately, the primary health care provider is not educated about these diseases, and they just assume it must be a false positive.

01:22:06.000 So, you know, our faculty had tracked them down and were able to get them into treatment.

01:22:10.000 And what is the treatment for Chagas disease?

01:22:12.000 It's an antiparasitic agent called benzidazole.

01:22:16.000 And that kills it?

01:22:17.000 That can kill if you catch it early enough, but sometimes you don't catch it early enough.

01:22:20.000 So if it becomes systemic, then you have...

01:22:22.000 Then that's why we're trying to develop a therapeutic vaccine for this disease.

01:22:26.000 But again, it's a therapeutic vaccine for a poverty-related disease, so it's very tough.

01:22:32.000 So the point is these diseases are widespread among the poor and we just don't pay attention to them.

01:22:37.000 Yeah, that's great.

01:22:39.000 And so I think, you know, again, I'd love to hear your thoughts.

01:22:42.000 I mean, what is it that we just turn our backs on the poor in this country?

01:22:48.000 It's disturbing.

01:22:49.000 It's very disturbing.

01:22:50.000 There's a dismissive attitude.

01:22:51.000 And they disproportionately affect people of color as well, right?

01:22:55.000 Because it's so linked to poverty.

01:22:58.000 Well, also, right, slavery.

01:23:01.000 Yeah.

01:23:01.000 I mean, the history of slavery in this country.

01:23:03.000 The history of systemic racism in places where they just literally would not sell homes to people who are African American.

01:23:11.000 All these things are connected to the contribution of maintaining these impoverished communities.

01:23:17.000 And there's been almost no effort whatsoever, other than the people living in the community trying to do better and raise everybody up.

01:23:23.000 Right.

01:23:23.000 There's been no effort whatsoever by the federal government to step in and try to rehabilitate, like a large-scale approach to rehabilitating places like the ghettos of Houston or Baltimore or Detroit.

01:23:38.000 You know, I thought I knew what poverty – before I moved to Texas in 2011, I was chair of microbiology at George Washington University.

01:23:46.000 And I thought I knew what poverty looked like.

01:23:48.000 I moved down to the Gulf Coast, and it's a different animal.

01:23:51.000 I mean, the depth and breadth of poverty in the Gulf Coast and the southern part of the United States is just extraordinary.

01:23:58.000 And it's been very hard to get people to want to really take it on and really address these poverty-related diseases.

01:24:08.000 What do you think the cause of it is?

01:24:10.000 I mean, you've studied this for quite a while.

01:24:12.000 The cause of the neglect?

01:24:15.000 I don't know.

01:24:18.000 Is it something about American exceptionalism or something that we just don't want to admit?

01:24:23.000 We have poor people.

01:24:25.000 I don't know.

01:24:26.000 I wasn't the first to come up to raise this issue about poverty.

01:24:29.000 When I was in high school or junior high school, I was forced to read a book and at the time I didn't care about it.

01:24:35.000 It was called The Other America. 0.80

01:24:36.000 It was written by a fantastic social activist named Michael Harrington.

01:24:44.000 I think someone told me he's a very devout Catholic actually.

01:24:47.000 And he wrote this book called The Other America.

01:24:50.000 It talks about the hidden poverty off the road.

01:24:53.000 And the actual number of people who live in extreme poverty hasn't changed since that book was written in the early 60s.

01:24:59.000 That book was what helped first Kennedy then Lyndon Johnson Yeah,

01:25:17.000 that is a very strange thing, our acceptance of these communities.

01:25:23.000 I mean, I've always said that if you want to make America a better place, The best thing to do is not invade other countries or intervene.

01:25:33.000 The best thing to do is try to rebuild these impoverished communities.

01:25:38.000 Yeah, well, Gandhi once said, a civilization is judged by the treatment of its minorities.

01:25:44.000 And by that criteria, we're not doing so well.

01:25:48.000 You know, our country was visited by the United Nations Special Rapporteur on Poverty in 2017. And his numbers came up with, we have 19.4 million Americans who live in what's called extreme poverty.

01:26:02.000 That is at half the U.S. poverty line.

01:26:04.000 And roughly around 5 million Americans living on less than $2 a day.

01:26:08.000 The same benchmark you'd use for global poverty.

01:26:11.000 5 million?

01:26:13.000 Yeah.

01:26:13.000 And guess what?

01:26:15.000 Those probably all have neglected tropical diseases.

01:26:18.000 5 million people.

01:26:18.000 Just like those living in extreme poverty in Africa.

01:26:21.000 5 million people living on $14 a week.

01:26:24.000 $2 a day, yeah.

01:26:25.000 That's insane.

01:26:27.000 The University of Michigan Center on Poverty has also shown that we have, I forget the number, 2.7 million families living on less than $2 a day, which is probably about the same as the 5 million number.

01:26:40.000 Jesus Christ.

01:26:41.000 Yeah.

01:26:42.000 And again, this is not a topic that is very popular.

01:26:45.000 I mean, when you see presidential debates, this is not something that comes up.

01:26:50.000 No, nobody talks about it.

01:26:51.000 And again, even for disease.

01:26:52.000 I mean, what are the diseases we hear about?

01:26:54.000 Ebola and diseases like that.

01:26:59.000 And sometimes in my frustration, I say, you know, these are imaginary diseases, and yet here we've got widespread diseases of the poor in the U.S., and the lights go out.

01:27:09.000 You remember when that woman came back from Africa, and she was a nurse, and she had been in some connection, contacted with Ebola?

01:27:19.000 She didn't have it, and they wanted to quarantine her?

01:27:21.000 Oh, yeah, and they stuck her out in some... 1.00

01:27:26.000 Something crazy like that.

01:27:28.000 What did you think about that?

01:27:29.000 I just thought it was so cruel.

01:27:31.000 Is it just an ignorance of how it's transmitted?

01:27:34.000 Yeah, that's right.

01:27:35.000 How is it transmitted?

01:27:36.000 Well, actually, Ebola, you know, it turns out is the opposite of measles.

01:27:39.000 Measles is one of the most contagious diseases known.

01:27:41.000 It has a reproductive number of 12 to 18. What that means, if a single individual gets measles, 12 to 18 others get it because the virus hangs around in the environment and it's so easily transmissible.

01:27:54.000 Hangs around like if you touch this table.

01:27:56.000 That's right.

01:27:57.000 That's right.

01:27:57.000 Or even in the atmosphere.

01:28:00.000 And that's why you get these really large measles outbreaks like you're seeing in Washington State.

01:28:06.000 And usually those are infants under the age of 12 months, not yet old enough to get vaccinated.

01:28:11.000 They're the ones that wind up hospitalized and sick.

01:28:16.000 Well, Ebola is just the opposite.

01:28:17.000 Ebola is a reproductive number of two or three.

01:28:20.000 So unless you're taking care of a dead or dying Ebola patient or someone who's recently died because it's only towards the end stage of the disease that you really get large numbers of virus particles in the body, you're not going to get Ebola.

01:28:33.000 So the reason it's being so hard right now to contain the Democratic Republic of Congo Yeah,

01:28:58.000 right, right.

01:29:02.000 What else should we worry about?

01:29:04.000 You're freaking me out.

01:29:06.000 Well, the point is a lot of these diseases are solvable if we just put our mind to it.

01:29:12.000 Or if people are even aware of it.

01:29:14.000 Well, one of the things I say in the book is because these diseases are so widespread among the poor in the G20 countries, if we could get The elected or the leaders of those G20 countries together at a G20 summit and say, we're really going to do something about the neglected diseases in our own borders,

01:29:31.000 and I'll include the United States, we could get rid of two-thirds of the world's poverty-related neglected diseases right off the bat.

01:29:38.000 So a lot of it is political will, ignorance or lack of awareness and political will.

01:29:46.000 Well, it seems like in this country, ignorance is a big part of it because this is something I've thought about many times, but I didn't know about chaga.

01:29:53.000 I didn't know about a lot of these other diseases you're describing.

01:29:56.000 Yeah, no, I mean, so we need to raise awareness about these.

01:30:00.000 That's why I'm so thrilled to come here because I've just amplified the number of people who've heard of this concept of blue marble health, which is a name that I've given a different name from global health to separate it from the two.

01:30:14.000 So, you know, coming on here is so powerful in terms of amplifying that message.

01:30:20.000 So again, back to the magic wand, what could be done?

01:30:24.000 I mean, is it a funding issue or is it at first, before that, an education issue?

01:30:29.000 Well, I think there's multiple issues.

01:30:32.000 So, I mean, again, the drivers we've been talking today about promoting these diseases, really tough to do anything about extreme poverty, war and conflict, climate change.

01:30:45.000 Climate change, clearly there are some things we can do.

01:30:47.000 Aggressive, unchecked urbanization.

01:30:50.000 But the other things that you can do is build better tools.

01:30:55.000 By that I mean better diagnostics, better drugs, better vaccines.

01:31:00.000 And unfortunately for these poverty-related diseases, there's no market incentive for it.

01:31:05.000 So it falls to academics, to professors, to people trying to do this in the nonprofit sector.

01:31:11.000 And we're doing the best we can.

01:31:13.000 But it's not nearly as good as having access to getting the pharmaceutical companies involved as well.

01:31:20.000 It also seems like this would cost an insane amount of money to just go through all these poor communities, test everyone and start distributing these drugs and what would pay for all that stuff.

01:31:33.000 Well, you know, some people have asked me, well, would the Affordable Care Act take care of this?

01:31:37.000 And I said, well, we're two steps away from the Affordable Care Act.

01:31:40.000 We're two degrees of separation away from the Affordable Care Act because we're not even recognizing these diseases.

01:31:49.000 Yeah, you've got to know about it first.

01:31:51.000 I mean, what percentage of the population even knows about all these parasite-created diseases?

01:32:00.000 Or know that vaccines don't cause autism.

01:32:03.000 Yeah, well, that's the biggest one, right?

01:32:06.000 Yeah, that's a tough one.

01:32:07.000 And again, I don't understand it.

01:32:10.000 I mean, I'm just saying it.

01:32:12.000 I'm saying vaccines don't cause autism because you're saying it.

01:32:15.000 Right.

01:32:15.000 And I think this is part of the boat.

01:32:17.000 Part of the problem, we're in this boat with a bunch of people who are scientifically illiterate, like myself, who are discussing these issues who don't really know what they're talking about.

01:32:26.000 I saw someone talking about tetanus Because some boy had tetanus and he was in the hospital for a long time and his hospital bill was like a million dollars.

01:32:39.000 Because it's an ICU admission, right?

01:32:41.000 Right.

01:32:42.000 And they were saying, hey, why didn't this kid get a tetanus shot?

01:32:45.000 And it goes back to the same thing, right?

01:32:48.000 That people don't want these vaccines.

01:32:50.000 That could have prevented.

01:32:52.000 And again, I don't blame the parents.

01:32:53.000 I think the parents in some ways are victims themselves.

01:32:56.000 They're victims of this very aggressive misinformation campaign that's out there.

01:33:00.000 Tetanus is a big one though, isn't it?

01:33:01.000 Yeah, tetanus and we have a vaccine for it.

01:33:03.000 That's part of what's called the DPT. That's one of the first vaccines you get as an infant.

01:33:08.000 There's no excuse for having a tetanus case in the United States.

01:33:10.000 Right.

01:33:11.000 And this kid was unvaccinated.

01:33:13.000 Right.

01:33:13.000 Yeah.

01:33:13.000 That's my understanding.

01:33:14.000 Yeah.

01:33:15.000 I mean, is there a cure for tetanus outside of vaccines?

01:33:19.000 Well, I mean, there are supportive measures that you can do.

01:33:22.000 But, you know, they require hospitalization, ventilation, putting on a respirator.

01:33:29.000 And you could still die.

01:33:31.000 So it's an awful, awful disease.

01:33:33.000 I've seen tetanus working in Central America and elsewhere.

01:33:36.000 You see a case of tetanus, you never forget it.

01:33:38.000 What is tetanus technically?

01:33:39.000 Well, the other name is lockjaw, where your muscles go into spasm, including the muscles involved in breathing, so you can't even breathe as a result of it.

01:33:50.000 It freezes the muscles.

01:33:52.000 What is doing it?

01:33:54.000 What's doing it?

01:33:55.000 Is it a parasite?

01:33:55.000 It's actually caused by a bacteria.

01:33:57.000 The bacteria releases a toxin called tetanus toxin.

01:34:03.000 That sounds like a horrible way to go.

01:34:04.000 I mean, these are awful diseases.

01:34:06.000 And I think one of the things that the anti-vaccine group or lobby, as I call it, does is they try to be very dismissive of these diseases.

01:34:14.000 They try to deliberately downplay the effects.

01:34:18.000 I mean, you'll see...

01:34:19.000 This stuff on the web, measles, build your immune system.

01:34:22.000 I have seen that.

01:34:23.000 You said it yourself.

01:34:26.000 I didn't read it.

01:34:27.000 I just saw it.

01:34:28.000 I said, that doesn't make any sense. 1.00

01:34:30.000 It's crap, right? 0.99

01:34:32.000 What are they saying? 1.00

01:34:34.000 They're saying it's just a rash.

01:34:35.000 It builds your immune system.

01:34:37.000 It makes you stronger.

01:34:39.000 It's something from a different planet.

01:34:43.000 I don't know where they're coming from.

01:34:44.000 I think the reason for that...

01:34:46.000 Becoming popular is because we do kind of helicopter parent our kids a little bit too much.

01:34:52.000 They should come in contact with a bunch of different things because it does build their immune system, correct?

01:34:56.000 Well, that's an interesting hypothesis called the hygiene hypothesis.

01:35:00.000 It says, you know, if your kids are living in too sterile an environment, then this can also result in autoimmune diseases and things like that.

01:35:10.000 Allergies.

01:35:11.000 Allergies.

01:35:12.000 And I have mixed feelings about the hypothesis.

01:35:14.000 To me, it's not airtight by any means.

01:35:17.000 You're tight, but there's some sort of a correlation, particularly between peanut allergies and keeping peanuts away from children.

01:35:23.000 And there was a study, Jonathan Haidt's work, in one of his books, talked about how there was a study done in communities where they didn't protect kids from peanut allergies and the much smaller percentage of people developing peanut allergies versus kids that they did.

01:35:41.000 Well, this is also one of the things that the anti-vaccine lobby is doing now, that they're When I write a book like this, Vaccines Don't Cause Autism, now what you're seeing, remember I told you about that whack-a-mole business where they went from MMR to thimerosal to spacing vaccines too close together to aluminum.

01:35:59.000 Now there's some groups that are moving away from autism altogether, and now they're saying, well, vaccines cause autoimmune disease or vaccines cause other neurologic deficits.

01:36:08.000 But it's all flim-flim.

01:36:11.000 It's all flim-flim.

01:36:13.000 There are vaccine courts though, right?

01:36:16.000 There are vaccine courts, yeah.

01:36:17.000 And they have handed out payments to people who were injured by vaccines.

01:36:22.000 Right.

01:36:22.000 What is that?

01:36:24.000 So, you know, it was, for instance, if you look over a 10-year period, I think it is between, I haven't looked at the numbers in a while, I think it's between 2008 and 2014 and 2015. Over that period of time,

01:36:39.000 there were 2.5 billion doses of vaccine given, 2.5 billion, of which the vaccine courts identified around 200 that were a list of serious injuries that they have a table of that they could attribute to vaccines.

01:36:58.000 So there were 2,000 payouts, and of those 2,080%, they didn't really think were attributed to vaccines, but they paid it out anyway because that's how the courts work, and then 200 where they could really say, yeah, it looks like this could be related to vaccines.

01:37:13.000 So you divide 200 by 2.5 billion, that's 1 in 10 million.

01:37:17.000 Or even 2,000 by 2.5 billion.

01:37:20.000 That's one in a million.

01:37:22.000 And these cases, what was happening to these people other than the shoulder injury that you were talking about?

01:37:27.000 Yeah, there's a list, and I talk about it in the book.

01:37:30.000 There's actually a table you can download on the web for each vaccine, a list of potential injuries that they allow.

01:37:37.000 And these potential injuries, is it, as we were talking about earlier, is this just biological variability that some people just react differently to different things?

01:37:45.000 I think in some cases we don't know.

01:37:47.000 In other cases, you know, with the live virus vaccines, If you have a severe genetic immune deficiency and maybe it wasn't picked up, then there's that risk.

01:38:00.000 But, you know, what's a one in a million?

01:38:02.000 What's a one in a ten million risk?

01:38:04.000 As I said, we have to keep that in perspective because the odds of getting hit by lightning is one in a 700,000, if you believe that number.

01:38:10.000 Or, you know, what's the risk every time you – Take your child out in a car and drive around the neighborhood.

01:38:16.000 I'm sure the risk is far higher than one in a million.

01:38:19.000 And the real danger is these actual infectious diseases spreading and the damage they could do, damage things like tetanus.

01:38:25.000 They're coming back, yeah.

01:38:26.000 Yeah, measles is an awful disease, causes measles, encephalitis, measles, pneumonia.

01:38:32.000 I find that a lot of people that are steadfast in their resistance to vaccines, they also believe in a lot of other questionable things.

01:38:44.000 It seems like these things get lumped into these groups of things that they don't trust the government about.

01:38:50.000 Right.

01:38:51.000 Yeah, I think that's probably true.

01:38:54.000 Yeah. 0.94

01:38:56.000 That's what sucks about having a sketchy government. 0.74

01:38:58.000 Well, you know, it was interesting.

01:39:01.000 So, you know, I said, you know, we need to hear from the Centers for Disease Control more than the Surgeon General.

01:39:06.000 Now they're starting to speak out.

01:39:08.000 But, you know, people accounted for that and said, well, part of the problem is people don't trust their government.

01:39:12.000 And I said, well, that's true of some.

01:39:13.000 But I think most people, you know, if we had a more visible public health force out there, people would listen to it.

01:39:22.000 Well, I think that what you're talking about in terms of these poor neighborhoods and these parasites getting into people's system and affecting cognitive development.

01:39:30.000 What was the other one besides chaga? 0.57

01:39:33.000 Toxicoriasis was the one that affects cognitive development.

01:39:36.000 And the fact that there's actual cures for these things, too.

01:39:39.000 I estimated in a paper there are 2.8 million African Americans living in poverty with toxicoriasis.

01:39:46.000 This is not a rare disease, Joe.

01:39:48.000 This is a common disease.

01:39:49.000 But it's so unknown.

01:39:50.000 But it's occurring among the poor and it's a chronic and debilitating infection.

01:39:54.000 It's not dramatic.

01:39:55.000 It's not Ebola.

01:39:57.000 It's not killing people.

01:39:58.000 Is this mostly in warmer climates as well?

01:40:00.000 It's more common in the south than in the north.

01:40:03.000 Is it because they have longer time to stay alive?

01:40:07.000 Yeah, because the eggs are in the environment and the worm develops within the egg.

01:40:12.000 Is there any other diseases that are going on that we don't know about?

01:40:16.000 Yeah, sure.

01:40:19.000 There's a brain parasitic infection called cystocercosis.

01:40:23.000 What's that one from?

01:40:24.000 That one is from eggs, often from individuals who have a tapeworm.

01:40:30.000 So we're seeing cases of that.

01:40:34.000 There's some of the viruses transmitted by mosquitoes.

01:40:38.000 One of the ones we don't talk about a lot, which is a very serious infection, Is West Nile virus infection.

01:40:44.000 That's got very high rates of not only encephalitis, but also one of our faculty members, Christy Murray, is showing very high rates of depression and other neurologic debilitation for, and that's another one.

01:40:57.000 We could probably use a vaccine for, but there isn't the market incentive to do it.

01:41:01.000 West Nile virus does come up, though.

01:41:03.000 At least that's discussed in the news and people are aware of it.

01:41:06.000 Right.

01:41:07.000 But there's no vaccine.

01:41:09.000 There's no vaccine, but there could be.

01:41:10.000 What is it?

01:41:11.000 There could be.

01:41:11.000 What's holding it back?

01:41:12.000 What's holding it back is lack of market forces, lack of financial incentive for the pharmaceutical companies to take it on.

01:41:19.000 So there's an extremely large investment to develop something along those lines?

01:41:25.000 That's right.

01:41:26.000 I mean, vaccines are, from an investor's perspective, a tough sell because, you know, there's a possibility.

01:41:33.000 First of all, you need many years of clinical trials.

01:41:35.000 It can sometimes take two decades from the original...

01:41:40.000 conception of a vaccine to actually going through clinical trials.

01:41:42.000 So the hookworm vaccine I've been working on, we've been doing it since the 1990s.

01:41:48.000 So we're talking decades-long time horizons.

01:41:51.000 When you talk to an investor about something with decades-long time horizons, you figure it out, right?

01:41:56.000 The lights go out very quickly.

01:42:00.000 That's where it gets gross, right?

01:42:02.000 Because this is all we're relying on These private businesses to invest money to cure a public health issue.

01:42:09.000 That's right.

01:42:10.000 That seems kind of crazy.

01:42:12.000 Well, so in response to that, what happened was after the Ebola fiasco in 2014, where we didn't have an Ebola vaccine in Guinea, Liberia, and Sierra Leone, A group of individuals came together at Davos, the World Economic Forum, including the Gates Foundation.

01:42:31.000 They developed this concept of an organization called CEPI, the Coalition for Epidemic Preparedness Innovation, to incentivize biotechs and pharmaceutical companies to embark on diseases of pandemic potential.

01:42:49.000 Like Ebola, like Lassa fever, like Mayor's coronavirus infection.

01:42:54.000 And that was great, but the problem was they didn't address these poverty-related diseases.

01:42:58.000 So those of us who are working on poverty-related diseases are still kind of on the outside looking in.

01:43:04.000 It just seems like Having everything managed by private companies that need to have some sort of financial incentive to attack these diseases, that seems like a crazy way to deal with health crisis.

01:43:19.000 That's right.

01:43:20.000 And so what I've recommended, as I said, that organization, CEPI, is great for what it's doing, but we need another mechanism.

01:43:27.000 What I've proposed is that since these diseases are so common among the poor in the G20 countries, These are the 20 largest economies to put together public sector funds for that purpose.

01:43:41.000 Aaron Powell Public sector funds for investing in developing vaccines and treatments?

01:43:45.000 For poverty-related diseases, these chronic debilitating diseases.

01:43:49.000 In fact, we can show that working with health economists, we actually work with a terrific health economist whose name is Bruce Lee of all names.

01:43:59.000 He's a professor at Johns Hopkins.

01:44:03.000 He's been able to show that our vaccines are not only cost-effective, they're cost savings, meaning that they're economically dominant, that they'll actually save money.

01:44:15.000 The problem is it doesn't help you with the fact that you still need some, but the return is on public health.

01:44:20.000 You still need somebody to come along and provide that investment.

01:44:24.000 So what's happened is our technical ability to develop vaccines has outstripped our financial instruments that we have to do it.

01:44:35.000 So I get a stream of young people In my office, wanting to go into global health, I mean, the commitment for this next generation, I know they get a lot of bad press, but my impression is this next generation, their commitment to public service is at an all-time high.

01:44:49.000 And they say, you know, Dr. Hotez, I'm all in. 0.99

01:44:52.000 I'm going to go into global health.

01:44:53.000 And they're a little bit disappointed when I tell them, get an MBA. Or get a law degree because where we need the innovation now is in the finance sector.

01:45:04.000 There must be a business model out there that would work, that would figure out how to do this.

01:45:10.000 I just don't have the background to do it.

01:45:12.000 It seems like once the momentum is in the corner of this being handled by the private sector, And that the private sector has to develop these vaccines and these treatments, and they have to do it with some sort of a financial incentive.

01:45:25.000 If they don't have a bucket of gold at the end of the rainbow, they're not going to take a ride.

01:45:29.000 That's right.

01:45:30.000 That's right. 1.00

01:45:30.000 Fuck! 1.00

01:45:31.000 That's crazy! 1.00

01:45:32.000 But that's the reality.

01:45:33.000 And so the exciting thing about what I do is developing these vaccines for poverty-related diseases.

01:45:42.000 There's no roadmap.

01:45:44.000 Right now that we're in clinical trials, I don't know what the roadmap is to get to licensure and getting these vaccines out to the public.

01:45:51.000 The terrifying thing, the thing that keeps me up at night, is there's no roadmap.

01:45:55.000 So it's both good and bad.

01:45:57.000 How much does it cost to get a vaccine, in general, from developmental period to actual application?

01:46:06.000 Well, the pharmaceutical companies have traditionally said billions, but I don't think that's the case.

01:46:12.000 I think one of the reasons they're doing that is because they're also recovering their R&D costs.

01:46:21.000 They're putting money into R&D that they charge in order to either make a profit or at least stay even.

01:46:32.000 The cervical cancer vaccine, the HPV vaccine, that when I last looked was $420 for the three doses.

01:46:39.000 It doesn't cost $420 to make that vaccine.

01:46:45.000 It's just that they're recovering their R&D costs, which is fair enough.

01:46:50.000 So one of the things that we're proposing to do for our neglected disease vaccines is we'll delink the R&D costs.

01:46:57.000 In other words, if we've gotten Grants, whether it's from the Gates Foundation in the past or the NIH or the European Union or the Dutch government or the Carlos Slim Foundation, we're not going to pass those costs on.

01:47:10.000 We'll just, you know, that was used for R&D and we would just cause for the cost of goods.

01:47:14.000 So at least we can get it down to just a couple of dollars a dose, a few dollars a dose.

01:47:19.000 Now, for anybody that's listening to this conversation and they have additional questions, where's the best place that you should guide them?

01:47:26.000 Would it be your books?

01:47:27.000 Probably the books, because I wrote the books for lay audiences.

01:47:31.000 Lay audiences, sort of.

01:47:32.000 I mean, somebody with a university education.

01:47:36.000 I mean, they're not, you know, they're published by Johns Hopkins University Press, and they are kind of, they're uneven in terms of how weighty they get into the science, but certainly the vaccines do not cause racials autism.

01:47:52.000 I wrote it with the idea of parents, vaccine-hesitant parents, and also the pediatricians.

01:47:56.000 Because the other problem with pediatricians is, you know, they're there in their office and parents are reading this stuff on the internet.

01:48:03.000 And they come and loaded for bear into the pediatrician's office with all these factoids.

01:48:08.000 And the pediatrician's like, well, gee, I never heard that before. 0.96

01:48:11.000 And then the pediatrician is made to feel stupid, like he's not keeping up with the science. 0.98

01:48:15.000 He is or she is. 0.99

01:48:16.000 But it's just they're not keeping up with the misinformation.

01:48:19.000 So I provide talking points in the epilogue of the book.

01:48:22.000 And Blue Marble Health is the best resource for people to understand these… About diseases of the poor in wealthy countries.

01:48:30.000 Then I have a third book that I wrote a few years ago called Forgotten People, Forgotten Diseases that describes the neglected tropical diseases.

01:48:37.000 Well, I really hope that what comes out of this is someone gets motivated to create some sort of a documentary really on both subjects.

01:48:45.000 I mean, I think that we'd greatly benefit from some clarity for people that do have concern about autism that's in a digestible form.

01:48:54.000 For good or for bad, people like to watch documentaries.

01:48:57.000 Right.

01:48:58.000 And I hope you don't get too beat up over this because I know the anti-vaccine groups are very passionate and Well, I mean, I don't have a position.

01:49:07.000 I mean, I don't know why they would beat me up.

01:49:09.000 Well, they beat me up a lot.

01:49:10.000 Well, I'm sure they'd go after you, and they already call me a shill.

01:49:13.000 They call me a shill for a lot of things, though, leaving the round earth.

01:49:17.000 Jamie has a t-shirt that he sells at youngjamie.com.

01:49:20.000 It's round earth shill.

01:49:22.000 Literally.

01:49:23.000 I've been called a round earth shill.

01:49:25.000 There's a lot of those.

01:49:27.000 I don't know if you know.

01:49:28.000 I didn't know that.

01:49:29.000 There's a lot.

01:49:29.000 So you get beat up no matter what if you're talking.

01:49:32.000 But I really think it would do a good service if somebody did put together a documentary because I think most people are just relying on this fear that vaccines do cause autism.

01:49:47.000 There's also this connection between people that are older, correct?

01:49:50.000 When they're older and they have children, there seems to be more likely...

01:49:54.000 There seems to be.

01:49:55.000 And that may be related to as you get older...

01:49:57.000 Your sperm or your egg have some genetic instability and more likely to produce mutations.

01:50:02.000 That would go hand in hand with the genetic basis of autism.

01:50:08.000 And then the Blue Marble Health book.

01:50:10.000 I mean, what you've been saying today about these diseases and how many of them exist and how many of them are almost unknown, untreated, undiagnosed, and just how many people are unaware.

01:50:23.000 I really hope that someone does something about that too.

01:50:25.000 But in the meantime, people can buy your books.

01:50:27.000 Are they available in audio as well?

01:50:30.000 Definitely the vaccines do not cause Rachel's autism.

01:50:33.000 It's audiobooks and I'm not sure about Blue Marble Health.

01:50:36.000 Okay.

01:50:36.000 But you can get it on Amazon.

01:50:37.000 Well, thanks for being here.

01:50:38.000 I appreciate it.

01:50:39.000 It's good to see you again.

01:50:40.000 Well, thank you for raising awareness of all this stuff.

01:50:42.000 I really appreciate it, Joe.

01:50:43.000 My pleasure.

01:50:44.000 And I appreciate you coming down here and explaining a lot of this stuff for us.

01:50:48.000 It's been a great time.

01:50:49.000 I really enjoyed the opportunity.

01:50:51.000 If people want to get a hold of you on Twitter, what is your Twitter handle?

01:50:53.000 Just at Peter Hotez.

01:50:55.000 Okay.

01:50:55.000 Thanks, sir.

01:50:56.000 Appreciate it.

01:50:56.000 Thank you.

01:51:05.000 Thank you.

The Joe Rogan Experience - March 11, 2019

Joe Rogan Experience #1261 - Peter Hotez

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