Transcript: Jodidi Lecture | Bending the Arc at the Hinges of History with Dr. Larry Brilliant

For the 2023 Samuel L. and Elizabeth Jodidi Lecture, Larry Brilliant sat down with Harvard Professor Erez Manela for an on-stage conversation. 

March 29, 2023 at Memorial Church

EREZ MANELA: Well, thank you, everyone, for coming. I didn't realize quite how high up this was before I walked up here. On behalf of the Weatherhead Center for International Affairs at Harvard University, I want to welcome all of you to the 2023 Samuel L. and Elizabeth Jodidi Lecture. We welcome those of you attending in person here in Memorial Church at the heart of Harvard Yard as well as those of you watching this online. 

My name is Erez Manela. I am a professor of history at Harvard and also the current acting director of the Weatherhead Center for International Affairs. The Jodidi Lecture, established in 1955, is among the most distinguished lecture series at this university. It is intended, and I quote, "for the delivery of lectures by eminent and well-qualified persons for the promotion of tolerance, understanding, and goodwill among nations and the peace of the world," unquote. 

Given this mandate, I can think of few people more qualified to deliver this lecture than our speaker today, Dr. Larry Brilliant. Dr. Brilliant, physician, epidemiologist, technologist, and philanthropist, was born in Detroit, Michigan in 1944. The first generation college student from an immigrant family, he received his undergraduate education in philosophy from the University of Michigan. He also earned a master's of public health degree from Michigan and an M.D. from Wayne State University in Detroit. 

Inspired by a lecture he heard Dr. Martin Luther King Jr. deliver at the University of Michigan in 1962 while Larry was an undergraduate there, he joined the Civil Rights Movement. Moving to San Francisco [AUDIO OUT], he became involved in the counterculture and even appeared as a quote unquote "hippie doctor" in the 1971 film Medicine Ball Caravan, which tells the story of a group of hippies who set out on the bus tour to spread the gospel of flower power around the United States. I have heard Larry say that this is a terrible movie, but he didn't make it. So it's not his fault. 

Traveling to India on a spiritual quest, Larry lived in a Himalayan ashram until his guru, Neem Karoli Baba, instructed him to go to New Delhi to work for the World Health Organization's smallpox eradication program and predicted, the guru did, that smallpox would soon be eradicated from the world at a time when most people were skeptical. Learning epidemiology on the job, Larry became a pivotal figure in a historic campaign that, by the late 1970s, had achieved the worldwide eradication of one of the oldest and deadliest diseases known to humanity. 

Returning to the United States, Larry served for a number of years as a professor of epidemiology and international health at his alma mater, the University of Michigan. While there, he and his wife Girija cofounded the Seva Foundation, which has helped restore eyesight to at least 5 million blind people in two dozen countries around the world. In 1985, with Stewart Brand, he also cofounded The Well, widely seen as one of the first online social networks. The Well, I think you told me, stands for Whole Earth 'Lectronic-- what was it-- List? 

LARRY BRILLIANT: Whole Earth 'Lectronic Link. 

EREZ MANELA: Whole Earth Electronic Link, thank you. In 2006, Dr. Brilliant became vice president of Google and the founding executive director of Google.org, Google's philanthropic arm. That same year, he was also awarded the TED prize. His TED Talk on that occasion, which I recommend to all of you, which was titled My Wish, Help Me Stop Pandemics, has since been viewed more than 1.5 million times. And I have to say, seeing that talk, as I just did again recently from our perspective today in 2023, it really does sound prophetic. 

In 2009, Larry became the founding director of the Skoll Global Threats Fund, and he remains a senior counselor at the Skoll Foundation. From 2010 to 2011, he chaired the White House National Biosurveillance Advisory Subcommittee. He's also the founder and CEO of Pan Defense Advisory, which helps organizations across the private, public, and nonprofit sectors mount effective and timely action in response to the COVID-19 pandemic. 

In 1985, while teaching at Michigan, Dr. Brilliant published an academic book titled The Management of Smallpox Eradication in India. His memoir, called Sometimes Brilliant, The Impossible Adventure of a Spiritual Seeker and Visionary Physician Who Helped Conquer the Worst Disease in History came out in 2016. I recommend that book, also, actually, both of those books to all of you as well. 

He's also a CNN medical analyst. And this summer, he will begin writing a column for Time magazine on the topic of science and religion. I will now invite Dr. Brilliant to deliver his remarks. After that, he and I will chat for a while on stage and then open the floor to questions. And I'm told there will be a microphone at the center there for you to come to and ask your questions. Dr. Brilliant, Larry, it's a real privilege to have you here. 

[APPLAUSE] 

LARRY BRILLIANT: Yes, it's high. The other 2,000 people who were coming have decided to work from home in order that we could better practice social distancing. But it's nice to see so many old friends here. Can we do a sound check? Because there's a big echo. Is it OK? 

Thank you, Erez. Thank you very much for that kind and overly generous introduction. And I also want to thank the Weatherhead Center for International Affairs and the supporters of the Samuel L. and Elizabeth Jodidi Lecture for inviting me. I also want to thank Sarah Banse, who has made our trip here so smooth. She's a remarkable treasure. 

So in preparing for this, I watched some of the previous lectures. Apart from making me feel inadequate, they really inspired me. And in particular, if you have a chance to listen to them, please listen to the talk by the Aga Khan. It's so wonderful. His defense of democracy as a Pakistani American actually, a Shia Ayatollah, his defense of America, will bring tears to your ears, maybe to your eyes too. 
To the students here, thank you for coming. I know that the last couple of years have been a very rough time. You've been through the pandemic, the Russian invasion of Ukraine, economic uncertainty. And I'm sure that you feel like one, two, or three years of your life have been put on hold. It will get better. 

My hope today is to leave you, if not inspired, at least to introduce you to a handful of inspiring people. Most of them work in the area of global health. They've inspired me. 

And as the title of the talk indicates, they have tried to bend the moral arc of the universe towards justice. If you have one thing to take away from today, please know there's still plenty left of opportunities yet to be won so that you, too, can help bend the arc towards justice. Because it hasn't all been done just yet. 

So I want to explain the title and the two parts of the title. I want you to, when we talk about helping to bend the arc, that's a very common phrase. We've all heard that. We've heard Obama talk about that. We've heard Martin Luther King talk about that. I'm going to tell you a little bit more about that. 

But you're probably less familiar with the term the hinges of history. Many historians have tried to identify inflection points in history and, particularly, those who've studied Western civilization, crossroads, perhaps, in the long human history. I have particularly been fond of the formulation of Thomas Cahill, who wrote a seminal six volume series called The Hinges of History, the formative moments in Western civilization. 

He was a classicist, who was studying to be a Jesuit priest, received a Pontifical degree, then studied Hebrew scripture at the Union Theological Seminary. He received another degree in philosophy. And he's not boring. He writes amazing prose. You've heard of some of his books. You heard How the Irish Saved Civilization. 

Maybe you've heard of The Gift of the Jews, one of his books, The Wine Blood Sea, Why Greeks Matter. Maybe you've heard of his books about Jesus and the life of the early followers of Jesus called Desire of the Everlasting Hills. He's tried to take those moments in time and stitch them together and, out of that stitching, to make a story of Western civilization. 

I hope you get the feeling that learning about hinges of history is also not boring. And that brings us to the other part of the title, bending the arc. I know Martin Luther King is widely attributed with bringing that title to us, but he was not the first of the people who talked about bending the arc. Although, certainly, the Civil Rights Movement was a hinge of history. And Martin Luther King was bending the arc at the hinge of history. 

But the earliest recorded use was right here or close to here in Boston by Theodore Parker, a Unitarian minister in Boston, who in 1750 and who was a compatriot of Emerson, and Thoreau, and an abolitionist fighting slavery, he wrote, "I do not pretend to understand the moral universe. The arc is a long one. My eye reaches but a little way. I cannot calculate the curve. But I can, by conscience, divine it. And I am certain that it bends toward justice." 

I first met Martin Luther King in Ann Arbor, Michigan, November 5, 1962. He was not yet so famous. He had not yet gotten his Nobel Prize. There had not yet been a letter from Birmingham Jail. 

The day that he came, Michigan was subject to one of its unusual weather events. If any of you've been there, you know that some days the rain does not fall vertically. It comes after you like a fierce gale horizontally. Nobody in their right mind would go out. And the hall that he was to speak in held 3,000 people, and less than hundreds of us got there. 

It was a tough time. The president of the university stood up and apologized. I was a very depressed sophomore. My father had just been diagnosed with cancer and was dying. I had no purpose in my life. 

No one in my family of immigrants had ever been to college. I thought it was a fluke that I was at the University of Michigan. I had won a full scholarship by accidentally doing well on a state math test competition. 

I'd been awarded a slot in the honors program in atomic physics. Yes, I'm so old that nuclear physics had not yet been invented. But watching my dad dying did not make me feel very comfortable about the idea of atomic physics working to make atomic bombs less than two decades removed from Hiroshima and Nagasaki. 

When Dr. King looked out and saw us, this mangy group of 100 people, he laughed so hard. There was something magnetic in his laugh. He looked around. And he said, I'm just calculating that they'll now be more of me to go around. 

He said, there's plenty of room here on that stage. It was a parquet floor stage much larger than this. He said, you all come on up. And all 100 of us sat with him. It was supposed to have been a 40 minute lecture. We stayed with him for 6 hours as we moved around Ann Arbor. And he gave talk after talk. 

And we were infected with a virus. We were infected with the virus of activism. I think we were infected with the virus of the search for justice. He talked about his faith, his dream, his confidence, that the moral arc of the universe was getting better. 

But he said it would not get towards justice, that arc would not get toward justice, unless you get off your ass, jump out of your seat, leap up and grab it, and bend, and pull that arc down towards justice. It won't get there without you. And in saying that, everyone thought he was talking directly to them because we were all heartbroken about the Vietnam War. 

This was the time of the Bay of Pigs. Bob Dylan was singing Hard Rain's Going To Fall. The horrors of racism were tough, and they were going to get tougher. So we knew we had to get off our butts and pull at that arc and drag it towards justice. That's what he told us to do. 
That time was a hinge of history. The Civil Rights Movement was a hinge of history. I think today is also a hinge of history, I think the moment that we live in right now. 

I come out of a world of global health that depends on international cooperation, a time when the UN was respected, WHO was valued. To eradicate smallpox, we had doctors from 100 different countries working together. We had Americans and Soviets, Russians, bury whatever hatchet had divided us and work together, many becoming long time friends. 

I think today, if you think of what the world is now and you think of Modi in India, Putin, and Xi, and Erdogan, and Orbán in Hungary, if you think of Trump, if you think of Bolsonaro, if you think of a world that is dominated not just by populists, but by nationalists who don't just say America first, they say the Philippines first, or Russia first, or China first, how can we ever find a way to work together in an environment that is as centrifugal as today? 

When we worked in smallpox and in polio, it was a centripetal time where all the forces of history were bringing us together. Every incentive pushed us to work together. But it's important for you to know always that, even though we also have a war today and we've also gone through a period of huge injustice, racial discrimination, and you guys have been stuck with the pandemic to boot, this is a time and a place for you. That was Martin Luther King's incredible offer, that at any time in history wherever you are you can still help bend the arc and pull it more towards justice. 

How is that possible? We can't all be Martin Luther King. Well, that's true. But perhaps it will help you if I introduce you to a few more people whose lives shine a different kind of light on bending the arc. First of all, I want to talk about someone we call Dr. V. 

And there's two of my friends here who know very well Dr. V was Dr. Govindappa Venkataswamy. Dr. V was an ophthalmologist in India. He began life as an obstetrician, but he developed a kind of crippling arthritis. And his fingers looked like crippled pretzels. And he couldn't catch a baby. His hands were not strong enough to hold an 8 pound baby or 7 pound baby. 

So he decided, instead, that he would try to catch a lens, the cataract lens when it is removed. They call it delivering the lens. So he became an ophthalmologist. 

We met him when he was just starting his hospital, the Aravind Eye Hospital. At that time, it was an eight-bed hospital. And all eight beds were in his house.  He had come to the University of Michigan the guest of another ophthalmologist, Carole West, who was there. And we were just starting the Seva Foundation. Since then, Aravind has partnered with the Seva Foundation to restore sight to more than 5 million blind persons and counting. 

I take Dr. V first because he came to Harvard, and he delivered the Witt Lecture. And in one day, he spoke at the School of Divinity, the medical school, and the Harvard Business School. I think that gives you an idea of what a polymath he was. 

He was a follower of Sri Aurobindo, who was a Bengali revolutionary fighting with Gandhiji, who then became a deeply respected Indian spiritual teacher living in a French colony, Pondicherry. He lived in a French colony because that was the only way the British couldn't find him and arrest him. He also became a devotee of Sri Aurobindo's partner, the mother of Pondicherry. 

When Dr. V had this vision of eliminating needless blindness, that was considered a fool's errand. At that time, the intraocular lens, which is what is put into the eye when the cataract is pulled out in order to cure the most common cause of blindness, that intraocular lens cost $500. It was impossible to think that you could give back sight to the 12 million Indians who are on the waiting list waiting for surgery. Most of them were doomed to die before they could get a $500 lens. 

Dr. V loved the idea of scale. He loved the idea of Google going to scale. But most of all, he loved McDonald's. As a Hindu, he didn't really love McDonald's hamburgers. But he loved McDonald's University, which is called Hamburger University. 

So he took a course at Hamburger University in order to learn how to use the best assembly line kind of techniques so that one doctor, instead of operating on three people in a day, could operate on 200 in a day. And by doing so and reaching scale and then ultimately by manufacturing those intraocular lenses in India, in Madurai, the cost of the lenses went down from $500 to the manufacturing cost of $0.86. That makes it appropriate technology. 

Very often, we fight over what's appropriate technology. I'll just tell you. Appropriate technology is that which everybody can afford. He was an amazing and inspiring man. 

I also want to tell you about some people who worked in the smallpox program who are heroes to me and very inspirational. I wish I could name every single name, but I'm going to name a few just so you can hear their names and understand the diversity and the countries that they came from, their religions, and the languages they spoke. I'll start with Zafar Hussain, who was a Muslim paramedic who saw a child die of smallpox, and learned that the child's name was also Zafar. And he decided to spend his life working to eradicate smallpox. Almost all of us who came to the program were taught by Zafar Husain. 

I want to mention D.A. Henderson. D.A. was a Calvinist, went to Oberlin. He was the head of the EIS program at CDC. And a Russian minister of health, Professor Zhdanov, suggested to WHO that the world come together and work on one thing to prove that we could work together and proposed eradicating smallpox. 

A lot of people thought it would fail. Many people thought by having an American doctor run it, if it did fail, wouldn't be so bad. But DA fooled him. He became an amazing manager. All of us benefited from his ability to get us to work hard and all look in the same direction. 
Some other names I'm going to mention, just so you hear their name, Muni Inder Dev Sharma, the commissioner of health, who once told Mrs. Gandhi, the prime minister, that if she followed through and kicked me out of India, as she was planning to do, he would adopt me. And then she would not be able to kick me out of India. For the whole program, he called me "Sonny," and I called him "Papa." 

Lev Khodakevich, this wonderful Russian epidemiologist. Zdenek Jezek a Czech epidemiologist. Albert Monnier from Mexico. Ciro de Quadros, from Brazil. The wonderful Isao Arita from Japan, who taught us all a very different kind of management for which I'm so grateful. And my friend, T. Stephen Jones III, who we call Uncle Steve, who's here in the audience. 

Uncle Steve and my friend Mirabai Bush also worked with my wife, Girija, and I to start the Seva Foundation. We worked through smallpox and blindness. I wonder what's next. 

I wish you could have known all of these people, every one of them. There were over 1,000 who came to India from all over the world and worked together. I wish we could do that again. We've seen great work in the polio eradication program. People have come from all over the world. 

We're having a little trouble with the last country, Pakistan, which only has under 15 cases of polio that we know of. We're doing great with Guinea worm because of one man, Jimmy Carter, who has almost single-handedly put the resources at his disposal together to get rid of a disease, which is a biblical disease called Dracunculus, "the fiery serpent," one of the most painful diseases that there is. 

There's a wonderful lesson, a moral lesson, from global health because it requires all of us to work together. But I'm going to focus on two smallpox heroes tonight. That's just because I can't focus on all of them. 

Nicole Grasset, who was Steve and my boss, she was a great admirer of Pierre Teilhard de Chardin, who was both a priest and a paleontologist, a scientist and a religious leader, a Jesuit who believed that understanding evolution was not a sin. Indeed, it was the key to spirituality. To understand evolution was the key to spirituality because that's how God works. 

She was also influenced by Paul Tillich, a German-American Lutheran theologian and an existentialist, who some called a religious socialist, who taught for some time here at the Harvard School of Divinity. Nicole, who ultimately won the Legion of Honor, was in part because she personally flew into Biafra in Nigeria during the civil war bringing vaccines for the children who would otherwise surely have died during that conflict. 

She was the World Health Organization woman of the year. And she led the Smallpox Eradication Program in India, Bangladesh, Nepal and Southeast Asia. She was so inspiring, a generation of young epidemiologists drew strength from her strength. We used to call her a hurricane on Gucci shoes because she was always perfectly coiffed even in the mud of Indonesia. 

Just to understand Nicole, after we had eradicated smallpox when everybody was going back to their university, going back to teach, going back to the government, Nicole said she wanted to do something that no woman had ever done. She wanted to drive alone from New Delhi to Paris. It was a pretty dangerous drive in those days. She had a very rusty old Toyota. 

But she decided that she could picture herself driving through the Khyber Pass. And she took her trusty Toyota, and she took her dog. And for safety, she took a gun. But because she was a Gandhian at heart and nonviolent, the gun was a starter pistol. It could only work to frighten. It couldn't work to kill. 

Afterwards, she wrote an article in Paris Match about her adventures. And that's what got her a lot of notice within France. When Erez and I were first talking, he confided in me that he had one of the only existing copies of her biography, which was written in French. The reason there are so few existing copies is because she thought it flatted her too much. And she had a judge ban all of them. Now, you get the picture of Nicole Grasset. 

I want to talk about Bill Foege. Bill Foege is known by a lot of people here in global health because he was the head of the Center for Disease Control. And he was the head of the Carter Center for Jimmy Carter. When Jimmy Carter was asked, how is it possible that you are the greatest ex-president? He said two words, "Bill Foege." 

Bill's grandfather was a Lutheran minister. His father was a Lutheran minister. And Bill was a Lutheran medical missionary in Nigeria during the Biafran Civil War. 

There was a big outbreak of smallpox. He had a very small quantity of smallpox vaccine. Under normal circumstances, the minister, the minister's cousin, the people who were rich and powerful, would have gotten the vaccine. 

Bill thought, what is the most moral thing that I can do? And he decided that the most moral thing you can do with the scarce vaccine in the middle of an epidemic is to vaccinate the people who are most likely to get the disease and get sick. So he scouted out every case of smallpox. And he vaccinated people who lived next door or were connected with the people who were infected. 

Now, right now, that seems so kindergarten and so obvious. They've given it name called ring vaccination, which is really not a really good name. But you understand the visual. It didn't exist before. 

In those days, in order to get rid of a disease when you had a vaccine, you would do mass vaccination. You would vaccinate everyone. What Bill did changed everything. He bent the arc. He bent the arc in a very meaningful way. I think, without Bill's insight, we'd still be working to eradicate smallpox. 

He did something else, too, which is not only did he do ring vaccination in Africa. But when he came to India, he also introduced the idea of search and containment. Find every single case. We literally had to find every single case of smallpox in the world at the same time. 
We had 150,000 people in India. We made over 2 billion house calls. But that alone was not enough. Bill wanted us to double down on the places and the people who are most likely to get smallpox and get sick. 

Well, that meant we worked with migrant workers. We worked with Aboriginals called Adivasis in India. We worked with the people who worked in the brick kilns because it was the lowest paying job. We worked and doubled down on people of the lowest caste or of Muslims who were the poorest living in cities. 

And by doing that, we did what Paul Farmer said to do, which is to consider a special option for the poor. I don't know that we did it consciously. But in retrospect, it's one of the things that made it possible to eradicate smallpox. 

But that does give me a chance to talk about the last person I'm going to talk about tonight. That's Paul Farmer. Of all the people I've talked about, he's the one best known to the Harvard community. Paul died recently way too soon. You may know him from some of the books written about him or one of the articles that he did or the talks that he did. 

But I became friends with Paul in the 1990s. We were both on the road raising money. I was raising money for the Seva Foundation. Paul was raising money for Partners in Health. We met at UCSF when we were both doing a seminar on global health. 
Our friendship blossomed when I was running Skoll. And we gave Paul and Jim Kim and Ophelia, the Partners in Health, at $1.5 million award as one of the first social entrepreneurs in the country that we named a social entrepreneur. It was a three year grant. It was given simultaneously to the leaders and the organization. 

Over the next two years, they so showed such amazing progress we did something we'd never done before, which is we gave them another one and then another one. It was the best investment we ever made. I will tell you about Paul, that he was working to improve the health of Rwandans and Haitians. Both of those places are pretty hot. 

Every year, we would meet in Oxford, which was pretty cold. Every year, he would show up coming from Rwanda or Haiti without a sweater because he was coming from a hot climate. Over the next seven years, I lost seven sweaters to Paul. He was such an amazing inspiration to everybody who knew him. 

I'd like to recommend a book and a movie to you. Of all the books that Paul wrote, the one that has the most salience to me, and I hope for you, is a book called In the Company of the Poor. And he wrote it as a conversation between Paul Farmer and Father Gustavo Gutierrez, who is one of the founders of liberation theology. And liberation theology infused everything that Paul did. 

It was in liberation theology that Paul found the way to define his mission and his mission for work in global health. And it was in the application of global health that Father Gutierrez found one of the most vivid examples of what public health doctors can do when they show a preferential option for the poor. 

Oh, and the movie, the movie was made by the Skoll Foundation. And it was about Paul, and it was about Jim. And it was about Ophelia. And the name of the movie should not surprise you. It was called Bending the Arc. 
So there we are, bending the arc at a hinge of history. We're here now at another one, and every one of us has a role to play. We may not know what it is. But like Paul, we'll find it if we look hard enough. But you may have to get off your ass, jump out of your seat, get up, grab it, twist it, and drag it down towards justice. Thank you very much. 

[APPLAUSE] 

I hope those of you who are listening to this streaming heard that. 

EREZ MANELA: Want to get your-- Coke's yours. 

Yeah. 

Are the mics on? Yes, good. Thank you. 

Larry, thank you very much for this. I have to say, since you ended with an injunction to get off our asses, I'm glad I'm the only one who was able to get up at that point in time. So apologies to the rest of you. 

I want to start with the hinge of history, actually. Because as a historian, as you mentioned, we think a lot about those moments in history. We think of them largely in retrospect. But nevertheless, we try to figure them out. 

Sometimes we call them moments of plasticity or periods of plasticity where more rapid change is possible. And one of the reasons we tend to think of them in retrospect, I think, is that history is very tough to figure out going forward. You can only really figure it out going back. 

One of the things I like to tell my students is that, as far as I can tell-- and maybe just me. But as far as I can tell, the one big lesson of history is expect surprises. Because we see time and time again that the events, the moments, of plasticity of change, of radical change, that we can identify in retrospect were, by and large, very surprising to the people who lived through them. 

But I said all this to point out that it seems as if the COVID-19 pandemic was an exception to this rule. Because if one watches your 2006 TED Prize talk, you lay out a scenario. And you even have a kind of graphic illustration of a scenario that looks eerily like the COVID-19 pandemic in the way that you have this thing breaking out in Asia and then spreading out. And you actually say, within a few weeks, it'll spread out to the entire world. It almost sounds as if you were peering into the future. 

And if one watches the 2011 movie Contagion-- how many here have seen this movie Contagion from 2011? So Larry was involved in making the movie as part of his involvement with the Skoll Foundation. And you told me part of the idea was to reach a broader public with this message, the sort of people who might not watch a TED Talk, but would go see a Hollywood movie. And that movie, too, if you watch it now, seems eerily prophetic, right down to the very last closing scene of the movie with the bat dropping in whatever it was, a piece of fruit-- I think it was a banana-- and the pig eating it, and then being picked for a restaurant, and being eaten by Gwyneth Paltrow. And the pandemic begins. 

And so I say all this to point out that, unlike most big historical events, it seems like the COVID-19 pandemic was not a surprise, that people in the know expected it and expected it to unfold more or less as it did. And I guess my question is, if that's the case, do you think we ought to have been more prepared for the pandemic that began three years ago almost exactly, at least here? And also, if you think that, how can it be more prepared for what appears to be the inevitability of another pandemic? And I mean this both as Americans, but also as just humans. 

LARRY BRILLIANT: Are you asking for a letter grade on our performance? Because-- 

EREZ MANELA: You can start with that, yeah. 

LARRY BRILLIANT: --I'd like to use the whole alphabet. 

EREZ MANELA: Yeah, we can start with that. 

LARRY BRILLIANT: I don't think an F is low enough. First of all, people like Laurie Garrett have been warning us about this for years. There's so many Cassandras because most of the epidemiologists who work in the field have always been saying it's not if it's when. No one knows the date, but it was a certainty. And it still is a certainty that there will be more pandemics as population increases, as we cut down more forests, as humans and animals live in each other's territory, as we eat more animals, and as we exchange vital fluids with chimpanzees, and as bats live in our territory, and the pressure to come closer and closer together to wild animals is such. 

A colleague of mine at Columbia estimates that there are 300,000 viruses in animals that have yet to be named and discovered that are capable of infecting humans. That doesn't mean that they're capable of killing humans or being pandemics, but it gives you an idea of the universe of unknown viruses that we're dealing with. So, yes, it was predictable. 

It wasn't predictable that this would be a coronavirus or an influenza virus. But it was probably predictable that the diseases that we think about with such passion and pathos-- when we look at HIV/AIDS or Ebola, we know that those diseases, as horrible as they are, they can't become the kind of pandemic that brings the world to its knees. A virus that has a 6 month incubation period and one that's spread by vital fluids can't achieve the liftoff velocity that a virus that spread respiratorily can. 

So we should have been more prepared. I think we were prepared. Actually, I think George Bush, for all of his faults, he was the most prepared of the presidents. He began the National Biosurveillance Advisory Subcommittee. 

He created a post in the Security Council for a physician. That post was filled by Obama as well. We had an admiral in that position until Trump came. And he, for reasons that we can't understand, just removed that admiral is one of the first things that he did, therefore blinding him to the constant vigilance that it takes to be prepared. 

Beginning even before Bush, we have a national stockpile. If we have a vaccine, we keep it. If we need needles, they're there. If we have antibiotics or antivirals that will work, they're kept there. They were well and fully stocked until the Trump Administration. 

There's something about the politics of wanting small government. It doesn't make people who want smaller government immediately make efficient governments. And we are the inheritor of that schism that has occurred between the left and the right where the right wants smaller governments and doesn't want government interference. And if there is a poster child for something where you do want central government and you do want interference, it's a pandemic. 

The irony, I think, is that early on in the pandemic the countries that did the best were not the democracies. They were that very same group of countries that I'm regaling against because they had a central administration. Now, they didn't do very well in the later stages of the pandemic when we had vaccines, but they did better in the beginning. 

I think that we should not necessarily be going back in time. Although if anybody is interested, the National Academy of Sciences will be having a symposium that's open to everybody. It's going to be virtual on May the 4th, May the 18th. And there'll be perhaps a third day where we'll be looking at country by country and trying to analyze what went well, what went wrong, what we need to do. 

There's probably 50 of those meetings. Every group I know is having a postmortem. It's very difficult to have a postmortem when the body is not dead yet. Because we are in the middle of the pandemic, not at the end. 

I want to say that here, when we've lost the ability to see how many cases there are, because antigen testing does not report into public health services, because people aren't testing, because we've lost that, we really rely on wastewater surveillance to know what's the direction of the current pandemic. And in Boston, in the Northeast right now as we speak, one out of three of the people sampled in wastewater is infected with COVID. This is the highest it's been in many months. 

We're probably getting one of these boom cycles due to the spring beginning, students going away for spring break. And I don't know where this will go. We have a couple of new variants. We're not very good at marketing in global health. 

I mean, the new variants are called these charming names, XBB 1.9.1. And if you didn't get it that time, the other one is XBB 1.9.2. These variants are the most transmissible viruses we've ever seen. They're the most transmissible of the variants because they are the leaders. That's how they became the surviving variant. 

But they don't seem to be more dangerous, at least not yet. But we can't tell if the reason that they don't seem to be more dangerous is because they're really inherently less dangerous, or because they're coming up against a wall of immunity. Because I'll bet many people in this room-- let me ask. How many of you have been vaccinated five times? 

How many of you have had COVID? How many have been vaccinated at least three times and have had COVID? Look around. This is our wall of immunity, those three groups. 

So if a virus came-- I guess you could make a joke about it at a bar or something. But if a virus walked in the room, it would not find a receptive audience. But this is not true for the whole country. I mean, there are parts of Alabama where nobody's had five doses of vaccine, where it's more common to find two if any. 

And even nationwide of the best vaccine, the hybrid vaccine, the most recent one, only 25% of Americans have had it. So we have the tools to create a wall of immunity. Because of it, we can't tell whether this variant is worse in terms of severity or not. But we know it's inevitable. And we don't know what's going to happen next. 

For those who are cheerfully saying that the disease is done with us, I'd point out there are now two dozen animals that are infected with SARS-CoV-2 with the virus that causes COVID. And that includes everything from the great apes in Rwanda to the big lions and cats in zoos, most of the white-tailed deer in the Northeast. Minx famously had to have mink farms destroyed because of it. It doesn't mean that inevitably it's going to bounce back, and be a terrible thing, and we'll have to relive 2020 all over again. But it is a reason not to celebrate and have a postmortem too early. 

My colleagues and I were asked to predict the next pandemic. That's a fool's errand. But we did it anyway. I think the inference is probably correct, that we're foolish to do it. 

But Foreign Affairs Journal, last month, we did an article called "Inevitable Outbreaks." And Paul Farmer loved this quote. He always-- outbreaks are inevitable. Pandemics are optional. It's our option whether we let an outbreak become a pandemic. 

But we looked at all the diseases that we've seen recently, whether it's Ebola, or Marburg, or MERS, or SARS. And we looked at some of the old friends, the cholera, the plague, tuberculosis. And we tried to figure out what category of disease is likely to be able to cause not just a pandemic technically, but one that could, again, bring the world to its knees. 

And we came up with two groups, influenza viruses and coronaviruses. Those are the most likely based on history, but it is in the being of a novel virus that it's novel. And there are a lot of other things that could come our way that we don't yet know about. 

Are we prepared? I don't think we're prepared at all. I think that the first thing you have to prepare for, the most important thing to be able to deal with a pandemic or any epidemic, is you have to have public trust. Without public trust, there's no public will. Without public will, there's no political will. And I don't think anybody in this room would say that any of the institutions in America are having too much public trust. 

So that puts us at a disadvantage right away. So many good epidemiologists, so many great virologists, so much wonderful success in making a vaccine-- the mRNA vaccines are a miracle. The fact that it was done in one year-- I mean, the previous winner in the clubhouse was four years. And that was for mumps vaccine. 

We had a smallpox vaccine for 170 years before we eradicated smallpox. We had a polio vaccine for 70 years before we even embarked on a global polio eradication program. Being able to make a vaccine that quickly is amazing. 

And yet, we have some people in Congress who are absolutely certain that it doesn't work or that it's got a little chip that Bill Gates put in it in order to control them. That's not something public health can fix. That's above our pay grade. But we need to figure out a way to make that work. Otherwise, nothing's going to work. 

EREZ MANELA: It's fascinating what you were saying about outbreaks being inevitable, but pandemics being optional. It reminds me there's a colleague of ours here in history who wrote a book about the US getting into the Vietnam War called Choosing War. And the point was that war was a choice that was made. I can almost see a book choosing pandemics about COVID-19. 

One of the things that you were talking about is comparing pandemic responses country by country. And I was struck from the very beginning that a lot of people were talking about pandemic response in that way, in a comparative way. This country is doing this. South Korea is doing that. Germany is doing that, United States, China, et cetera. 

Because I would have thought the conversation would be more about what we are all doing as humanity. And so I want to ask you about the World Health Organization. I once read, when I was doing research on the origins of World Health Organization, that this was founded in 1945. This is a period really before the Cold War heated up. 

There was a lot of optimism with the generation who we had lived through two world wars about the possibility and necessity of international cooperation. And they explicitly chose the term World Health Organization to signify that it wasn't simply international. It was beyond nations. It was about the world. 

So I guess I would say, where would you put the World Health Organization or international health, global health, more broadly in this story? How would you assess the role that they played or didn't play? And I guess, if you were made director general of the WHO, I mean, to what extent has it met its founder's vision? And is that something we should still hope for or work for? 

LARRY BRILLIANT: Well, first of all, the current director general of the World Health Organization is wonderful. His name is Tedros. I think he's the best we've had in a very long time. We should be really grateful that he's there. 

How many of you are in the field of global health? And how many have worked at WHO? Just Steve? So I think pretty much everybody who's worked at who has a love-hate relationship with WHO. Bill Foege, when he was asked about what to do about WHO-- and one of the options presented to him was to start all over again. 

He said, you'll never be able to build it as good as it is if you start it all over again as problematic as it is. The structure of WHO is terrible. If you were starting a company today and you are looking to find members for your board of directors, I don't think you would put all of your customers on the board of directors, all of your employees, all of your competitors, and all of your critics. 

But that's the structure of WHO. It's governed by a World Health Assembly. And decisions are based pretty much unanimously by 200 health ministers who come to Switzerland every year thinking they're going on holiday. They come ill-prepared. 

The structure is regional. So all of the money goes to the regional heads. And the power goes to the regional heads impoverishing the center. So as well-intended as Tedros is, his budget is a fraction of the WHO's budget. And the WHO's budget is a fraction of the budget of Mass General. 

So for example, WHO is the UN agency charged with responsibility for dealing with the health consequences of climate change. And that convergence of health and climate change is vitally important for all of our lives for the next decade. The WHO budget for each country for climate change and health is $25,000. That's for the country. 

I don't think we can grasp how underfunded WHO is. I'm not saying that it's not wasteful. I'm not saying that it doesn't have corruption. I'm just saying, with the amount of money that it has, the corruption is so little money. 

You do have a lot of other issues with WHO. Historically, vertical campaigns, like smallpox eradication, polio eradication, Guinea worm, are not popular in WHO. Because they're trying to build up public health systems all over the world. So they've overinvested in barefoot doctors. The Russians call them feldshers. Chinese call them barefoot doctors. 

And there's a great place for them. But they really are deliverers of medical care and medical services in the villages. I wouldn't necessarily call them public health workers. We don't have a good public health system for the world. 

And WHO has squandered some of the respect that it should have had over the years by making bad choices. In the totality, it's done a very good job. But people look at the mistakes, and they magnify them. 

In the case of COVID, WHO did not declare COVID as a pandemic until March 20th. Almost all of us knew who work in the field that it was a pandemic in January. We had a meeting of a group called ending pandemics January 15. We had people from WHO, and CDC, and the Gates Foundation, and Rockefeller Foundation, all the groups working together. 

We knew then that this was a pandemic. We started writing about it as a pandemic. It took two more months before WHO called it a pandemic. They did call it a PHEIC. Maybe you didn't hear that-- PHEIC. That's a Public Health Emergency of International Consequence, a PHEIC. Did I mention that we're not very good at marketing? 

But by calling it that, it didn't have the salience of calling it a pandemic. And so we lost two months. And during that period of time, we had people in China and in the United States make terrible decisions based on nationalism. 

Trump, when the Diamond Princess Cruise ship tried to dock in Oakland with 1,200 probably infected Americans on the ship, Trump famously said, I do not want that ship to dock in any American port. Because if it does, it'll be counted against my numbers. 

Xi permitted Chinese holiday goers at the beginning of Chinese New Year to pass through Wuhan and to go all over the world knowing that Wuhan was the epicenter of an epidemic while simultaneously not allowing anybody from Wuhan to go any other place in China. That's not WHO's fault. The WHO gets blamed for all those things. 

Trump said in the middle of a pandemic that he would take the United States out of WHO, and he did. History will record that, in the middle of a pandemic removing the US, US expertise, US collaboration, US laboratory agreements out of WHO. So we have a lot to explain to our children, our grandchildren, and our ancestors-- and our descendants. This was not being a good ancestor. 

EREZ MANELA: We met earlier. Before we came here, we met with Harvard's president and provost. And one of the things Larry Bacow asked me to do is to interrogate you vigorously. 

So I'll ask you about the lab leak versus natural origin debate. And I know that this is a scientific debate that's been overlaid and perhaps polluted even with all sorts of political overtones. And I'm interested in where you think the weight of evidence is on this now. 

But I'm even more interested in what you think, if what you think is at stake in the answer. That is to say, if we discover it was a lab leak versus natural origin, what would be the implications for what we need to do going forward perhaps in terms of research or dealing with these types of pathogens? And I remember, by the way, that after smallpox was eradicated there was a whole big debate that lasted for a number of decades as to what to do with smallpox viruses that remained in various repositories and still today remain in various repositories around the world. So I'm wondering what you think about that. 

LARRY BRILLIANT: Well, we have to try to find out where COVID began. We have to do everything that we can to learn the origin story. But if we do it as a criminal investigation, then we're not going to get very far. 

We know that the Wuhan fish market is not really a fish market. It's a wet market. It has animals, and it has fish. And it has people having lunch there, and getting skinned meat and taking it home, and bringing animals to sell, and buying animals for pets or for export. China had promised for years that it would close all of the wet markets. 

And in part, that's because China was the source of SARS-1, the original SARS. SARS-1 wasn't like SARS-2. SARS-2 is very, very infectious, very transmissible. There's a very low death rate, much greater than influenza, but much less than 1%. 

SARS-1 has a death rate of 10% to 60%. It's a hugely fatal disease. It began, we think, in a civet cat, which is like a badger, in a wet market in China. And then the government of China hid it for six months out of embarrassment. 

We wouldn't have known about it as fast as we did were it not for an electronic system in Ottawa called GPHIN, which would troll all the newspapers in the world in 11 different languages, one of which was Mandarin, and found a report in Mandarin that there was an outbreak of atypical pneumonia. A good friend of ours, David Heymann, was an additional director general or assistant director general of WHO at that time. And he was charged with the responsibility of trying to find out what its origin was. 

But we know that it was a zoonosis. It was a disease of animals. And we knew that this particular animal had it. But we wouldn't have been able to find it if we hadn't had a digital disease surveillance system that was trolling all of the publicly available literature. 
So I think China must be feeling deja vu right now. Of all the three possibilities that you've offered, none of them will reflect well on China. If it was a lab accident-- and I want to remind everybody that, when Steve and I worked in smallpox, we would think of the last case of smallpox either being the last case in Somalia or the last case in Bangladesh, depending on whether you're talking about Variola major or Variola minor. 

We wouldn't think of it as being from a lab accident. But the last death from smallpox was a lab accident. And it wasn't in some faraway exotic place. It was in Birmingham, England. It was a woman named Janet Parker, who is a photographer in a lab. 

Her photographic studio was a story above a lab in which smallpox was being investigated under agreement with WHO. And somehow either that virus became airborne and went through the HVAC system, or some other way that we don't know, she contracted smallpox. And she died, and she infected her mother. Her father was so terrified, he died of a heart attack. Maybe he had smallpox, too. 

We're not hating Birmingham. We're not saying they're criminals. It's a tragedy, not a crime, if there's an accident. For those of you who remember only a few years ago, we found a file cabinet that was run by the FDA with an agreement with NIOSH and CDC. And in that file cabinet, there was infectious viruses of smallpox after smallpox had been eradicated. 

Because you can eradicate the disease, which means no human being has it. And it can still be in places. And as you said, by agreement, there are two legal places that have smallpox vaccine-- 

EREZ MANELA: Virus. 

LARRY BRILLIANT: Virus, thank you-- two places that have smallpox virus that has been kept alive-- not really even alive, the virus in liquid nitrogen. And one of them is in Moscow at a place called Biopreparat, which was also used famously for trying to make a biological weapon, half smallpox and half Ebola, and in the United States at USAMRIID CDC. We know those two places. 

And yet we think of smallpox as being eradicated because no human has it and, for a long time, because we also had a huge immunity shield. Because we were vaccinating everybody. Every year, that immunity shield gets less and less. 

That's one of the reasons we had a monkeypox outbreak. As long as you're vaccinating everybody in the world against smallpox, monkeypox can't become a big epidemic. Because the smallpox virus protects you against monkeypox as well. 

So am I stalling? I think I'm stalling. People say that the choices are either that the Wuhan Institute of Virology was doing studies. They call it gain of function studies-- nothing wrong with gain of function studies. 

What that means is you have the virus, and you want to project how might it evolve so that we could make antivirals that work today and tomorrow, make vaccines for today and tomorrow. That's a perfectly legitimate thing, although dangerous and should only be done under conditions that were much more careful than in Wuhan. But it's not a criminal enterprise. That's one possibility. 

There's lots of other kinds of laboratory accidents, though. One accident is that somebody could spill something-- it happens-- and get infected with the virus, not know they're infected, go home and infect their family, who then went out to the market. The Wuhan Institute of Virology is 30 minutes drive away from the fish market. 

There's another laboratory. There's a laboratory that's 300 yards, three football fields, away from the fish market, close enough to go out for lunch, which many of the people who worked at it did. It's called the Wuhan CDC, much smaller. 

In preparing this article for Foreign Affairs, we found movies that were made by the Wuhan CDC proudly talking about how successful they had been in sending out virus hunters to go all over China, all over Myanmar, Burma, all over Thailand, all over India, all over Mongolia looking for bats that might have coronaviruses and bringing back thousands of bats to the Wuhan CDC, which I mentioned was just a short lunch walk away from the Wuhan fish market. Willie Sutton's law, you know, why did he rob banks? Because that's where the gold is. 

I mean, it's not such a great stretch that, if you're looking for bats that have the possibility of having coronavirus, you're going to find some. And if you have 1,000 bats hanging in a closet, it's not so much of a stretch to think that maybe those bats exchanged coronaviruses, and this awful version of SARS-CoV-2 arose from that. That's a possibility. That, to me, is more likely than the Wuhan Institute of Technology, which was a BSL-4 lab, making some horrific mistake. 

But they did make mistakes. But the CDC is a BSL-2 lab, which means they have less precise agreements on how it's kept. And then there's just the Wuhan market itself. 

Now, we've found some blood from a different animal that was being trafficked in the Wuhan fish market called a raccoon dog. Raccoon dog is susceptible to COVID, to SARS-CoV-2. But we didn't find a living raccoon dog. We found blood that had traces of raccoon dog DNA and SARS-CoV-2 RNA on the same swab. 

So does that mean that there was an animal at the fish market that had SARS-CoV-2? If that were the case, it's understandable why the Wuhan seafood market became a superspreader event. But if somebody got one of those bats in the Wuhan CDC and they were done experimenting on it and they wanted to sell it at the fish market, that's another reason why you have a superspreader event at the Wuhan fish market. 

You know, if we could all just get along and do this in a methodical way with good science and good intentions, we would get a lot further than we're going to get in the next couple of weeks in the US Congress where there's politics at stake, money at stake. I think we're going to get a lot of thunder. We're not going to get much light out of the current study. 

EREZ MANELA: Thank you. 

LARRY BRILLIANT: That's more than you wanted to know. 

EREZ MANELA: What's that? 

LARRY BRILLIANT: That's more than you wanted to know. You were holding that question. 

EREZ MANELA: Actually, there's more I want to know, but we can talk about it later. One of the things you mentioned when you were just talking about SARS is GPHIN, which stands for Global Public Health Intelligence Network. 

LARRY BRILLIANT: Good for you. 

EREZ MANELA: Well, you mentioned it in your famous 2006 TED Talk. So I listened to that. And that, if I am understanding it correctly, is a kind of system that scrapes the internet, as it were, scrapes online sources in order to gather information that could lead us to discover that there is an outbreak somewhere around the world. 

And in that talk, I think the mantra that you repeat is early detection, early response, early detection, early response. And of course, it goes to the lesson that you learned in smallpox eradication with ring surveillance, what they called at the time surveillance containment, and now you described as ring vaccination. 

But, actually, that reminded me that connection to the internet, that, although you've had a storied career in global health, you also had a career in technology. And I mentioned in my introduction that you were the cofounder of one of the very earliest online social networks, The Well. You also founded and led a number of other technology companies. 

And I guess what I'm wondering about this is, in the way you've lived your life, you always seem to have a number of different things going on. There's things you do in technology. There are things you do in epidemiology. You're also interested in spirituality. 

And one of the things I've noticed-- and tell me if you think this is an observation that you agree with-- is that it seems to me that one of your skills is connecting people from different walks of life, who do different types of things, who wouldn't otherwise connect, who wouldn't otherwise think to do things together, and showing to them that they have things in common and that they can work in common and work together toward a common goal. That's my sense is it's a fairly unusual sort of skill. And I'm wondering if you've thought about that explicitly, or it's just something that happens to you. 

LARRY BRILLIANT: I do think I have a mild multiple personality disorder. I mean, I think it's very functional. I'm just really interested in a lot of things. But I think most of the epidemiologists I know have that same characteristic. It sort of goes with the field. 

You know, I don't think I do anything. But I think if-- and none of us ever succeed in being humble or putting our ego away or any of those things that we aspire to do. But I watched Nicole Grasset manage some of the smartest and toughest people you could imagine. 

And if you'd walked into a room that she was running a meeting, you wouldn't have known that she was running the meeting. She brought out the best in all of us. She allowed us to be the best version of ourselves. 

That's not exactly the formula for American management studies at the Harvard Business School or any other business school. We have this kind of illusion of the great leader who knows everything. And it's a myth. It doesn't exist. 

If you can get people to work with you who are smarter than you and bring them together and shut up and listen, you're really going to go much further. That's what she taught me. I fail at it every day, but that's what she taught me. 

EREZ MANELA: One of the questions I asked you when we had dinner a couple of nights ago was how you went from being involved in smallpox eradication, founding the Seva Foundation, and being a professor of epidemiology at the University of Michigan to founding The Well, founding this online social network. And you told me the story, so I know the answer. But I think it's such a good story that I want you to tell it again to this group here. 

LARRY BRILLIANT: I think it's human nature. If you've climbed the highest mountain, you want to do it again. And I think for those of us who were lucky enough-- and make no mistake about it. Those of us who worked in smallpox, we got a hell of a lot more back than we gave. 

Those of us who were lucky enough to work in the Smallpox Eradication Program, after it had been finished, we all went back to our universities or our institutes or our governments. And after a while, we maybe got a little bit bored because the smallpox program had been so exciting and so wonderful. And there was a kind of consensus that we wanted to do something like it again. 

In fact, there were many people who felt that way. Some people went into trying to eradicate polio. Other people, as I've said, went into trying to eradicate Guinea worm. 

My wife and I had written an article called "Death for a Killer Disease" in a Christian-- a kind of optimistic magazine. And a lot of people sent us money. We were living by a little lake near Ann Arbor. And we got almost $20,000 in cash in the mail in envelopes usually with $3, $4, or $5, $50 in them. 

And we knew that we shouldn't buy a Mercedes with that money. So we called together people who we knew and we loved and who we'd written about in that article. And so that was the formation of the Seva Foundation. 

Now, because my Rolodex was a little bit weird, I did bring people from WHO and invite people from the CDC. But I brought a clown. It's very easy to get epidemiologists from the CDC. It's very hard to get a clown. 

And I brought a lot of musicians. Grateful Dead became kind of our house band. And we brought a lot of ophthalmologists. And we had a meeting. Steve was there. 

And at that meeting, we asked what should we do that would allow us to do something like we did in smallpox eradication, but this time do it with friends who weren't necessarily credentialed in the way you had to be to work for WHO. And I wanted us to work on diarrhea because diarrhea was the major killer of children in those days. 

My friend Wavy Gravy, who was the clown and who was the master of ceremonies at Woodstock, he said, great idea. I'm going to put on a benefit for diarrhea. We're going to call the benefit No Shit. 

[LAUGHTER] 

I thought that was a great idea. It didn't go over very well. Nicole Grasset, who was my boss, she wanted to work on blindness. And I think a vote was held. And I may not have gotten any votes. And we decided that we were going to tackle blindness. 

But we wanted to do it in a scientific way. And in those days, in public health and in epidemiology, you would envision a program as a sandwich. It would have a slice of bread at the bottom, a slice of bread at the top, and then the meat of the program. 

The slice of bread at the top would be a survey, a needs assessment, some statistically valid understanding of what the problem was. The piece of bread at the bottom would be the evaluation that you would do. And in the middle would be the program that would depend on what you learned. 

So we wanted to do a survey of blindness needs. And it happened that there was a celebration of smallpox eradication. And WHO was having a celebration in New Delhi. And WHO is really great at putting name tags on you and putting place tags with your name on it and organizing people alphabetically. 

And they did a kind of weird alphabetizing. And Nicole sat next to Nepal and the Netherlands. And Nicole said, we'd like to work in Nepal. And to do that, we would like to have a survey. And Netherlands said, we'll pay for it. And it happened just like that. 

I'm kind of trunking about a year into that. So we wound up having an amazing man named Leslie Kish, who was the founder of survey sampling at University of Michigan, he drew a stochastic valid inferential possible random sample of 108 villages in Nepal. I'm really going to get to your question. 

EREZ MANELA: I know. 

LARRY BRILLIANT: The 108 villages, Nepal being what it is, had about 30 of them that were inaccessible to the epidemiologists that we were bringing and the ophthalmologists. And we had to have a helicopter to bring them to those places, especially as the monsoon began. Otherwise, they would have been left there for the whole monsoon period. 

Steve Jobs, who had been at the monastery that I'd lived in India, gave us an Apple, Apple II number 13, and Corvus hard drive with 5 megs of memory. He said, that's all the memory you'll ever need. Nobody will ever need more than 5 megs. And a Hayes modem-- I see some people with gray hair. So you know that the way we communicated was chhh, that 300 baud modem scratching? 

So he gave us that. And his roommate at Reed lived in McMinnville, Oregon. And in Oregon, there was a helicopter company called Evergreen Helicopter. And they persuaded the head of Evergreen Helicopter to give us a helicopter. 

So they did. They gave us an Alouette III, perfectly capable of flying over Mount Everest, which the pilot did all too often. And so we had a helicopter, but it was in McMinnville, Oregon. We had to take it apart, put it in a box, get it to India, reassemble it in Palam Airport, and then fly it in to Kathmandu. That was expensive. 

So Wavy talked the Grateful Dead into doing a benefit concert to raise the money that we could put that box on a Flying Tiger Lufthansa flight, which they flew into New Delhi. It's just a regular day at the office. And we wound up with a helicopter for six months in Nepal. And we visited all those villages dropping off ophthalmologists. And it worked really well. 

On the last day of the survey, after we'd been to 107 villages and we were at our 108th village, the helicopter crashed, but not crashed like you and I think about. The pilot said it came down like an oak leave in the autumn. And it landed quietly, but it had no motor. It was in an inaccessible part of Nepal. 

I was back in Kathmandu. Nicole was on the flight. We had to figure out how to get that helicopter to get a new motor then to get it to fly out of Nepal. And how do you do that? 

So my office in the Nepal government, the Nepal Blindness Office, was right next to the World Meteorological Association. And they were just celebrating the fact that two new Landsat satellites had been launched. I knew a group at the University of Michigan that had a computer conferencing system called Confer. 

If only I could get a signal from Kathmandu to Ann Arbor, then I could bring in the US ambassador to Nepal and to India, the UN High Commissioner, the Senator Hatfield from Oregon, the head of Aérospatiale, the Alouette III manufacturer, Evergreen Helicopter, all on one big computer conference call. So I did. The World Meteorological Association figured out a way that I could get a signal from the chhh to the satellite, and then bounce it to Ann Arbor, and then get everybody on the same call. It was the beginning of something new called computer conferencing. 

When we finished with that, that helicopter that had landed in an inaccessible place without an engine, we were able to fly in an engine, get it attached, and the helicopter fly out in 72 hours. And nobody in the United Nations had ever seen anything happen in 72 days. And so we were pretty happy about that. And we had a new technology, computer conferencing. 

When we got back and we came back to Ann Arbor and all the people went back to their homes, Seva found that we had a lot of people living in lots of different places. So we used that same technology to introduce everybody. And we carried out our meetings. We created a management product called Seva Talk. You guys remember that. Remember Bev Spring used to call it "talking to the box"? 

So Steve Jobs got an honorary doctorate at the University of Michigan. He was giving a talk. He stayed at our house in Ann Arbor. And he'd given me the money to start Seva. And I showed him this thing Seva Talk. I was so proud of it. 

I said, Steve, what do you think? He said, it's the ugliest thing I've ever seen. It was ASCII text on a green cathode ray. There was nothing pretty about it. He said, I'm never going to use any product that uses Unix. 

Now those of you who know know that every product that he did after that was Unix based, just changed a few things here and there. But it was really a funny moment. And then I said, by the way, Steve, we need more money for Seva. 

And Steve famously said, see that thing? That product that you have is ugly, but it's a product. Take your own fucking product, make your own fucking company, make your own fucking money, fund your own fucking charity. And I'll help you. 

And he did all those things. And I started a company called network technologies, which gave birth to The Well. And Steve got me an investment banker. I had never owned a share of stock except for 100 shares of stock I got as a bar mitzvah present when I was 13. 
And then I got involved in technology, and I really enjoyed it. So every once in a while, I would work in the field and run out of money. And I would wind up starting a company. That's what I mean by a multiple personality disorder that's functional. I think all of us have a little bit of a multiple personality disorder. We need to find ways to harness it. 

EREZ MANELA: Larry, I've got one last question before we open it up. And it relates to the fact that we are in a church. And by the way, as you were quoting Steve Jobs there, I was wondering whether this is the most times the F word has been used in this church in a single lecture. But Ted is saying no. So I want to see that other lecture where he had more. 

LARRY BRILLIANT: I was just quoting. 

EREZ MANELA: Right. 

LARRY BRILLIANT: You saw the quotation marks, didn't you? 

EREZ MANELA: But what I wanted to ask you-- and as we're talking, I'm also thinking I don't remember the last time I've sat in a chair that had a back that's higher than my head. I almost feel like it's a coronation that's about to happen. But the last question I want to ask you-- 

LARRY BRILLIANT: Beautiful church. 

EREZ MANELA: It is, yeah-- is about faith. You're obviously a person of science. You studied medicine. You do stochastic sampling and so forth. 

And yet you talk a lot about faith in your memoir. You talk a lot about God. When we met the other day, you had a cap on with the word God on it in Sanskrit. 

And it's not just you. Many of the people you mentioned, including Bill Foege and Paul Farmer, were all individuals of deep faith. And I'm wondering what's the connection you see here. How does that all fit together for you? 

LARRY BRILLIANT: Well, I'm trying to explore that. That's why I'm doing this series for Time magazine on science and faith, to try to give me an excuse to interview people who are struggling with putting those two things into their own self. I don't see how you can be a scientist and look at the wonder of the world and not have faith. 

It's interesting that one of Nicole Grasset's inspiration, Pierre Teilhard de Chardin, he wrote all the time about science and faith. He was a scientist who's a paleontologist. And Paul Tillich said that it was in the understanding of evolution that he came to see the face of God. 
Albert Einstein, who was able to do what we call a gedankenexperiment in his mind to work out the entire formula for E equals mc squared and its mathematical proof, he said that looking at the way the world is put together, how can you not believe that it didn't happen by accident? And he famously said, I do not believe that God plays at dice with the universe. 

You know, sitting in a church, you can go back to Galileo. All the scientists were people of faith. The original clerical robes that we now look at as academic robes, if you go to a graduation ceremony, those are all clerical robes with just a little bit more pizzazz on them. 
I don't know people of deep faith who have honestly looked at the world who do not believe in science. I mentioned the Aga Khan who is a great scientist and a great person of faith. The Dalai Lama constantly talks about how important science is. 

And maybe some religions are more amenable to that than others. But I think it's more in recent times that we find a evangelical right wing that doesn't believe in science or doesn't-- I shouldn't say they don't believe in science, but don't prioritize science. Science is only the way that God works mysteriously to make things happen. 

I don't find a contradiction. But I know I'm in the minority on that. Bill's faith has inspired me. Dr. V's faith in Aurobindo and the teachings of the mother and one particular bit of what really is scripture, "Savitri," the long poem in Telugu or Tamil, inspires me. The people who have faith who can work harder and longer because of that and work on science inspires me. 

I don't think you have to have faith to be a good scientist. I don't think you have to be a scientist to have good faith. But it's something that, for me, seems like maybe the most important question that we can ask in this material age is how we can find a way to navigate our way through a difficult and mysterious world. So I'm going to be trying to do that. That's sort of my next act. 

EREZ MANELA: Thank you. We'll open it up to questions. I don't know exactly where the mic is. Oh, it's coming? OK, so the mic will be placed here in the center. 

And you're welcome to come up to it and ask you a question. And the reason you should come up to the mic is both that we can hear you and also that it's heard on the recording. And please introduce yourself before. 

AUDIENCE: Thank you so much. My name is Kumar Singh Dangi. I worked at Harvard Innovation Lab last 18 years. I'm from Nepal. I'm coming to here to see the Dr. Larry Brilliant. 

And thank you for organizing, Samuel L. Elizabeth Jodidi Lecture. It's been years before I born they started this tradition. And I'm fortunate to be seeing-- I follow the same guru, Dr. Larry Brilliant. 

Thank you. So before I born, Dr. Larry was with our guru, Baba Neem Karoli. And when he was talking in the podium, I'm looking at there like guru talking, looks the same. He's talking. I don't know. It's look like I'm following him, the guru. And he's a earliest devotee. And exactly he was looking like that. 

EREZ MANELA: Can I just ask, can everybody hear him OK? 

AUDIENCE: Yeah? Thank you. So I'm here reaching out, one of our Baba's grandson, Dr. Dhananjay Sharma. So I'm creating the foundation, the name of the Baba Neem Karoli Foundation. And I'm looking forward to get health blessing from the Dr. Larry Brilliant. 
So I am get the paper from prayer requests. This is the best time using the prayer request. And looking at him is like my guru's devotee. 
And he's a kind of guru. He was with our guru. He passed away when I was little, you know? The guru passed away, but he's alive right here. So I'm working this foundation. 

EREZ MANELA: Forgive me. Is there a question? 

AUDIENCE: Yes, it is a question, so. 

EREZ MANELA: OK, thank you. 

AUDIENCE: And one of my friend, Dr. Uttam Gaulee, he's at Morgan State University. He's a professor. Him and I am starting foundation. And I try to reach him. The experience he been with guru and then he been in Nepal is Seva Foundation. 

[INAUDIBLE] created those people are not having their eye and give the one thing, only one thing this foundation worked. And in the early stage, he mentioned how difficult in the helicopter. What year was that, Dr. Brilliant? 

LARRY BRILLIANT: So the survey was 1979 and 1980. And the Nepal blindness program began right after that. And so far, I think over a million and a half blind people have had their sight restored in Nepal. And Neem Karoli Baba died in 1973. 

AUDIENCE: Thank you, Dr. Larry for your service and for the humanity. And Dr. Larry, earlier they mentioned everybody has to play their role. He served the whole humanity. He's asking us to step up, do the role. Thank you so much for your service. Thank you. 

EREZ MANELA: Thank you. 

LARRY BRILLIANT: You better not say so many nice things about me. Because if my children hear, they will bust me, a fairly easy thing to do. 

AUDIENCE: Hi, there. My name is Matt Weiner. I'm a dean of Religious Life at Princeton University. And your talk was framed about bending the world towards justice. But when I listened to what you had to say and the tone of your voice, it was all about your friends and friendship. And even some of the people here who I heard kind of whispering to each other-- oh, listen to the way he's talking about them. He loves these people. 

I'm curious about the relationship you see between friendship and doing social justice. And how important is friendship? Or where does friendship fit into the justice work you're doing and the innovation work you're doing? 

LARRY BRILLIANT: I think if you're working on social justice, it's hard, isn't it? You either are starting off with your friends, or you're working together so closely. But after some time of working together, you're all friends anyway. It's hard to imagine the work of social justice-- which, I mean, global health is easy compared to working against racism, or sexism, or homophobia. 

We used to say that smallpox had no friends. And smallpox eradication didn't have a lot of enemies. There were some. A lot of Hindus looked at the way in which we made the vaccine, which killed cows. If anybody had a right to be antivax, they did. 

But still, we got tremendous support from everybody. I mean, there's always the exception. I mean, it's true that I don't think you can work on hard things other than with your friends. That doesn't mean they all have to look like you. 

And that's why I tried to read that list of names. Because I think it's true, Steve, that we became friends, all of us. We shared a deep experience. They talk about soldiers who fight a war, how their comrades become the closest family that they have. 

It was like that for us. We continue to have Listservs, and even now, 50 years later, are still friends. But we didn't all look alike. We didn't all have the same religion. We didn't all have the same color skin. We didn't all have the same faith. 

But we found a job, or it found us, that made it that we wanted more to defeat the demon of smallpox than we wanted to score points on our fellow workers. But thank you for asking that question. I had never thought of it that way. But I do feel deeply that these are my friends and my family. I think all of us do. 

EREZ MANELA: One of the things-- I was waiting for somebody to come up. But if you want to come up, then I'll-- yeah. 

AUDIENCE: Thank you, Dr. Brilliant. My name is Will, and I'm just recently graduated from an MPH program at Emory. 

LARRY BRILLIANT: Congratulations. 

AUDIENCE: Thank you. And I was really inspired by your talk and struck by a lot of the stories that you told particularly in India. And one of the things that I've heard you mention is, in spending time with Maharaj-ji, that there were moments where you understood that it wasn't just that he loved everyone in the world, but that, when you were with him, that his devotees were able to deepen in their love and compassion for everyone in humanity. 

So my question, because of this interest in the recent project, becoming better ancestors and really seeing how Dr. Bill Foege has done things like implement, as part of the criteria into Emory Medical School, gaining admission-- being a compassionate doctor is a part of that process now. And so I'm fascinated by the role of love and compassion in the work that you do and the motive. And I'm curious what that looks like from your perspective going into the work that you do, sort of why love and compassion have been important in becoming better ancestors. 

LARRY BRILLIANT: Thank you very much. So Maharaj-ji would tell us love, serve, remember. There's a foundation named Love, Serve, Remember of the folks around Ram Dass and Maharaj-ji. And love came first even before service. 

So he mentioned something that I hope everybody gets a chance to look at because it will make you happy. Bill Foege has a program. Bill is 87, 86. And he has written a lot about the goal in life is to become a better ancestor, to leave the world better than you found it. 
And he has a teaching series which has nine lessons. And there are nine lessons in how to be a better ancestor. And the website, for those who have implements, is 9lessons.org And each of these lessons takes something that we learned from smallpox and makes a lesson about it that you can use whatever your project is. 

The first lesson is this is a cause and effect world. The second lesson is truth matters. The third lesson is about transparency of what you've learned. And there's a series of lessons like this. So it's not like the lesson you learn is to use a vaccine, or the lesson is to bring vaccination. It's the lessons that really were hard for us to learn because we didn't see them. Because they were so obvious. 

And love and compassion are at the heart of it all. Building trust is the most important thing. Being truthful is a necessary condition for success and I think for life, actually. So you know, for those of you who have read anything that Ram Dass has written and has written about his guru, that's Neem Karoli Baba. And [INAUDIBLE] and I were really lucky enough to sit at his feet and to learn from him. 
When you're around people like that-- and people like that exist today. It's not all over. It's not that all these wonderful, lucky people got to go to India and meet these saints and there are no more, over, end of story. There's lots of saints living amongst us that we don't know and in every religion. You don't have to be exotic-- every religion. 

I don't know how we could have gone on without that kind of fuel, the love that he gave us. And you mentioned something that we all felt, that when we sat in front of Maharaj-ji it wasn't just that we felt like he loved everybody in the world. That was his job. He was a saint. If a saint doesn't love everybody in the world, fire him. 

What was so difficult for us to understand is that, when we said in front of him, we loved everybody in the world. I mean think about that. Have you ever had the feeling that you love everybody in the world other than when you were stoned? 

I mean, it doesn't come natural. | sitting around him, that's the way we felt. I still feel that way when I think about him. I wish it were more often. 

So, yeah, I mean, if I could encourage people to do things, it would be to find people that you love to work with, to find people who inspire you, to be part of what they're doing, and to be around people who love as much as you want to love, which I hope is a lot. Thank you for that. 

EREZ MANELA: I think we have time for one more question. I think that's you, yeah. 

AUDIENCE: Hi. My name is Romi, I'm a student. This is very awkwardly tall. 

EREZ MANELA: You can bend it down. 

LARRY BRILLIANT: You can bend the arc. 

AUDIENCE: Ah. 

EREZ MANELA: Yeah, there you go. No, that's OK. You can just bend the top part, yeah. 

AUDIENCE: So as you were talking-- very inspirational-- I was thinking about how I know a lot of people my age, we grew up with the internet. We've kind of had an overwhelming amount of information about the world. And sometimes it can make people numb to it. 
People will joke, oh, this crisis, that crisis. It's kind of hard to process it all. So this is a very broad question, but what are some actionable steps that you would recommend for someone who doesn't really know where to start if they want to pursue justice? 

LARRY BRILLIANT: So full disclosure, this wonderful woman is the daughter of this wonderful man and his wonderful wife. And we had a wonderful dinner. 

[LAUGHTER] 

So this is not a new question. 

EREZ MANELA: But it's not a planted question. 

LARRY BRILLIANT: Not a planted question. 

EREZ MANELA: Implanted. 

LARRY BRILLIANT: So I mean, for the gray hairs here, I think we were born-- those of us who got to live through the '60s got the best deal of the hand. We lived at a time when it seemed like possibilities were endless. We were raised with the idea that every generation would be richer and happier than the previous generation. That was the social contract. 

I think your generation hasn't had that yet. When we talk to the president, another Larry, he said that he thought the students at Harvard felt shortchanged, that they were even angry about what my generation had bequeathed to them. And how could you not be angry? 
I mean, we've not left the world better than we found it. The world is worse than we found it in so many ways. I can list 100 ways in which it's better. Believe it or not, there are fewer people in uniform fighting wars. There are fewer wars. There are fewer deaths from war. 
Life expectancy has doubled in the last 100 years. 100 years ago, life expectancy was 40. Now, it's over 80. But the United States has dropped two years in the last year because of opioids and COVID. 

But still, there's a lot of great things that have happened. I find it exhilarating that we see phenomenal telescopes that we put into space. And we look back at the very origin of the whole thing. And we watch that space is expanding. And we infer from that that time is continuing. 

I mean, wow. I find it breathtaking that the scientists at CERN have discovered what they call the Higgs boson particle, which is called the God particle. And it's called the God particle because it begins life as a wave with no weight, no mass. 

And as it goes through the universe and through time, it somehow picks up cosmic dust. And it arrives at that cyclotron with weight and mass going from nothing to something. It must be God's will. That's why they call it the God particle. I'm so curious about that. 
I see so many advances in science. The vaccine is the most palpable example. But for those of you who have friends who have cancer, looking at CAR T gen, a brand new cure for cancer, there's so many cancers that can be cured now. Look at CRISPR, the ability to take microscopic particles of the human genome and mess with it, and clip it out, and move it into different places. I even have a lot of fun with ChatGPT-4. 

I asked ChatGPT-4 what I should tell you today. But it lied. I also asked IT to tell me about Wavy Gravy's children. And it announced that he had four. And he gave them fabulous names that are nonexistent. But I love talking to ChatGPT-4. 

My wife is doing a 70-day Buddhist intensive. And she was once on the call with other Zen Buddhists. And she said, I'm here studying a fifth century Buddhist tome. And my husband's in the other room talking to ChatGPT-4. It's a mixed marriage. 

I think there's so many things to celebrate being alive today, but it would be disingenuous not to say that we've been shitty ancestors. And we owe you a lot more than we've given you. But it's your chance now. 

And what Martin Luther King said to those of us-- and we were depressed. We were in the middle of a different kind of Civil War. It wasn't just Republicans versus Democrats. It was parents against children. 

It's hard to believe. But the Vietnam War separated us horizontally, not vertically. And many of my friends didn't talk to their parents for years. And their parents didn't want to talk to their kids who were antiwar. 

It was a tense time. We were worried that the nuclear weapons that Russia was bringing into Cuba were alive and that we were threatened. We lived constantly under a nuclear shadow far worse than you do. It was a really dangerous time. 

But nonetheless, we've left you with a climate that's precarious. We've underinvested in the amount of work we need to do to make it safe. It's probably the single most important thing to do right now is to work on climate change. 

But you have something to do that can really make that arc bend. I think this is a moment in time when we are at a hinge in history, at a turning point. Will it turn out better each year or worse each year? I think that your community who are your age and with the great school you go to far better than this one, Northeastern, that that school is going to generate a whole new cohort of great scientists and activists. I think it's a wonderful time to be alive, but I wouldn't begrudge you anger at what has been left for you. 

AUDIENCE: Thank you. 

EREZ MANELA: Larry, thank you so much, absolutely wonderful, wonderful talk except for that last comment against Harvard, which we'll have to expunge from the recording. Other than that, thank you so much for coming here and really blessing us with your presence and with your wisdom. Thank you. 

[APPLAUSE] 

LARRY BRILLIANT: Thank you. Thank you so much. 

[APPLAUSE]