#1261 - Peter Hotez

The Joe Rogan Experience #1261 - Peter Hotez

March 11, 2019

Peter Hotez, M.D., Ph.D. is Dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology & Microbiology at Baylor College of Medicine where he is also the Director of the Texas Children’s Center for Vaccine Development (CVD) and Texas Children’s Hospital Endowed Chair of Tropical Pediatrics. 

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when I asked him to come on the show that's what I initially wanted to talk to him about but then we found out through the fact that he was talking about coming on the show that a lot of people were very interested in his take on vaccines people that are pro-vaccine and people that are anti-vaccine who accuse him of being a shield anyway I enjoy talking to him and I think we we went into vaccines quite a bit and explain why he believes that vaccines do not cause autism what the actual cause of vaccines are how it can be identified we also talked a lot about infectious diseases including a lot of infectious diseases that are extremely common are parasites are extremely common in the United States that I didn't even know about his name is dr. Peter hotez he's a professor and Dean of the national school of tropical medicine at Baylor College of Medicine and he's a great guy and I really enjoy talking to him so please give it up for dr. Peter ho.

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The Joe Rogan Experience

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and we're alive Toys R Us how are you when I asked you to come back on that you were heavily involved in this whole vaccine debate what I wanted to have you on to talk about is tropical diseases because I remember when we did that Sci-Fi show you explain to me that some ungodly percentage of people that live in tropical climates are infected by parasites that's right by developing vaccines for a tropical diseases we developed the vaccine is no one else will make because the weather for the world's poorest people so we call him tropical diseases but they really are diseases of poverty the vaccine issue the out of 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 vaccine so it was a natural that I'd get trotted to it yeah so when I said that you're going to come

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then I got inundated by people that are in armpit the vaccine thing is such a polarizing issue so many people seem to think they absolutely know what causes what especially when it comes to something like autism which is a huge issue in this country it's a huge issue around the world and it didn't used to seem to be the question is was that because it was undiagnosed was that because it just is more prevalent today what do you think what is your take on but I don't think we really know 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 we do use pejorative terms like mental retardation what's my Jimmy

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the clock is off no no no it's okay he was just saying he was just telling me that there are clock is screwed up because of the daylight savings time right sorry totally unrelated to what country's flag is green so so we don't know we don't well you know what one thing is clear that the number of diagnosis is going up but part of that is because what we used to call for Jordan things like mental retardation now get thrown into the autism category the other thing out too well you know now we call it but it's part of the autism spectrum we also because autism off and has a lot of associated intellectual disabilities not always but sometimes the other is that is that based on aptitude test like how do you how do they decide how did it's not wet. They have a list of diagnostic category

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stop razor it's not like you could test someone if they test positive for a disease that's right that's one of the interesting side pieces to this is you know the there's a group of people out there who self-identify themselves is the autistic's and they get very resentful or hurt when they're called a disease or disorder the end because they say when we're not an epidemic work with a person and they that is part of this whole neurodiversity movement which is quite interesting diversity move right they say they're neurodiverse that they think differently from others and they respond differently than others but they're not quote abnormal in and I think they have a good argument I heard of crazy argument wants what someone that was said about to the point is that it's you know that the impairment like Rachel my daughter it's not so much for autism that torture you know ability to have Partners were to have a

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full career it's the fact that she has provided in her case profound intellectual disability that goes along with it when they do you say that people have a there's a spectrum right in some people who are autistic have an incredible abilities that's right Democrat with mathematical abilities musical abilities language abilities and then some people do not some people have legitimate issues you have with Rachel's case my daughter it's she has a pretty good verbal IQ 80 90 which is very low performance IQ 40 she can't do simple math she ain't got money but unfortunately Goodwill Industries came to her rescue in 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 and even if it's minimum wage right

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it's not like you can test positive for syphilis so you can test positive for the flu right although those terms because it puts people on the autism spectrum as though they have a disease or which I don't like to do autism disorder if it's just a disorder autistic don't like to think of themselves as a disorder they like to think of themselves as different different but not necessarily is a disorder that doesn't help us when we gets hard to talk about so they're trying to stop you from talking about it in a certain fashion which is actually accurate when they have an issue there is an issue to say there's no issue is kind of ridiculous

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it's the mean is a reason why so many people are so concerned about autism and vaccines and just autism in general environmental pollution that neurodiversity thing and actually having intellectual disabilities that go along with it okay if we don't know what causes autism we do we do well we're getting there very closely so we've now there was a very important paper produced by written by a group of the broad Institute Harvard MIT which is one of the Premier genetics genomics organizations in the country and they've now identified 99 Jeans it's a it's a huge team of scientists not only at the Broward including PSI does a Baylor College of Medicine 99 genes involved in autism are all involved in early fetal development early brain development in the first

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second trimester of pregnancy so now we're starting to really get her arms around what autism is and that's one of the things I talked about in the book I mean we we have learned so much in the last couple of years but autism how it begins early fetal development well before kids ever see vaccines and that's one of the reasons I say vaccines did not cause Rachel's autism vaccines don't cause autism because autism is already underway in her early brain development is it possible that some people have this tendency towards autism and it's exacerbated by vaccines I don't think so I think what would happen if the sequence of events happens during pregnancy but the full clinical expression of autism often doesn't happen till 18 or 19 months of age like Rachel Francis wasn't actually diagnosed till 19 months of age and there's some fat fabulous studies now

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showing that that clinical expression of autism actually coincides with a big increase in the expand the volume of the brain you can actually show on cereal magnetic magnetic resonance imaging serial MRI of the brain starts to the brain volume starts to increase and that's very important cuz parents I will often to remember on my kid got back sneaking around 18 months of a jerk or 15 months of age want to link the two but now you can go back to 6 months of age in this is studies done at the University of North Carolina Chapel Hill showing so that you could do an MRI at 6 months of age and they can predict now with they say with 90% accuracy which of the kids will go on to develop autism and then you can take what are they saying I have to go 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 develop

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I'm done it with the serial MRI that's what they think right now we have the 99 Jeans so we can even take it back further by doing what's called whole-exome sequencing sequencing all the DNA all the express DNA of an individual in Rachel's case we did that and we actually find the mutation in the gene controlling neuronal connections which makes a lot of sense if you think about autism of course so so there is a way to to show whether children will be more likely to develop autism and there's there is a way to still look at their brain through fmri at a very early age and and also do the chin muscle do genetic sequence so it's not simply a matter of how they perform on cognitive test that's right that's right we're getting much better at getting arms around the diagnosis 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 the sudden or meezers measles mumps and

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Elias the one that gets repeated over and over again that's the one that made my child have autism I've heard that so many times and I've heard it from friends from friends that have children that have autism they had a child their child got the measles mumps rubella shot and then immediately there was a very distinct change in the child's Behavior question when you get the measles mumps rubella vaccine many times do kids cry in pain things like that and then autism will then begin sometime between the first and second year of life so it's logical to want to connect it to but now we know it's not even plausible because we know that if you go back to that an MRI at 6 months of age or go back prenatally we can even determine which kids are going to go on to develop autism are massive epidemiologic for 1 million kids that infect a new paper was just released this week showing that kids who get the MRI get the MMR vaccine are no more likely to get autism

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if you don't if you don't get the MMR vaccine and the kind of Converse is also true kids on the autism spectrum are no more of likely to have gotten the MMR vaccine the kids not on the autism spectrum so it's a combination of that those big studies of over 1 million kids together with knowing what autism is that completely ruled out the possibility these jeans she's me the in the issue with these jeans and then the ability to scan the brain with the serial MRI and that so you can tell which children have the propensity 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 it's a good question I don't know I'm a vaccine scientist so I'm you know the vaccine site is really tried to do a deep dive in autism doing research on the book versus human development

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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 in during cereal MRI that they will not go on to develop autism is that true far as we can tell you as we can tell so children without those issues who get vaccinated have have no problems which most children have no problems yeah I mean you know we've learned a lot about the risk of vaccines and the numbers are extraordinary I'm in the risk of a severe adverse event happening after getting a vaccine is roughly on the water of one-in-a-million between between one and a million and one in 10 billion so and I found an internet report want satellite likelihood of getting struck by lightning is 1 and 700000 so it's the end of the life we're having a severe event after a vaccine is your bet odds are better of getting struck by lightning then when you say severe event

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my severe event though there's actually a table that's put out by the national vaccine compensation act that includes shoulder injury that's one Encephalitis and shoulder internal yeah that's from the actual injection yet but getting injecting it in the wrong place so it goes into the joint or something like that yeah yeah is that common no no so they're there have been issues were children have adverse effects and reactions to vaccines what do you attribute those two but one thing I wanted a milli I think you know in some cases biological variability I think it's some cases in New Britain lie if it's a live virus vaccine like the measles mumps rubella vaccine you have an underlying immune deficiency that wasn't picked up before then. Virus can replicate better but very rare things like that so as far as you know children who are healthy who get

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vaccine it's it's not biologically possible for them to develop these traits these mutations in the genes and these issues that you just as best we can tell right now that seems to be the case is best you can tell right now it's a it's a great thing to say but for people to like on the outside like what does that mean I'm not a doctor I'm not smart enough to understand with Doctor hotels is saying that studies number 1 million children that there's no link between vaccines and autism that's number one and so let me park how do they let us out to into bits so there's there's the studies on of 1 million children showing their vaccines do not cause autism that's part 1 the second is that I did and then I'll do it the second part shows not only is there massive evidence that there's no link between

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because we know so much about art is inherent begins in pregnancy and car so let's go back to the first part the first part is that he's never 1 million children one of the things that the NT vaccine Lobby does is they play this game of what I want not really gay but what they what they do is play this kind of thing of vaccine whack-a-mole because at first they alleged was the MMR vaccine and that came out of the study that was published in the Lancet 1998 then another group came along as a no no no we didn't mean the MMR vaccine we meant the five Marisol preservative that used to be in vaccine and the scientific Community not only are linked by Marisol link then the anti-vaccine lobby came along and said don't know we didn't mean that we're spacing vaccines too close together then they changed it to get around again I'm saying now it's the alemar aluminum in vaccines so the end of each time the scientific Community response with massive epidemiologic study show just absolutely none of those things are true

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do you think that it's just when you look at see if there's one in a million that has an issue with this and there's snot autism so whatever whatever those issues that they hear these stories in 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 so these people hear about these stories and people are terrified obviously your children become very overprotective of her children he worried a lot and then you also don't know like why do they get so many shots all in a row like that why does a baby get 10 shots in a day that seems crazy well they don't get 10 shots in a day most of the most of the vaccines are now combined so for instance in 1 vaccine we can vaccinate against diphtheria pertussis tetanus

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polio opolis influenza type B which is a terrible cause of of meningitis and in some cases not even hepatitis someone shot is very well then combined and there's all sorts of study showing that it's safe to combine them in and it's fantastic now you can vaccinate with one shot against six diseases are life-threatening so the only concern is a child's immune system when they're bombarded with this one is so a lot of times it causes them is it be tired or they get sick cuz I don't live in this system is not that's another kind of a misnomer that the misunderstanding that's put out by the anti-vaccine lobby remember the child got the intestines and the respiratory tree is is this or are organs of antigen presentation a baby on average is exposed to hundreds of new antigens everyday so the idea that you're going to put overwhelm the immune system with an a

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seen again six diseases just doesn't make any sense I got this is all phony baloney stuff put out by the anti-vaccine let's let's be clear the anti-vaccine lobby owns the internet right now they've what does that mean what that means is they've got their put on up 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 the anti-vaccine misinformation that's number one second we know now it's Amplified social media like Facebook other forms of social media so at 3rd in a look at the Amazon site I mean it's it's incredible so my book this book the good news is it's I think it's right now is the highest rated pro-vaccine book on Amazon the bad news is overall strength about 20 because there's 19 other phony baloney anti-vaccine books

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now the anti-vaccine books way to get even worse then you also have now they're pretty complete aside their political action committees multiple States lobbying state legislators about fault with applying them with false information about what backs vaccines do so and and the problem is we don't have a robot system of pro-vaccine advocacy the counter it so we don't really hear as much as we need to from the federal government from the CDC from the Surgeon General so unfortunately in this country the defensive vaccines falls to the handful of academics like myself and you know I'm an academic I wrote a book what chance do I stand against this major media Empire. Why do you think that exist why do you think there is this major media Empire that's against vaccines that's a great question what's the motive what's the motivation number one and number two for the money coming from

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pictures real money behind those millions of dollars behind this to put out funny documentaries and phony books what's a good funny documentary 2.20% and you know I don't have the means to defend a lawsuit and things like that so I usually don't mean I understand these documentaries what do you think their motivation is honestly believe that vaccines do cause harm or vaccines do cats know I mean is there some kind of other agenda that they have I mean we do know in some cases that the are some elements of the anti-vaccine lobby are promoting phony autism therapies right there doing terrible things like this thing called MMS which are bleach enemas bleach enemas to get you into Chili Bowl at the children bleach

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bleach because they're cleansing the immune system cleansing them a really awful stuff and they're doing chelation therapy which is very dangerous what is that that's where they they claim you know kids are overdose with toxic metal so they give a chemical that actually can chelate the metal but it can kill that your calcium and then put you into a fatal arrhythmia as well they're also am I doing this chelation therapy like what you can google okay it's whatever these doctors like in some cases there a doctors and fortunately or other health professionals what is it to get to work and then and then there is really bad but it's it's good for recovering from injuries and the under certain select supposed to who-knows-what who knows what it's doing to a young kid right and then so you shouldn't be doing that then the other then that's one

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how much of this is being driven by Financial motivation pedaling these phony autism therapies I can take my senses that's not the big piece of this there's also some reports not Russian Bots and trolls that are amplifying this and sewing political instability Ryan but again you add that all up the funny autism therapies the Russian Bots intro to my mind that really doesn't get her arms around the Big Driver this thing so I think we really need some good investigative journalist to look into this think that there's some sort of a concerted effort or do you think that you're just a bunch of people that really believe that vaccines do cause autism they don't truly understand the science and they haven't talked to someone like you and maybe they have this idea that cemented in their mind and they're not willing to look at it objectively and look at the full spectrum of possibilities and look at the science behind what you guys are saying because in their had they've been saying

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vaccines cause autism they've been saying it for so long that once someone gets that and they're connected to that it's very difficult for the machine gears big people have a really hard time not being married to an idea and I spent a lot of time on the country giving I would have called Grand rounds lectures dub hospitals and medical schools pediatric Grand rounds I've had the chance to talk to a lot of Pediatricians nurses and nurse practitioner even and more and more than a few parents impression is most of the parents aren't here for a call to be so-called vaccine hesitant this is the word of the day are not really deeply Doug and I mean you can you can have a conversation with them and explain to them like we're talkin now you know non-technical way you know the evidence showing vaccines don't cause autism in the lack of plausibility given that it that it begins in pregnancy and no vaccinate their kids

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there is another percentage and I don't know what the percentage of their 10 15% that are deeply dog in and are wholly invested in this conspiracy theory that the that the government is in cahoots with the pharmaceutical companies in body body and then if you try to talk him out of it they just think you're part of the conspiracy so that sort of a no-win approach there but you can have a good conversation with most parents it's not necessarily the most parents right I mean what what you're dealing with is these people that maybe they're into a bunch of different alternative therapies but different kinds of cleansing and there's a lot of that nonsense that you find online where me look there's a legitimate

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but I guess but I guess my point sorry that's okay but I guess my point is parents don't get the chance because they're so inundated with phony anti-vaccine information that whatever you know whatever search they do so what do you think should be done should there be a pro vaccine documentary that makes sense thanks for the question I think there's three things that need to be done I think first of all some of this anti-vaccine media Empire needs to be dismantled to Samantha Samantha wants and that I don't like shouldn't didn't mean it seems like there should be some sort of a debate right like if there's someone who sang that there's some evidence of vaccines cause debates you're saying there's no evidence of vaccines cause debate has me itching cause autism when you're saying there's no evidence that vaccines cause autism there should be a debate where there's some sort of like some sort of a monitored conversation where you can

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have you versus someone else and break this down yeah but that that has that's a two edged sword to because you know then it gives some false legitimacy to TNT vaccine side that's like debating does smoking cause cancer problem I mean it seems like if there's this many if you do Google Search and you're just overwhelmed right with antivirus seems like the fight is already been lost if that's the case that's right so giving them legitimacy legitimate say it's giving them you rather a forum to dismiss their legitimacy in a part of it has to be done is this gets into all sorts of First Amendment issues and I'm not a lawyer but you know the the idea that Amazon now is putting out all of these phony boxing and funny documentaries distributor

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maybe Amazon maybe Facebook should all be hiring Chief scientific Officer says to you know putting some stops on the dissemination of of information because it's harming children I mean I mean this is the reason I get passionate about it the reason I actually wrote the book is is kind of interesting I and actually happened before all of these big measles outbreaks that we've been having I noticed that in Texas there was where I my Laboratories at Texas Children's Hospital Baylor College of Medicine we noticed that there was a steep increase in the number of kids whose parents were opting them out of getting vaccinated to the point where in Texas we have over 6 of a 60,000 kids not getting their vaccines in the state of Texas and those the ones we know about we don't know anything about the 325,000 homeschool kids so we probably have over a hundred thousand kids not getting vaccinated all because of this misinformation campaign and I was really troubled by the fact that there was no response to it than that

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drove me to write the Books up the point is now Texas is very vulnerable to measles outbreak can I say measles more than the others cuz that's the most highly contagious disease of a child getting measles is there any benefit to a child getting measles in terms of their immune system now there's no benefit in one of the books they put out of Melanie's marvelous measles I mean it's it's awful so what do they say in that book they say build your immune system it does not it does not remember I'm after so let's go back a little bit smallpox was eradicated in the late 1970s through vaccination 1 smallpox was eradicated radican measles was arguably the single leading killer of children globally 2.6 million children died of your measles because it causes measles pneumonia measles Encephalitis talk about permanent neurological injury that's a bad actor measles and then deafness at all and then through Global vaccination campaigns we brought

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down by the year 2000 to about half a million kids dying and then the Gates Foundation put up 750 million dollars to create the gavi Alliance the global lines are vaccines and immunization we brought it down out of a hundred thousand but not measles is coming back your absolute disaster right now he's got 80,000 measle cases in 2018 in Europe and now it's coming back to the US and so My worry is this me the anti-vaccine media Empire isn't it started out as a fringe group but now it's really affecting Public Health allowing a deadly disease like measles come back to think if there's some sort of definitive evidence that shows to the general public like you could you could show it to them like this is what causes autism we've narrowed it down to these jeans and it it has nothing to do with vaccines if you give these vaccines to people without these jeans there is no way they're going to get autism they get autism specifically because of these variations in their chain you just you just Summarize the book but I

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we need more than a buck has Disturbed me when I hear about all these kids getting measles and and not just measles but means in some places polios made a Resurgence well polio you know we're down to about three three countries that still have transmission a wild-type polio it's Nigeria pakistan-afghanistan so hopefully we're getting arms around polio but measles is now come back growing back with a vengeance having people that contracted polio outside of those areas and those are the areas where it's come out every now and then some cases pop up at some Havoc wherever there's collapse in Health Systems infrastructure from war political instability these diseases can come back they can come back and the people that are vulnerable to children that are not immunized that's right and when you're immunized you're not going to pulse right yeah this is it's a really confusing thing for people because on the outside they people always want to think that big Pharma

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but I've I've said some terrible things about big Pharma and the reason being is pain killers cuz painkillers and antidepressants and there's ssris which over-prescribed and the pain-killer one kills me because I know people directly that have been addicted to these goddamn things in the doctors are passing them out like candy so people look at big farm as being o these are the monsters that push this they're also the people that give you things that save people's lives of the big pharmaceutical companies I mean one of the things that the anti-vax the insults that anti-vaxxers her let me as they say I'm a shield for industry they say I'm secretly taking money from taxes if I don't take a penny from them and I had that like it's not even how do you attach a spider from the University I can pay by the university and some of that some of my salary is offset by not grants for nonprofit foundations then

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but like the National Institutes of Health right and then they say I'm secretly making millions of dollars for our vaccines for hookworm and schistosomiasis in shock as we do with all that money the case right these are diseases of the poorest of the prom ever make up a penny on the deceased is we've gotten a lot of progress of their vaccines be gone all the way from Discovery through early phase process development and Manufacturing and IND filing with the FDA investigational new drug applications for working and kind of stuck in Phase 1 Phase 2 clinical trials cuz we don't have the big Pharma money to take us all the way to license or 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 so is 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 cuz there's

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is quite a few health-related documentaries that I know where horseshit because I've talked to actual real scientist in a clinical researchers that say like all these things are saying wrong and this is why the wrong in this you can show this the wrong way and then when someone says hey I saw this documentary it says that all she eat is toast you can see listen man you got to go here and watch this and I'll show you why that's nonsense is there anything like that right now. Right now there are some discussions but it's worth a long way off in that and the problem is the anti-vaccine documentaries are being distributed widely distributed widely sold and talking about it hears it does a problem whenever I talk to someone about what I've been doing this a lot lately or talk to someone about something that passion about ago what books you read on it

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it's like when I saw this documentary in the Roblox 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 that's that's why I wrote the new book it's a very confusing thing for parents cuz you're scared you know you have this little tiny baby that you love more than anything in this world and then the doctor say hey we've got this round of vaccines, and you're just terrified that you're going to do something to your child's can you turn your child into a someone who's a compromise in the point is probably has her back now instead of the urgency to vaccinate is now more than ever I mean remember right now look what's going on in Vancouver Washington right now where the measles outbreak is underway the ones who who are at greatest risk are infants under

► 00:41:11

CH 12 months not yet old enough to get their vaccine so that if your parent right now living in Vancouver Washington you're terrified you're terrified of taking your baby out the Walmart or the public library never get the accident so they have the disease is coming back because the older kids are catching it and the Ant and the anti-vaccine lobby where the personal Liberties of this parent now who's terrified to take her in her infant anti-vaccine he's a he's a big one he seems like a very intelligent guy how could he not be aware of the science behind this and what is he getting wrong what what is getting wrong is just about everything you know he's formed an organization called Children's Health defense and and start he had a press conference about it I think was September October of last year it is probably one of the best organized auntie

► 00:42:11

vaccine groups out the other things other than vaccines you doing a lot of things about environmental health and things like that I don't know any part of that business I've only followed what they what he does with vaccine but it's all it's all nonsense why is he doing this about back saying just don't know what he be a guy that you would want to have a debate with her have a discussion with but again I mean I'm uncomfortable with the idea of the debate because it's like it's like the bathing I don't know it's like debating a holocaust denier left the Holocaust exist I mean not that this mess up if you're you're complaining there's 19 books ahead of yours that are anti-vaccine books you've already lost the battle like it's time to regroup and maybe regrouping would be confronting someone with actual scientific information mean you are a real doctor your guy who actually studies is and you're a man who understands the science your legitimate academic you could you could actually put a dent in this with a real conversation

► 00:43:11

yeah potentially potentially me what would he be able to say like what is his take on it well remember he's he's an attorney and he's he's very clever right now he knows he presumably knows how to do arguments in court and what am I I'm a scientist do you think or do you think that maybe he's just incorrect into his accumulation of data I can't say what his motivation is but his his his information is is highly misleading what else is you say the lobby is this an organized thing good question again we need somebody who really wants to do a deep dive in this and kind of the sect out the pieces to understand but it's it's impressive what you got out their terms of the hundreds of websites in the amplification on social media and everything else is it are there just one or two or three groups behind it

► 00:44:11

or is it a random collection of organizations that that needs to be looked at what do you think is causing autism and in your personal estimation do you think that it is a that there is a rise in the factors that are causing autism or do you think that it's of a rise in the understanding of these variables that contribute to it that you could diagnose people within that before they were previously undiagnosed so I think most of it is that that we're just diagnosing it more recruiting individuals in the autism category that and we didn't before and by the way the numbers are about to go off even more because we're getting better at diagnosing girls and women with autism which is also quite interesting used to say it was 10 to 1 boys to girls and now we know there's a lot more girls to women on the autism spectrum it's just that they're usually more verbal and they can camouflage it better but they have very high rates of comorbidities like obsessive compulsive disorder

► 00:45:11

attention deficit hyperactivity disorder a lot of the teenage girls with eating disorders now they're finding could actually be on the autism spectrum so the numbers are about to go up again I mean that's just an example I mean is I guess what you're really trying to get at is it is it beyond that is there is there a bona fide increased beyond the number of diagnosis and and that one I'm still not sure about an article about early onset gender dysphoria being connected to young girls at the office right now but there's a disproportionate number of girls with gender dysphoria who turned out to be all so autistic I have heard that as well yeah that's actually so it's really fascinating I think about nice paper by very good environmental scientist named Phil Landry used to be at Mount Sinai now I think he's a Boston College now and he publishes about five or six chemicals in the environment which if you're exposed to 4

► 00:46:11

long periods of time during early pregnancy your child will be born with some features that resemble autism one of them is Depakote valproic acid which is a psychiatric medicine used as a mood stabilizer or an antidepressant so prolong use of Depakote during pregnancy has been linked to

► 00:46:39

something that resembles autism does a common medications a common medication but now that we know this information we don't use it anymore and someone who thinks that I've been saying to you know people like Bobby Kennedy and everything else if you really want if you really think there's some environmental linked to autism we've got a list of at least six chemicals during early exposure in pregnancy that are probably causing mutations and things like that that are leading to autism why don't we why isn't anybody looking into that it's just crazy at me so all the focus on Frozen to 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 or the other thing that happens in many state legislatures and things like that the focus so much about vaccines that we don't talk about what autism parents really need I mean what do I need for Rachel we need no employment counseling and help we need mental health counseling what do we do after we're gone Rachel right now

► 00:47:39

living with us I'm shy turn 60 my wife is in a 58 what happens to us 10 15 20 years from now there's no roadmap so so all of that gets shunted aside because of these phony baloney anti-vaccine arguments why I get angry that's when I start to realize these guys in addition to affecting public health or actually hurting autism families as well that makes sense I mean and I can completely understand why this would upset you especially as a scientist 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 and publish something about this is this something that is there an article that people can go to that says something about that I talked about it in the book and the book when I could open up the book I can provide it for you can read online about this without going to your book probably one of the problems that we face in this country

► 00:48:39

that we've put a lot of scientific articles behind paywall one of the things that I've done now is one of the I found it up an Open Access Journal call the public library science neglected tropical diseases so that anybody with the computer you know an internet connection in a printer can download the articles for you to charge and we need more of that that's great but right now if someone wants to find out these chemicals they have to buy your book or by some sort of access to Scientific I'm not sure what that particular paper whether it's behind a paywall or not I'll have to look

► 00:49:20

that means besides measles what other diseases are more prevalent now because of people not vaccinating the kids as one stuff to three diseases that I worry about the most actually for whooping cough is another one so that that was one but the other one I worry about the flu vaccine kids aren't getting their flu vaccine last year in the 2018 flu epidemic 150 unvaccinated kids died of influenza despite the recommendation of accident that can you enlighten me on this because what I've been told is that sometimes they get the flu vaccine wrong so you can get vaccinated but it doesn't doesn't protect you for the strain of flu that everybody's getting well so that's again something of us have an idea was heavily Push by the anti-vaccine lobby here's the story you're right last partially last year the other was not

► 00:50:11

perfect match between the between the the virus and the vaccine that killed virus and the vaccine and the wild-type flu strain that was out there but it was good enough to prevent you from dying and it was good enough that would likely prevent you from being hospitalized I'm so would happen if that's right cuz it was enough cross-protection so that it wouldn't they have the food they said all that it didn't work that's right but it did because it prevented you from getting sick and dying and then again that was that was a message that never really got out in 2018 who's a healthy person I've had the flu before but I don't usually get a flu shot that's crazy you should especially water is one of the leading it's probably the single leading infectious disease killer of of of adults in the United States but every time I do it it's really been like just a couple of days out I rest while you got lighter fluid

► 00:51:11

tell lucky my friend since I want yet yet yet I mean less than 80000 adults who died in the influenza epidemic 2018 in the United States your right A lot of them had underlying things like diabetes or cardiovascular disease respiratory disease maybe they were smokers but that they're still but they're still fat but you're still thousands of individuals who are perfectly healthy who died of influenza that we know so you mean you don't get your flu vaccine you're taking a terrible chance and and why not what I mean what what are you risking by getting the flu vaccine busy bro

► 00:51:55

you know what you know where I you know where I get my vaccination Walgreens even better we have a big grocery store chain and Texas a big Supermarket called HEB I get and I get it I get the injection right the pharmacy light the fire all of my vaccines I've gotten for the last few years been given by the pharmacist the flu since you been getting the vaccine every year you know I've gotten I've gotten sick but I would like a cold like a like a sore throat and feeling crummy was that a mild case of the flu I can't really tell but you've never gotten sick right after you got a vaccine some people do right know something about forgetting your vaccine you can get you some soreness and you can feel maybe a slight fever for a few hours or a day but usually it's your fine what is that

► 00:52:55

is that what is that fever why it why are you getting a fever because the the vaccine is stimulating the immune system and stimulating the inflammatory system so even though you feel like you're getting sick because the vaccines actually good for your immune system. That's right and you're not really sick I mean it's nothing like is nearly as bad as getting the flu I'm the other vaccine now that you're getting up there you have to start considering is the shingles vaccine shingrix and that's a that's a great vaccine it hurts though for a couple of days do you take care of your immune system and other ways do you take probiotics are you cautious about your diet I'm not as clashes about my diet is I should be on my junk food a holic actually it seems like a terrible thing for your help that is a terrible thing from something my wife is that working on it. That seems ridiculous for someone who works with health yeah yeah. Sometimes man I just don't get it right

► 00:53:55

how often do I steal a bag of chips or something like that that's my daughter with autism that's like our thing is to go to the called The Burger Joint or to Shake Shack to Canada to get a cheeseburger with sticks the sneak some fries though so you living large we call it mouth pleasure so much you willing to sacrifice a little bit I am the case well I mean I don't have to tell you but there's a large body of data that connects poor diet to a host of diseases

► 00:54:40

that seems like a crazy decision for a guy in your line of work there you go sometimes. Sometimes the it's not all brain it's it's it's something else but I mean if you ate healthy food I mean either thing is your body starts craving healthy food you start feeling no question about it because most in the Mets and American in the American Society of clinical research on the efficacy of vitamins especially vitamins D vitamins I have taken vitamin D for periods recommendation of my internet essential fatty acids with your great for your brain fish oil at all these different things that are fantastic. And I'm not going to argue with you you got you got you got it over me

► 00:55:40

listen to you would have a much better argument that you're over here making my life stay here taking care of yourself 100% and said I just don't need to get your stuff back seats aren't going to prevent cancer. Of disease or diabetes vascular disease, and other lifestyle change ya sedentary life I try to go on the treadmill for 30 minutes walk this morning I do that too so I don't I don't know but I deal with 30 minutes on the treadmill in the morning and then I take a long walk with my wife in the evening yes I find that very frustrating because you don't exercise right and then you eat you don't eat while while in your control the diet as well so that's why I have a solution to that and eat well and are

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does does a solution to that just do it and I treated like I'm brushing my teeth I brush my teeth every day I actually says every day too. So when I travel I don't have an option when I land I go to the gym this is how it goes I land I get my hotel room I put my shorts on yeah I did that too I do that too and I see only way if you have to do it if you've said this is just what gets done this is how you do it I try to be really compulsive about that so I know what I'm going to do especially if the hotel has a good gym the hotel if they have weights in the bunch of the outside only with chemicals and injectable forms to facilitate health fair enough

► 00:57:40

macromolecules what's the liquid typically would be saline or in a saltwater or not now what is missing from today's vaccine protocol if anything in terms of diseases we should be vaccinated for both are not yeah they're certainly are one of them is a big big problem on Young and sense especially premature infants call RSV respiratory syncytial virus infection what did I come from its what's a respiratory virus that Peaks around the same time the flu does so it's a very severe respiratory illness so this is again one of those vaccines that's not a big moneymaker so the Bill and Melinda Gates Foundation is trying to provide grants for supporting that one that that's a good one and then they're all the diseases that affect poor people both in developing countries that even among the poor in the United States

► 00:58:40

Facebook that's that's the next one how can marble help poor people infectious diseases and that the rise of these infectious diseases even the United States about that's all right I don't let let this big campaign to raise awareness of some to call neglected tropical diseases are in TDC so the most common afflictions of people living in poverty I call him the most important disease you've never heard of their diseases like schistosomiasis and show August disease and leishmaniasis and I've been devoting my life to seeing if we could develop vaccines for those diseases in the nonprofit sector you know because the big pharmaceutical companies just don't see just aren't going to take these on so we're trying to do in the nonprofit sector but this book The Blue Marble health book

► 00:59:40

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 that found something very surprising in 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 their their butt on the numbers bases most of these poverty-related diseases are actually in the G20 economies

► 01:00:15

the 20 wealthiest economies together with Nigeria which is not a G20 country but has an economy bigger than the bottom three or four so that was pretty amazing amazing for me to find that out because you know at first I didn't believe the numbers because I said well how could it be if their poverty related diseases why are they in the 20 wealthiest economies and then I realized that it's among the poor living in wealthy countries

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so the poorest of the Rich today now account for most of the world's poverty related diseases and what what's the cause of this so why why the link with poverty so that's a great so one of the things I do in the book cuz I asked that what what is it about poverty that's making me susceptible I don't think we really know if I mean clearly in some cases if you live in Port dilapidated housing without windows screen things like mosquitoes and kissing bugs and sand flies can get inside the house or if you look in important neighborhood so I can turn around Houston you see a lot of environmental degradation around the neighborhood you see discarded tires that breed it is chipped by mosquito or standing water but I don't think so. One of the best habitats for the mosquito that transmits Dengue and zika and a Chikungunya and yellow fever are discarded tires that's what they'll

► 01:01:43

so does she know if you go into poor neighborhoods you'll see a lot of Tire dumping for instance and that's those are habitats for that that 80s trip by mosquitoes blood in urine Southern Calif so is it when water gets Natasha a little bit of water that's exactly it yeah you know I moved into a house once in Encino down the street from here in fact and no one has lived in the house for about a year-and-a-half two years and the pool has not been taken care of and I went out into the pool and it was green and there were schools of mosquitoes on going to heaven if you don't have it so strange so you got absolutely that's where we're getting number of these diseases is really kind of amazing in that regard well it depends so you know it's some counties were they do aggressive spraying and things like that you won't but many counties probably probably some of the poorest counties poor District

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will do I mean in terms of the way it is on the East Coast like I grew up in Boston and then the summertime you just have fucking mosquitoes everywhere that they just can't get away from them and then I've been to Alaska which is the craziest place I've ever been to a my wife in terms of mosquitoes right have you been I haven't been to Alaska it's hilarious you get out of your car and they attack you like a horde of birds because you are super aggressive in their they're also very large the big problem is on the Gulf Coast of the us we have that fetus trip by mosquito and that's why I got so worried about zika virus hitting the gulf coast of the US yeah mosquitoes and other countries obviously contain malaria mean we've been very fortunate that that's never made it over to hear Stitch both the one that was a real killer disease called El Super in malaria on the Gulf Coast and even up into Illinois in the Ohio River Valley we had a lot of malaria

► 01:03:42

when was that buy back from the 1800s in fact there's a hole there's a book written by Dickens when he visited the United States called Martin chuzzlewit no need to scribes all these sickly people in Illinois and Cairo Illinois on the Confluence of the Mississippi in the Ohio River you clearly describing malaria why I did not know so what stopped it so that's a great question we so there's actually a very nice book written by a medical historian at Duke University named Margaret Humphreys call malaria race and poverty and she has a hypothesis what I think she's on to something that hit the decrease the malaria dropped and associate with aggressive Economic Development so that the FDR's New Deal including something called the agricultural adjustment act that got people off of off of with agrarian Pursuits and put them into factories quality housing went up and that's probably

► 01:04:42

cost a lot of the reduction in these tropical diseases members are really diseases of poverty I spend a lot of time working in China and I'm seeing that play out right now in China in a China is at this very very aggressive program of Economic Development mostly in the eastern part of the country but in the southwest part of the country going to Yunnan statue on provinces you go back in time 75 years and you still see those diseases 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 clearly economic development is a very potent driver know 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 study but you know unfortunately for many countries economic development is still decades away so that's why that's the rationale for developing these vaccine is it because Economic Development moves people into more urban environments with his left strap

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disease I think that's part of it although some tropical diseases thrive in urbanized environments like you know yellow fever and zika and Dengue as well so it's not only urbanization yeah it has to be urbanization with good planning that's not done on check that outstrips the infrastructure in terms of water and sanitation so this brings me to the thing that I wanted to talk to you about in the first place cuz this is what you brought up to me when we were doing this Sci-Fi show and you said something me that has been haunting me ever since that the vast majority of people that live in tropical climates have parasites

► 01:06:20

vast majority that's right. That's right there's things like Toxoplasma Gondii and let's look at those let's look at the Hit Parade right the top one is one call ascariasis intestinal roundworm are the estimates are on 800 million people have asked her if roundworms in their bellies so who live in extreme poverty 400 million have hookworm infection 400 million have Whiplash 200 million people with scabies which is an ectoparasite on on the skin that causes terrible itching and and secondary bacterial infections schistosomiasis is another month at point is every almost every single person who lives in extreme poverty has one of these what I call neglected tropical diseases and what are the interesting features about them is they're very debilitating they not so that not only occur in the setting of Harvard

► 01:07:20

but I think they reinforce poverty cuz they make people too sick to go to work they make actually shape we can show they shave IQ points off of kids where they have them with this is the hookworm connection to the idea of the slack-jawed dumb Southerner bright red States on my faculty of working with environmental activist named Katherine Coleman flowers and Alabama founded hookworm is still present in Alabama for the longest time there was a stereotype about people that live in the south that they were dull minded right and that this could be directly connected to hookworm infection which had run rampant right there is even the term given called The Cult drum of laziness that that hookworm infection because it causes severe anemia so if you're walking around with terrible anemia of course you're going to your to your not feeling up to

► 01:08:20

working a full day in and all that sort of stuff. Hook when was widely president present in the southeastern United States turn of the 20th century and then as malaria went down with economic development so it's so did hookworm infection as well but we still have pockets in this country and this wasn't understood at the time right they didn't know these people are infected with hookworm freak for for forever no up until very recently so the cause of hookworm wasn't discovered till 1900 what is that cause it's called indicator americanus the American killer is then that's the name of the worm and it goes in through the hands or enters all parts of the body, yeah when I found that one out I was like oh my god well that's it that totally makes sense because for the longest time is it there was that stereotype and then when you find out that is directly connected to

► 01:09:20

a massive infection of this disease has worm so these are the diseases that are holding back people who live in poverty originally I thought only in places like the poorest countries in sub-Saharan Africa southeast Asia but now I realize it's the pockets of poverty across the entire planet that people are affected by these disease and these diseases can be vaccinated that's where we're trying to prove that we can make a vaccine and there is a hookworm vaccine right now in clinical trials but the problem was it was actually causing people to get Lyme disease so that's a talk about controversial topics of that that was developed actually for my colleague of mine at Yale University that it was and they licensed it I think it was to GlaxoSmithKline and they developed it is a click all that limerick's it was the Lyme disease vaccine at actually most of the studies suggest that actually work pretty well the problem was there were a number of people

► 01:10:20

who felt that the vaccine made them worse or they said they had chronic lyme disease that wasn't effective so was really up Market perception problem more than anything else in the world Summit Lee hurt the bottom line of the company and they they withdrew it from the market got the vaccine and then got Lyme disease they think he got Lyme disease from the vaccine probably not as weird were well that's a nice night and get Lyme's disease is caused by the Lyme bacteria that the spirochetes called borrelia burgdorferi and the vaccine is not a live vaccine it's a recombinant protein based vaccine so it's not so there's nothing in that vaccine that could have caused this adverse reaction that they directly Tribute To That vaccine probably not your same problem I don't know the patient I don't even examine the end of a household

► 01:11:20

reinforce by a lot of negative information out there on the internet because it wasn't working but because of Market perception and and all that's hers and that was a time before the number of cases of Lyme disease have really taken off so vaccine because of perception I think the reason was because the the cost-benefit equation Works a little differently with measles measles is a killer disease Lyme disease without a killer disease and almonds wrecking people now and some case it seems to be connected to a host of other ailments to correct

► 01:12:08

like Lyme disease that exacerbates a bunch of different maybe possibly even existing health issues and this gets into another controversial Rabbit Hole I'm not sure we want to get into or not today but you know the Infectious Disease Society of America Francis has come out with a strong statement saying that there's really no such thing as chronic lyme disease and I'm the scientific evidence does not support something called chronic lyme disease got there lots of people suffering with chronic debilitating illness who claimed that it's caused by Lyme disease yes so this is something that is out there right now they saying that there is no such thing as chronic lyme disease what's their evidence the evidence is that there's no evidence that they can detect spirochetes in the body in many cases of people who had Lyme disease don't have persisted avid

► 01:13:08

having antibodies any longer to to the Lyme spirochetes so it's a whole different area but they do have this chronic inflammation and pain in their Joint breaking down they have something but it doesn't seem to the directions to decide if America which is one of the leading 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 there saying that there's no evidence that that that's actually associated with active infection with Lyme disease how are they describing and what how are they the song another what's what's a what's causing all these unknown unknown but isn't it bizarre the same people got Lyme disease first and then how about these host of issues after work well the 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 unfortunately there are number of his unscrupulous Healthcare Providers even Physicians out there

► 01:14:08

that are making the misdiagnosed either they're making a misdiagnosis of Lyme disease or in some cases they're actually taking everyone who comes to the door and diagnosing Lyme disease I'm sure you're aware the lone star tick allergy to red meat yeah right that's really fascinating is going well actually all star on the rise now possibly because of climate change which is another factor in her country that's doing that's all we're seeing you know if you'd look now it what are the big drivers of infectious diseases right now in the UN not only in the US but globally there really some interesting forces in a lot of them are social determinants so a big one is poverty that's that's a huge one the other big one is political instability in war because it interrupts Public Health control measure so for instance Venezuela which was leading Public Health control and Latin America

► 01:15:08

for decades know what the collapse of the Economy Inn in the in the shop as aronow into the Medora area Majora area we've got a terrible situation where we've had measles return in a big way so huge numbers of cases of measles while we fed all the neglected tropical diseases come back as well as malaria shots disease leishmaniasis so it's really interesting how that is destabilizing the whole region because now Venezuela has one of the largest diaspora is of people as big as the diaspora coming out of Syria and Iraq so now the diseases are moving into a stationary is a Brazil and Colombia and Ecuador and so it's really in the end that's another big driver is political instability the third one eye we think is climate change may be very important so you know why did we see this big surge of chikungunya virus infection in the Western Hemisphere razika we don't really understand the forces of that and what's going on in southern

► 01:16:08

right now is quite concerning we've had malaria returned to Greece after it's been gone for 70 years malaria is returned to Italy we're seeing schistosomiasis neglected tropical diseases on the island of Corsica we've got Dengue Chikungunya West Nile Virus across Italy Spain Portugal so we're trying to understand why that isn't there some thought that climate change maybe a big driver that now what other infectious diseases or parasites rather do they have vaccines for today have a vaccine for toxo but there's no vaccine for toxoplasmosis there's a prototype malaria vaccine that there's a malaria vaccine is calm Oscar access the trade enables developed supported with a lot of funding from the Bill and Melinda Gates Foundation and working in partnership with GlaxoSmithKline

► 01:17:08

that malaria vaccine now has been approved for use in children by the European medicines agency and its being introduced now in three countries in Africa Malawi Ghana I forgot the third one I think is there an adverse reaction that people have that stuff cuz I know the traditional malaria medication I had friends that took it and had horrible nightmares I am getting very blurry dreams and so far no

► 01:17:36

and so there when you say children how old are the children that they're at Beck's ending with us while the problem that you get into with malaria is that before 6 months of age you have maternal antibodies and Brendan Fraser born with antibodies from your mother and they'll start to wane by 6 months of age so the ones who get hospitalized with measles was what's called cerebro malaria which is a devastating condition artwork by severe malaria anemia which is also a killer are those children between 6 months of age and 5 years of age those the ones that we want to protect now and it's one of the leading killers of children globally right and sickle cell is connected to a crack right sickle cell is it has something to do with the people developing an immunity to malaria I'm surprised

► 01:18:36

I'm sure she is but she's well she's right home really is like it's it's not really but it's a natural protection so individuals who have the sickle cell trait seem to be partially resistant to malaria and that's the thinking why the gene for sickle cell has been preserved in Africa for so long is because it does confer some protection against malaria so the reason for keeping the gene in the gene pool that we were actually discussing it because of friend that I grew up with died from it so it seems to only exist in African Americans or Africans is that correct if there's some other places as well but predominantly place an African and African-American people whose ancestors came from the tropical climates right so it's really quite an amazing story so there's no no no vaccine for toxoplasmosis is there anything on the horizon is there anything we worked

► 01:19:36

because that's a big one right it's a real big problem on people with HIV aids for instance that's it because it reactivate your toxoplasmosis and we even see it and I even seen in kids sometimes but the thing is it in some countries up to 30% of people are actually infected with Toxoplasma 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 reactivated and cause of called cerebral toxoplasmosis pictures of quite serious so most people Handler toxoplasmosis very well you know you do die with it and don't even know you have it but in some cases it gets reactivated 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

► 01:20:36

why would there be no incentive is such a large-scale disease its hundreds of millions of people worldwide right that's right and part of the problem is we have almost no information on the actual number of people who have it and how extensive it is so we call that disease bird we don't have good disease burden estimates of toxoplasmosis feral cats and I'm praising systems intact than you're okay now there isn't a related disease that from cats called toxocariasis and that's a parasitic worm infection or finding in the United States among the poor and that's a weren't so what happens is if you going with the poor neighborhoods you know you see a lot of feral cats and dogs and for neighborhood Almost 100% of them have this warm in their intestines and they're seeding the environment with eggs in their feces in the feces are spread all over the poor neighborhood kids come into contact with them in the worm

► 01:21:36

the ability to my grits to the brain across syrebral toxocariasis and I think it's an important cause of Developmental delays it's one of those neglected diseases in the US and talked about in the book and there's no vaccine for that either no vaccine for Edwina very little awareness about it wow so it's not rare I mean in some cases do you know up to 10% certain populations like African African Americans living in poverty are infected with it and it's primarily pets or does it is it rodents as well at least mostly stray dogs and a stray dogs and cats and dogs and I give her in this is an example of a neglected tropical disease here's here's a disease of up to 10% of African Americans living in poverty in the United States and almost nobody is studying how right it can affect the way your mind function right now to developmental delays so you know everybody wants to know why you no key

► 01:22:36

is living in poverty have developmental delays in people just assume it's because they live in deprived environment and that sort of thing but I think toxocariasis is an important underlying reason for it in this is an example of a neglected disease know we I mean everybody's heard of Ebola Ryan and everyone's worried about ebola and and the truth is Ebola is never going to come to the United States why not ever going to because it's too difficult to transmit unless you have a complete collapse in the house system we're never going to have Ebola epidemic in the United States but here's a disease of 10% of African Americans living in poverty and no one's heard of it and sent it to study it so that's why I'm trying to raise awareness about these poverty-related diseases and events that's why I don't understand why people don't talk about that it's a no-brainer right I mean cancel but you know it's very hard to get people to care about to seize the pot Ramen and this is one of them striking things about when I wrote the book

► 01:23:34

was you know I've had a lot of success getting people to care about neglected tropical diseases in Africa and worked with you need the u.s. agency for International Development to support a package of medicines that's not speaking Minister Tober a billion people annually and now he knows one of my proudest accomplishments has is helping to raise awareness about neglected tropical diseases like we've been talking about a book Mormon sheet to my assistant Africa each Latin America but the minute I talk about poverty related diseases in the US the lights go out why is it I don't know I can't I can't figure out what I'm doing wrong success getting parent people that care about Auntie Dee's neglected tropical diseases in poor developing countries but you know there's been no response to this book I mean it is

► 01:24:24

and in the estimates and I come up when the book are we have 12 million Americans live in poverty with a neglected tropical disease toxocariasis is one of them another one is Chagas disease and the list goes on it's been very hard to get people to care about the poor in this country that's very strange to me and I've always said that about the way we treat other countries we want to send the maid and rebuild these countries but we don't do anything about these terrible communities that have been terrible in this country for decades upon decades so I try to make the point the world has changed this whole Norm of global Health developed vs. developing it still exists but it's going away where what we're seeing is our general rise in all all economies in some African countries of 8 or 9% economic growth but it's all leaving behind the bottom segment of society 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 to see

► 01:25:24

and you know I know what's your name AOC congresswoman from New York is talk a little bit about hookworm in Alabama somewhere last time I was in Washington I dropped off a copy of the book in her office but no response yet she's pretty busy too. She's doing a lot of other stuff and someone said you could do whatever you want to fix this what would you do so I did meet with a couple of people on the hill and and they asked me that question what's the magic wand and there's a couple of things one we need to actually look for these diseases because the problem is they're the the disease that causes a sudden like developmental delays so that if you're you know a kid who lives in poverty with developmental delays the pediatrician both even think to do a test for toxic Rises so that was so we need to raise awareness we need to go into poor communities across the country and actually take a blood test and act

► 01:26:24

measure for the presence of that disease where that parasite once you find that disease what would you do that well it depends on the disease in some cases we have treatments for in life the treatment for toxic rice is a 5-day course of a simple pill of albendazole the one I was looking for these diseases the other one is really trying to understand how these diseases are transmitted what is it about poor neighborhoods that is facilitating transmission I think the third problem is the diagnostic test themselves because they're very complicated test sometimes you know they are done at the Centers for Disease Control and prevention are lab or national school of tropical medicine does a few of them but it's not like you know when you go for a you go for blood work and your doctor and you get a little lab slip from Quest Diagnostics with the you know the blood chemistry is the blood counts there's no box there

► 01:27:24

toxocariasis and improve test point-of-care diagnostic test test but just make it more accessible to the CDC or to the International School of tropical medicine is there treatment for toxo there is a treatment for toxoplasmosis what is it it's a pair of methenamine sulfa drug

► 01:27:49

but it requires a long treatment course how long I'd have to look up the number to days I haven't read a page with toxoplasmosis in a while but and you kept for life if you don't get treated right okay so then if you're compromising the comes back then that that's a problem as well so most people that have it really don't even know they have this right and most people who have neglected tropical diseases don't know they have it either of a parasitic disease called shock heart disease we are members of our faculty we're actually able to track down individual to a donated blood and the Gulf Coast Regional Blood Authority actually found

► 01:28:40

somebody popped people positive for Saugus disease they were told to go see your primary health care provider and the unfortunate the primary health care provider is not educated about these diseases and they just as it must be a false positive so you know our faculty attract them down and raible to get them into treatment and what is the treatment for Chagas had it so that's a anti-parasitic Asian called that's all and that kills it that can kill if you catch it early enough but sometimes you don't catch it early so if I become systemic then you have then that's why we're trying to develop a therapeutic vaccine for this disease but again it's a therapeutic vaccine for poverty related diseases what's up it's very tough to know it again I'd love to hear your thoughts mean what is it that we just turn our backs on the poor in this country and so this disturbing is ready to stir is a dismissive out and and they

► 01:29:40

disproportionately affect people of color as well right now cuz you know because it's so linked to Poverty well also write slavery in the history of slavery in this country than the history of systemic racism in places where they just literally would not sell homes to people who are African-American all these things are connected to the the contribution of maintaining these impoverished communities and it's been almost no effort whatsoever other than the people living in the community trying to do better and raise everybody out there's been no effort whatsoever by the federal government to step in and try to rehabilitate a large-scale approach the rehabilitation places like the ghettos of Houston or Baltimore or Troy know I thought I knew before I move to Texas in 2011 I was cheering microbiology George Washington University and I thought I thought I knew it poverty look like I move down to the Gulf Coast it's a different animal that mean the the day

► 01:30:40

Brett the poverty in the Gulf Coast in the southern part of the United States is just extraordinary and it's been very hard to get people to want to really take it on and really addressed these these poverty-related and see since you think what do you think the cause of it is if you've studied this for quite a while what the cause of did neglect yes yeah I don't know what you know of is it something about American exceptionalism or something we just don't want to admit we have poor people I don't know you know what I wasn't the first to come up you know to raise this issue my poverty 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 was called the other America was written by a fantastic social activist named Michael Harrington who is I think someone toys very devout Catholic actually so and he wrote this book called the other America talks about the hidden poverty off the road

► 01:31:40

and the actual number of people who live in extreme poverty hasn't changed since that book was written in the early 60s that book was hoped was what helped Lyndon first Kennedy then Linda Johnson launched the war on poverty 1964 I dusted off that book and it's still it's still works today and that's how I start out talking my book Blue Marble Health about that book the other America by Michael Harrington yeah that's that is a very strange thing our acceptance of these communities and have always said that if you want to make America a better place

► 01:32:16

the best thing to do is not invade other countries or intervene the best thing to do is try to rebuild these impoverished communities one set of civilization is Judge by the treatment of its minorities and we're not by that criteria we're not doing so well you know the young we are country was visited by the United Nations special repertoire on poverty into a 2017 and his numbers came up with we have 19.4 million Americans who live in what's call Extreme poverty that is it half the u.s. poverty line and roughly around 5 million Americans living on less than $2 a day the same Benchmark could use for Global poverty everywhere and and guess what those probably all have neglected tropical diseases just just like just like those living in extreme poverty in Africa and they're waddling people living on $14 a week to $2 a day yeah that's insane

► 01:33:15

University of Michigan Center on poverty is also shown that we have to get the number 2.7 million families living in less than $2 they which is probably about the same as the 5 million Jesus Christ now and again this is not a topic that is very popular mean when you see presidential debates this is this is not something to come out and then nobody talks about it even for disease I mean foot what are the diseases we hear about ebola disease is like that in some types of my frustration I say you know where these are imaginary diseases and yet here we've got widespread disease of the poor in the u.s. in the lights go out remember when that woman came back from Africa and she was a nurse and she had been in some connection contacted with ebola she didn't have it and they want to quarantine are they stuck around and some

► 01:34:12

cabin on the airport or something crazy is terrible. What did you think about that I just thought it was so cruel is it just an ignorance of how the ads Modesto right how is it transmitted you know what turns out as the opposite of measles measles one of those contagious diseases known it has a reproductive number of 12 to 18 but 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 hangs around the Stables right so that's why you get these really large measles outbreaks like your singing Washington State and usually those are infants under the age of 12 months not yet old enough to have actually loved ones wind-up hospitalized the

► 01:35:04

the ball is just the opposite t-ball is a reproductive number of two or three so unless you're taking care of a dead or dying Ebola patient or someone has recently died cuz that'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 so the reason is being so hard right now to contain the Democratic Republic of Congo is not because it's so highly contagious is just that the place is decimated by the claps and infrastructure associate with Civil War so even though we have now and Ebola vaccine it's hard to vaccinate everybody and how is it transmitted by contact with fluids of somebody with with you both so it has to get into your tissues right now

► 01:35:49

what else should we worry about your freaking me out the point is a lot of these diseases are solvable if if we just put our mind to it and where of it was one of the things I say in the book is if 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 the G20 Summit and say we're really going to do something about the neglected diseases in our own borders and I will quit the United States we could get rid of two-thirds of the world's poverty-related neglected diseases right off the bat wow so a lot of it is political will

► 01:36:34

what is it seems like in this country ignorance is a big part of it because this is something I thought about many times but I didn't know about cha got to know about a lot of things at a distance you're describing yeah I know I mean so we need to raise awareness about these that's why I'm so thrilled that was so thrilled to come here because I've just amplify the number of people who've heard of this concept of Blue Marble Health has a name that I've given the different name from Global Health it to separate separate from the two so you know coming on here is so powerful in terms of amplifying that message so again back to the magic wand but what could be done I mean is it a funding issue or is it at first before that an education issue well I think there's multiple issues so I mean if the drivers we've been talking today about promoting these diseases

► 01:37:26

really tough to do anything about extreme poverty war in Conflict climate change climate change clear there's some things we can do aggressive unchecked urbanization but the other things that you can do is build better tools by the enemy better Diagnostics better drugs better vaccines and unfortunately for these poverty-related diseases there's no Market incentive for it so it falls to academics to professors two people trying to do this in the nonprofit sector and we're doing the best we can but it's not nearly as good as having access to getting the pharmaceutical companies involved as well as also seems like this would cost an insane amount of money to just go through all these poor communities test everyone to start Distributing these these drugs and what would pay for all that stuff well you know some people ask me to love what would the Affordable Care Act take care of this nice it will work to step

► 01:38:26

away from the affordable 4222 standard deviant not just MD weekday to Degrees of Separation away from the Affordable Care Act cuz we're not even every recognizing these diseases yeah you got to know about it first what percentage of the population even knows about all these

► 01:38:46

parasite created diseases that vaccines don't cause autism. That's the biggest one I mean that's about fun and again I don't understand it I mean I'm just saying it I'm saying vaccines don't cause autism cuz you're saying it right and then I think this is the part of boat is a lot of be a part of the problem that you were in this boat bunch of people who are scientifically illiterate like myself are discussing these issues who don't really know what they're talk like a guy I saw someone talking about tetanus cuz some boy had tetanus and he was in the hospital for a long time and is his bills hospital bills like a million dollars okay and yeah yeah because it's an ICU admission and they were saying hey you know why I didn't get a tetanus shot and it get it goes back to the same thing right the people don't want these vaccines the parents I think the parents in some ways are victims themselves or victim of this very aggressive

► 01:39:46

information on appendix out there cutting this is a big one though isn't it that's part of the back of the DPT that's one of the first vaccines you got is an infant there's no excuse for having a Sprite and this kid was unvaccinated right yeah that's my understanding is there a cure for tetanus outside of vaccines are supportive measures that you can do but you know they require hospitalization ventilation put on a respirator it's it's a bad and you can still die so it's it's an awful awful disease I've seen tetanus working in Central America and elsewhere you see a case of technician never forget it either name is lockjaw where your muscles go into spasm and and you including the muscles involved in breathing so you can't even breathe as a result of inherited freezes the muscles what it what is doing it what's doing is it in Paris it's actually caused by a bacteria the bhakti

► 01:40:46

releases a toxin called tetanus toxin

► 01:40:50

what something horrible way to go see parabenizar awful diseases and I think one of the things that the NT vaccine group Allah be as I call it does if they try to be very dismissive of these diseases they try to deliberately downplay the effects I mean you'll see the stuff on the web measles build your immune system said it yourself I didn't read it yet I just saw it as it doesn't make any sound of somebody asks it scrapped right now and it's it's it's something out of from a different planet I don't know where that could we do that I think the reason for that becoming popular is because you we do kind of helicopter parent our kids a little bit too much they should come in contact with a bunch of different things cuz it does build their immune system correct well that's an interesting hypothesis is called the hygiene hypothesis

► 01:41:50

is there a living too sterile environment than this can also result in autoimmune diseases and things like that but it allergies allergies and I have mixed feelings about the hypothesis to me it's not not airtight by any means but it's some sort of a correlation particular between peanut allergies and keeping peanuts away from children and that there was a study showed that Jonathan paetz work in one of his books talked about how there was a study done in the communities where they didn't protect kids from peanut allergies in this much smaller percentage of people developing peanut allergies versus kids if they did one of the things that the end table he's doing now that you know when I write a book like this vaccines don't cause autism now what you're saying 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 now there's some groups that are moving away from autism all together and

► 01:42:50

they're saying no vaccines cause autoimmune disease are vaccines cause other neurological deficits that it's all it's all flim-flam it's all there are vaccine courts the right in vaccine vaccine courts and they have handed out payments to people who were injured by vaccines right what it what is that so I know it was for instance if you look over a 10-year. I think it is between I haven't looked at the numbers in a while I think it's between 2008 and 2014 2015 over that period of time there were 2.5 billion doses of vaccine given 2.5 billion of which the vaccine quartz identified around 200

► 01:43:38

that were a list of serious injuries that could be that they have a table of that they could a tribute to vaccine so there are 2,000 payouts one of those 2018 % didn't really think we're tribute at the vaccines but they paid it out anyway cuz I saw the courts work and then 200 where they could really say yeah it looks like this could be related to vaccine so you divide 200 by 2.5 billion that's one in 10 million or even 2000 by 2.5 billion cells other than the shoulder injury that you were talking about the other so there's a list and I talked about in the book there's actually a table you can download on the web of breach vaccine a list of potential injuries they allow these potential is it as we were talking about earlier is this just biological variability that some people just react differently to different things I think in some cases we don't know another cases you know with the live

► 01:44:38

Paris vaccines if you have a severe genetic and immune deficiency in the maybe it wasn't picked up then that then there's that risk but you know what's what's a one-in-a-million what's a 110 million race cuz I said we have to keep that in perspective because the odds of getting hit by lightning as one of 700,000 and you believe that number or you know what's the risk every time you take your child out of the car and drive around the neighborhood I'm sure the risk is far higher than one in a million and the real danger is these actual infectious disease is spreading and the Damage they could do damage things like that in there and coming back Yeah Yeah Yeahs meet measles is it is an awful disease causes measles Encephalitis measles pneumonia I find it a lot of people that are that are steadfast in their resistance to vaccines they they also believe in a lot of other questionable things it seems like these things get lumped into these groups of things that they don't trust the government about

► 01:45:38

Frank I think that's part of think that's probably true

► 01:45:44

that's what it's not sure which was which was in Twilight you know it was interesting so you know I said we know we need to hear from the Centers for Disease Control and more in the Surgeon General now they're starting to speak out but he knows people tell her that she was part of the problem is people don't trust their government I say the last true but I think most people if you know if we had no more visible Public Health Force out there people would listen to it talk about in terms of these poor neighborhoods in these parasites getting the people cyst of infecting cognitive development and what it was the other one besides chocolate was toxocariasis was the wisest cognitive development African Americans living in poverty with toxic Rises wow it's not a rare disease Joe this is this is a common disease affection is not dramatic it's not

► 01:46:44

not Ebola it's not killing people is this mostly in this is as well it's probably a common in the South than in the north is it because they're long longer time to develop the eggs are in the extra in the environment of the worm develops with with it within the egg is there any other diseases that are going on that we don't know about yeah yeah sure there's other pictures of brain parasitic infection called cysticercosis found that one is from eggs often from individuals who have a tapeworm so that's we're seeing cases of that there's some of the virus is transmitted by mosquitoes one of us we don't talk about a lot which is very serious infection is West Nile Virus Infection that's got very high rates of not only Encephalitis but also on one of our faculty members Christy Maria showing very high rates of depression and other neurologic debilitate

► 01:47:44

4 and that's another one we could probably use a vaccine for but there isn't the mark incentive to do in West Nile Virus does come up though that least that's disgusting a news and people aware of it right right but there's no vaccine is nerve actually but there could be what is it there could be holding it back is lack of Market forces lack of financial incentive for the pharmaceutical companies to take it off so if there's an extremely large investment to develop something along those lines perspective a tough sell because you know there's a possibility the person that you need many years of clinical trials it can sometimes take two decades from the original conception of a vaccine to actually going through clinical trials for the hookworm vaccine I've been working on we've been doing it since the 1990s so we're talkin decades long time Horizons when you talk to an investor about something with decades long time Horizons

► 01:48:44

you're not right the light the lights go out I mean that very quickly so we're gets gross right because this is all we were lying on these private businesses to invest money to cure a public health issue that's right. It's right that seems kind of crazy while so in response to that what happened was after the Ebola Fiasco in 2014 where we didn't have any Bola vaccine library in Sierra Leone group of individuals came together a Davos World economic forum and including the Gates Foundation and they put around nipple developed this concept or which an organization called seppi the Coalition for epidemic preparedness Innovation to incentivize biotech and pharmaceutical companies to embark on diseases for which of pandemic potential like Ebola like Lassa fever like mares coronavirus infection and that was great but the problem is

► 01:49:44

in the trustees poverty-related diseases so those of us who work in poverty related diseases are still kind of on the outside looking in it just seems like having everything managed by private companies that need to the need to have some sort of a financial incentive to attack these diseases that seems like a crazy way to deal with Health crisis that's right that's right and so what I've recommended does I said this that organization seppy is great for what it's doing but we need another mechanism what I've proposed is that I'm since he's 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 public sector funds for investing in developing vaccines and treatments for poverty related diseases these chronic debilitating diseases and in fact you know we can show that using working with health Economist we actually work with it

► 01:50:44

terrific Health Economist his name is Bruce Lee of all know he's a professor Johns Hopkins he's been able to show that are vaccines are not only cost effective their cost savings meaning that their economic Lee dominant that they'll actually save money the problems you still doesn't help you with the fact that you still need some but the return is on public how you still need somebody to come along and provide that investment yes I'll let you know so what's happened is our our technical ability to develop vaccines has outstripped are are are financial instruments that we have to do it 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 or come in the public services in an all-time high and they say you know doctor hotels I'm all in I'm going to go into Global health and they're a little bit disappointed when I tell them

► 01:51:43

get an MBA or get a law degree because where we need the Innovation now is in the Ensign the finance sector there's a there must be a business model out there that would work that would figure out how to do this I just don't have the background to do it 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 in these treatments and they have to do with some sort of a financial incentive if they don't have a bucket of gold at the end of the rainbow did not going to take a ride that's right that's right so that's crazy is crazy but that's the reality and so what the exciting thing about what I do is not developing these vaccines for poverty related diseases there's no roadmap 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 the terrifying thing the thing keeps me up at night is there's no roof

► 01:52:43

how much does it cost to get a vaccine in general from developmental. To actual application pharmaceutical companies have traditionally said billions but I don't think that's the case I think one of the reasons are recovering their R&D costs another putting money into our environment that they that they that they charge in order to you knows either make a profit or at least they even still friends in the cervical cancer vaccine the HPV vaccine that you know when I last look was $420 for the three doses it doesn't take cost $420 to make that vaccine it it's just that they're recovering their R&D costs which is which is fair enough so one of the things that we're proposing to do for our neglected diseases vaccines is will D-link

► 01:53:43

the R&D cross mother was a we've gotten grants whether it's from The Gates Foundation in the pasture 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 I will just you know that was used for R&D and we would just cause 4 the cost of good so at least we can get it down just a couple of dollars at dos a few dollars does out for anybody this listing is conversation and they have additional questions where's the best place you should guide them we would it be your books probably the books cuz I wrote the books for Lay audiences my leg and it's a sort of it mean when somebody with a cowl University education but I mean they're not they're they're published by Johns Hopkins University press so dry and they are kind of

► 01:54:32

there's an even in terms of how weighty they get into the science but certainly the vaccines. Cause Rachel's autism I wrote it with the idea of parents vaccine hesitant parents also the pediatrician's cuz the other problem with pediatrician says you know they're there in their office and parents are reading the stuff against it and they come in loaded loaded for bear into the pediatrician's office with all these factoids and the pediatrician's like what you had never heard that before in the and then the pediatrician is made me feel stupid like he's not keeping up with the science he is or she is but it's just they're not keeping up with the misinformation so I provide talking points in the epilogue of the book and Blue Marble health is the best resource for people to understand these diseases of the poor and Wealthy countries that have a third book that I wrote a few years ago gotten people forgotten diseases that describes when the collected tropical diseases someone gets motivated to create some sort of a documentary really on both

► 01:55:32

subjects and I think that we would greatly benefit from some clarity for people that do have concern about autism that's in adage estable form for good or for bad people like to watch documentaries and I hope you don't get to beat up over this because I know the anti-vaccine groups are very passionate and while I'm in there that day if they have a position where they beat me up a lot like I'm sure they're go out to you and to call me a shield they call me a show for a lot of things though I'll be leaving the round earth Jamie has a t-shirt that he sells that young Jamie., round earth shill right literally I've been called the round earth shill is Lotto so but if I really think it would be it would do a good service if somebody did put together a documentary because I don't think most people are aware I think most people just relying on this fee

► 01:56:32

like the vaccines do cause autism I'm there's also this connection between people that are older correct when when they're older and they have children there seems to be a lot more like it there seems to be in that may be related to as you get older your sperm are your egg have some genetic instability and more likely to produce mutation yes that's probably the man that would go hand-in-hand as genetic basis of autism and then the Blue Marble health book I mean what what you've been saying today about these diseases and how many of them exist and how many of them are almost unknown untreated right undiagnosed and just how many people are unaware I really hope someone does something about that too but in the meantime people can buy your books are they available in audio as well definitely the vaccines. Cuz Rachel. Business audiobooks and I'm not sure about Blue Marble out okay but you can get it on Amazon thanks for being here appreciate it's good to see you again thank you for raising awareness of all the stuff I really appreciate you

► 01:57:32

you are coming down here and explaining a lot of stuff for us it's been a great time I really enjoyed the opportunity if you want to get ahold of you on Twitter what is your Twitter app Peter hotez okay thanks I appreciate you

► 01:57:45

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