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I Don't Want them to Get Away With It…

2024-10-25 · explainer · Hank · 5:08 · watch on YouTube

Topic: Global development (also: Health) · mode: Advocacy & fundraising · tags: timely hook, self promotion, heavy topic

Hank explains how strep was diagnosed by culture and now by rapid antigen tests, why TB resists such tests, and how GeneXpert's DNA cartridges detect TB and drug resistance; he says cartridge costs leave TB (and lymphoma mistaken for it) undiagnosed, that Danaher cut its standard TB cartridge to $7.97 but keeps drug-resistance cartridges at $15 and has not released its promised audit, and praises John's book Everything Is Tuberculosis.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — Strep diagnosis by blood agar culture and by rapid antigen tests; why antigen tests fail for TB

  • ★ Hank recalls getting strep a lot as a kid and clearly remembers having his throat swabbed to test him. — 00:00:12
  • ★★ Hank explains that in the 1980s a strep swab was cultured on a blood agar plate made with sheep's blood; strep broke open the red blood cells, turning spots of agar clear. — 00:00:20
  • ★★ Hank says culturing is a way to find out what disease a person has, but not a great one: it takes a lot of time and sheep's blood. — 00:00:38
  • ★★ Hank says strep is now mostly diagnosed like COVID, with a rapid antigen test whose binding molecule changes color; it is fast, cheap and pretty accurate. — 00:00:47 · COVID-19 pandemic
  • ★★★ Hank says rapid antigen tests don't work for TB: there are often few bacteria in the body, TB hides well, and its big, oily, waxy cell wall is hard to bind to. — 00:01:05 · tuberculosis

00:01:27 — TB culture today and GeneXpert's DNA cartridges that detect TB strains and drug resistance

  • ★★★ Hank says TB is still often diagnosed today by culturing the bacteria, which is slow, labor-intensive, expensive and not very informative. — 00:01:27 · tuberculosis
  • ★★★ Hank says the GeneXpert test arrived in 2013: instead of binding surface molecules, it explodes the pathogen and tests for specific DNA sequences. — 00:01:37
  • ★★ Hank says such tests can detect specific strains, including genes that help a pathogen survive a particular treatment. — 00:01:57
  • ★★ Hank says that with this technology a new test only needs the right target DNA sequence and a label for it; the sample glows under specific wavelengths of light. — 00:02:05
  • ★★ Hank says one cartridge can hold several labels glowing at different wavelengths, e.g. four for four genes, showing exactly which drugs a pathogen resists. — 00:02:30

00:02:55 — Cartridge costs, lymphoma undiagnosed as TB in poor countries, Danaher's at-cost pledge and missing audit, praise for John's book

  • ★★ Hank says the technology is used all over the world and its maker Cepheid, a division of Danaher, makes a lot of money from the tests. — 00:02:55
  • ★★ Hank says he thinks it is great that Cepheid makes a lot of money from the tests. — 00:03:00
  • ★★★ Hank says that in some places cartridge costs mean the tests go unused even where the machines exist. — 00:03:05
  • ★★★ Hank says he recently learned lymphoma rates are very low in the poorest countries because people assume they have TB; with no test, the cancer goes unrecognized and they die. — 00:03:12 · tuberculosis
  • ★★★ Hank says people dying of undiagnosed cancer for lack of a test doesn't have to be this way. — 00:03:24 · health equity
  • ★★ Hank thinks Danaher's pledge a little over a year ago came partly from this community's pressure. (hedged) — 00:03:30 · Nerdfighteria
  • ★★★ Hank says Danaher pledged to provide standard TB cartridges (not drug-resistance ones) at cost to the Global Fund, cutting the price from $10 to $7.97 and allowing millions more tests. — 00:03:35 · tuberculosis
  • ★★★ After showing Danaher's statement, Hank says more than a year has passed and Danaher has not done the audit, joking that annual things happen every year. (playful) — 00:03:55
  • ★★★ Hank says he was lucky to read John's book Everything Is Tuberculosis early; it changed how he sees all illness, with fascinating histories and stories of present-day tragedies. — 00:04:05 · Everything Is Tuberculosis, John Green, tuberculosis

00:04:23 — The 20% price cut versus $15 drug-resistance cartridges, the audit, thanks to John, sign-off

  • ★★★ Hank says the standard TB cartridges got 20% cheaper, but those testing for drug resistance remain $15 though by all accounts they cost basically the same. — 00:04:25
  • ★★ Hank says it is frustrating that Danaher has not released the audit. — 00:04:33
  • ★★★ Hank proposes giving Danaher a little more time, since the audit may have been harder than expected, then pointedly asks whether it will release it soon. (playful) — 00:04:38
  • ★★★ Hank says these things change when we pay attention, he would never have paid attention without John, and thanks him for his work and his book. — 00:04:55 · John Green

In the description and comments

Threads in this video

Where the stories that moved here went next

Mentioned

Central: Danaher Corporation · Everything Is Tuberculosis · GeneXpert · tuberculosis

Also: Organizations: Cepheid · Global Fund to Fight AIDS, Tuberculosis and Malaria

Concepts: antimicrobial resistance · cell wall · DNA · health equity · lymphoma · multidrug-resistant tuberculosis · rapid antigen test · red blood cell · Streptococcal pharyngitis

Events: COVID-19 pandemic

Only in the description or credits: United States · United States presidential election

Also centred on Danaher Corporation: Barely Contained Rage: An Open Letter to Danaher and Cepheid · Talking Tuberculosis, GeneXpert, J&J, and more with MY HEROES · So, um.... GOOD NEWS?!?!?! · End of a Rough Year · I Own Danaher · Is It 2010? IT'S A PARTS VIDEO

Also centred on GeneXpert: Barely Contained Rage: An Open Letter to Danaher and Cepheid · Talking Tuberculosis, GeneXpert, J&J, and more with MY HEROES

← Previous: My New Book: Everything Is Tuberculosis · Next → If Hank and John Were God for 15 Minutes