We can’t all go to Ethiopia, Uganda, or Haiti, or perhaps even to a malaria vaccine lab in a strip mall across town, to witness suffering or to fully understand the need, opportunity,
and possibility. But if we are purposeful about using our moral imagination, we shouldn’t have to.
In today’s world more than at any time in human history, we have access to all of the information we need to bridge the chasm between distant and near. The question is what we will do with it: whether we will not only analyze and categorize and think about it, but also let ourselves feel something about it and act on those feelings.
Compassion is both blessing and balm. But unless it is hitched to the power of imagination, it can leave us one step behind the next tragedy, and the next, always a day late and a dollar short. We’ll likely end up doing good, but not nearly good enough.
Moral imagination is supposed to be what differentiates us from other species. But our boast is bigger than our bite. We remain only partially evolved, a work in progress to be admired and resisted both at once. We find ourselves, as Bruce Springsteen sings, “halfway to heaven and just a mile outta hell.”
If we hope to truly change the world rather than just the bits and pieces of it that drift in front of us, we must reach for more than the traditional tools stored in those drawers we glibly label “social entrepreneur,” “business leader,” or “politician.” Indeed, we must reach inside, not out; we must shape our own evolution, with faith that the greatest value we can deliver may lie not in what we know but in what we seek to know.
ACKNOWLEDGMENTS
T
HIS BOOK WAS MADE BETTER by many heads and hands—especially by PublicAffairs editor Clive Priddle, who created order out of chaos. He never lost sight of the story I wanted to tell, even when I kept it pretty well hidden. Thanks also to my initial editor, Morgan Van Vorst, and to Susan Weinberg, publisher, and Peter Osnos, founder and editor-at-large of PublicAffairs, for taking a gamble on this book and for their faithful commitment to giving voice to those who might otherwise be voiceless. Katherine Streckfus’s copyedit improved every page and I deeply appreciate her extraordinary diligence, as well as the formidable production skills of Melissa Raymond. I am also grateful to my longtime friend and agent, Flip Brophy, for helping to make such a perfect match, as she has done many times before.
There were many experts in the global health field who generously guided me through their own stories as well as the history and science of malaria and vaccine development. I
have the utmost respect for their expertise and dedication. They include Ruth Nussenzweig, Pedro Alonso, Peter Hotez, David Lanar, Jay Keasling, Kinkead Reiling, Jack Newman, Paul Roepe, Dan Carucci, Marcelo Jacobs-Lorena, Judith Epstein, Victoria Hale, Ray Chambers, and Brian Greenwood, and also Regina Rabinovich, Joe Cerell, and their colleagues on the staff of the Bill and Melinda Gates Foundation.
My greatest debt of gratitude goes to Steve Hoffman and his wife, Kim Lee Sim, who repeatedly and patiently opened up their lab and lives so that I could get a glimpse of the human trials and tribulations behind the science. Their work, assisted by their three sons, has genuinely been a family affair, and if the way Alexander, Ben, and Seth have turned out is any indication of how Sanaria’s vaccine to eradicate malaria will fare, the world has reason for hope.
At critical junctures along the way, I was sustained by creative and caring friends, including, first and foremost, Jeff Swartz, as well as Joel Fleishman, Harris Wofford, Chris and Diana Chapman-Walsh, Leah and Bill Steinberg, Rick Russo, David and Katherine Bradley, Sue and Bernie Pucker, and my sister-in-law and babysitter extraordinaire, Patti Jordano.
The staffs of Share Our Strength and Community Wealth Ventures generously took up the slack, as they always have when my attentions were focused elsewhere. Their unrelenting determination to end childhood hunger, and the sacrifices they’ve made in pursuit of that goal, speak volumes about who they are, the choices they’ve made, and their shared commitment to those who are the most vulnerable
and voiceless among us. Special thanks to my executive team colleagues Pat Nicklin, Chuck Scofield, Eric Schweickert, and Josh Wachs, and also to Amy Celep from Community Wealth Ventures. My sister Debbie, cofounder of Share Our Strength, always an indispensable leader, has once again been a selfless champion of my attempt to put words to the lessons we’ve learned. Thanks to Alice Pennington for her enthusiasm in keeping me and the manuscript organized, and for always being such a thoughtful colleague and caring friend, and also to Sarah Sandsted for so capably fielding all manner of assignments large and small.
In this and all I do I’ve been inspired by the strength and resilience of my older son Zach, the determination of my daughter Mollie, and the curiosity and joyfulness of my young niece Sofie Shore.
My wife, Rosemary, has been a partner in this project in every way, with characteristically unfailing instincts upon which I’ve greatly depended. She and our son, Nate, a fount of imagination in his own right, bore the brunt of my conflicting desires to write and keep my day job. But their love, energy, and spirit made the long hours and absences bearable, and finishing the book especially rewarding. In the course of my research I frequently realized just how many things I don’t know, but I do know how lucky I am to have them at the center of my life.
NOTES
CHAPTER 1
3
Rosemary Williams, ed., and Bill Aron, photographer,
Creation Out of Clay: The Ceramic Art and Writings of Brother Thomas
(Grand Rapids, MI: William B. Eerdman’s, 1999), 90.
7
Sun Tzu,
The Art of War
(Mineola, NY: Dover Publications, 2002).
CHAPTER 2
2
Quotes from scientists and others that are not otherwise attributed are from interviews I conducted with them in person or by phone. Often we met more than once, in some cases numerous times over a period of several years. Steve Hoffman and I met regularly over a period of nearly five years at his office or over meals, and we talked frequently by phone and e-mail.
CHAPTER 3
1
Paul R. Russell, “Introduction,” in
Preventive Medicine in World War II
, vol. 6,
Communicable Diseases: Malaria
, Col. John Boyd Coates, Jr., ed. (Washington, DC: Medical Department, U.S. Army), available at
http://history.amedd.army.mil/booksdocs/wwii/Malaria/chapterI.htm
.
10
Ruth Nussenzweig, conversation with the author in her lab at New York University, March 18, 2009; Douglas Birch, “The Struggle to Vanquish an Ancient Foe,”
Baltimore Sun
, June 18, 2000.
CHAPTER 4
3
E. Nardin, F. Zavala, V. Nussenzweig, and R. S. Nussenzweig, “Pre-Erythrocytic Malaria Vaccine: Mechanisms of Protective Immunity and Human Vaccine Trials,”
Parassitologia
41, nos. 1-3 (1999): 397-402.
CHAPTER 5
2
P. Trouiller, P. Olliaro, E. Torreele, J. Orbinski, R. Laing, and N. Ford, “Drug Development for Neglected Diseases: A Deficient Market and a Public-Health Policy Failure,”
The Lancet
359, no. 9324 (2002): 2188-2194.
6
B. H. Kean, with Tracy Dahlby,
MD: One Doctor’s Adventures Among the Famous and Infamous from the Jungles of Panama to a Park Avenue Practice
(New York: Ballantine Books, 1990).
8
Dr. Ronald Ross, speech at the Nobel Banquet in Stockholm, December 10, 1902, reprinted in
Nobel Lectures: Physiology or Medicine (1901- 1902)
(Singapore: Published for the Nobel Foundation by World Scientific Publishing Co., 1999).
9
Stephen Hoffman, Presidential Address to American Society of Tropical Medicine and Hygiene, December 2001,
American Journal of Tropical Medicine and Hygiene
67, no. 1 (2002): 1-7.
CHAPTER 6
1
Philip Bejon, John Lusingo, Ally Olotu, Amanda Leach, Marc Lievens, Johan Vekemans, Salum Mshamu, et al., “Efficacy of RTS,S/AS01E Vaccine Against Malaria in Children 5 to 17 Months of Age,”
New England Journal of Medicine
359, no. 24 (2008): 2521-2532,
http://content.nejm.org/cgi/content/short/359/24/2521
.