Health

More than 1 million people die of tuberculosis every year. They don’t have to.

It’s difficult to know what’s happening on the ground, as ongoing lawsuits try force aid funding to resume and the Trump administration itself has given conflicting information at times. One TB program director told The Guardian last week their funding had still not resumed despite receiving a reassurance from the administration that it would. It’s […]

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3 months ago

March 19, 2025

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More than 1 million people die of tuberculosis every year. They don't have to.

It’s easy to feel like that progress is inevitable or natural or somehow it was always going to happen. But it wasn’t always going to happen. It happened because millions of people worked together to make it happen, because we decided collectively to value children’s lives more and to work hard to protect them.

Instead of being a disease of wealth and civilization, it became a disease of poverty. The implications of this were huge because it meant that we could control tuberculosis by trying to control the bacteria that caused TB. But it also meant that we wanted much more control over the lives of people living with tuberculosis.

This is one of the reasons why tuberculosis used to be a narratively convenient disease, a disease that was the subject of so many books. It was a narratively compelling disease because it tends to take a life slowly over the course of months or years, rather than all at once like a disease like cholera or the black plague.

In many communities, that’s what’s happening as a result of this sudden, chaotic, very unpredictable, haphazardly rolled out funding freeze. Hundreds of thousands of people have seen their treatment interrupted, and we know that’s a catastrophe, not only for those individuals, many of whom will die, perhaps most of whom tragically will die, but also because it means that they will develop drug resistance.

Now, we knew this was hogwash from the beginning. There were lots of doctors, including African American doctors and researchers, pushing back against this notion. They argued, correctly, that the actual cause of tuberculosis was crowded living and working conditions, poor pay, malnutrition — all the stuff that today we know does cause tuberculosis.

Classically, we understood death as something that occurred very early on in life because about half of people died before the age of 5, or something that occurred late in adulthood, in your 50s or after. Tuberculosis killed so many people in their 20s and 30s that it was called the robber of youth. But it also killed people early in childhood and late in adulthood. It killed indiscriminately.

That takes a long time to build, so TB has an extremely slow growth rate compared to other bacteria; in some cases, hundreds of times slower. That means that it sickens us slower because it takes a long time to overwhelm the body’s defenses.

Now, the vast majority of those people will never become sick. They’ll have what we call latent TB, where these clumps of white blood cells form what are called tubercles to surround the bacteria and keep it in check. But in about 10 percent of people who experience a TB infection, they will become sick.

The weirdest thing about TB is the cell wall that the bacteria builds. It builds this really thick, fatty cell wall.

The further the rich world feels from someone’s life, the less likely the rich world is to intervene. So for me, it’s about shrinking that empathy gap everywhere we can so that we understand that the lives of other people, even other people whose lives may feel distant from ours are just as real and just as important as ours, that their joy and grief and longing and loss is as real and profound as ours is.

It’s also a threat to the United States. We have 10,000 cases of active tuberculosis in the US every year. We have a tuberculosis outbreak right now in Kansas. Tuberculosis anywhere is a threat to people everywhere and allowing tuberculosis to spread unchecked throughout the world is bad news for all humans. It’s bad news for human health.

What’s so frustrating to me is that all of those deaths are unnecessary because we’ve had a cure since the 1950s.

There has been imperfect progress on global health, but progress nonetheless. But now the US government is pulling back from the global health commitments that have helped make that progress possible. What does this mean for TB specifically?

Starting in the 1940s, we began to develop treatments for tuberculosis that were very powerful. We created combinations of multiple antibiotics that, given over the course of several months or even years, could cure tuberculosis. This disease that had always been one of the leading human killers suddenly became curable.

It’s really, really important that people in power hear that it is unacceptable for the United States to walk away from its long-term commitments to global health and human health, and that it’s unacceptable for the United States to break its promises. They need to hear it’s also bad for America. It’s bad for farmers who provide food aid. It’s bad for overall human health in the United States. We’re seeing our own numbers of tuberculosis cases go up every year, and that will accelerate now.

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Humanity’s battle against tuberculosis has been one of slow and imperfect progress. The disease no longer kills one in seven people in the US, as it did in the 19th century. But look elsewhere and its burden is still terrible: TB killed more than 1.2 million people in 2023, likely making it once again the deadliest infection on Earth, after it was briefly supplanted by Covid-19 during the pandemic.

And as John Green, the YA author, YouTuber, and author of the new book Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection, told me in an interview: “That number is about to go up.”

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The funding freeze is not only a threat to people in the developing world who live with tuberculosis as an ever-present threat, Green told me — it also poses a risk to the US itself. Right now, Kansas has 68 active TB cases, one of the largest US outbreaks in recent history. One estimate from the Center for Global Development finds that US TB cases will rise in parallel with cases in the rest of the world. That won’t just increase health care costs — it will increase the risk that TB will become more drug-resistant and therefore deadlier to people around the world, including in the US.

In the book you called TB both a form and an expression of injustice. It seems to me that TB is one very striking example of a pattern of injustice that applies across a lot of diseases.

What options are available to people like Vox readers, who want to contribute in some small way to making these problems better?

“All of this is a direct result of the decisions made by the US government,” Green told me. “Allowing tuberculosis to spread unchecked throughout the world is bad news for all humans.”

What is the state of tuberculosis right now? Why do people in the US and other wealthy countries often think of it as a disease of the past, a problem that has been solved?

I spoke with Green about the history of one of humanity’s oldest infectious diseases, the threat posed by the Trump administration’s cuts, and what concerned people can do in response.

If you or I got tuberculosis tomorrow, even if we had a complex drug-resistant case, we would get access to the best personalized, tailored treatments of antibiotic cocktails we would need in order to cure our TB. But for someone like my friend Henry living in Sierra Leone, when he got really sick in 2019 and 2020, those drugs weren’t available to him.

We’ve made so much progress in human health during my lifetime. The year I graduated from high school, 12 million children died under the age of 5. Last year, fewer than 5 million did.

As part of its evisceration of US international aid, the Trump administration is ending funding for its global TB programs. The US is the world’s largest single funder of tuberculosis treatment, and the spending cuts quickly interrupted medical care for TB victims. And any delay in treatment can lead to worse outcomes for patients and makes it more likely the bacteria will evolve to resist antibiotics.

All of this is a direct result of the decisions made by the US government.

After we understood the disease as infectious, it became racialized in a different way, where it came to be argued that people of color were uncommonly susceptible to tuberculosis. Instead of believing that it was impossible for them to get tuberculosis, people started to argue that their susceptibility to tuberculosis was owing to some factor inherent to race.

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We understand some of the risk factors for developing active TB disease. They include malnutrition, other health problems like diabetes, or HIV infection. But we don’t fully understand why some people develop active TB and others don’t.

The United States has long been the most generous donor when it comes to fighting TB, and now essentially all tuberculosis-related funding has been cut. That’s catastrophic on a number of levels. To my Republican friends and congressional representatives, I try to compare it to the 2008 financial crisis when the capital markets just froze, and it was very hard to get them to start working again.

At the same time, by the middle of the 20th century, we developed vaccines and cures. How did our perception of TB continued to change — and how did race increasingly factor into it?

I try to do that in the book by telling Henry’s story because you can talk all day about what a great investment tuberculosis response is, and it is a great long-term financial investment. You can talk all day about how many people are dying of TB every year. All that just boils down to statistics. And the statistics don’t decrease the empathy gap, at least for me. And so I wanted to tell a human story at a human scale because I feel like that’s what really changes our perspective.

Now what we’re seeing is the first regression of my lifetime when it comes to overall human health. We’re seeing it in the United States where life expectancy has been going down. We’re about to see it globally where tuberculosis cases, by one estimate, will increase by 30 percent over the next couple of years, leading to 13 million people getting sick every year instead of 10 million and leading to hundreds of thousands more people dying.

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I used to think of it as a disease of the past as well. I thought of TB primarily as the disease that killed John Keats, and then we figured out a solution to it, so now it’s not a threat anymore.

It sounds meaningless and everybody says it, but it’s true. When you reach out to your congressional representatives insofar as you’re lucky enough to have some say in your governance, it really matters. What funding we’ve been able to claw back for USAID is a result of people reaching out to their senators and representatives and those senators and representatives in turn reaching out to Secretary [of State Marco] Rubio and saying, “This is ridiculous. This can’t happen.”

It breaks my heart. It’s devastating. I’m often asked whether I think people are good. Like, at the end of this book, do I think people are good? And I can’t answer that question.

You call the disease “weird” in your book. What is weird about TB?

Until 1882, at least in Northern Europe and the United States, it was generally believed that tuberculosis was an inherited genetic condition. But in 1882, the German doctor Robert Koch proved that tuberculosis was in fact caused by bacteria. The moment it became an infectious disease is really the moment that our imagining of the disease changed radically.

Today, how does tuberculosis look in the United States versus a place like Sierra Leone, which you cover extensively in your book?

Our conversation is below, edited for clarity and length.

To some extent, it still does. I mean, 218,000 kids are going to die of tuberculosis this year.

TB had long been understood by Europeans as a racialized disease. It was widely believed in Europe and in the US among white doctors that only white people could get consumption because it was a disease of civilization. To acknowledge that consumption was common among people of color and colonized people would have been to undermine the entire project of colonialism itself.

There are many deaths that we simply don’t have the technology or the tools to prevent. But there are many, many, many, many deaths that we do have the technologies and tools to prevent. It’s important to understand that as a justice problem, as an equity problem, as a failure to appropriately apportion the resources that we as a human species have developed.

But the racialization of the disease was so profound that it’s still shaping who lives and dies of tuberculosis.

What I can say is I think people are capable of extraordinary generosity and compassion and sacrifice. When people are proximal to suffering, they show an extraordinary capacity for giving. And when people are not proximal to suffering, when people don’t let themselves become close to the suffering of others, they can act monstrously.

I’m curious where you think that failure comes from? And have you seen anything that’s sort of effective in overcoming that?

There may be as many as 10 million additional TB cases by 2030 because of the cuts, depending on how deep they ultimately are, according to one initial estimate. An additional 2.2 million people could die in that worst-case scenario.

Yeah. I think it’s really important to acknowledge that tuberculosis is not the only disease of injustice. Hepatitis is a disease of injustice. Malaria, HIV, cancer are diseases of injustice. When my brother got cancer, one of the first things he said to me was that there was a 94 percent cure rate if you have access to treatment, and about a 5 percent cure rate if you don’t.

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We started to understand them very differently. We started to see people with tuberculosis as a threat to the social order.

This disease has been with us forever. It was even glamorized to an extent in earlier generations. But then there was a transition when it became more stigmatized — it became associated with being dirty and poor. How did that happen?

I feel like it’s hard for people to understand the feedback loop that’s potentially in play here that can put our health at risk because diseases are spreading elsewhere. I think it’s also hard for us to take the long view.

Even a couple of weeks without getting access to your medication means a skyrocketing chance of drug resistance. Even if they’re able to get back on treatment, the relatively inexpensive treatment that worked before may no longer work. That means more cases of extensively drug-resistant tuberculosis circulating in communities. So even though his TB was very curable, his life was at risk — not ultimately because of a lack of technology, but because of failure to get the technology to the places where it’s most needed.

It’s very hard to grapple with the fact that the real cause of a huge percentage of human death is injustice — the failures of human-built systems.

Unfortunately, we did a really poor job of distributing this cure to the places where it was most needed. As a result, we’ve seen the development of extensive drug resistance for tuberculosis, and we’ve seen a huge amount of ongoing suffering from the disease. The Ugandan HIV researcher Dr. Peter Mugyenyi said of HIV drugs in the year 2000: “Where are the drugs? The drugs are where the disease is not. And where is the disease? The disease is where the drugs are not.” And that’s very much the case with tuberculosis as well.I think we have to bridge the empathy gap. There’s always an empathy gap between every person, right? I don’t know what it’s like to be you. I don’t know about your joys and sorrows. And even when I do, I can only kind of situate them in my own experience. I can only relate to it through my own eyes because those are the only eyes I get to see through for the whole time that I’m here.Swati Sharma

And so there’s always an empathy gap, but that empathy gap grows or shrinks based on how close you allow yourself to be to the suffering and joy of others. And so you know when my uncle gets sick, I’m going to respond to that very differently than if I hear through the grapevine that someone else’s uncle is sick. And for me, the empathy gap is also a social justice gap.But in fact, tuberculosis is still the world’s deadliest infectious disease. It kills over 1.2 million people per year. That number is about to go up. It sickens about 10 million people per year. Around a quarter of all living humans have experienced a TB infection.

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Simone Biles Fires Back at 'Sick' Transphobic Comments About Athletes

Simone Biles went toe-to-toe with political activist Riley Gaines after the former competitive swimmer allegedly made comments about transgender athletes playing sports. OutKick podcaster Gaines, 25, reposted the Minnesota State High School League’s Friday, June 6, X upload about winning a softball tournament. Advertisement Advertisement Advertisement “Comments off lol,” Gaines wrote on Friday. “To be […]

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June 9, 2025

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Simone Biles Fires Back at 'Sick' Transphobic Comments About Athletes

Simone Biles went toe-to-toe with political activist Riley Gaines after the former competitive swimmer allegedly made comments about transgender athletes playing sports.

OutKick podcaster Gaines, 25, reposted the Minnesota State High School League’s Friday, June 6, X upload about winning a softball tournament.

“Comments off lol,” Gaines wrote on Friday. “To be expected when your star player is a boy.”

In response, Biles, 28, called out the “Gaines for Girls” podcast host for her allegedly transphobic comments.

Simone Biles Explains Why It Was ‘Important’ to Stand Up for Teammates After MyKayla Skinner Comments

“@Riley_Gaines_ You’re truly sick, all of this campaigning because you lost a race. Straight-up sore loser,” Biles wrote later that day. “You should be uplifting the trans community and perhaps finding a way to make sports inclusive OR creating a new avenue where trans [people] feel safe in sports. Maybe a transgender category IN ALL sports!!”

She added, “But instead … You bully them … One thing’s for sure is no one in sports is safe with you around!!!!!”

Gaines, in response, said that she found the Olympic gymnast’s comments to be “disappointing.”

“It’s not my job or the job of any woman to figure out how to include men in our spaces,” Gaines replied. “You can uplift men stealing championships in women’s sports with YOUR platform. Men don’t belong in women’s sports, and I say that with my full chest.”

Biles fired back, further defending the transgender community.

Simone Biles’ Most Honest Quotes About Mental Health and Wellness Through the Years: ‘We’re Human’

“Bully someone your own size, which would ironically be a male,” Biles wrote, tagging Gaines’ account.

In subsequent tweets and comments, Biles continued to advocate for allyship while Gaines doubled down on her perspective. Neither has further addressed their differing points of view.

Biles, for her part, has long been a supporter of the LGBTIA+ community.

“The world we live in makes me sad, but I’d do x1000000 more commercials with you just to piss everyone off,” Biles wrote via X in November 2020, referring to an Uber Eats commercial she did with nonbinary Queer Eye star Jonathan Van Ness. “The LGBTQIA will always have my support and feel welcome on my socials.”

Biles’ former teammates also praised her for advocating for others.

“After Tokyo, I said to [Simone], ‘There has to be so many people around the world that were suffering in silence and struggling with their mental health. You have no idea how many of those people you helped,’” retired gymnast Aly Raisman told Sports Illustrated in January. “She helps people feel less alone.”

In addition to supporting the LGBTQIA+ community, Biles has also shone a spotlight on mental health awareness. In 2020, she withdrew from the Olympic Games over mental health issues about suffering “the twisties” mid-competition.

“I have to focus on my mental health. I just think mental health is more prevalent in sports right now,” she said at the time. “We have to protect our minds and our bodies and not just go out and do what the world wants us to do.”

Health

Bryce Young's Camp Ignites Memories and Mental Health Conversations

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16 hours ago

June 9, 2025

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Bryce Young's Camp Ignites Memories and Mental Health Conversations

Bryce Young, the No. 1 overall NFL draft pick, hosted the Young 9 Foundation’s CareSource Football Procamp, emphasizing mental health awareness for youth. Reflecting on his own childhood experiences with legends like Kobe Bryant, he’s committed to providing kids with memorable opportunities. This second annual camp featured Panther coaches and teammates, fostering a supportive environment for campers while instilling the significance of mental health. Young, raised in a household that valued emotional well-being, seeks to eliminate stigma for others and equip them with essential tools.

By the Numbers

This is the second year for the Young 9 Foundation camp in Charlotte.
Young hosted over 100 children at the Procamp.

State of Play

The camp occurred between OTAs and the Panthers‘ minicamp, creating a unique atmosphere amidst the NFL schedule.
Younger players, including teammates and coaches, participated to share insights and support the initiative.

What’s Next

As Young embarks on his third season with the Panthers, he aims to continue expanding the Young 9 Foundation’s reach and influence, with future camps and initiatives focused on youth mental health awareness.

Bottom Line

The Young 9 Foundation’s camp exemplifies Bryce Young’s dedication to mentoring youth and prioritizing mental health, highlighting the importance of giving back and fostering emotional resilience in the next generation.

Health

Olympic great Simone Biles shares mental health journey on first Hong Kong visit

Simone Biles has 11 Olympic medals and 30 World Championship wins. She is considered one of the best gymnasts of all time. Still, even she has to deal with negativity online. “That was hard for me to wrap my head around,” Biles, 28, told the audience during her first visit to Hong Kong last week. […]

Published

1 day ago

June 8, 2025

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Olympic great Simone Biles shares mental health journey on first Hong Kong visit

Simone Biles has 11 Olympic medals and 30 World Championship wins. She is considered one of the best gymnasts of all time. Still, even she has to deal with negativity online.

“That was hard for me to wrap my head around,” Biles, 28, told the audience during her first visit to Hong Kong last week.

Reading such harsh words can be difficult, so she has learned to protect herself.

“When I’m not mentally well enough to read the comments, I turn them off or ignore them,” she said. She also reminds herself that many of these people are strangers: “They don’t know me, and they don’t know my character, so how can they judge through a screen?”

Biles spoke to more than 500 students at the one-hour event hosted by UBS. She talked about her record-breaking career and maintaining her mental health under public pressure.

As a professional athlete, taking care of your mental health is just as important as your physical health, Biles explained.

“Elite athletes [face] a lot of mental effort to step onto the big stage and compete for your country. Obviously, it’s such an honour, but it can be really tough,” she said.

More than 500 students came to see Simone Biles on her first visit to Hong Kong. Photo: Handout

Knowing when to step back

The training schedule of a professional athlete is challenging. Biles and her team train 32 to 34 hours a week. They do two workouts on weekdays and one on Saturday, taking only Sunday off.

Considering all this effort, Biles stunned the world at the Tokyo Olympics in 2021. She withdrew from several events, including the team final, all-around final, and individual event finals.

The reason for her decision was a mental condition called the “twisties”.

Having the twisties can make gymnasts feel like their rhythm is off and that they are not in control of their movements. It can lead to serious injuries.

Biles looks back on the experience positively. She is proud that she put her mental health first.

Sports psychologist discusses why teen athletes struggle to keep their head in the game

“It’s the most courageous I’ve ever felt,” she said. “The number one reason why I did it was to speak out and stand up for myself. I felt worth more than gold.”

Having a strong support system helped her feel confident about her decision. “My team, my family, the nurses and doctors and the mental health specialists, they all understood,” she said.

“Having people in your circle of trust that help you and you can confide in really, really helps,” she explained. “If I’m ever having a bad day, they let me have bad days, and they cheer me up. On the good days, they still uplift me.”

Biles competed at the 2024 Paris Olympics three years later. She took home three gold medals and one silver.

Simone Biles poses with her gold medal during the podium ceremony after the artistic gymnastics women’s all around final during the Paris 2024 Olympic Games on August 1, 2024. Photo: AFP/Getty Images/TNS

Meaning of mentorship

Biles is also passionate about supporting children in the foster care community.

She and her siblings entered foster care when she was only three years old. Their biological mom struggled with substance abuse. After a few years, Biles was adopted by her grandfather and his wife.

“I never let what happened to me stop me from believing in my dreams,” she said. “It doesn’t matter how you start; it matters where your journey takes you and how you walk that path.”

For the last few years, she has worked with Friends of the Children. The organisation partners with community organisations, schools, and foster care systems. They pair children in need of long-term, nurturing relationships with an older friend who acts as their mentor.

“A lot of people think that foster kids can’t do great things, but I think we’ve proven over so many years [we can]. Never let that determine who you are,” she said.

‘Fly High’ charity sports programme gets Hong Kong youth moving

Students who listened to her story said they were inspired. Fifteen-year-old Ila Chan has been on the Hong Kong gymnastics team since she was nine. She said her biggest takeaway was learning how to handle high-pressure situations.

“She should keep going because she’s an idol for lots of people around the world,” Ila said.

Lexie Rhodes, 12, has been doing gymnastics for around five years. She said she felt encouraged to recharge. She also learned the importance of letting off steam and taking the time to relax.

Biles appreciates the chance to serve as a role model, especially for young athletes. She offered up a tip for staying motivated and avoiding burnout: make sure you’re always having fun.

“You never know how long your career is gonna last,” she said. “So I would say to just have fun. Dream big, and then dream bigger after that. As long as you’re having fun, you can accomplish anything and love what you do.”

Get the word out

elite 精英

to be highly skilled in a particular field

foster care 寄養照顧

a system in which children who cannot live with their biological family are moved into homes with temporary parents or carers

harsh 刻薄

cruel or unkind behaviour

withdrew 退出

to voluntarily quit a competition or event

confide 傾訴

to share personal thoughts or feelings with someone you trust

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Jacksonville mental health counselor talks breaking stigma around men's mental health

JACKSONVILLE, Fla. – As June marks Men’s Mental Health Month, a Jacksonville mental health counselor talked about ways to break the stigma around the topic. WATCH: Local group works to help men tackle mental, physical health Recommended Videos Mental health can be a tough topic for anyone, but for men, talking about it can feel […]

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Robert Gallery's long journey with brain trauma reaches a surprisingly happy destination

Robert Gallery’s long journey with brain trauma reaches a surprisingly happy destination | The Gazette Skip to content More Stories 5

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Bryce Young Speaks Out on the Stigma That Comes With Mental Health Struggles as an Athlete

Bryce Young has been on a bumpy ride with the Carolina Panthers since being drafted, and it even took a toll on him last season. Unlike many others, the former number one overall pick has decided to speak openly about his mental health struggles. Prompting a conversation that not many fans, players, or coaches want […]

Published

2 days ago

June 7, 2025

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Bryce Young Speaks Out on the Stigma That Comes With Mental Health Struggles as an Athlete

There’s always been a stigma about mental health struggles as an athlete. When Dak Prescott opened up about it in 2020, the response was somewhat deflected by the public. Negative attitudes and biases have seemingly discouraged some athletes of older generations from speaking out. Whether it be something external, like a family issue, or something internal, like their level of play.

It’s no secret that ever since being selected number one overall in the 2023 NFL Draft, Bryce Young has struggled to find his footing. In 28 career starts, he’s won just 6 games. And all of the losses have weighed heavily on him mentally. Young opened up about it while discussing the stigma surrounding the topic.

“There’s definitely been a big stigma around [discussing mental health in] athletics for a long time. For me, I like to deal and live in the truth. I’m super grateful to have my profession. I’m super passionate about it, but we’re all human,” he told GQ Sports.

“People, a lot of times, think that we don’t have the same struggles, we don’t deal with the same things. Our lives, at times, maybe can look different from others, but it’s all a set of circumstances. The makeup of who we are, what we go through from an emotional level, it’s all the same,” he added.

Young explained how he comes from a family that works as therapists and counselors. His father, Craig, is a mental health therapist and played an instrumental role in his upbringing. His mother, Julie, is a former special education teacher who offers Bryce her unwavering support.

Young’s father once explained how important mental health was in their family. “It’s just something that we’ve always paid a lot of attention to,” Craig told CBS Sports. “And we always wanted to provide an environment for Bryce where he felt safe and he felt loved and he felt encouraged irrespective of his outcomes.”

He added: “We provided a safe place for him to express his feelings or sometimes not to express his feelings… that whatever he’s feeling was okay and that we were there to help him problem solve and that through that problem-solving journey he was always loved and we were there for him.”

The style of upbringing seems to be paying off. Young is now on a mission to make mental health a more suitable topic to talk about in NFL culture. Even though most fans don’t want to mention it, the Carolina QB wants to let every kid know that it’s okay to ask for help.

Look, the studies and statistics don’t lie. Between 5% – 35% of elite athletes have some form of mental health disorder. And that’s just the elite ones. Almost everyone goes through the mental obstacle of coming to terms with the idea that they aren’t as good as the elite athletes. Which is an unquantifiable number.

Young’s generation is simply not as afraid to let people know when they aren’t doing okay mentally. And while the stigma has always dissuaded such athletes from speaking out about it, it’s great that Bryce is trying to change that notion. Behind the education from his parents, his status, and his great smile, he could indeed make a difference.