Many will recognize Dr. Larry Brilliant as CNN’s resident COVID expert, but the epidemiologist is most famous for leading the World Health Organization team that eradicated smallpox. He’s also stewarded the philanthropic efforts of both Google and Salesforce and has been a mentor to many tech leaders, including Steve Jobs and Mark Zuckerberg. But before all that, Brilliant lived in an ashram in India for many years, studying under guru Neem Karoli Baba (also the spiritual teacher of Ram Das), who drove him to pursue a career in public health. 

Brilliant sat down with Techonomy founder David Kirkpatrick at the Techonomy 2022 retreat in Sonoma, CA, to discuss his journey into public health and the connection between global warming and global health. This transcript has been edited for clarity and brevity. The full interview can be viewed here.


David Kirkpatrick: You had this period when you were a devoted follower of a very inspiring guru. And he inspired you then to go into public health. Tell us about that.

Dr. Larry Brilliant: Here’s the kind of inspiration he used: I would sit there, and I would meditate and he would throw apples at my testicles and say, “you should get out of the ashram.” He had really good aim. My guru, Neem Karoli Baba, told me I should go to the World Health Organization office in New Delhi and get a job helping eradicate smallpox because this was God’s gift to humanity. So, I went to WHO, which took about 17 hours on a train and a bus, and of course, they kicked me out because I was wearing this white dress, had hair down to the middle of my back, and had a big beard. 

I went back up, and I saw my guru, and he asked, “Did you get your job?” And I said, “No.” He said, “Go back.” I took the 17-hour journey back and, of course, they kicked me out again. Rinse and repeat about 12 times, but I got smart. I trimmed the beard, I lost the dress, and I put on a suit and tie. 

One time I walked into the WHO office, there was this tall American. And he said, “Are you American? Who are you?” I said, “I’m a doctor.” He said, “Okay, why are you here?” I told him that my guru, who lives in the Himalayas, told me that I was supposed to come work for WHO and help eradicate smallpox. “Well,” he said, “I’m the head of the global smallpox eradication program, and we don’t have a smallpox eradication program in India. But since we’re here, maybe I could interview you.” He eventually did hire me, and I became the head of the program. It took ten years to eradicate smallpox. 


And you did more or less eradicate smallpox.

With 150,000 of the most wonderful, courageous people in the world. It’s the only disease that’s ever been eradicated. 

You have done enormous research and communication around the pandemic. What’s the connection between global health and global warming, particularly concerning pandemics?

The primary connection is that the antecedent causes of climate change and global warming are many of the exact antecedent causes of pandemics. As the Earth gets warmer, animals from the south migrate to the north. Over a billion more people are at risk of malaria right now because the Anopheles mosquito can now breed at higher altitudes and greater latitudes. Animals meeting other animals carrying the same viruses leads to variants. We’re having a tremendous amount of spillover because the forests and rainforests are being clear-cut. 

I was the science advisor on the film Contagion. We tried to make a movie that would be a fictional representation of what we thought would happen. We didn’t expect to get it so close. But the whole premise was a bat with a virus enters the human environment, which is what happened with COVID—and with SARS, and probably with MERS and Ebola. 

Fossil fuels create greenhouse gases, leading to global warming. And with that, you wind up changing the way water works, the way salt works, and the entire ecosystem of the planet. The same things that cause climate change cause spillover, where animals and humans live in each other’s territory. Spillover is occurring now at five times the rate that it did 50 years ago. Every year one, two, or three new novel diseases that have never been seen in human beings are spilling over from animals, and we’re exposed to them. 

All of these factors are hitting simultaneously, leading to animals and humans sharing the same habitat. That’s why we’ve gotten a cacophony of these viruses over the last ten years, like SARS, MERS, Ebola, West Nile disease, Lyme disease, and COVID. 

There are a lot of other linkages to climate change. Global warming increases famine, drought, and floods and winds up putting more salt in the Earth. One of the biggest things we see in global health is that as water levels rise, they bring salt and we lose agricultural land. That means that climate change can lead to famine.


The primary culprit is modernity. The most invasive species in the world is us humans. We’re the ones that are putting the world at such ecological risk. And with it, we will find challenges to our food, challenges to our water, challenges to agriculture, and challenges to pandemics as well. 

You also are very worried about COVID variants right now. Could you tell us why?

Right now, we’re in a funny stage with the COVID pandemic. Three years ago, I wrote an article in Foreign Affairs called “The Forever Virus.” And people got mad at me because we were all done with the pandemic and wanted to move on. I hope that’s true. We may be there. Right now, there are four coronaviruses that preceded this one that retired into the retirement home of coronaviruses, which means they became colds. That’s right, half of the colds you get are Coronaviruses, which are related to SARS-CoV-2. This virus may be going through that process now. And I pray to God that it is. 

But we’ve also got five terrible new sub-variants. Each one is more infectious than the other. All of them are mysterious in terms of how many diseases they’ll cause. And right now, we’re playing a whack-a-mole game with new vaccines that are more effective in stopping you from getting it, but great effectiveness and preventing you from dying. But we’re fighting the battle of the last variant. So, I am still determining where it’s going to go.

The theme of our conference is innovation must save the world. Do you think innovation is going to help us save the world?

A lot of innovations are pretty terrible. Nuclear weapons are an innovation that hasn’t really worked out. But I hope innovation is going to make a big difference. In the fight against COVID, for example, DARPA worked on mRNA technology for years, and as a result, we had it ready to convert into vaccines. That quickly saved millions and millions of lives. 

But the innovation we need is a total change in human consciousness about compassion, altruism, and stopping to think of others as others. When I think of innovation, I think of the infrastructure of how we allocate resources and the decisions we make. To have innovations that are going to have enduring value, we have to help bridge the gap between the rich and the poor, and do equitable redistribution of the resources that we need to make the world a better place. We’ve got to focus on vision and values. 

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