The Axis of Good A Woman's Fight to Save the Poor from Black Fever

Black fever kills about 60,000 people a year, most of them poor. There is a cure, but the global pharmaceutical industry wasn't interested in producing the drug, at least not until an American woman began her crusade.

By Uwe Buse

Cured patients in India: If left untreated, black fever is almost always deadly.
OneWorld Health

Cured patients in India: If left untreated, black fever is almost always deadly.

It is 10 a.m. as Victoria Hale walks into her office in a glass-fronted high-rise in San Francisco's financial district, the city's conservative heart. She takes a seat and nods curtly, almost in military fashion, to her press agent. The press agent once worked for Bill Clinton when he was still president of the United States. Hale sits down in front of a glass of water, places her hands on the table, palms down, and says: "Yes?" She seems a bit stressed.

Hale returned from London a few days ago. She travels to Seattle tomorrow, to the East Coast at the end of the week and then on to India. With so much travel through so many different time zones, it isn't surprising that Hale might be just a bit disoriented and not exactly sure what she is doing here in this office.

In Seattle, Hale plans to meet with representatives of Bill Gates, who wants to make sure that the $47 million he has given her so far are being spent wisely. The purpose of her trip to the East Coast is to meet with representatives of the Rockefeller family.

Hale, 45, a mother of two and a pharmaceutical executive, is the current darling of America's major philanthropists. Bill Gates's wife Melinda has praised her publicly, and Hale is being showered with international awards. Her name appears on a list of America's 50 most important scientists, Switzerland's renowned Schwab Foundation has called her one of the "most extraordinarily socially minded businesswomen," and US magazine Esquire named her its businesswoman of the year.

Hale is being celebrated because she is a woman who offers hope, and because she is living proof that it is possible for an individual to fight glaring injustice, even in a globalized world in which everything is supposedly interconnected and in which all too often events are shaped by the power of reality rather than by politicians.

Her financial backers support her for these reasons, and because what Hale offers them is unusual and exceedingly rare in the global charity business: the opportunity to go down in history as someone who helped liberate an entire continent from a killer plague. It's an opportunity that only comes around once every few decades, if at all.

Aid organizations and their backers spend most of their time fighting recurring calamities -- earthquakes, floods, famine. In the tough battle against poverty, disease and war, getting the chance to eliminate an epidemic is like winning the lottery. The last time a prize was awarded for wiping out disease was in the mid-1970s, when the World Health Organization eradicated smallpox.

Killer disease

This time the enemy is called "Kala Azar," or black fever. A disease of the poor, black fever currently infects an estimated 1.5 million people worldwide. It kills about 60,000 people a year, primarily in India, Nepal and Bangladesh. Hale has made it her mission to save these people -- and herself.

People warned Victoria Hale: "You are destroying your career."
Andy Berry / Orange Photography

People warned Victoria Hale: "You are destroying your career."

Victoria Hale's story began nine years ago in San Francisco, at DNA Drive Number One at the headquarters of a company called Genentech. Genentech, a legend in the industry and in the United States, develops drugs using genetic manipulation, and when it was founded in 1976 it was the first company whose researchers played God, essentially giving evolution a kick start. The company attracted and continues to attract the best and the brightest, the ambitious and the devout, from all over the world.

Hale began her career as a manager at Genentech in 1995, working as an expert in the complex licensing process of the government health bureaucracy. She was partly responsible for making decisions over whether years of work and an investment of well over a $100 million would lead to a marketable drug or a ruinous loss.

Hale, who had worked for the Food and Drug Administration (FDA) -- the enemy, in a manner of speaking -- before coming to Genentech, understood the workings of these licensing procedures. At the FDA she quickly developed a reputation for working not as a bureaucrat but as an investigator who was skilled at pin-pointing weaknesses in her opponents' arguments. She had studied pharmacology, and she routinely inundated companies with questions whenever she had any doubts about the safety of a drug, how data were derived or the results of clinical trials. Her future bosses at Genentech liked her approach and were convinced that they had a place for someone as tough as Hale. So they poached her.

She spent the next three years working diligently, was promoted and offered stock options. She had no reason to leave the company.

And yet, in the summer of 1998, Victoria Hale went to her boss and told him that, as much as she appreciated everything Genentech had done for her, she was resigning. Her boss was surprised, and so were her colleagues, and her family was speechless. Why was she throwing away her career?

"There were a few numbers that I couldn't get out of my head," Hale says in her San Francisco office.

Drug industry ignores the poor

The global pharmaceutical industry spends about €90 billion a year on research, and 90 percent of this enormous sum is used to treat the illnesses and minor discomforts, cosmetic and erectile problems of less than 10 percent of the world's population. Of the 1,556 drugs that were invented and marketed worldwide between 1975 and 2004, only 21, a paltry 1.3 percent, have been used to treat diseases that primarily affect the poorest people in the world.

In Africa, Asia and South America -- the world's poverty zones -- almost three million people die every year of tuberculosis and malaria, and about 170,000 are ravaged by diseases that are virtually unknown in the more affluent regions of the world. Chagas's disease, for example, claims 13,000 lives each year. Sleeping sickness kills 50,000, dengue fever 21,000, bilharziosis 15,000 and black fever 60,000 annually. Next to malaria, black fever is the second-most severe parasitic disease.

These were the numbers and facts that prompted Hale to quit her job at Genentech. She felt that by continuing to work at the company she would have made herself complicit in developing drugs almost exclusively for the world's more affluent citizens. To this day, she can only conjecture why she was the one who was so affected by this sense of injustice. Perhaps it had something to do with her childhood. Hale was a sickly child, often bedridden, who spent an inordinate amount of time in doctors' waiting rooms. Perhaps it was precisely because she had suffered so much herself that she could no longer ignore the suffering of others.

No one -- neither her colleagues nor her friends -- truly understood why she left Genentech. She kept hearing the same sentence over and over again: "You're destroying your career." But Hale didn't care. She believed in the mission she had chosen. It began with many unanswered questions.

Which disease did she plan to fight? With which drug would she succeed? Did this drug already exist, or would she have to invent it herself? And how would she pay for it all? Where would she get the millions her mission would cost?


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