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The Imaginations of Unreasonable Men: Inspiration, Vision, and Purpose in the Quest to End Malaria
A small cadre of scientists—collaborators and competitors—are determined to develop a vaccine for malaria, a feat most tropical disease experts have long considered impossible. Skepticism, doubt, and a host of logistical and financial obstacles dog their quest. Success may ultimately elude them. Why, and how, do they persist?
The kind of person who decides to combat malaria must have a very rare combination of attributes: dogged enough to keep going when results are slow; independent enough to continue, often alone, when other, more popular, causes distract attention from their work; self-confident enough in the importance of the work to persist when the beneficiaries may reside thousands of miles distant. Above all, taking on a challenge of this scale requires a fearlessly bold moral imagination that defies reason. Bill Shore tells the story of man’s attempt to combat malaria through the drama of the handful of scientists and organizations currently seeking to curb, and in one case, at least, cure, the world of this most ancient and persistent scourge. It is a drama to the death.
The story of these uncompromising scientists serves as a springboard for Shore’s passionate inquiry into the character and moral fabric of those who devote their lives to solving the world’s most pressing and perplexing problems. During his career as a social entrepreneur Shore has persistently wrestled with this fundamental question: What does it take to make a truly transformational difference? To achieve not just incremental progress but a game changer or, in the case of malaria, a life saver? In this moving and inspiring book, he offers compelling answers.
The kind of person who decides to combat malaria must have a very rare combination of attributes: dogged enough to keep going when results are slow; independent enough to continue, often alone, when other, more popular, causes distract attention from their work; self-confident enough in the importance of the work to persist when the beneficiaries may reside thousands of miles distant. Above all, taking on a challenge of this scale requires a fearlessly bold moral imagination that defies reason. Bill Shore tells the story of man’s attempt to combat malaria through the drama of the handful of scientists and organizations currently seeking to curb, and in one case, at least, cure, the world of this most ancient and persistent scourge. It is a drama to the death.
The story of these uncompromising scientists serves as a springboard for Shore’s passionate inquiry into the character and moral fabric of those who devote their lives to solving the world’s most pressing and perplexing problems. During his career as a social entrepreneur Shore has persistently wrestled with this fundamental question: What does it take to make a truly transformational difference? To achieve not just incremental progress but a game changer or, in the case of malaria, a life saver? In this moving and inspiring book, he offers compelling answers.
320 pages, Paperback
First published November 9, 2010
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Displaying 1 - 13 of 13 reviews
April 16, 2013
The thesis of this book is that it takes someone a little crazy to solve big problems. It is a health science book, wrapped in biographical hero worship. To this end, Shore tells us the tale of the scientists working to save the children of Africa through the development of a vaccine against the malarial parasite. His point is made largely by repetition and he uses of multiple examples of the same thing, scientists who are working outside the establishment because they have big ideas and won’t take no for an answer. More than an attempt to understand the battle against malaria, the book is a tribute to the mad, loner scientist.
The author’s naïve enthusiasm and lack of medical or scientific background are apparent in his characterizations of the scientists and research projects involved in the fight against malaria. This is not necessarily a fatal flaw but does define the book’s audience as solidly not physicians, scientists or those actually engaged in the efforts to control or eliminate malaria in the developing world. In addition, this lack of expertise in the area in which he has chosen to illustrate his broad principle causes the author to miss many key aspects of the work and the application of his principles that leave large gaps in his overall theory and a number of questions that are left unanswered.
Many of the scientists profiled in this book are fighting to overcome, not the imagination gaps that the author claims are the problem, but simple production problems, the type of problem that they all share and might best be approached through teamwork and cooperation rather than competition. The author remarks that the business world’s spirit of competition would be a useful addition to the field of science and one that is demonstrated by Steve Hoffmann and the other scientists profiled in the book. However, these scientists would likely acknowledge that science has always involved a healthy competition for the latest discoveries, grants, public recognition. What is more difficult is to foster are meaningful collaborations across institutions and disciplines that are natural allies in their overall battles towards a cure or enhanced understanding. They do not require more incentive to compete with each other, that comes naturally and has been practiced throughout their academic and professional careers. What is lacking are the systems and tools that would help these researchers to put their heads together and share ideas and knowledge that could help to move the entire field forward.
Shore only briefly addresses the history of vector-borne disease elimination efforts as one dominated by successful vector-control campaigns without giving significant coverage to current efforts to combat malaria through bed nets and pesticides. Yellow fever in the U.S., for example, was wiped out largely by destroying mosquito habitats and not by the later vaccine development efforts that were ultimately also successful. What Shore does not address about these disease control efforts is that they were undertaken by public health officials, engineers, and volunteers with little or no connection to science or health care. The battles were waged in ditches with gasoline canisters, not in laboratories with pipettes. Shore and the scientists he profiles seem to believe that malaria can be fought like measles, when it clearly has much more in common with yellow fever and should be approached as such, with even less emphasis on vaccine development because malaria is caused by a parasite and there has never been a successful vaccine developed to protect against a parasite.
One reason for an approach to malaria control other than vaccine development is the nature of the disease itself. Malaria is a disease that people contract repeatedly throughout their lives. There is some level of immunity that develops because the severity of infection declines over the course of a lifetime, but much of this decline can be attributed more to overall disease-fighting capacity in adults versus children than to induced immunity from prior infections. The types of infections that people contract many times, the common cold, foodborne illnesses, “stomach viruses,” are not those that are readily protected against with vaccines. Even the flu, which has an effective and widely used vaccine, requires a different vaccine every year to prevent infection. While the need for innovation and thinking outside the box are essential to the struggle for control of malaria, it also makes sense to look to the history of infectious disease control efforts and to learn from the lessons of our past. This is directly contradictory to the message presented in this book and espoused by its hero, Steve Hoffman.
I was most interested to read Shore’s descriptions of the history of philanthropy and current social entrepreneurial trends, as this is a field in which he clearly understands the intricacies of the issues involved. Shore argues that over the last few decades, philanthropic institutions and leaders have begun to move away from the stopgap measures and multitudes of small, isolated projects model, “to go beyond good intentions to actually solving and eradicating neglected social diseases.” In many ways Bill Gates represents the best example of this shift, especially in the field of global public health. He and his foundation are not interested in supplying Band-Aids; their goal is to address the most pressing issues in a way that makes those Band-Aids unnecessary in the future. Shore seems much more thorough in his treatment of this topic in a few pages than he is in his treatment of malaria over the entire book. Then again, it is possible that he makes the same mistakes here but I cannot detect them because I have no training in business or experience investing in social entrepreneurship.
Beyond the basic ‘think outside the box’, ‘wackos do great things’ premise, Shore draws several lessons from his interactions with the scientists involved in this important struggle that are intended to be applied to a wide range of social enterprises. His first lesson, “Invest in Bringing Existing Solutions to Scale Rather Than in Discovering New Ones,” is perhaps most emblematic of his failure to comprehend the intricacies of the field from which his examples are drawn. In stating that the researchers in this book represent this type of investment, Shore demonstrates a deplorable lack of imagination. Vaccine development, especially for a vector borne, parasitic disease, is far from an existing solution. It is a lofty goal, a dream that may one day save a lot of people, or may be a gamble that never pays off. Vector control on the other hand, is a tried and true method for reducing malaria infections, one that could make good and immediate use of the large grant funds being poured into fancy labs in Maryland to save the lives of children in Africa. I am certainly not saying investing in science is a waste of money but it does represent the direct opposite of the ‘doing more of what we already know works’ principle.
The book was an interesting peak into the lives and motivations of some very passionate and driven individuals who each have different ideas about the best way to solve the problem of malaria. It also largely failed to draw the broader conclusions that the author was trying to make. I am left with the overall impression that Shore would have had greater success in illustrating his point had he drawn from his own field of expertise, perhaps business, law or the campaign to end childhood hunger, in his search for great minds doing things differently. His argument is severely weakened by the points he fails to address and the questions he does not ask because he does not adequately understand the fields of scientific inquiry and global public health.
The author’s naïve enthusiasm and lack of medical or scientific background are apparent in his characterizations of the scientists and research projects involved in the fight against malaria. This is not necessarily a fatal flaw but does define the book’s audience as solidly not physicians, scientists or those actually engaged in the efforts to control or eliminate malaria in the developing world. In addition, this lack of expertise in the area in which he has chosen to illustrate his broad principle causes the author to miss many key aspects of the work and the application of his principles that leave large gaps in his overall theory and a number of questions that are left unanswered.
Many of the scientists profiled in this book are fighting to overcome, not the imagination gaps that the author claims are the problem, but simple production problems, the type of problem that they all share and might best be approached through teamwork and cooperation rather than competition. The author remarks that the business world’s spirit of competition would be a useful addition to the field of science and one that is demonstrated by Steve Hoffmann and the other scientists profiled in the book. However, these scientists would likely acknowledge that science has always involved a healthy competition for the latest discoveries, grants, public recognition. What is more difficult is to foster are meaningful collaborations across institutions and disciplines that are natural allies in their overall battles towards a cure or enhanced understanding. They do not require more incentive to compete with each other, that comes naturally and has been practiced throughout their academic and professional careers. What is lacking are the systems and tools that would help these researchers to put their heads together and share ideas and knowledge that could help to move the entire field forward.
Shore only briefly addresses the history of vector-borne disease elimination efforts as one dominated by successful vector-control campaigns without giving significant coverage to current efforts to combat malaria through bed nets and pesticides. Yellow fever in the U.S., for example, was wiped out largely by destroying mosquito habitats and not by the later vaccine development efforts that were ultimately also successful. What Shore does not address about these disease control efforts is that they were undertaken by public health officials, engineers, and volunteers with little or no connection to science or health care. The battles were waged in ditches with gasoline canisters, not in laboratories with pipettes. Shore and the scientists he profiles seem to believe that malaria can be fought like measles, when it clearly has much more in common with yellow fever and should be approached as such, with even less emphasis on vaccine development because malaria is caused by a parasite and there has never been a successful vaccine developed to protect against a parasite.
One reason for an approach to malaria control other than vaccine development is the nature of the disease itself. Malaria is a disease that people contract repeatedly throughout their lives. There is some level of immunity that develops because the severity of infection declines over the course of a lifetime, but much of this decline can be attributed more to overall disease-fighting capacity in adults versus children than to induced immunity from prior infections. The types of infections that people contract many times, the common cold, foodborne illnesses, “stomach viruses,” are not those that are readily protected against with vaccines. Even the flu, which has an effective and widely used vaccine, requires a different vaccine every year to prevent infection. While the need for innovation and thinking outside the box are essential to the struggle for control of malaria, it also makes sense to look to the history of infectious disease control efforts and to learn from the lessons of our past. This is directly contradictory to the message presented in this book and espoused by its hero, Steve Hoffman.
I was most interested to read Shore’s descriptions of the history of philanthropy and current social entrepreneurial trends, as this is a field in which he clearly understands the intricacies of the issues involved. Shore argues that over the last few decades, philanthropic institutions and leaders have begun to move away from the stopgap measures and multitudes of small, isolated projects model, “to go beyond good intentions to actually solving and eradicating neglected social diseases.” In many ways Bill Gates represents the best example of this shift, especially in the field of global public health. He and his foundation are not interested in supplying Band-Aids; their goal is to address the most pressing issues in a way that makes those Band-Aids unnecessary in the future. Shore seems much more thorough in his treatment of this topic in a few pages than he is in his treatment of malaria over the entire book. Then again, it is possible that he makes the same mistakes here but I cannot detect them because I have no training in business or experience investing in social entrepreneurship.
Beyond the basic ‘think outside the box’, ‘wackos do great things’ premise, Shore draws several lessons from his interactions with the scientists involved in this important struggle that are intended to be applied to a wide range of social enterprises. His first lesson, “Invest in Bringing Existing Solutions to Scale Rather Than in Discovering New Ones,” is perhaps most emblematic of his failure to comprehend the intricacies of the field from which his examples are drawn. In stating that the researchers in this book represent this type of investment, Shore demonstrates a deplorable lack of imagination. Vaccine development, especially for a vector borne, parasitic disease, is far from an existing solution. It is a lofty goal, a dream that may one day save a lot of people, or may be a gamble that never pays off. Vector control on the other hand, is a tried and true method for reducing malaria infections, one that could make good and immediate use of the large grant funds being poured into fancy labs in Maryland to save the lives of children in Africa. I am certainly not saying investing in science is a waste of money but it does represent the direct opposite of the ‘doing more of what we already know works’ principle.
The book was an interesting peak into the lives and motivations of some very passionate and driven individuals who each have different ideas about the best way to solve the problem of malaria. It also largely failed to draw the broader conclusions that the author was trying to make. I am left with the overall impression that Shore would have had greater success in illustrating his point had he drawn from his own field of expertise, perhaps business, law or the campaign to end childhood hunger, in his search for great minds doing things differently. His argument is severely weakened by the points he fails to address and the questions he does not ask because he does not adequately understand the fields of scientific inquiry and global public health.
October 19, 2011
Very interesting. I didn't realize it would be so focused on malaria, but so far a neat peek into what has motivated the money behind malaria research and how we've approached/are approaching this problem.
I really appreciate this book for examining many sides of a "single disease" problem approach. The author talks a good deal about the few people trying to develop a malaria vaccine, but also about those addressing the problem with treatments, prevention, and most importantly money and regulations! It was an encouragement to take those same passions and persistence as a model in our struggles against the plethora of problems we are facing in today's world.
I really appreciate this book for examining many sides of a "single disease" problem approach. The author talks a good deal about the few people trying to develop a malaria vaccine, but also about those addressing the problem with treatments, prevention, and most importantly money and regulations! It was an encouragement to take those same passions and persistence as a model in our struggles against the plethora of problems we are facing in today's world.
September 28, 2018
This book really seemed like it should be interesting, but I probably should have been warned off by the title: it was much more about "inspiration, vision, and purpose" than about the quest to end malaria. Much of the book seemed to be a repetitive series of business-school maxims and parables, plus a near-hagiography of Stephan Hoffman, the founder and CEO of Sanaria, a company working on developing a malaria vaccine.
I finished the book, but it was a struggle, and quite disappointing.
I finished the book, but it was a struggle, and quite disappointing.
December 22, 2020
Repetitive to the point of irritation. Decent review of the state of anti-malarial science is spoiled by repeating the same facts and arguments in multiple sections of the book.
September 13, 2012
One of the previous reviewers wrote that if you are only going to read one book about the quest for a vaccine to prevent malaria, this might not be the best choice. I couldn't truthfully attest to that, but it was enough for me to be satsfied.
As it stands today, there are no vaccines that can stop infections transmitted by parasites. This book explains that those who are normally infected with malaria are the marginalized, the mute, the vulnerable. They have no political voice and no money to find a solution for what affects them. The lack of high profit potential is only one variable in the ability to solve a problem that is both economic and logistic.
It was interesting to learn what a problem infectious disease is for our military troops and how these diseases are first studied by (and funding put forth by) the U.S. military in order to more effectively consider the well being of our troops in developing nations and their ability to stay healthy in the field. Their focus is on the adult traveler but the interst of the world is on affected children, particularly in Africa.
Diagnosing malaria and treating it are better done in the developed world where there is access to labs, equipment, and pharmacies. Though there is no vaccine for malaria, it can be treated if diagnosed in a timely manner. The battle is to make make an affordable medicine and then to share it with those who cannot afford to purchase it.
As it stands today, there are no vaccines that can stop infections transmitted by parasites. This book explains that those who are normally infected with malaria are the marginalized, the mute, the vulnerable. They have no political voice and no money to find a solution for what affects them. The lack of high profit potential is only one variable in the ability to solve a problem that is both economic and logistic.
It was interesting to learn what a problem infectious disease is for our military troops and how these diseases are first studied by (and funding put forth by) the U.S. military in order to more effectively consider the well being of our troops in developing nations and their ability to stay healthy in the field. Their focus is on the adult traveler but the interst of the world is on affected children, particularly in Africa.
Diagnosing malaria and treating it are better done in the developed world where there is access to labs, equipment, and pharmacies. Though there is no vaccine for malaria, it can be treated if diagnosed in a timely manner. The battle is to make make an affordable medicine and then to share it with those who cannot afford to purchase it.
May 27, 2019
I was disappointed with this book but only because I had thought it would be an in-depth look at malaria and the effort to find a cure. It turns out that 5% was information about malaria and 95% was information about Steve Hoffman and the business of producing vaccines. It IS about malaria but only in the sense that everyone profiled is working to treat or eradicate malaria.
The biggest problem with the book is that the author spends too much time hero-worshipping Steve Hoffman and repeating the phrases “good is not good enough” and “most failures are failures of imagination”. He makes his points early on but then makes them again and again. And again. I understand that Hoffman is a great man because he’s daring to make the impossible possible, but I don’t have to be told that time and time again. And again.
Read this book if you want a better understanding of the social, scientific, and economic factors that go into developing a vaccine (and the author’s championing of social entrepreneurship). If you want a more complete book about the facts and history of malaria, I suggest reading The Fever by Sonia Shah.
The biggest problem with the book is that the author spends too much time hero-worshipping Steve Hoffman and repeating the phrases “good is not good enough” and “most failures are failures of imagination”. He makes his points early on but then makes them again and again. And again. I understand that Hoffman is a great man because he’s daring to make the impossible possible, but I don’t have to be told that time and time again. And again.
Read this book if you want a better understanding of the social, scientific, and economic factors that go into developing a vaccine (and the author’s championing of social entrepreneurship). If you want a more complete book about the facts and history of malaria, I suggest reading The Fever by Sonia Shah.
August 9, 2016
Billy brings a fresh perspective to a seemingly intractable social problem -- the eradication of malaria. He does a good job balancing writing for a popular audience with maintaining scientific rigor. At times, though, seemed as though he fell off this tightrope, sometimes pursuing a strain of scientific investigation beyond my point of interest and sometimes dumbing down ideas that I would have loved to explore further.
At the end of the day, I think Billy's motivation was a personal quest to understand what kind of person is needed to solve a social problem and what kind of environment must exist. The book is, at the surface, about the quest to end Malaria. But a deeper look at the book reveals a character study and an examination of the market forces at play. Here is where Billy excelled and the book truly brought new thinking to my perspective on the world: how can philanthropy best accelerate the achievement of improved social outcomes and where is philanthropy impotent? How do we overcome that impotence?
The light Unreasonable Imaginations sheds on those questions is still igniting the backburners of my brain today.
At the end of the day, I think Billy's motivation was a personal quest to understand what kind of person is needed to solve a social problem and what kind of environment must exist. The book is, at the surface, about the quest to end Malaria. But a deeper look at the book reveals a character study and an examination of the market forces at play. Here is where Billy excelled and the book truly brought new thinking to my perspective on the world: how can philanthropy best accelerate the achievement of improved social outcomes and where is philanthropy impotent? How do we overcome that impotence?
The light Unreasonable Imaginations sheds on those questions is still igniting the backburners of my brain today.
July 29, 2013
Bill Shore has written an amazing book about the people seeking to do something about malaria infection in the developing world where they don't have access to the drugs like many in Western countries would. Although wrapped in the cause of malaria, the book offers more of a generalized statement about what it takes to solve the seemingly unsolveable problems of this world. It takes unreasonable men and women who beileve that good is not good enough, also it takes people who are willing to do some creative thinking. It does not automatically take a genius with the latest and greatest idea, but can take the form of someone working with systems and organizations already in place. A really uplifting book amid a black sea of doom and gloom world is going to end tommorow thinking.
January 16, 2015
One of the most inspirational books I've ever read. it's not just about the quest for Malaria vaccine, but about men with the vision, determination, and imagination to make nothing impossible. It is also about a new type of social philanthropy, which aims to eliminate market gaps that often undermine social solutions. I was also pleasantly surprised at the number of female leaders/visionaries Shore mentions in his book. Finally, Shore's ending quote "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",is a great description of every great scientist's life, but is also a motto every human should aspire to.
February 27, 2012
Interesting book on the quest to end Malaria. With the Bill Gates Foundation's attention (and money) on the issue, we are seeing an increase in attention to the problem. Shore reiterates that the failure to end malaria is a failure of imagination -- once imagined, much progress has been made toward solutions from several different perspectives. Hopefully the near future will bring one that works -- the malarone was very hard to tolerate. There must be something better!
July 6, 2014
I found both the premise and the information intriguing but the writer's organization perplexing and disjointed. The last two chapters were both exceptions to that statement and very valuable information, presenting Shore's summary analysis of "Philanthropy's Shifting Tides," his associated 6 lessons, and a call for "Moral Imagination." A worthy read.
June 24, 2011
If you're going to read only one book on malaria, I strongly recommend Sonia Shah's Fever, which is more complete and way more interesting.
This reads more like an extended newspaper piece that went on for far too long and I shouldn't have bothered to finish it.
This reads more like an extended newspaper piece that went on for far too long and I shouldn't have bothered to finish it.
Displaying 1 - 13 of 13 reviews