Policy

I did three segments on @TheUnpopularView_MichaelBrown on the topic of sepsis with Dr. Niranjan “Tex” Kissoon, President of @GlobalSepsisAlliance. I did this because I nearly died from sepsis in June 2025—four days in the hospital, with my fever peaking at 106.4°F. Only afterward did I realize how much bigger the problem is than I ever understood, even after decades working in places where infectious disease risks in Africa and other remote parts of the Global South are rampant.

As a then‑73‑year‑old sepsis survivor who hit that high fever mark, passed out, and spent four days inpatient. At the same time, clinicians tried multiple antibiotic regimens before finding the combination that pulled me back, I’m approaching this conversation as both a patient and a policy person shaped by lived experience.

In this final segment, Tex and I look at what happens when antibiotics stop working—how sepsis turns routine infections deadly, why this is a warning sign for “superbugs,” and how the sepsis crisis exposes deeper failures in antimicrobial resistance (AMR) policy, the antibiotic pipeline, and public‑health systems in both the United States and the Global South.

From that lived experience, we move into the wider sepsis crisis in the United States. We talk through how an estimated 1.7 million adults develop sepsis each year, around 350,000 die from it, and roughly one in three hospital deaths involve sepsis—with tens of thousands of children developing sepsis and more than 1,800 dying annually.

Surprisingly, sepsis is also the number one cost of hospitalization in the U.S., driving tens of billions of dollars in annual spending and high 30‑day readmission rates. These statistics underpin an economic argument: investing in better diagnosis, sepsis care bundles, and readmission prevention isn’t charity; it’s high‑return, common‑sense policy.

Tex connects sepsis to the AMR challenge and the antibiotic pipeline problem. We outline the limited number of truly innovative antibiotics approved in recent years, the modest set of agents in clinical development that meet meaningful innovation criteria, and why companies that bring new antibiotics to market still struggle or even go bankrupt. The segment touches on major funding initiatives, the ongoing annual gap in “push” funding for early‑stage R&D, and the lack of strong “pull” incentives that reward companies for developing drugs we must use sparingly to preserve effectiveness.

Tex widens the lens to the global burden of sepsis. We discuss estimates that place sepsis in the tens of millions of cases and millions of deaths each year globally, with sepsis implicated in roughly one in five deaths worldwide and the majority of that burden falling on low‑ and middle‑income countries.

The highest sepsis burden sits in the Global South—across Africa, Asia, Latin America, and parts of Oceania—where health systems are under‑resourced and high‑tech, high‑cost solutions are least accessible. Tex and I argue that common‑sense prevention and robust public‑health initiatives—infection prevention and control, clean water and sanitation, maternal and neonatal care, vaccination, basic diagnostics, and timely antibiotics—have to be the priority for reducing sepsis deaths and slowing AMR in these settings.

We briefly reference high‑profile stories like the recent death of NASCAR champion Kyle Busch from pneumonia that progressed into sepsis, as a reminder that sepsis can move fast and affect people far beyond the ICU stereotype. But the core of the segment is Tex Kissoon’s global perspective: his work with the @GlobalSepsisAlliance, the push from @ENDSEPSIS, and his insistence that “we cannot protect ourselves without protecting others.”

Sepsis emerges here not just as a clinical syndrome, but as a pillar of global health security and a practical entry point for fixing the broken links between prevention, health systems, AMR policy, and the antibiotic pipeline.

This 21‑minute segment begins where many Americans first heard about sepsis recently: the tragic death of Kyle Busch and the sudden attention on a disease most people rarely think about. From there, we widen the lens to ask a harder question: where is sepsis actually killing the most people, and why?

Dr. Niranjan "Tex" Kissoon and Michael Brown walk through the numbers and the lived reality with particular focus in the Global South:

Maternal deaths remain shockingly high, with the US and UK still seeing maternal mortality as a leading cause even with far more resources.

In low‑resource settings, a mother and newborn are an inviolable dyad—if the mother dies or is gravely ill in childbirth, her baby faces an extraordinary risk of dying within the first year.

Neonatal sepsis alone accounts for roughly three million cases a year globally, with at least 180,000 deaths and likely more.

A 2020 Lancet study shows that about 85% of sepsis cases and deaths occur in Sub‑Saharan Africa and South Asia.

We explore how poverty, malnutrition, malaria, anemia, and tuberculosis create a “perfect storm” for sepsis, and how fragile health systems—no transport, out‑of‑stock antibiotics and fluids, and too few staff—turn treatable infections into mass casualties. We also connect sepsis to antimicrobial resistance: the untreated and undertreated infections degrading the very drugs US ICUs depend on.

This is a long, narrative episode: part personal field anecdote, part data‑driven global health conversation, and part agenda for realistic, low‑tech prevention and public health solutions that could save mothers and newborns at scale. #MaternalMortality

Every dynasty eventually faces the same question: what was it actually built on? Boston's sports story is told as one of loyal suffering rewarded, but the story is more complicated than nostalgia suggests. This episode looks at whether the city's sports identity has drifted away from grit, patience, and local roots.

Hubris has toppled governments, derailed foreign policy, and wasted billions in development aid. So what happens when it takes over a sports city? This episode uses Boston fandom to examine how success can turn healthy pride into entitlement and how expectations change when winning becomes the baseline.

Sixty years of winning, four franchises, and more championships than any city has a right to expect raise a cultural question: has Boston's run of dominance turned healthy pride into something the rest of the country finds insufferable? CNBC senior correspondent Alex Sherman joins the conversation.

Every development program claims its goal is to leave. None of them do. The Green Revolution helped India move from famine risk to food exporter status and then ended because it succeeded. Much of today's aid system has not followed that logic. This episode argues that the only development model worth funding is one designed to make itself unnecessary by shifting authority, capacity, and long-term control to communities.

AIDS arrested. Ebola contained. Malaria deaths cut in half. That was not charity; it was the international system protecting everyone. But if this system can deliver vaccines and health results, why does it so often fail to create durable economic and institutional change? Michael Brown examines where international development works, where it fails, and why the difference matters.

Michael Brown concludes a three-part North-South dialogue with longtime colleague Koffi Kouakou on African realities, American assumptions, and the China factor. They examine Africa's youth surge, technology adoption, political risk, and the race between transformation and instability.

Michael Brown sits down with longtime colleague Koffi Kouakou for a North-South dialogue on African realities, American assumptions, and the China factor. They challenge single-story narratives about Africa and look at what outside observers routinely miss.

Episode 6 critiques how U.S. leaders and institutions repeatedly misread societies they intervene in because they rely on the wrong frameworks and reward the wrong metrics. Michael Brown lays out an operating framework of assumptions that distort analysis from Timbuktu to Tehran.

This episode argues that one of the most consequential developments in the Israel-Palestine landscape is labor migration and replacement. Michael Brown examines what India's workers in Israel reveal about political incentives, economics, and the future for Palestinians.

The American offset model lets the United States outsource the visible costs of mining, emissions, standards, and consumption while preserving a cleaner story about itself. This episode connects copper, carbon, supply chains, and geopolitical risk.

America needs copper and strategic minerals for energy, defense, and industrial resilience, but its own permitting and political choices often block the mines it says it needs. This episode examines the contradiction between clean-energy ambition, resource dependence, and policy reality.

In 1983 Somalia, Michael Brown discovered systematic aid fraud that nearly got him killed. That experience taught him how oversight collapse happens and why the same failures repeat in domestic welfare systems and international aid.

The opening episode introduces The Unpopular View: challenging the narratives dividing Boomers, Gen Z, and the Global South. Michael Brown frames the show's focus on foreign aid, development, climate, governance, and the global realities public debate often ignores.