[00:00.540 --> 00:07.920] Hello, everyone. Thanks to Nina and everyone at Biohack Village for having me. My name is [00:07.920 --> 00:13.100] Anthony DeFranco, and I'm one of the founders of the Open Insulin Project. And I'd like to [00:13.100 --> 00:22.020] tell you a little bit about the general problem that we're addressing and how we're approaching [00:22.020 --> 00:29.980] it, and how you all can maybe get involved if you're interested. So let me begin. [00:32.560 --> 00:44.240] The basic fact is that worldwide 50% of the people who need insulin to survive don't have access to [00:44.240 --> 00:59.980] it. And when we take that figure into account, and also look at the population of people worldwide [00:59.980 --> 01:08.720] with diabetes, and some bounds that we have on the death rate that's directly attributed to it, [01:08.720 --> 01:18.540] and we also look at the insulin access statistic here, and we put all of the [01:19.260 --> 01:25.400] information we have together to get a rough estimate of what the [01:27.320 --> 01:34.260] impact of this situation is, where, you know, fully half of people who need insulin to survive can't get it. [01:35.800 --> 01:44.580] A very rough order of magnitude estimate is that about 20 million people, you know, 10 to 20 million [01:44.580 --> 01:52.340] people a year are dying due to lack of access to insulin worldwide. And to put that in perspective, [01:52.340 --> 01:59.340] 12 million people per year was the rate that people were dying due to World War II [02:00.020 --> 02:05.380] from all causes, which was the deadliest conflict in history. So [02:09.940 --> 02:15.360] this situation where half of the people in the world lack access to insulin [02:16.540 --> 02:27.240] is really a crisis on a historic level, you know, it's something that it's hard to find anything that compares to this. [02:28.460 --> 02:38.800] However, unlike a war or, you know, a very kind of complex problem like that, [02:39.840 --> 02:46.600] the fundamental technical realities of making insulin and getting it to people are fairly simple. So [02:48.020 --> 02:51.860] we're going to look a little bit at why, despite that, [02:52.480 --> 02:55.720] there is a problem of this magnitude and how we can [02:56.400 --> 03:00.200] try to approach and how we are trying to approach it in the Open Insulin Project. [03:03.840 --> 03:06.540] So that's kind of the worldwide situation. [03:09.360 --> 03:14.920] Here in America, where the many people in the project are based, [03:14.920 --> 03:18.380] we know a little bit more. [03:19.180 --> 03:23.560] Now, the worldwide situation is largely due [03:25.100 --> 03:35.140] to, you know, supply chain issues and the kind of geopolitics around [03:35.760 --> 03:43.080] different countries' access to markets. So those issues don't really exist within the U.S. [03:43.240 --> 03:48.340] The U.S. has plenty of infrastructure to get insulin to people. [03:50.560 --> 03:55.800] You know, the technology to produce is well established here. So [03:57.420 --> 04:03.620] it's a little even more puzzling to note that there's still a significant problem in the U.S. [04:05.140 --> 04:08.800] So we want to look a little bit at that. [04:10.200 --> 04:17.540] So here are some figures on just the prevalence of diabetes in the U.S. [04:18.180 --> 04:27.060] You know, almost half of people have either diabetes or a risk of developing it in a fairly [04:27.060 --> 04:39.800] short term. Just diagnosed diabetes alone is a over $300 billion a year cost for everyone. [04:40.180 --> 04:47.080] Having diabetes significantly increases overall health care costs. [04:51.840 --> 05:00.400] And there's a bit more detail on how, you know, diabetes is contributing to the global [05:00.400 --> 05:04.960] death rate. So this is another kind of data point, a little bit more specific about what [05:04.960 --> 05:13.340] we were talking about earlier, where, you know, we can actually say that the deaths are directly [05:13.340 --> 05:27.100] attributable to diabetes, also quite significant. So, you know, why is this eminently treatable [05:27.100 --> 05:36.880] disease still causing so many deaths? And why is lack of treatment even in an industrialized, [05:38.580 --> 05:44.160] advanced technologically and infrastructurally country like the U.S., you know, why is this [05:44.160 --> 05:50.620] disease still causing so much harm and so much clearly preventable death? [05:51.860 --> 06:02.180] Well, one of the factors is that the, you know, supply of insulin, even though it's very easy to [06:03.140 --> 06:08.240] empirically speaking, just has a lot of trouble reaching the people who need it. [06:08.720 --> 06:13.740] And the first step in that process is the manufacture of it. And [06:16.420 --> 06:25.540] globally, three manufacturers control almost the entire supply of insulin. [06:25.540 --> 06:34.900] And that is true in the U.S. as well as true everywhere. So, you know, already we're seeing [06:34.900 --> 06:42.620] that at the very first step in the supply, there is a kind of a restriction that may prove [06:42.620 --> 06:55.460] significant. And as a result, the list prices have risen on a, you know, roughly exponential [06:55.980 --> 07:06.700] trajectory. So this has been part of a pattern of all of the major manufacturers [07:07.900 --> 07:14.200] raising their prices at about the same time by about the same increment for decades. And, [07:16.080 --> 07:23.080] you know, this has resulted in the list price becoming unaffordable for many people. [07:25.320 --> 07:30.920] And because of the complexities in the U.S., for instance, you know, the U.S. kind of has a [07:31.600 --> 07:40.820] strange healthcare system where, you know, some aspects of the prices are subsidized in various [07:40.820 --> 07:46.340] ways by different parties who negotiate amongst themselves. You know, there's a very complex [07:46.340 --> 07:52.120] system involving insurers and manufacturers and pharmacy benefits managers and pharmacies. [07:52.700 --> 07:59.320] And there's a set of complex and mostly secret agreements among them as to, you know, [07:59.320 --> 08:05.100] what people are actually paying. But anyone who doesn't have insurance, which, you know, [08:05.100 --> 08:11.040] is tied to having a job largely in the U.S., you know, they're likely to have to pay that list [08:11.040 --> 08:21.500] price and to be unable to afford it. So this is, you know, implicated in what the problem may be [08:21.500 --> 08:29.880] as we come to understand it more. And then the result of that has been that one in four people [08:29.880 --> 08:39.860] with diabetes in the U.S. have reported rationing their insulin and not taking as much insulin as [08:39.860 --> 08:49.100] you need puts you immediately a much greater risk of the complications of diabetes. In the short [08:49.100 --> 08:59.480] term, you can develop diabetic ketoacidosis, which is potentially deadly within hours or days. [09:00.040 --> 09:04.360] And in the longer term, if you're not taking as much insulin as you need, [09:04.360 --> 09:12.500] you can develop the longer term complications of diabetes, which are many of which are listed here, [09:12.500 --> 09:19.080] you know, blindness, cardiovascular disease, and amputations, for example. [09:22.760 --> 09:31.960] So it's a rather grim situation, but it's kind of difficult to understand why this would be the case [09:31.960 --> 09:39.500] since insulin in some form or another has been produced as a medicine for almost a century. [09:39.500 --> 09:48.180] And even the state-of-the-art forms of insulin, you know, the most modern forms that we have are [09:48.740 --> 09:58.340] largely off patent. So why is it that there's still this access crisis? Why are only, you know, [09:58.340 --> 10:04.480] three manufacturers still controlling almost the entire market and able to price the insulin out [10:04.480 --> 10:13.880] of reach of many people? So there have been some investigations into this where people have looked [10:13.880 --> 10:23.100] at the price increase patterns and are, you know, finding evidence that there may be collusion. So [10:23.800 --> 10:30.820] some of these cases are still in progress here. But, you know, the fundamental reality is that, [10:31.420 --> 10:37.500] you know, whether or not there is explicit collusion here, there is this pattern of [10:37.500 --> 10:42.440] price increases and it has become unaffordable. And [10:45.400 --> 10:51.160] at the technical level, there's really not that much of a challenge to making insulin. So [10:52.940 --> 10:57.200] that's what we're focusing on now in our project is how to make insulin. [11:01.040 --> 11:04.840] So this is part of a broader problem in [11:07.760 --> 11:17.240] how health care and the economy around medicine is, you know, thought to [11:19.300 --> 11:26.640] what the kind of dominant philosophy and how to manage it is. There was a [11:28.480 --> 11:35.460] kind of economic theory that gained a lot of credibility in policy circles in the mid-20th [11:35.460 --> 11:44.900] century that said that, you know, making medicine is kind of different from [11:46.300 --> 11:49.180] other economic activities in that [11:50.620 --> 11:59.180] subsidies are needed to do all of the research involved and that a monopoly is [11:59.180 --> 12:09.420] an expedient form of subsidy. So that, you know, that would be a sensible policy to tolerate and [12:09.420 --> 12:17.420] even encourage monopolies around medicine. And these claims actually collapse fairly [12:17.420 --> 12:26.560] quickly under scrutiny. You know, most of the R&D involved in making medicines is already done [12:26.560 --> 12:36.140] with public money and universities and the companies themselves spend much more of their [12:36.140 --> 12:42.000] own budgets on other things like marketing and executive compensation than they do on R&D. [12:42.000 --> 12:48.960] Also, this belief that monopolies are essentially harmless has been, you know, roundly debunked [12:48.960 --> 12:58.840] since then. But nonetheless, that's the system that we've inherited. So the result of this is that, [12:59.340 --> 13:05.160] you know, we've had this complex system of agreements grow up around it, you know, with [13:06.120 --> 13:10.720] all those other, you know, parties like pharmacy benefits managers that we'll look a little bit [13:10.720 --> 13:18.760] more at later in the presentation. And, you know, they kind of partition up the market and [13:20.960 --> 13:28.860] it's very difficult to do anything outside of one of these kind of proprietary partitions, [13:28.860 --> 13:37.320] or to go between them, you know, even to the point that some people who are allergic or don't [13:37.320 --> 13:41.600] tolerate one brand of insulin are unable to get it covered by their insurance because the insurance [13:42.480 --> 13:48.800] only covers one brand at the preferred tier. So even when there's clear medical necessity, [13:48.800 --> 13:58.760] it still doesn't matter in this system. So, you know, it's not much of an economy in the end, [13:58.760 --> 14:09.520] because it's so thoroughly, you know, shot through with monopolies and monopolistic arrangements. [14:11.940 --> 14:19.040] And we see, you know, the problems that are typically associated with this. [14:20.440 --> 14:27.060] And, you know, one of the most notable is pricing the poor out of [14:29.020 --> 14:32.560] the market, but also, you know, you can see that [14:34.540 --> 14:40.840] progress that would threaten an existing [14:42.900 --> 14:49.100] line of business is discouraged. And, you know, one example of that was that, [14:51.060 --> 14:57.220] you know, an analyst here at Goldman Sachs is asking, is curing patients a sustainable business [14:57.220 --> 15:05.480] model? You know, the answer in an economy where competition is essentially impossible is no, [15:06.160 --> 15:13.480] because, you know, the profits are already being maximized by chronically treating things, [15:13.480 --> 15:18.800] and so curing them doesn't make any sense if people don't have any alternative. [15:19.200 --> 15:25.220] And so that's kind of the unfortunate result of this. And this is something that, you know, [15:25.220 --> 15:38.760] many have researched this. One of my favorite theorists of this is Mr. Schmitz at Minneapolis [15:38.760 --> 15:47.460] Fed. So, you know, he has looked at how monopolies actually do cause the harms that we've discussed. [15:47.600 --> 15:54.720] And in the case of medicine, the harms aren't just economic, they are directly related to [15:55.900 --> 16:04.040] you know, lost lives and, you know, really tragic and tragically avoidable health consequences for [16:04.040 --> 16:14.760] people. So one of the things that is noted in general that we've seen in insulin is, [16:14.760 --> 16:21.440] in the case of insulin in particular, is that, you know, we have [16:25.100 --> 16:31.460] seen people, you know, turning to crowdfunding because the cost of insulin when they lose [16:32.480 --> 16:40.780] health insurance or health coverage of some sort is, you know, more than many people make in a [16:40.780 --> 16:47.740] month. It could be many thousands of dollars a month. So this is really a quite egregious example [16:47.740 --> 16:55.200] of how, you know, people get priced out of the market fairly quickly. And, you know, [16:55.200 --> 17:05.600] it's not just a subtle effect, it is a really, you know, a very large difference in prices that [17:05.600 --> 17:12.080] people have to bear to the point where, you know, it'll be exceed everything else that they're [17:12.080 --> 17:22.360] paying for in life by quite a bit. So just to make that a little bit more concrete, the cost [17:22.360 --> 17:29.360] of manufacture of insulin is about $5 per vial, but the list prices have risen to the point where [17:29.360 --> 17:39.580] they're around $300 to $600 per vial in some cases. And, you know, these conditions have [17:39.580 --> 17:46.460] persisted for decades, and they've only gotten worse. There hasn't been any successful pushback [17:46.460 --> 17:57.760] against them yet. So what we are trying to do is kind of invert everything that we've observed in [17:57.760 --> 18:08.660] our project. So instead of relying on proprietary development and mechanisms of monopoly, we are [18:08.660 --> 18:15.840] sharing everything that we develop in a commons, and we are looking to produce insulin in [18:17.540 --> 18:22.100] low overhead distributed networks of small scale manufacturing sites. [18:23.060 --> 18:30.240] And instead of having this really strong conflict of interest between the producers who are [18:30.240 --> 18:38.200] motivated by profits and to deliver profits to investors, instead we're looking to have the [18:40.020 --> 18:49.380] people who use the insulin actually be directly involved in the governance of the organizations [18:49.380 --> 18:57.360] that are making the insulin so that they'll be able to make decisions as to how everything is [18:57.360 --> 19:04.800] managed in the interests of themselves and each other and the people using the insulin. [19:04.800 --> 19:13.600] And a helpful side effect of this will hopefully be that we'll be able to be a lot more nimble and [19:17.340 --> 19:22.740] actually make a lot more improvements and not be incentivized to keep old things around just [19:22.740 --> 19:30.260] because they're already profitable and actually move things forward and hopefully make progress [19:30.260 --> 19:45.220] And in part, we're inspired by other successes in the diabetes community. [19:45.960 --> 19:55.900] So although we're the first effort I know of to make insulin itself open source, for [19:55.900 --> 20:05.680] about 10 years now, people have been working on artificial pancreas systems, which is essentially [20:06.020 --> 20:12.900] a software algorithm that controls an insulin pump to determine the timing and the amount [20:12.900 --> 20:18.240] of the dose of insulin automatically, usually based on feedback from a continuous glucose [20:18.240 --> 20:27.920] monitor. And this is something that was already possible with technology from the 80s, but [20:27.920 --> 20:38.120] the manufacturers just never seemed to be able to bring it to market for whatever reason. [20:38.300 --> 20:45.260] But once the technology to do this became more widespread, you know, once [20:46.660 --> 20:54.740] embedded computers became cheaper and easier to work with, and knowledge of software and how [20:54.740 --> 21:02.360] to write these kinds of algorithms became more widespread, individual diabetics and small groups [21:02.360 --> 21:08.740] were able to just pick up this work and bring it to completion within the space of a few years. [21:08.740 --> 21:17.560] For almost a decade, there have been DIY artificial pancreas systems that, you know, [21:17.560 --> 21:22.440] many people have been relying on and trusting with their own lives and the lives of their children, [21:22.440 --> 21:29.320] and, you know, they're working very well. And this was done without any, you know, large R&D budgets [21:29.320 --> 21:34.880] or institutional overhead. It was just people collaborating in these horizontal networks to [21:35.480 --> 21:40.360] solve their own problems and each other's problems. So we're working on [21:41.940 --> 21:46.020] enabling this for the insulin itself so that we can kind of complete [21:47.600 --> 21:57.120] the open source economy for treating diabetes. And it turns out that the same trends that [21:58.520 --> 22:07.680] made the DIY artificial pancreas systems possible are also going to help us. [22:08.940 --> 22:19.140] The, you know, more pervasive and cheap computing technology is going to play some role in letting [22:19.140 --> 22:26.080] us automate different aspects of the production and purification, and it also just makes it easier [22:26.080 --> 22:33.700] for us to collaborate with each other. And so we're seeing signs that we can reproduce this [22:33.700 --> 22:46.260] kind of success. And, you know, the result of that will be ideally to move this activity from [22:46.800 --> 22:53.620] these, you know, proprietary fiefdoms and into the commons. And this is something that is [22:54.400 --> 23:00.460] good for people. It's very good for business as well, you know, judging by how it's gone [23:01.240 --> 23:08.840] with, you know, open source software businesses. But, you know, major difference is that it [23:10.860 --> 23:20.920] actually respects and promotes competition and innovation instead of sabotaging it and, [23:21.840 --> 23:26.660] you know, trying to go on needlessly suffering and dying for no reason. [23:28.120 --> 23:39.420] So that's our goal. And we're working on developing both the technology and the organizational forms [23:39.420 --> 23:45.540] that are associated with this to, you know, create a comprehensive alternative for the status quo. [23:45.540 --> 23:55.700] And we're trying to prioritize the people who currently lack insulin and need it most in [23:57.770 --> 24:04.960] how we develop things so that we can most directly address the most urgent problems [24:04.960 --> 24:13.800] that people in society have. So this is a closer look at the existing supply chain [24:16.300 --> 24:22.280] just so that we can contrast it with what we're setting up. So I mentioned earlier that there are, [24:22.280 --> 24:32.120] you know, these multiple middlemen who operate in these complex networks in between the [24:32.720 --> 24:38.240] manufacturer and the consumer. And so I won't even really try to go through this in any detail, [24:38.240 --> 24:45.340] but you can see that there are, you know, quite a few complex patterns of interrelationship [24:45.340 --> 24:52.540] among them. And most of these are done in secret, so there's no transparency into how [24:53.020 --> 25:01.860] this works in any detail. And, you know, it involves kickbacks being passed up and down [25:01.860 --> 25:12.200] the chain and, you know, all kinds of things that just are in themselves a great challenge to [25:14.000 --> 25:19.340] making any sense of things. And so when the system produces the nonsensical [25:20.940 --> 25:27.800] result of, you know, denying people insulin that they need to survive that costs [25:28.540 --> 25:33.060] very little to make, you know, this is kind of how that is able to [25:35.040 --> 25:39.600] grow and that kind of problem can grow and sustain itself in this environment of [25:39.600 --> 25:45.000] artificial complexity. So we're going to address that by [25:46.600 --> 25:54.840] making things as simple and as direct as possible. So right now we're working in our community labs [25:54.840 --> 26:03.180] to develop the microbes and the technology, and then we're going to publish the information [26:03.180 --> 26:11.160] associated with them. And then using that public information about how the technology works, [26:11.160 --> 26:17.940] we're looking at setting up a system of cooperatives where the insulin users can [26:17.940 --> 26:26.580] participate directly in the ownership and the governance of those organizations. And [26:27.380 --> 26:34.940] we may also be partnering with hospitals and local pharmacies that already do work that is [26:35.780 --> 26:42.560] similar in some technical aspects to this, and they already have, you know, people who [26:43.580 --> 26:51.580] would need the insulin, they have relationships with them, and we may also be looking at [26:51.580 --> 27:00.960] collaborating with local and state governments. And, you know, aside from these fairly small [27:00.960 --> 27:10.020] and simple low overhead organizations, it's going to be as direct to the users as possible. [27:12.140 --> 27:18.360] So a closer look at some of the technical work that we're doing. [27:19.720 --> 27:27.880] And this is, you know, this is just a general look at how protein production [27:27.880 --> 27:30.440] purification works and how this applies to insulin. So [27:33.160 --> 27:40.620] right now we've designed some genetic modifications to some microbes. We have [27:42.080 --> 27:45.240] actually three systems we're working on now, this is two of them, [27:45.240 --> 27:50.920] but we have two yeast-based systems for producing insulin glycogene, which is a [27:50.920 --> 27:59.180] long-acting insulin, and one E. coli-based for producing LISPR, which is a rapid-acting insulin. [27:59.180 --> 28:09.980] And so we have ongoing work with the microbe engineering. Some of it has produced some [28:09.980 --> 28:14.320] small yields already, but we're working on getting the production to be reliable in the [28:14.320 --> 28:21.680] practical level. And then once the microbes are engineered, we're going to focus on [28:22.400 --> 28:30.920] a small-scale purification system, initially using proprietary equipment, but we're also [28:30.920 --> 28:42.220] working on making open-source equipment for that. And we've also started to look at the [28:45.760 --> 28:52.640] verification and quality assurance questions of making that product suitable for use as a [28:52.640 --> 28:59.000] medicine. And so once we've got all of these aspects in place, we've got all the technical [28:59.000 --> 29:07.380] problems for making insulin in a small-scale setting solved. So here's a look at [29:09.680 --> 29:19.600] a kind of demonstration version of a bioreactor. So it is essentially just a bit of plumbing, and [29:19.600 --> 29:27.520] aside from having to keep it sterile, there isn't anything terribly technically complex about it. [29:27.520 --> 29:37.860] You're going to have some, you know, some pumps and some valves and temperature sensors, [29:37.860 --> 29:46.940] pH sensors, and that sort of thing. And then for the purification, you're going to have, [29:46.940 --> 29:53.720] you know, perhaps a column, which is a, you know, just a tube with certain ports filled with [29:57.140 --> 30:03.620] some materials that may be a little bit costly, but for the most part, this is something that, [30:03.620 --> 30:09.060] you know, you can, as these people have for this demonstration unit, they fit everything you need [30:09.720 --> 30:17.320] to do it onto a tabletop. So, you know, we can work in a similar envelope. [30:18.820 --> 30:22.940] You know, the corner of a room could be enough to produce insulin for [30:23.980 --> 30:30.620] you know, a small city if we are, you know, running at a reasonable efficiency. [30:32.300 --> 30:39.580] And as a result, we can bring the cost of insulin back down to [30:40.680 --> 30:48.600] what the cost of production already is. So our own projections for what our cost of production [30:48.600 --> 30:54.780] be are in line with what they are for the large-scale production that dominates right now. [30:55.320 --> 31:02.060] So based on our preliminary model, we could be providing this to people for seven dollars a vial, [31:02.060 --> 31:07.900] which is, you know, very close to the three to five dollars a vial that it's usually produced for. [31:07.900 --> 31:18.480] So, you know, we're seeing that there isn't really any economy of scale here and that, [31:18.480 --> 31:29.600] for the limited supply that we see right now. So as I mentioned, we are still working on [31:31.060 --> 31:36.220] the microbe engineering, but we have started to work on the open hardware as well. So we're [31:36.220 --> 31:46.300] making progress on the technical aspects of this process and we're looking forward to [31:48.300 --> 31:55.820] reaching some of the milestones on that fairly soon. And we've, you know, begun [31:56.980 --> 32:03.500] working not just on the open hardware but also on some of the regulatory and organizational research [32:03.500 --> 32:16.180] to make that hypothetical system of cooperatively organized production a reality. So, [32:16.180 --> 32:22.700] that's going to involve some outside-of-the-box thinking and we're, you know, getting into [32:23.370 --> 32:30.020] looking at a lot of interesting precedents like ideas from personalized medicine and [32:30.740 --> 32:39.730] other forms of cooperative medicine and health care and state-level frameworks for things like [32:41.190 --> 32:46.970] direct public offerings, you know, financial mechanisms, and so it's really [32:49.710 --> 32:59.070] taking us on both a deep and a broad look at a lot of very promising alternative ways of [32:59.070 --> 33:06.930] doing things that we hope will apply not just to insulin but to perhaps medicine in general [33:06.930 --> 33:15.390] and business in general in the near future as well. So here's a closer look at the bioreactor [33:15.390 --> 33:29.750] design that we have just recently completed the first look at. So, [33:30.750 --> 33:37.070] as you can see, the bioreactor, when we break it down to the specifics, as I was saying [33:37.070 --> 33:46.110] before, it's kind of some pumps and some sensors and, you know, an air pump and some heating pads [33:49.430 --> 33:57.710] and this is a design that was based on one that another fellow in the community, [33:57.710 --> 34:04.170] Sebastian Kosioba, was working on. So he was kind enough to show us around his design and [34:04.170 --> 34:11.450] we have a group of interns that's working on this right now. So this was made by Paige Hanoka and [34:12.630 --> 34:19.470] it took her just a couple of weeks to come up with this and the bill of materials for this comes out [34:19.470 --> 34:31.810] to $115.80. So this would have a capacity of a few liters and a capacity of a few liters if you run it [34:34.170 --> 34:40.750] fairly close to continuously that can supply insulin for a few thousand people. So, you know, [34:40.750 --> 34:47.370] this is still leaving out the purification and the QA aspects but, you know, those don't add [34:47.370 --> 34:52.090] an order of magnitude more cost to this. So you can see that the, you know, capital requirements [34:52.090 --> 35:02.570] for doing this are negligible. So we've talked a bit about how we're looking to organize the [35:02.570 --> 35:10.210] production ultimately but we are also organizing the R&D work that we're doing right now [35:11.110 --> 35:18.070] in a similar way. So we're a fairly horizontal open source oriented [35:21.510 --> 35:27.210] organization. We're taking cues from other open source foundations that are stewards of different [35:27.210 --> 35:35.650] kinds of technology. So we have groups working on the wet lab R&D, the hardware [35:37.230 --> 35:43.530] supporting software for our organization, developing the business plans, doing the legal and policy [35:43.530 --> 35:52.630] research, and doing communications with our supporters and touching on fundraising as well. [35:54.050 --> 36:01.250] And here a few folks from the team, you know, we are a loosely organized network of volunteers so [36:01.250 --> 36:08.670] people kind of come in and out. We weren't able to list everyone but here are a few of the more [36:10.130 --> 36:19.070] regularly involved folks. You know, Jan is our chief scientist working on the microbe stuff [36:21.190 --> 36:28.450] and David and Max are also working on that here in our Oakland lab. Alex Hay recently developed [36:28.450 --> 36:34.930] an open source glucometer which we have a blog post up on our blog about which is very interesting. [36:35.530 --> 36:43.830] Nicole has been helping us with the legal work that we're doing. Yifei has helped with software. [36:44.410 --> 36:52.650] Louise is working on communications and fundraising with the interns. Jessica is also working on [36:54.630 --> 37:00.190] the microbe engineering in the wet lab and with an intern group as well. [37:00.190 --> 37:03.930] Remy has helped us with some collaborations and [37:05.450 --> 37:12.390] Kadi is actually one of our international collaborators in Senegal who is getting her lab [37:13.430 --> 37:21.130] set up now to join us and perhaps help us look at some new possibilities involving [37:21.130 --> 37:26.110] plant-based production. So, very interesting potential there. [37:28.010 --> 37:35.090] Within our group, we are fairly horizontal as I said. So, you know, we [37:36.450 --> 37:42.610] kind of go on the open source credo of, you know, loose consensus and [37:44.330 --> 37:51.110] working protocols we could say and just take on tasks on our initiative. For the most part, [37:52.070 --> 38:00.730] so we've had to collaborate remotely. So, you know, we're doing things in online meetings, [38:00.730 --> 38:08.130] which anyone is welcome to join. And, you know, if anyone is interested in that, you can go to [38:08.130 --> 38:14.650] our website, openinsulin.org. And we have some posts up there that will give you some contact [38:14.650 --> 38:25.210] information and information about the meetings. So, you know, with that, I'd be happy to hear [38:25.210 --> 38:29.890] from any of you if you're interested in learning more about what we're doing or, you know, helping [38:29.890 --> 38:37.010] with any aspect of this. And the more the merrier and the more people are helping out, the faster [38:37.010 --> 38:43.610] we're going to be able to solve this very urgent problem. So, it would be a pleasure to hear from [38:43.610 --> 38:51.870] you. And, again, thank you for having me here. And thanks to Nina and the Valhack Village folks.